Despite going into nursing with the express goal of pursuing licensure in Advanced Practice I find myself weeks from graduation with very little understanding of the options ahead. Early on I made the concious decision not to look at, read about or research graduate school as I realized it could be a huge distraction. Truth is if you flunk out of Pharm I then there isn't much point in dreaming about grad school. Unfortunately it would appear that I took this too far. Penance for my sin of ommision has been a flurry of networking, research, emails and phone calls to try and sort out the basics of what I actually need to be doing to make the culmination of my efforts feasable and not slip through my fingers. On this site is a series of posts that will outline key areas of confusion that I have attempted to tame. Most of the information is focused on clinical degrees rather than education or leadership, although much of the information is universal to all graduate school modalities.
Scroll down or follow the links in the right hand column of this page under 'Blog Archive' to access a basic primer on graduate school for nurses. Blue text is hyper-linked.
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24 November 2008
An outline
I met briefly last week with one of the Nursing Faculty to express my frustration. Summed up this is what I don't get:
- There is no support for nursing graduate school plans at the campus I attend unless you are interested in their graduate program.
- The pre-med program (not an actual degree - therfore not an actual deparment) has a 'graduate school' advisor.
- There is no consistent database to find schools. Word of mouth seems to be the way people decide on nursing graduate school programs. Currently students in my BSN classes are fairly consistently aware of the following programs with a clinical emphasis: University of Utah, Westminster College (both northern Utah universities so that makes sense), Oregon Health Science University (about a days drive away - they have a fairly aggresive marketing campaign), and Southern Alabama University... Southern Alabama? how did that make it into the mix?
She agreed completely and said she faced the same thing when she was working on her MSN and is dealing with it herself again as she looks at schools to pursue a PhD. I asked her if she had any advice on how one goes about this process. She had the following three points that she felt were the important decision makers:
- Decide what kind of a degree you want (clinical vs. adminstration/leadership vs. education)
- Decide if there are any geographic areas that appeal (or don't appeal) to you
- Are there any schools you have a personal preferance for (or against)?
With these things in mind the following posts will explore various areas that I wish I'd had at my disposal earlier on. Namely:
Oh yes, and before I forget. Start studying for the GRE now. I mean it... now. If you are like me the only math you have done in the last 3+ years is med calculations (want-over-have times whatever...) Not all schools require this but in the survey of schools that I have done in my dazed confusion it seems like about half do. The school I obtained my BSN from has a GRE prep course. There are of course self study guides and other pograms. Also, know that if you take it early and don't do well some schools average your test scores if you repeat it hoping to get higher. So seriously start studying now...
Finding a School
There is no all-inclusive database for nursing school graduate programs. This is the honest truth. However, the following sites appear to provide a fairly comprehensive list of graduate schools and avoid the hassle of using a search engine to try and find a school.
The NLNAC site: only lists those schools credentialed by them
The AACN: You can't search by program type but they do provide a link to the school website.
All Nursing Schools: This site used to be a comprehensive list including obscure programs in tiny states like New Hampshire. Then you needed to use a backdoor link to get anything besides 'featured' schools and now it would appear that they are 'All Nursing Schools Who Pay Us a Subscription Fee To Be Listed.com'. Still, they do have a lot of schools and you can search by specialty.
The NLNAC site: only lists those schools credentialed by them
The AACN: You can't search by program type but they do provide a link to the school website.
All Nursing Schools: This site used to be a comprehensive list including obscure programs in tiny states like New Hampshire. Then you needed to use a backdoor link to get anything besides 'featured' schools and now it would appear that they are 'All Nursing Schools Who Pay Us a Subscription Fee To Be Listed.com'. Still, they do have a lot of schools and you can search by specialty.
Accreditation
We nurses sure love our acronyms. RN, BSN, FNP, ANP, PMHNP-BC. You get the drift. These are three that are important with regard to schools.
CCNE: This is the Commission on Collegiate Nursing Education. It is adminstered by the American Association of Colleges of Nursing. It is "an autonomous accrediting agency contributing to the improvement of the public's health. CCNE ensures the quality and integrity of baccalaureate and graduate education programs preparing effective nurses."
NLNAC: This is the National League for Nursing Accrediting Commission. It is "nationally recognized by the U.S. Department of Education as the accrediting agency for postsecondary and higher degree nursing programs."
ANCC: This is the American Nurses Credentialing Center. It is a subdivision of the American Nurses Association. They are "the world's largest and most prestigious nurse credentialing organization." They do institution accreditation and individual nurse credentialing.
You will note that each claims to be the premier credentialer of nursing programs. As you can imagine there is of course debate on the point of which is a better one to have certify the school you attend...
CCNE: This is the Commission on Collegiate Nursing Education. It is adminstered by the American Association of Colleges of Nursing. It is "an autonomous accrediting agency contributing to the improvement of the public's health. CCNE ensures the quality and integrity of baccalaureate and graduate education programs preparing effective nurses."
NLNAC: This is the National League for Nursing Accrediting Commission. It is "nationally recognized by the U.S. Department of Education as the accrediting agency for postsecondary and higher degree nursing programs."
ANCC: This is the American Nurses Credentialing Center. It is a subdivision of the American Nurses Association. They are "the world's largest and most prestigious nurse credentialing organization." They do institution accreditation and individual nurse credentialing.
You will note that each claims to be the premier credentialer of nursing programs. As you can imagine there is of course debate on the point of which is a better one to have certify the school you attend...
Funding
Information about funding graduate school is definitely something to look at and be aware of but to arrange more specifically once you have been accepted into a program. Obviously there are military contract programs through each of the branches of service especially if you come to them already having earned a BSN. Aside from that, and scholarships which are either school specific or require outside research and application, the U.S. Government is your best bet for funding programs.
Pell grants, Stafford Loans, Perkins Loans and PLUS loans are all available to graduate students with the appropriate demonstration of financial need. The application is a one stop shopping place for almost all government administered financial aid programs. The benefit to this is that you only fill out one application. You are automatically offered any program for which you are eligible.
Most schools like to have the results from this application by february or march for academic years starting in the fall. Also remember that your school may have a school specific application that you should fill out also.
The National Health Service Corp is a program seperate from the other federal financial aid packages. There are two tracks, a Scholarship track and a Loan Repayment track.
Pell grants, Stafford Loans, Perkins Loans and PLUS loans are all available to graduate students with the appropriate demonstration of financial need. The application is a one stop shopping place for almost all government administered financial aid programs. The benefit to this is that you only fill out one application. You are automatically offered any program for which you are eligible.
Most schools like to have the results from this application by february or march for academic years starting in the fall. Also remember that your school may have a school specific application that you should fill out also.
The National Health Service Corp is a program seperate from the other federal financial aid packages. There are two tracks, a Scholarship track and a Loan Repayment track.
- Scholarship is a funding program that pays up front for tuition, books, equipment, supplies and a monthly stipend. After graduation you are contracted for one year for each year that you recieved assistance with a two year minimum. The contract requires that you obtain employment in a designated underserved area. Clinics and healthcare institutions apply for this status through the NHSC.
- Loan Repayment is applied for after graduation and provides up to $25,000/year of loan repayment for the first two years and $35,000/year for each additional year of work.
To view areas that are currently considered underserved, look here I recommend leaving the projected hire date blank so you can see all opportunities. Obviously the jobs you see now may or may not qualify as NHSC sites by the time you have graduated, but it gives you an idea of how broad the kinds of areas serviced are.
Applications are accepted each year until July.
Fellowships, sponsorships, etc. are another thing that may be difficult to find but well worth it if you do find one. Check with your school and local healthcare agencies/institutions. Networking is the best way to sniff these out. Here's an example of one: Intermountain Healthcare Urban North Region is looking to hire ten Pscyh Nurse Practitioners in the next five years. They are offering a tuition/book reimbursement program for individuals that are interested in this modality. The program also includes a stipend opportunity that pays the difference between full time and part-time wage so that you can work part-time while in school. The contract for this program is a 1:1 years in school to years of full-time work post graduation.
Modality Options
Nursing is incredibly diverse. For me it was almost overwhelming when I realized how many choices a bachelors degree in nursing opens up for you. Advanced practice isn't any different in this respect. However, in choosing a modality it is important to realize that the wide expanse of options begins to taper as you move forward with further education. This is particularly true with clinical degrees. Each degree with it's specialization area has an associated scope of practice. The ANCC certifies several different levels such as Nursing Specialties, Clinical Nurse Specialists, and Nurse Practitioners.
The following nurse practitioner modalities are recognized by the ANCC:
The following nurse practitioner modalities are recognized by the ANCC:
- Acute Care NP
- Adult NP
- Adult Psychiatric and Mental Health NP
- Diabetes Advanced
- Family NP
- Family Psych and Mental Health NP
- Gerontological NP
- Pediatric NP
- School NP
The American Association of Nurse Anesthetists (AANA) has their own board certification for
- Certified Registered Nurse Anesthetist
The American College of Nurse Midwives has their own board certification for
- Certified Nurse Midwife
Each of these lend themselves to a particular patient set that can be further specialized. Many Family NPs find that they particularly prefer pediatrics, some pediatric NPs go into oncology. However, it is important to understand the scope of practice of your chosen modality. As a general rule for example it would be poor form to be prescribing for a pediatric patient if your license says you are a Gerontologic NP. It is also important to remember that NP doesn't automatically mean prescriptive practice. This varies by modality and by state. In Utah for example a Family NP has prescriptive license, as does a Psych Mental Health NP, but not nurse anesthetists.
Going away for school
Each state has a Practice Act that outlines the rules and laws that govern nursing in that state. It outlines some areas of scope of practice, licensure and certification requirements, disciplinary issues, etc.. Although nursing is generally the same country wide it is important to recognize that practice can vary state to state. This becomes important if you are planning on leaving the state that you earned your RN license in to go away to graduate school. Some states require additional certification/course work beyond the standard ADN/BSN course work such as HIV/AIDS awareness, and IV certification. Also note that only 21 states are part of the Interstate Compact.
Nurse practice acts, how they are written, and where they are put into state law is about as varied as the acts themselves are. TheTravelNurse.com has a nice database of practice acts for all 50 states and some other areas such as Samoa and Guam; here.
Nurse practice acts, how they are written, and where they are put into state law is about as varied as the acts themselves are. TheTravelNurse.com has a nice database of practice acts for all 50 states and some other areas such as Samoa and Guam; here.
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