So you Decided you wanted to be a nurse, where do you start?
Updated: Aug 16, 2021
Okay, so you want to be a nurse and do not know how to get started; by the end, you will be well equipped with adequate information to help you through this journey.
The first thing you need is to obtain your high school diploma or your GED. Once you have one of those, you have to decide what type of nurse you want to be.
Licensed Practical Nurse (LPN) is usually the quickest; it's fast-paced and ranges between 9 months to 18 months depending on the length of the program and your status (Full-time student) or (part-time student). Most programs are vocational training schools or community colleges. Ensure that the school you go to is an accredited program, please! Accreditation is essential, and without Accreditation, your chance of succeeding is low. Accreditations assess the quality of the program, creates a culture that encourages and fosters improvement in the academic quality of colleges and focuses on raising the standards of education, integrates faculty and staff comprehensively in institutional evaluation and planning, and establishes guidelines for professional certification and licensure for upgrading courses (Nursing CAS, 2018). The scope of practice for the LPNs varies based on the state, but the regulations are similar. LPNs perform essential nursing duties; they are responsible for vital signs, collecting samples, providing basic assessments, administering medication, advise R.N. or physician of the patient’s health status, provides patient comfort. LPNs are hands-on and can have various jobs. Different jobs for LPNs: Nursing homes, hospitals, join healthcare, physician substitute, Allergy specialist, doctors’ offices, private duty, surgical hospitals, mental health facilities, hospice care, forensic nursing, insurance companies, theme parks, school systems, dialysis, traveling nursing, corrections (Indeed Editorial Team, 2021).
Registered Nurse (RN), okay, so this might get confusing, but I will simplify it for you. First, you have R.N. with associate degrees (ASN), R.N. with bachelor’s degree (BSN), Rn with master’s degree (MSN). Then you have Advanced Practice nurses (APN), which are technically R.N.’s, but they have branched off into four branches: Certified nurse specialist (CNS), Certified registered nurse anesthetist (CRNA), nurse practitioner (NP), and Certified nurse-midwife (CNM). With the N.P., the role breaks down into additional positions as well as the CNS. Therefore, it is crucial to determine what type of N.P. or CNS you want to specialize in (DeCapua, 2021). As an R.N., you usually have to have your prerequisites before your acceptance; however, some programs allow you to enter the nursing program if you have a couple of prerequisites that still need completion. The scope of practice varies contingent on the degree and state you reside in, for the Associated degree is usually two years and your BSN in four years. Both your ASN and BSN is an undergraduate course. Your MSN is a graduate course and averages a total of 5-6 years. Once nurses complete their master’s in nursing, they can go back to school for post-graduate studies. An example of this is a master’s in forensic nursing, and then a nurse decides they want to do midwifery, they would go back to school and obtain their post-graduate degree in CNM.
Distinguishes between APN: Nurse Practitioners
Nurse practitioners are autonomous in their practice and respected role. N.P.'s are distinguished by their advanced health assessment, diagnoses, and clinical management skills, including pharmacology management. N.P.'s are responsible for health promotion, health education, disease prevention (primary, secondary and tertiary), counseling, diagnosing and managing acute and chronic medical conditions. In addition, N.P. can specialize in family care/individual healthcare across the life span, pediatrics, internal medicine, geriatrics, neonatal, psychiatric/mental health, and women's health (National Council of State Boards of Nursing, n.d.). N.P.'s had many setbacks due to ANA defining nursing practice in the 1950s. ANA omitted nurse's ability to diagnose and prescribe medication which mitigated the APN role in the twentieth century (Hamric et al., 2014). In addition, N.P.'s were once looked at as an extension of physicians and were required to work under a physician instead of being looked at as an independent professional provider; some states still require N.P.'s to work under a physician. Nevertheless, N.P.'s’ prove to be effective primary care, and there have been several studies that suggest that health outcomes are equal or better, with NPS being primary care providers (Macy, Jr. Foundation, 2010).
Clinical Nurse Specialist
Clinical nurse specialist is distinguished between four sub roles, clinical expert, consultant, educator, and researcher (Hamric et al., 2014). The role of the CNS encompasses the nurse, healthcare organization and system, and the patient (National Council of State Boards of Nursing, n.d.). Furthermore, CNSs provide direct care to patients with complex healthcare problems (Hamric et al., 2014). The CNS is responsible and accountable for diagnosing and treating health/illness states, disease management, health promotion, and prevention of illness and risk behaviors among individuals, families, groups, and communities. The National Association of Clinical Nurse Specialists needs to clarify the 2004 Statement on the CNS practice and education and the 2010 competencies for the CNS (Hamric et al., 2014).
Certified nurse-midwife provides independent care to women's health care. Due to the specific patient population, the CNM can provide advanced individualized health assessment in women's health and childbearing. CNM's specializes in a specific patient population that includes pregnancy, childbirth, postpartum period, care of newborn, family planning, women's gynecological health, and treats the male partners of females with STI's (Hamric et al., 2014). National Council of State Boards of Nursing n.d., also states that the CNM provides preconception care and prenatal care. The American College of Nurse-Midwives (ACNM) does not support DNP requirements into nurse-midwifery practice (Hamric et al., 2014). This could be a development concern in the advancement of the profession; however, in 1986, a report concluded that N.P.'s and CNMs provide care equivalent to the quality of care to physicians (Hamric et al., 2014).
Certified Registered Nurse Anesthetist
Certified registered nurse anesthetist practice independently in collaboration with physicians and provide direct care to a specific population of patients. CRNA is distinguished by advance procedural and pharmacological control of patients that require going under anesthesia (Hamric et al., 2014). CRNA provides care for individuals across the lifespan for individuals; they also provide care to healthy patients and emergency care, extreme care, or life-threatening regardless of acuity (National Council of State Boards of Nursing, n.d.). Nurse anesthetists date back to the late nineteenth century. During the late nineteenth century, utilized nursing students for staff and used nurses that graduated as a nurse anesthetist. Before WWI, medical professionals questioned nurses' ability to administer anesthesia. Although opportunities presented the need for nurse anesthetists, there was conflict regarding nurses administering anesthesia once WWI was over. Kentucky courts ruled in 1917 that nurse anesthetists as legal but below professional medical personal. In 1930 the practice of nurse anesthesia was legal and within the nurse's scope of practice, as long as it was under the supervision and guidance of a physician (Hamric et al., 2014).
How to decide
The decision is up to you, and although it is a lot of information to take on; the journey is rewarding. Figure out your time, decide if you want to do online, hybrid, or in-person learning, determine if you're going to be in school continuously for years before getting a degree or obtaining your degree through steps, i.e., LPN-RN-BSN-MSN-APN, there are pros and cons to going through each step so do your research. There are so many options out there for school options and the way you receive your education. There is no right or wrong way to get your degree in nursing; however, I encourage all to further your education. As a nurse, you never stop learning, whether it's from patients, colleagues, CEUs continuing your education is essential for keeping clinical skills up and providing optimal care for your patients. Once you figure out what nursing program you want to complete, start looking at schools. *Accreditation Once you have a few schools write pros and cons about each school to help your decision-making process. Once you decide, apply! See if they will waive the application fee; some schools do. Do your FASFA for the schools you selected; most students will get some form of financial aid. Before each year of college, apply for grants, loans, or work-study with FASFA (FASFA, 2021). Lastly, I initially started out as an LPN; once I completed it, I went right back for my ASN. I did an online bridge program once I finished my ASN I went back and obtained my BSN. I’m currently looking into different schools trying to determine what I want to specialize in.
There will be a post out soon on how to succeed in nursing school! As well as elements of regulation for the APRN. Thank you for reading D. Jones
DeCapua, M. (2021, June 17). Overview of nursing roles & their scope of practice. Top Schools Offering Nurse Practitioner Programs. https://www.nursepractitionerschools.com/resources/nursing-roles-by-scope-of-practice/
FASFA. (2021). Federal student aid. Federal Student Aid. https://studentaid.gov/h/apply-for-aid/fafsa
Hamric, A.B., Hanson, C.M., Tracy, A.B., & O'Grady, E.T. (2014). Advanced Practice Nursing: An Integrative Approach, (5th edition). St. Louis, MO, Elsevier.
Indeed Editorial Team. (2021, January 29). Different types of LPN jobs and career paths. Indeed Career Guide.
Macy, Jr. Foundation, J. (2010, April). WHO WILL PROVIDE PRIMARY CARE, AND HOW WILL THEY BE TRAINED? The Josiah Macy Jr. Foundation. https://188.8.131.52/docs/macy_pubs/JMF_PrimaryCare_Monograph.pdf#page=169
Martsolf, G. R., Auerbach, D. I., Spetz, J., Pearson, M. L., & Muchow, A. N. (2015). Doctor of nursing practice by 2015: An examination of nursing schools' decisions to offer a Doctor of Nursing Practice degree. Nursing Outlook, 63(2), 219-226. https://doi.org/10.1016/j.outlook.2015.01.002
National Council of State Boards of Nursing. (n.d.). APRNS in the U.S. NCSBN. https://www.ncsbn.org/aprn.htm
Nursing CAS. (2018, September 24). What's the deal with Accreditation? NursingCAS. https://nursingcas.org/whats-the-deal-with-accreditation/
Registered Nursing. (2017, October 20). (APRN) advanced practice registered nurse - Roles, programs, salary details || RegisteredNursing.org. RN Programs - Registered Nurse || RegisteredNursing.org. https://www.registerednursing.org/aprn/