Sabrina Loring, RN, MSN, ANP-C, began as a Surgical Technician over 30 years ago, and went on for an AD in nursing. She received her BSN and MSN from the University of South Maine and has practiced as an Adult Nurse Practitioner in Internal Medicine and Orthopedics. Most recently she has been teaching LPN nursing students, writing medical articles and raising her family.
Nurse Practitioners provide a unique blend of nursing with medical care. Many have been practicing as registered nurses for many years prior to becoming a NP. This extensive background in nursing gives them a different perspective from the traditional medical model practiced by physicians and PAs (physician’s assistant) in that they treat the patient as a "whole person," not just the complaint or problem. For example, a patient may come in with symptoms as simple as a sore throat. An NP will deal with that, and ask "is there anything else bothering you today?." NPs are skilled, therapeutic listeners and can "hear what patients can’t or won’t say." Patients typically feel very comfortable with an NP. I had a female patient tell me once that, "No one in the medical field has ever listened to me prior to this visit." We went on to have a close, professional relationship for several years.
NPs’ duties include educating patients, especially about preventative measures such as tobacco cessation, diet and exercise programs, and how to make healthier choices. They diagnosis and treat acute and chronic conditions such as high blood pressure and diabetes, infections and injuries. They prescribe medications, order diagnostic tests, lab work and x-rays. They work collaboratively with other health care providers and refer to specialists. They report high patient satisfaction because they take time with their patients and really listen. In many states NPs can practice independently after working full-time for 2 years under a physician’s supervision. This means they can have their own patients and manage their overall care. NPs practice in rural, urban and suburban communities and practice in many types of settings. These include clinic, hospitals, private physican or NP practices, nursing homes, correctional settings, schools and colleges.
As an NP starting out I worked in Family Practice and Internal Medicine for several years to become proficient in all aspects of patient care. I also worked per diem in a Correctional Facility. That experience was fantastic. It was so satisfying to help a population that tends to be forgotten. I have worked in Gastroenterology, Orthopedics and am currently teaching in an LPN program. I have found being an NP is extremely satisfying and offers a variety of employment opportunities.
Lorry Schoenly, PhD, RN is a nurse writer and educator with over 25 years of experience. She has been certified in five different clinical specialties including critical care and emergency nursing. Starting as an associate degree registered nurse, she continued her schooling in traditional and distance-learning settings to obtain a BSN, MSN, and PhD in nursing while working full-time and raising a family. Lorry teaches nursing in a variety of settings including webinars and online nursing courses.
There are so many opportunities for nurses with graduate degrees. A graduate degree (MSN or NP) begins a specialization process that will influence your career options.
What do you like about nursing?
To decide which degree is best for you, first consider what you like about nursing? If you have a strong interest in diagnosing and treating illnesses, you may prefer a nurse practitioner (NP) position and therefore seek a graduate degree in an NP specialty. If you prefer managing and improving the systems of nursing care delivery or gravitate toward developing new staff members, you may wish to pursue a master’s degree in nursing (MSN). This degree will help you move into a nurse manager position or a nursing faculty position.
Which degree will help you find a job?
Either an MSN or an NP degree will open doors. There is a projected increased need for Nurse Practitioners and Master’s Prepared Nursing Faculty in the decade ahead. You have prospects for an advanced position no matter the route you select.
The American Association of Colleges of Nursing (AACN) developed a Nursing Faculty Shortage Fact Sheet that outlines some specific needs. Almost two-thirds of schools of nursing listed faculty shortages as a reason for turning away potential students. The average age of nursing faculty is advancing, indicating future need due to retirement. Another reason cited for the current shortage of nursing faculty is the salary comparison to the clinical sector. The average salary of a US nurse practitioner, according to the American Academy of Nurse Practitioners, is $89,450. By comparison, the average salary of master’s prepared nursing faculty is $69,489.
What are the pros and cons of an NP degree? An MSN?
Considered only from the salary perspective, the nurse practitioner degree would be the most promising. In addition, Money Magazine, among other sources, lists Nurse Practitioner as one of the Best Jobs in America. Job growth over the next decade is projected at 23 percent. Nurse practitioners are a cost-effective method of providing health care in many areas of the country making it a position of interest in the health care reform currently underway. Some states already allow nurse practitioners to practice independently of physicians, and there has been a push for expanding the nurse practitioner role in other states as well. With all the positive aspects of the position come some challenges, including dealing with a potentially heavy workload and ’haggling’ with insurance companies.
Nurse educator positions can also be very satisfying, though challenging, jobs. The lower salary may come with greater flexibility and increased down-time. Faculty positions may blend well with other obligations or include reduced tuition benefits for dependent children.
Overall, you cannot go wrong with an advanced nursing degree if you are careful to evaluate your preferences and the job opportunities in your geographic location.
Learn more about MSN and NP careers with the interviews below:
Chris O’Brien received her BSN from Auburn University and her Master’s inPublic Health degree from Emory University. With a background in cardiac care, home health, nursing research & education, and medical writing, she now enjoys the dual paths of being a freelance medical writer and yoga teacher in Decatur, GA.
For starters, medical doctors (MDs) go to medical school and nurse practitioners (NPs) go to nursing school. MDs go to school for a minimum of eight years whereas NPs go for six.
There are also legal differences in terms of what MDs and NPs can do with patients. MDs can prescribe drugs, but NPs can’t do that in all states. Both MDs and NPs can function independently or as part of a healthcare team, so either one could open an office and start seeing patients, but NPs are more limited by state laws in terms of what they can do for patients and what they can bill insurers for. MD licensure can be used across state lines, which is not true for NPs who are required to get a separate license for each state where they practice.
Framework for Practice
MDs are trained from a medical practice model, which has a problem-focused illness approach, whereas NPs are trained from a nursing practice model, which has a holistic preventive approach. NPs are trained health educators and work well in settings where disease prevention and wellness can be emphasized. However, NPs also commonly work in acute care settings like clinics and hospitals and treat sick patients, working side-by-side with MDs. Because NPs are trained to look at the whole person, not just the part that’s creating a problem, they may spend more time educating patients and family members on ways to prevent problems, as the work setting allows.
MDs earn more than NPs and they often have greater legal responsibility, in some cases supervising the work of NPs. NP salaries, like MD salaries, vary depending on the specialty. I have a brother who is an emergency room doctor and a sister who is an MD in a family practice setting. They have very different lifestyles because of their work schedules and there is a big difference in what they make as well. Of course some of the pay difference has to do with location and years of experience, and also who they work for. My sister, the family practice doctor, works for the state, has great holidays, and makes a good living. My brother works for a private hospital, has what I consider a non-family conducive schedule, and makes a really good living. Now my brother-in-law is a NP who switched from a higher paying emergency room position to a clinic position, mainly so he could have more time with his family. The nice thing about nursing is the ease with which you can move around, but compensation is often less in environments that are less stressful, and that’s true for both medicine and nursing.