so you want to become a nurse
practitioner you want to work in
healthcare
but being a doctor seems like overkill
why not have many of the doctoring
upsides while avoiding many of the
doctoring downsides
here's how you can decide if becoming an
np is a good career for you
dr juval medschoolinsiders.com welcome
to our next installment in so you want
to be
in this series we highlight a specific
specialty or profession within medicine
such as nurse practitioner and help you
decide if it's a good fit for you
you can find the other videos on our so
you want to be playlist
and make sure you're subscribed if you
want to vote for future videos
before we dive in note that as with all
my so you want to be videos
this video was created with input from
experts in the field
after all i'm an md not an np and i
relied on practicing np input for
guidance and accuracy a nurse
practitioner is an advanced practice
registered nurse
and a type of mid-level practitioner
similar to yet distinct from a physician
assistant which we covered in a previous
episode
nps assess a patient's needs order and
interpret tests
diagnose conditions and formulate and
prescribe treatment plans
their training covers disease prevention
patient education
managing acute and chronic conditions
and coordination of care
but they are not trained to the same
extent as mds or do's
and therefore may not be able to
recognize and manage more complex and
nuanced conditions straight out from
graduation
do note however that after working with
supervising physicians for
some number of years they may be better
equipped to handle more complex levels
of care
similar to the physician assistant
profession the first nurse practitioner
program was developed in the 1960s to
address the shortage of primary care
physicians
particularly in rural areas which were
most heavily impacted
by the 1970s there were approximately 15
000 nps across the united states and by
the late 1990s closer to 70
000 there are currently over 250 000
nurse practitioners in the us
the scope of practice for an np varies
and in some states they must work under
the supervision of a physician
whereas in others they can practice
independently the scope of np work has
not been clearly defined and is not only
dependent on state legislature
but also on what the supervising
physician is comfortable with
in terms of specialization it's not a
matter of choosing a residency or a
fellowship
the np education model is more focused
from the beginning and you should
therefore attend a program that caters
to your intended area of specialization
these areas include primary care acute
care family
women's health neonatal emergency
pediatric acute
pediatric primary and surgery if an np
school has multiple programs they may
allow for flexibility in changing
as the first year is more general
education but this is an important
caveat to note
your future practice and specialization
will largely depend on the np
program you attend in comparison the
medical school you attend has
comparatively
little influence on the specialty you
may pursue as a physician
and similar to physician assistants if
you go into the operating room you'll be
first assist as a nurse practitioner
not actually doing the surgery which is
the role of the surgeon
there's a broad range of myths that
confuse pre-health students considering
a career in health
care let's set the record straight first
contrary to what some people think
becoming a nurse practitioner isn't
simply a matter of being an
rn for long enough it requires separate
training
second many lump physician assistants
and nurse practitioners in a single
bucket as
dr light but they're under two different
training models
physician assistants go through the
medical model while nurse practitioners
build upon the nursing model
while they do have many similarities as
mid-level providers
they are distinct entities third the dnp
degree
stands for doctor of nursing practice
but that doesn't make them physicians
as the term doctor generally indicates
physician in the clinical setting
many find it misleading for a dnp to
introduce themselves to a patient as a
doctor
and many states have legislation
prohibiting this
this is an area of controversy while
nurse practitioners are intelligent
capable and contribute greatly to the
healthcare system
they are not physicians and do not
receive the same level of training
on one hand most physicians are against
nps calling themselves doctors
as it leads to patient confusion and
obfuscation of roles
on the other hand some nps argue they've
worked hard for their degree and want
the right to call themselves doctor
my np colleagues who helped in the
creation of this video
believe that nps should not call
themselves doctors
nursing has a separate training and
organization structure compared
to medicine to become a physician you
attend medical school
residency and test for board
certification in a given specialty
in nursing there are multiple types of
advanced practice registered nurses
nurse practitioners are what we're
focusing on but there's also a
certified registered nurse anesthetist
or crna
who provides anesthesia services in the
operating room and intubation in
healthcare settings
certified nurse midwives or cnm's
specialize in women's reproductive
health and childbirth and provide
prenatal and postpartum care and deliver
babies
clinical nurse specialists or cns's
focus on
advanced clinical knowledge and
evidence-based nursing in a specific
area
there are two main pathways to become a
nurse practitioner traditional
and direct entry the traditional pathway
involves first earning your bsn
abn or msn to become an rn after taking
your nclex exam
most that take this pathway will work as
an rn for a few years although this is
not required
next they attend a master's or doctorate
program to become an np
if you attend a full-time master's
program it will generally take two years
but if you are undergoing a part-time
dnp program they can take
up to five choosing between a master's
or doctorate program
is not mission critical as it doesn't
change your practice
pay or licensing exams more programs are
moving toward the doctorate program
which
in comparison is more focused on
research and enables you to teach
the second pathway or direct entry nurse
practitioner programs
are for those who earned a bachelor's
degree in something else
these are three to five year programs
where you will take both the nclex to
earn your rn but
also complete a master's or doctorate
program to become an np
again more programs are transitioning to
the doctorate program which is generally
longer by approximately one year
at the end of either path you choose
you'll take your certification exam
which is the nurse practitioner board
exam
it does vary based on your area of
specialization and after that
you can apply for licensing in your
state and find a job
in terms of cost nurse practitioner
tuition costs are lower than pa or
medical school paths
in-state tuition averages about eighteen
thousand dollars to complete an np
program while out of state is around
thirty two thousand dollars
online programs are in the middle
totaling around twenty two thousand five
hundred for completion
while private universities are more
expensive around 45 000
average compensation is around 110 000
per year but there is variation
depending on the certification
women's health are at the bottom around
98 000
whereas acute care and peace and
psychiatric mental health and peace are
at the top
around 114 000 there's a lot to love
about being a nurse practitioner
there's a favorable work-life balance
usually without call
you'll also have varying levels of
autonomy where you can be a provider
making decisions
yet the training is not nearly as
hardcore or as lengthy compared to that
of a physician
np training is shorter than becoming a
physician lasting generally two to four
years compared to
four years of medical school plus three
to seven years of residency
the cost is much lower too so you'll
likely graduate with substantially less
debt than if you went the md or do route
as an np you also won't have to take
work home with you
or deal with things like overnight call
these are all factors that come with the
added responsibility of being a
physician
and because you're not the person on the
line there's less stress about
malpractice
or things going sideways unless you're
practicing independently
if you're ever unsure about something
there's often a supervising physician to
run things by
most rns don't get the opportunity to
build longitudinal relationships
but as an np particularly in a primary
care role
this is the norm and many find it highly
gratifying
hours are usually regular and
predictable depending on your practice
setting
while it depends on the specialty you
can expect to work around 40 hours per
week
while being a nurse practitioner has its
perks it's certainly not for everyone
if you're interested in primary care the
np route is great
but if you want to keep your options
more open and possibly consider
something surgical
there tends to be more opportunities
going the pa route
while training is much shorter you will
also be making one half to one third of
the average physician's salary
if you care about prestige and respect
which are
not great reasons to base your future
career off of then the md or do route
may satisfy that to a greater degree
on the other hand if you're able to put
your ego aside and understand your role
on the team including your
responsibilities and scope of practice
this likely won't be an issue if you
want to have extensive knowledge of the
human body and how to manage various
ailments
the np rat will give you the foundations
but it won't offer you the same
level of training as going the physician
route you'll be able to handle the
majority of bread and butter primary
care but when things get more
complicated you may want to seek
physician guidance
between pa np and physician nps usually
receive the fewest clinical hours
somewhere between 500 and 1500 depending
on the program
in comparison pas are required to have 2
000 clinical hours
and physicians between 16 000 and 20 000
at minimum there's a tremendous deal of
controversy over the scope of practice
for
nps the american association of nurse
practitioners has been lobbying hard for
increased scope of practice
meaning allowing nurse practitioners to
provide more care independently of
physicians
after all with greater scope comes
greater autonomy and compensation
but so does liability as some are
learning the hard way in malpractice
cases
opponents to increase scope push back
about the implications on patient safety
after residency a physician has accrued
approximately 20
000 or more hours of clinical experience
in their particular specialty
in comparison a dnp only needs a
fraction of that
between 500 to 15 hours of patient
contact hours to graduate which
aren't necessarily focused in their
ultimate specialization
my np colleagues tell me that those
pushing for increased scope of practice
are a vocal minority
but that most nps don't share this
mentality
don't get caught up in the online hype
this isn't about physicians
versus nurse practitioners the
healthcare team needs to work together
to serve the patient
when both groups of professionals work
together and as intended within their
scope of practice
everyone including the patient wins in
recent years
given the growth of diploma mills and
online only programs in conjunction with
increasing scope of practice there are
growing concerns regarding patient
safety
if you'd like to learn more about this
issue i recommend checking out the
physicians for patient protection
and organization with great articles and
presentations about this subject which
go
much deeper than i can cover in this
video how can you decide if becoming a
nurse practitioner is a good fit for you
if you enjoy being a team player
educating patients and making
decisions regarding patient care the np
route may be a good fit
those who may not like the patients or
costs required for medical school
will likely appreciate the shorter and
less costly option of going the np
route if you are currently on the
nursing tract and want to go to the next
level consider becoming an np
if you prefer the medical model then you
may want to consider the pa route
instead
if you want more control autonomy and
depth knowing all the ins and outs of
various diseases
including the obscure ones and be at the
pinnacle of patient care and research
go to medical school and become a
physician these are all trade-offs and
there's no
right or wrong here no specific path is
better or worse than another path
you have to figure out what type of life
you want look at the future paths of
each
and see which is better suited to your
personality values and long-term desires
big shout out to nurse liz family nurse
practitioner for helping me in the
creation of this video
go show her some love and check out her
youtube channel link in the description
if you enjoyed this video check out my
video on so you want to be a pa
or my video comparing the
competitiveness of pa school
to np school to medical school much love
and i'll see you guys there