Aspirations

Lately I've felt stagnant in my career growth :( Since graduating from Texas Tech with a bachelor's in nursing, I've felt like I haven't done much to move forward. Now I'll say that I had quite extraordinary preceptors upon starting out in CCU after graduation. I was on orientation with a preceptor for about a month and a half before being on my own. I started taking open heart surgery patients on my own about 3 or 4 months after graduating. That is very uncommon. Definitely. It was not me, but amazing preceptors that enabled such progress. I took on the role of relief charge nurse at 6 months post graduation, and have become a full time charge (well, that's the two days a week that I work).

While all of those things are rare, I feel like soon after finishing school I stopped. With the exception of looking up medical conditions and drugs I am not familiar with, I've stopped pursuing progress. I'm stagnant. I think the 2 1/2 years of experience have made me comfortable and confident in my nursing skills, but I've stopped moving forward. And I think that may just be the problem- I'm comfortable and confident. And I don't mean confident in the arrogant sense; I mean that when a situation arises that requires quick critical thinking, I can handle it with ease. I can start medication drips stat, run a code, precept new nurses with all their questions.

But this is not where I want to be forever. Since Sam started school again this fall, I realized how much I miss learning. I miss taking classes, taking notes, even having to study for a test (though I don't miss the tests). I miss shopping for new school supplies as nerdy as that may sound. I especially love the feel of a mechanical pencil in my hand as I start to write on a new sheet of notebook paper or put a few sticky notes in my book to mark what's important.

Sam and I have discussed it, and as he's just finished applying to school to start a physician assistant program- hopefully, hopefully to start in the summer/fall 2011, I will soon begin my application for nurse practitioner school to start next fall as well. I'm very excited at just the thought, but am worried about what route to take- something I need to decide prior to applying. I'm considering the family nurse practitioner program as well as the acute care nurse practitioner program. I just cannot decide!!

Family NP- I can see patients in a doctor's office, assess, diagnose, and treat. I can prescribe meds, including narcotics. I can start my own clinic if I wanted to.

Acute Care NP- I do all the same as above but see sicker patients in the hospital, including patients that are on ventilators and lots of critical drips. I can put in chest tubes, central lines, and make changes on the ventilator.
here's a pic of a chest tube

and one of a central line, which is bascically a large IV site


The Acute Care NP is more appealing to me, because these are the patients I see day in and day out, and I enjoy the hospital setting. It also is a plus that I would be especially trained and educated to be in the hospital to see acute patients. What I'm unsure of is the scope of practice of a Family NP. A good friend, a very smart friend and well experienced nurse, just told me that that law changes are currently in the works to limit the hospital scope of practice of Family NP's. Ah! That's scary, because should I decide to take that route, I want to retain the ability to stay in the hospital. I don't want to be limited to clinics only. To me, that'd be super boring. (She will be starting Acute Care NP school in January.)

I need to do a lot of research on the differences in liability, scope of practice and privileges of each. I am very excited though and have until the end of May to decide. God willing, I'll be a nurse practitioner in the next couple of years! And that will bring mine and Sam's dream closer to a reality.

Our family goal and dream is to both work no more than 2-3 days a week each, preferably the same days. That way we'll have 4-5 days a week to be together and home school our kids. We've already made the decision that we want to home school, but having both of us there would be fantastic. I just want more time with my husband and our growing family.