A Master’s of Science in Nursing (MSN) is a broad degree with many degree and career specialties to consider. One such specialty is a nurse practitioner. A nurse practitioner is an Advanced Practice Registered Nurse (APRN) who has completed advanced education and extensive training.
In this interview, Karla Wilson, RN, MSN, FNP-C, CPON offers valuable insights about her education and career to help aspiring MSN students learn more about becoming a nurse practitioner. She currently serves as a nurse practitioner for the Department of Population Sciences and Epidemiology in the Center for Cancer Survivorship in California.
1. What position do you currently hold? Can you tell us about your key responsibilities as a nurse practitioner?
I am the nurse practitioner for a childhood cancer survivorship program. What this means is that I see patients of all ages who had cancer when they were under 22 years of age. Currently my patients must be at least 5 years from diagnosis and 2 years off treatment. Our program is somewhat unique in that we are a clinical research program and all the patients sign a consent to participate in our program. We screen the patients for late effects from treatment and provide education and counseling regarding healthy life-style practices. We do not treat but refer patients to specialist or to their PCP for treatment of any identified problems. Patients are seen on an annual basis and in addition to the physical exam and diagnostic tests the patients fill out research questionnaires related to their health knowledge and psychological welfare.
- Coordinate the care of all patients within the program – regardless of whether I am the actual provider that they see in clinic.
- Develop comprehensive summaries of their cancer treatment, patient education specific to their risk factors for health care problems based on their treatment exposures.
- Obtain research consent for new patients.
- Recruit new patients.
- Do physical exams, and health education.
- Dictate H&P, review all diagnostic test results, write follow-up letter to patient regarding test results – call them if there are unexpected abnormalities, send letter to patients’ PCP and consultants regarding visit.
- Supervise a clinical research assistant (CRA) who provides clerical and scheduling support for the program.
- Enter data into research data base.
2. Can you describe your typical work-day?
I work 4 days/week and have clinic 2 days/week. On non-clinic days I am preparing patient folders on upcoming patients, completing post-clinic documentations, entering research data, etc. I do a lot of educational programs, lectures, etc., including developing educational CD-ROMs, publications for journals, textbooks, etc. and work on these when time permits- although most of these professional development activities are done outside of actual work time.
3. Why did you decide to become a nurse practitioner?
I initially became an advanced practice nurse (APN) when most nurse practitioner programs were certificates and not masters. I had worked 5 years as a bedside nurse and then worked in expanded roles and felt that a master’s was important to be able to have broader and more independent roles.
4. Tell us about your educational background. Did you start out studying towards an RN or did you have your long-term career path planned out?
I went to a diploma school of nursing straight out of high school. In all honesty not really sure why I went into nursing other than I had always thought that I wanted to work in an area where I could help people and make a difference in their lives.
5. What is your specialty and how did you arrive at your decision?
I started out as a pediatric nurse out of nursing school because the pediatric unit of the university hospital that I wanted to work at was starting a “new innovation” for the time called primary nursing. It was to replace team leading where the RN mainly supervised LPNs and patient care assistants (PCAs), passed meds, and took care of IVs. In primary nursing the RN actually got to take care of patients and I thought it would be fun to do. I fell in love with pediatrics and it became my career. From the start I really liked working with kids with chronic illnesses – and I particularly loved oncology.
6. Describe your first job after graduating from nursing school.
In 1975, nurses had to work 8-hour shifts and the only “straight” shifts were evenings (3-11:30 PM) and nights (11 PM-7:30 AM), so I had to rotate all 3 shifts- often within the same week. We worked long- hard hours and in some ways I feel like it was in the dark ages. We did not routinely have IV pumps and almost all patients had peripheral IVs or “cut-downs” when you couldn’t get a peripheral IV. CT and MRI scans were just coming out and a brand new invention called a Broviac revolutionized care of children with cancer. The mid 1970’s was also the time that parents were first being allowed to stay at their child’s bedside and spend the night in the room – prior to that they were regulated to a few hours of the day visiting their child. Many of the older staff members thought this new way of care was going to be the downfall of pediatrics, where new staff couldn’t imagine what it would be like for a parent not to be able to be with their child. Those first few years of nursing were some of the best times of my career as I learned the foundations of how to take care of children and families and I knew that I wanted to excel at it.
7. How do you balance your work schedule with your personal life?
Sometimes it is really tough – especially when deadlines are due. My personal life is very fulfilling and I have lots of friends, wonderful pet companions and I love to garden, hike, and read. I volunteer at my local public library a half-day/week and I volunteer with a cat rescue group and help by trapping and neutering feral cats and fostering others until they are adopted.
8. What is your favorite part about being a nurse practitioner?
Being an independent practitioner within a team and feeling valued and respected for my knowledge and contributions.
9. What is your least favorite part about being a nurse practitioner?
Bureaucracy and the lack of equitable health care in the US.
10. If you could do it all over again, would you still become a NP?
Probably – if I went back in time and still chose to be a nurse, I would definitely become a nurse practitioner. However, if I went back in time I might become a veterinarian instead. I think there are many more options open to women today than there were in the 1970s.
11. What do you consider to be your biggest accomplishment in your career so far?
Making a difference in the life of my patients and being a role-model and mentor for others including the development of educational CD-ROMs that have become the basis of education for pediatric hematology/oncology nurses.
12. What factors should a prospective MSN student look for when selecting a school?
What is the focus of the curriculum and does it match your interests and goals? Are there professors that will be good mentors for you.
13. What qualities make someone a good candidate for a MSN degree?
Wanting to broaden their horizons and have an open mind about alternative health care practices that you will encounter. Being able to think outside the box and be flexible; understanding that there are many ways to do the same thing correctly.
14. About how long does it take someone to complete coursework to earn their MSN degree?
18-24 months usually.
15. What are the most popular specialties for a MSN student to choose to study?
The folks I know are in pediatrics, oncology, pain management, and palliative care.
16. What are some of the most common courses a MSN student will have to take?
I think that would depend on the subspecialty.
17. When is the best time to enter into a MSN program in your opinion?
After 2-5 years of bedside nursing. That provides the foundation of nursing care and knowledge and will strengthen your ability to practice as a well-rounded NP.
18. What do you think are the challenges that nursing educators face?
Preparing students to cope with the problems with health care access.
19. Online, blended nursing programs such as MSN’s, bridge programs and dual degrees are becoming more popular. What do you know about these programs? Can you see any benefits from receiving part of your nursing education online?
I’ve instructed students form those programs and worked with graduates from them as well. Many are woefully inadequate, although some are excellent. I think basic personality and motivation are important factors.
20. Why should someone NOT become a NP?
If they view it as a job and not a profession, or if they are unwilling to commit to keep updated in knowledge and skills.
21. What are the most common misconceptions about nursing compared to the actual career?
That it is glamorous and easy work. It is hard work and takes a true commitment. The longer you are in it the harder and longer hours you work.
22. How do NP’s use technology in their daily lives?
Very dependent on specialty. – Computers make life so much easier with electronic medical records and almost immediate access to tests results.
23. Do you have any tips for new NP grads on the job hunt?
Be honest! Don’t be cocky and if you are someone coming into the field with limited experience get a job as a bedside nurse and volunteer in community or free clinics to hone your skills.
24. What skills does an aspiring NP need to have?
Ability to be open-minded about weaknesses and strengths. Capitalize on the strengths and work to improve the weaknesses.
25. What is one piece of advice you would give an NP student, just starting out in the field?
Be humble, ask for constructive feedback and take responsibility for your behavior and actions and LEARN from your mistakes as well as your successes.
26. What’s the biggest perk about being a NP?
Two things actually 1) Being recognized as an expert in my field and 2) having patients say they would rather see me than a physician because I make the feel comfortable, do not appear rushed, and answer the questions in a way that is easy for them to understand.
27. What are some of the challenges the nursing profession faces as a whole?
Dealing with the intricacies of the health care system; e.g., in California where I currently practice, MediCal/CCS will not accept prescriptions from a nurse practitioner – so I have to have a physician sign a prescription on a patient they have never seen.
28. Can you suggest any valuable resources; publications, books or blogs for new NP’s and MSN’s?
I think it is key to belong to professional organizations- such as American Association of Nurse Practitioners (AANP) and whatever organization fits your sub-specialty (mine are Oncology Nursing Society (ONS) and the Association of Pediatric Hematology/Oncology Nurses (APHON).
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