< Previous28 American Nurse Journal • 2020-2021 E DUCATION AND C AREER G UIDE MyAmericanNurse.com H ave you decided you’re ready to pursue becoming a nurse practitioner (NP)? If so, take some time to discuss your ca- reer goals and pursuit of graduate education with family members who will be most affect- ed by this decision. You’ll want (and need) their support. Next, identify the patient popu- lation you’re most passionate about and the settings in which you prefer to practice. After that, choose the educational track that will help you meet your goals, find a program that accommodates your individual learning needs, and select the appropriate certification and licensure. Use this article as a guide to help you carve your NP educational path. What’s your preferred patient population and setting? NP patient population options include family (across the life span), adult-gerontology (acute or primary care), pediatric (acute or primary care), neonatal, women’s health, and psychi- atric/mental health. One of the most impor- tant decisions you’ll make as a prospective NP student is deciding which patient population you’ll pursue and what setting you prefer. Do you want to care for adults with chronic but stable conditions in a clinic or home setting? Or do you see yourself caring for patients with acute or critical conditions in a hospital setting? Commonalities and overlap of NP education exist. For example, all NPs receive graduate- level education (either a master’s or doctoral degree) and licensure is attained in the state where you’ll practice. Scope of practice, which is regulated by state boards of nursing, varies between states and continues to evolve, and Choosing the right NP education Prepare to meet your education and career goals. By Kathleen Ballman, DNP, APRN, ACNP-BC, CEN; Dawn Carpenter, DNP, ACNP-BC, CCRN; Christine Colella, DNP, APRN-CNP, FAANP; Donna Lynch-Smith, DNP, APRN, ACNP-BC, NE-BC, CNL; Helen Miley, PhD, APRN, AG-ACNP, CCRN; and Marcia Johansson, DNP, APRN, ACNP-BC 2020-2021 Education and Career Guidehospitals govern institutional privileging related to practice parameters. (To view details about patient populations, scope of practice, practice settings, and links to websites for more infor- mation, visit myamericannurse.com/?p=67269.) What are your educational options? Choosing the appropriate NP program requires education and guidance. Speak with a faculty member who practices and teaches in the NP track you’ve selected or with someone from the state board of nursing in the state where you plan to practice. Program options include: •bachelor of science in nursing (BSN)-to- master of science in nursing •BSN-to-doctorate of nursing practice (DNP) •postmaster’s certificate or postgraduate certificate (PMC). It’s important to note that some programs will soon require a DNP as entry into practice. For instance, the Council on Accreditation (COA) for certified registered nurse anesthetist (CRNA) programs will require a DNP beginning in 2025, and the National Association of Clinical Nurse Specialists (NACNS) will require a DNP in 2030. Currently, the American Association of Colleges of Nursing (AACN) and National Organization of Nurse Practitioner Faculties (NONPF) are in discussions about mandating a DNP as entry level for all NPs. You also might consider a dual program, such as adult-gerontology acute care NP (AG- ACNP)/family NP (FNP), AG-ACNP/pediatric acute care, or psych-mental health/FNP. These programs typically include additional didactic and clinical courses. PMCs are designed to allow nurses with a graduate degree in nursing to either continue their education to become an NP or for practic- ing NPs to add to their scope of practice. PMCs vary in length depending on the individual’s prior education and focus. A gap analysis will help customize educational plans, including clinical experiences and coursework needed to care for new patient populations. After com- pleting the PMC, you’ll then need to apply for additional certification to be licensed for that patient population. MyAmericanNurse.com June 2020 American Nurse Journal • 2020-2021 E DUCATION AND C AREER G UIDE 29 2020-2021 Education and Career Guide What’s in the APRN Consensus Model? The Consensus Model standardizes licensure, accreditation, certification, and education and defines advanced practice RN (APRN) roles based on population foci. You can learn more about the model by reviewing the frequently asked questions page developed by the National Organization of Nurse Practitioner Faculties (goo.gl/dupTdD). APRN Consensus Work Group, National Council of State Boards of Nursing APRN Advisory Committee. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification & Education. July 7, 2008. ncsbn.org/Consensus_Model_for_APRN_Regulation_July_2008.pdf Advanced practice registered nurse specialties Focus of practice beyond role and population focus linked to heatlhcare needs. Examples include but are not limited to: oncology, older adults, orthopedics, nephrology, palliative care Licensure occurs at levels of role and population foci Families/ individuals across life span Adult- gerontology NeonatalPediatrics Women’s health/ gender-related Psychiatric- mental health Nurse anesthetist Nurse-midwife Clinical nurse specialist Nurse practitioner Population foci APRN roles s ssssHow and where do you want to learn? Education platforms include traditional (face- to-face), fully online, or hybrid (combination of both) and vary by state. What works best for you may depend on your need for regular interaction with faculty and other students (traditional is probably best) or flexibility be- cause of personal and work obligations (on- line or hybrid may be better). Other factors to consider include program quality and ac- creditation, fit with your interests and career goals, cost, time (including program length, time to complete assignments and clinical re- quirements, and class and travel time), loca- tion, and ultimate degree goal. Clinical placement Clinical placement is an important considera- tion when looking at programs. Placements are a collaborative effort between the college and the clinical setting and are based on the clinical program objectives. Clinical placement depends on your scope of practice and popu- lation focus. For example, an FNP program may require clinical time in pediatric, women’s health, and adult settings. For an AG-ACNP program, your clinical experiences may be with a hospitalist or intensivist. Application process When applying to an NP program, carefully fol- low all application instructions and timelines. Clearly answer questions and provide requested information. Choose references who can speak to your abilities as a learner (such as previous instructors or an NP with whom you currently work) and your work ethic and skills as an RN (such as your current nurse manager). (To view a list of questions you might be asked and those you may want to ask in a program interview, visit myamericannurse.com/?p=67269 .) What do you know about licensure, accreditation, certification, and education? The AACN and the NONPF collaborated to design NP curriculum content and standards in the United States. Three documents out- line the standards: The Essentials of Master’s Education in Nursing, The Essentials of Doc- toral Education for Advanced Nursing Prac- tice, and Nurse Practitioner Core Competen- cies Content. 2020-2021 Education and Career Guide MAKE A LIFE-SAVING DIFFERENCE With skill, knowledge and compassion, UCLA Health nurses take on and overcome the most complex clinical challenges around, including global pandemics like COVID-19. As California’s #1 health system with multiple Magnet® hospitals and an unwavering commitment to the highest standards of nursing excellence, UCLA Health is the place where dedicated nurses can make the most of their abilities and unwavering commitment. We invite you to join us as we elevate the practice and enhance the impact of nursing in our community and throughout the world. As a valued and respected clinician, you will work with state-of- the-art technology and collaborate with some of the top medical professionals in the country. If you want to practice at the highest level of your profession while delivering hope and healing to a diverse and dynamic community, UCan at UCLA Health. UCLAHealthCareers.org 30 American Nurse Journal • 2020-2021 E DUCATION AND C AREER G UIDE MyAmericanNurse.comThe Advanced Practice Nursing Consensus Work Group developed the “Consensus model for APRN regulation: Licensure, accreditation, certification and education” (Consensus Model) for all NPs. Following the model ensures role standardization, educational preparation, and licensure. (See What’s in the APRN Consensus Model?) After graduating from an accredited NP pro- gram, you’ll be eligible to take a certification exam. Several national organizations—includ- ing the ANCC, the American Association of Critical-Care Nurses, and the American Acad- emy of Nurse Practitioners—provide NP certi- fication. When you pass the national exam, you’ll want to obtain a state license. The consensus model explains that specializa- tion in a particular clinical practice area (such as cardiology, oncology, or orthopedic medicine) is outside of the parameters of national certifica- tion. Instead, specialty certifications are provided by specialty professional organizations. Professional success Despite national support for the consensus model, NPs and employers struggle to match education with the correct patient population, so you’ll need to clearly understand the role and scope of practice you want to pursue. If you do your research, consult trusted col- leagues, and map out a plan to meet your goals, you’ll be well on your way to profes- sional success. View a list of references at americannursetoday.com/?p=67269. Kathleen Ballman is an associate professor and coordinator of the Adult-Gerontology Acute Care Nurse Practitioner programs at the University of Cincinnati College of Nursing in Cincinnati, Ohio. Dawn Carpenter is a nurse practitioner (NP) in the medical intensive care unit at Penn State Health Milton H. Hershey Medical Center in Her- shey, Pennsylvania, and an associate professor at the University of Massachusetts Medical School in Worcester. Christine Colella is a pro- fessor and executive director of graduate programs at the University of Cincinnati College of Nursing. Donna Lynch-Smith is an associate professor, concentration coordinator of the Adult-Gerontology Acute Care Nurse Practitioner program at the University of Tennessee Health Science Center College of Nursing/Department of Acute and Tertiary Care in Memphis. Helen Miley is an NP in the MICU at Robert Wood Johnson University Medical Center and professor emeritus at Rutgers University in New Brunswick, New Jersey. Marcia Johansson is an assistant professor and coordinator of the Adult-Gerontology Acute Care Nurse Practitioner program at the University of South Florida College of Nursing in Tampa. 2020-2021 Education and Career Guide MyAmericanNurse.com June 2020 American Nurse Journal • 2020-2021 E DUCATION AND C AREER G UIDE 3132 American Nurse Journal • 2020-2021 E DUCATION AND C AREER G UIDE MyAmericanNurse.com Your future starts now You can never start networking and building relationships too early. Every day on the clinical unit is a job interview. Use these strategies to propel your career forward: •Journal your clinical rotation activities so you have a personal record of your skills. Reflective journaling can help you learn from past experiences and promote a richer understanding of your thought processes. •Hone your networking skills. For example, when you meet new professional contacts, request their business card to demonstrate your interest in what they do and create a conduit for future connection and outreach. •Research and reach out to organizations you might want to work for. •Consider internship or volunteer opportuni- ties. They can help advance your clinical learning experience and competency. •Prepare a draft of your résumé and cover letter, and ask your career services special- ist or a faculty member to provide feed- back. •Before you graduate, join your school’s alumni association so you can connect with other alumni. Connecting with alumni and taking advantage of career support the as- sociation may offer can help you •learn strategies for getting your foot in the door •find out what hiring managers look for in candidates •get tips on the job application process. Choosing a specialty Start your specialty search by visiting the asso- ciation websites of specialties that interest you. Talk to nurses already in the specialty to learn more about training and education, career op- portunities, and the work itself. In addition, ask yourself these questions: 1. What work setting do I feel most comfort- able in? For example, do you prefer outpatient or inpatient settings? 2. What brings me joy and keeps me motivated at work? For exam- ple, do you like to work with chronically ill patients or do you prefer a fast-paced environment such as an ambulatory surgery center? 3.How important are salary and benefits? For example, are you willing to take a slightly lower salary in ex- change for greater opportunity for advance- ment? Are you looking for “must-have” benefits such as tuition reimbursement? 4. Am I willing to relocate? Being willing to relocate will open up greater opportunities, but that may mean being more geographi- cally distant from friends and family. Job interview: Before, during, and after Your first nursing job interview is scheduled. Now what? Before the interview •Identify your personal and professional 2020-2021 Education and Career Guide Forging your career from the start Begin to map out your future on the first day of nursing school. By Susan Rux, PhD, MSN, RN, PHN, ACNS-BC, CHEP, CNE, CPRW, NEA-BC I n nursing school, grades and test scores measure accomplishment. Students are keenly aware of the program’s academic expectations, but they also must consider their careers from the very first nurs- ing class by mapping out a career plan with guidance from instruc- tors, mentors, and clinical staff. goals. Be able to tell the interviewer why you’re a good fit for the organization. •Research the organization. Be familiar with its mission, vision, and values. •Schedule a mock interview with your career services specialist, faculty mem- ber, and a trusted peer. Include behav- ioral-based questions in your practice, such as •Describe a situation when you were up- set while assisting a patient or customer. How did you handle this situation? •Give an example of a time you had to make a quick decision. What were the results? •Prepare questions to demonstrate that you’re serious and invested in the process. •Verify the name of the interviewer(s) and the location and time of the interview. To avoid being late, do a timed test run to the location, factoring in traffic patterns. •Review your résumé and take extra copies to the interview. To view an interview tool that can help you prepare, visit bit.ly/3fpmc2s . And the American Association of Colleges of Nursing offers advice at bit.ly/36B3osW . Interview day •Arrive at least 10 to 15 minutes early. •Be confident and display your profession- alism via your attire and demeanor. •Answer interview questions honestly. If you don’t know the answer, it’s okay to say so. When necessary, ask the inter- viewer to repeat the question. •Focus on your unique patient care experi- ences and educational preparation. For example, be prepared to respond to a question such as, “How has your educa- tion prepared you for a nursing career?” •Highlight special training that might give you an advantage over other applicants. The interview is an important time to showcase your accomplishments and how your skill set positions you more favor- ably compared to others. After the interview •Send a thank-you email to each of your interviewers within 24 hours. •If a week goes by and you don’t hear about next steps, follow up with the orga- nization’s human resources department. You don’t want to be a pest, but you do want to advocate for yourself and make your interest in the position clear. Positioned to make a difference Your education has primed you to make a difference, but how do you want to shape your career? These tried-and- true methods can help position you on your journey. •Lead others to improve healthcare delivery and treat- ments. You can start building your leadership skills by serving on unit-based committees. •Work collaboratively with clinicians in other professions. •Exercise resilience and model teamwork and collaboration to ensure a healthy work environment. •Persevere—turn setbacks into catalysts and inspiration for achieving your goals. •Strive for a healthy work-life balance that incorporates self-care. Consider the re- sources available through Healthy Nurse Healthy Nation™ ( healthy nursehealthynation.org ). •Practice lifelong learning and leverage data to inform healthcare policy and prac- tice. For example, consider joining a quality improvement taskforce to become a practice change agent. •Be sure you understand the organiza- tion’s values and how you impact them. 2020-2021 Education and Career Guide Prepared to participate Healthcare will continue to present challenges. As you transition from student to a profes- sional practicing nurse, take steps to ensure you’re ready to actively participate in facing those challenges and moving the profession forward. Dr. Susan Rux is the dean of academic affairs at Chamberlain Univer- sity in North Brunswick Township, New Jersey. References American Association of Colleges of Nursing. What Every Nurs- ing Student Should Know When Seeking Employment . aacn- nursing.org/Portals/42/Student/what-every-nursing-student- should-know-when-seeking-employment.pdf?ver=2017-07-28 -083316-627 Hargreaves J, Pabico C. How to choose your first nursing job wisely. Am Nurse J. 2020;15(5):30-1. MyAmericanNurse.com June 2020 American Nurse Journal • 2020-2021 E DUCATION AND C AREER G UIDE 33Y ou’ve decided to return to school to get your bachelor of science in nursing (BSN) degree, but you’re nervous about how you’ll manage. Here are a few strategies to help you not just survive but also thrive in school. Manage your time Time-management skills are essential for the RN returning to school. Setting priorities, planning, and organizing your daily activities are key to your successful academic journey. Here are a few suggestions. Balance family needs. As an RN-BSN student, you’re probably employed full-time and you may have a family to care for. Childrearing and childcare can be challenging for adults returning to school; you want to carve out time for studies in your busy routine, while not ignoring your children or family. Ideally, another adult caretaker can help with childcare and schedule adjustments, but if that’s not possible, a babysitter or other assistant is your next best option. You might also want to have a backup for last-minute sitter cancellations so you don’t have to miss class. You may have to study after your children go to bed or during work breaks. Remember, you can’t add more hours to the day, but you can find your own rhythm—learn to work with what you have. Organize study time. You’ll have minimal study time, so use it wisely. As soon as you get your course schedule, highlight the important dates for each assignment, quiz, exam, and project on your syllabus. Then develop a system that lets you see dates at a glance so you don’t miss any deadlines. Many RN-BSN students miss due dates, fall behind in reading and assignments, procras- tinate, or let life get in the way of their education goals. Best practice is to make school and studying part of your daily routine. You may experience some trial and error as you work to find a time and place that best fit into your schedule and family life, but be per- sistent. Good study habits include a quiet place with no distractions, a flat surface for writ- ing, good lighting, being rested and well-fed, and a positive attitude. This is an important journey you’re on. With your family’s support, plan for your study time, schedule it, and stick with it. You’ll be surprised how much it will become a part of your daily routine. Hone your note-taking and questioning skills Don’t fall behind in your assigned readings. They will help you know what’s important to take note of during lectures, presentations, or webinars. Be an active learner. Make sure you understand everything that’s bolded or italicized in the text, as well as anything that’s further explained with a picture, diagram, or chart. If the authors have displayed information in a different color or size print, it’s important to know. If questions are presented at the end of the chapter, make sure you can verbally ex- plain the answers. Talking through the answers to these questions is a great way to test your knowledge. Use note cards. Taking notes using index cards (writing questions or terms on one side and the answers or definitions of the other) can be helpful. These cards can easily be car- ried in your pockets or purse and pulled out whenever you have a few minutes to review; they’re an excellent use of time while waiting in line or during a work break. Ask questions. If you’re attending a face-to-face class, read class material before at- tending, write down any questions you have, and ask them in class so the instructor can 34 American Nurse Journal • 2020-2021 E DUCATION AND C AREER G UIDE MyAmericanNurse.com 2020-2021 Education and Career Guide School survival skills How to find success while working full-time and getting your BSN. By Debra A. Hrelic, PhD, RNCFrontier Nursing University fosters a Culture of Caring to help students ful昀ll their potential. As we promote caring together, we exemplify the support, respect and inclusivity we hope to bring to the wider healthcare system. Creating a Culture of Caring Visit: frontier.edu/ana Offering master’s and doctoral degrees through distance education. Specialties Offered: • Certi昀ed Nurse-Midwife • Family Nurse Practitioner • Women’s Health Care Nurse Practitioner • Psychiatric-Mental Health Nurse Practitioner Take the 昀rst step today at vcuhealth.org/careers. The next step in your career. Designed with you in mind.36 American Nurse Journal • 2020-2021 E DUCATION AND C AREER G UIDE MyAmericanNurse.com 2020-2021 Education and Career Guide provide answers. If you’re an online student, keep up with your readings and don’t hesi- tate to email faculty with your questions. Leverage your strengths If you’re a student with plenty of real-life nursing practice under your belt, you may find it helpful to put learning in terms of actual patient experiences. For example, when learning about hypercalcemia in a pathophysiology class, a nurse who’s cared for a patient with this condition might find it easier to relate that patient’s clinical presentation to what’s being taught. For example: •The patient had muscle weakness, decreased muscle tone, and lethargy. •He had GI upset, was nauseated, had little appetite, and suffered from constipation. •He had polyuria and cardiac arrhythmias with ECG changes. •He showed classic signs and symptoms of hypercalcemia. Reviewing a disease process in terms of a real-life patient can help solidify the information in your mind. Tap into resources Your school likely offers a variety of free resources to assist you in achieving your academic goals. Technology assistance center. The technology assistance center (help desk or computer help desk) can help you with computer issues related to your classes, required programs, and learning management systems needed for taking online classes. Advisors. Your advisor, who will be assigned to you by the school, can help you plan your schedule and register for classes. Meet with your advisor regularly (in person, on the phone, or via a remote meeting app) to gain invaluable advice and guidance. Tutoring and study groups. Schools usually have tutoring services available for most if not all liberal arts courses, as well as for many nursing courses. Take advantage of this help if you need it. Frequently, study groups form within individual classes. Studying in a group brings different perspectives and provides support. Writing assistance. You’ll have to complete many writing assignments in nursing school. If writing isn’t your strong suit, see if your school has a writing center, where you can take advantage of one-on-one help with your writing skills and learn American Psychological As- sociation writing style, which is preferred in most nursing programs. Counseling. All colleges offer free counseling and support for students. If you need emo- tional help, encouragement, or support, seek out these resources. Faculty and teaching assistants. Don’t hesitate to contact faculty with any questions or concerns. Your course syllabus is a “contract” with your instructor. Dates and times, expecta- tions, and assignments typically are non-negotiable. You’re responsible for meeting deadlines. If for some reason you can’t meet an assignment date or need to miss a class, contact the in- structor before the due date, not after. The instructor will appreciate that effort and will be more likely to accommodate a request for extension, if possible. Faculty post their contact information and office hours and location on the course syllabus. Keep that information in your phone or other easily accessed location. If your class has a teaching assistant, have that person’s contact information readily available also. Your instruc- tor and teaching assistant want you to be successful and to help you in any way possible. Be realistic Be realistic in your expectations of yourself, your school, your job, and your family. But if you find the right school for you and follow this advice, you’ll enjoy a successful experience that helps you grow in your career. Debra A. Hrelic is the RN-BSN program coordinator at the University of North Carolina Wilmington. Reference Hrelic DA. How to be a success in nursing school. Am Nurse Today. 2018. myamericannurse.com/Digital/Educa- tionGuide18-19/#p=22MyAmericanNurse.com June 2020 American Nurse Journal • 2020-2021 E DUCATION AND C AREER G UIDE 37 Carson-Newman Online Nursing A Christian university recognized for nurs- ing excellence, Carson-Newman believes in providing a life-changing education where students come first. That’s why our online nursing students receive clinical place- ments for MSN and post-master’s level clin- ical rotations and unrivaled student sup- port. Our CCNE-accredited programs are designed for busy nurses with no manda- tory class login times. Learn more today. 888-293-9444 admissions@onlinenursing.cn.edu onlinenursing.cn.edu/ Arkansas State University Arkansas State University (A-State) Online is one of the oldest online degree pro- grams in Arkansas. Designed around work- ing nurses, the RN to BSN program in the College of Nursing & Health Professions is ACEN accredited with multiple starts per year. Students can finish in as few as 12 months. 866-621-8096 astatenurses.com Eastern Michigan University The CCNE-accredited RN to BSN online pro- gram from Eastern Michigan University is designed for the working nurse with 30 credit hours that can be completed in as few as 12 months, 6 start dates, and pay as you go courses that are the same price for all students. 844-351-9389 online.emich.edu/americannurse National Institute of Whole Health NIWH is a content provider of evidence based, Whole Health Education® curriculums, a research organization in the field of Whole Health Education® and Behavioral Engage- ment with Pure Presence ™ and an educational organization which conducts professional de- velopment and accredited continuing educa- tion programs in Whole Health Education® for credentialed health professionals. Since its inception in January 1977, NIWH has held a compelling vision for American healthcare to include demystified health information to pro- mote self-care and disease prevention. 888-354-4325 Excelsior College Excelsior College provides nursing degree programs working nurses can pursue on- line, on their own time, while maintaining personal and professional obligations. Our bachelor’s completion program prepares you for career advancement and the pursuit of lifelong learning. Our three master’s pro- grams offer you a first-rate graduate educa- tion to prepare you to assume leadership roles. 844-843-9296 excelsior.edu/programs/nursing/ Case Management Institute The Case Management Institute offers on- line, on-demand courses for busy nurses and nurse case managers in the following areas: •Foundations of Case Management •Case Management Certification Preparation • Utilization Management •MCG 978-272-2968 CaseManagementInstitute.com Central Michigan University Bachelor of Science in Nursing: RN-to-BSN CMU’s online RN-to-BSN program builds on your nursing foundation and broadens your expertise in nursing leadership, ad- vanced health assessment, culture and di- versity in patient care, and the overarching concepts of global and population health. 877-268-4636 global.cmich.edu/rn-bsn Frontier Nursing University Versailles, KY Frontier Nursing University offers commu- nity-based distance education programs to registered nurses who wish to become nurse-midwives and nurse practitioners. FNU offers Doctor of Nursing Practice and Master of Science in Nursing degrees as well as post-graduate certificates in advanced practice nursing specialties, including nurse- midwifery, family nursing, women’s health, and psychiatric-mental health. 859-251-4700 admissions@frontier.edu frontier.edu Northern Kentucky University Northern Kentucky University emphasizes lifelong learning, offering undergraduate, graduate and doctoral accredited pro- grams built with the working nurse in mind. Our evidence-based programs en- hance your leadership abilities and pre- pare you for professional nursing roles across a broad spectrum of healthcare settings. Light your path to a rewarding future. 800-985-7215 onlinedegrees.nku.edu/americannurseNext >