I interviewed a family friend who was practicing as an RN and recently received her NP. She now practices as an NP at Dayton Children’s Hospital. My intended goal is to become an NP and work in pediatric oncology at a children’s hospital, so this interview really opened my eyes and allowed me to get a better look at why my future career could look like. She gave me advice on how to best get to where I want to be in the future and the correct steps to take along the way!

1. Do you recommend working and getting experience as an RN before getting your NP? Or go right into getting your NP after you graduate with a BSN?
   • This is a very heated debate in the NP world!  There are advantages to both situations.  For me, I absolutely believe you need some experience.  I was able to take my years of experience with me into my grad school and I truly believed it helped me through the process. I know I could not do the job I am doing now if it wasn’t for the years of experience in the PICU, my experience is what got me the job.  As a new grad RN, you are learning the fundamentals of nursing care. It takes at least two to three years before you feel like you have the hang of it.  I do not recommend going for your NP until you have at least five years of experience.Now with that said, the NP I work with went straight through from RN to NP.  She only had a total of three years as a nurse before she became an NP. She is an excellent provider and my mentor.  What I have noticed is she has been in the provider role for so long that she has lost her touch with the RN role.  I loved being an RN, I still help out the nurses from time to time just because it’s still my passion.  I also love my role as an NP, to me I get the best of both worlds.
2. What does a day in the life look like working in peds as an NP?
   • My typical day starts around 0630 with handoff from the night call resident.  We discuss how the patients did overnight and I get an update on the patients I will be caring for during the day.  I then do a chart review on my one or two patients and formulate a plan for them for the day then head off to go assess them. I sometimes make changes to their plan of care at this time or I wait until we round as a group.  Around 0830 we start PICU rounding with the PICU attending doctor, all the residents, myself, the charge nurse and the bedside nurse.  We go to each patient and discuss the plan for that patient for the day.  Depending on how sick they are, depends on the plan and how long we spend discussing the patient.

     After rounds, I update my patient notes with the daily plan.  I am also responsible for knowing the plan of not only my patient but all the patients on the unit.  The attending doc relies on the NP to know what is going on at all times.  This can be very stressful especially if we have a lot of patients.  Usually, after lunch, I check on the patients to make sure the plan we discussed in the morning is being carried out or if there is a problem with the plan.  I also am responsible for responding to code blues and PRT (patient response team) which is similar to a code blue, but the patient is typically stable but needs closer attention.  The PICU can be very demanding, but very rewarding.  I do get to spend more one on one time with my patients that the attendings do not have time for.  My favorite are the little ones under five as they most often have the best outlook on what we are doing to them, if not you cheer them up with a Disney movie or a sticker!

3. What are you able to do differently now that you are an NP vs. when you only practiced as an RN?
   • It was definitely a challenging transition from bedside/charge RN in the PICU to nurse practitioner in the PICU!  The first few weeks I had a difficult time not being the “RN” The biggest change is being able to make the plan for care for the patient and to carry it out.  I get to make the decisions on how to manage the patient.  While I was respected as seasoned RN and often made suggestions on what needed to be done for the patient, now I am in the position to actually do so.  What I love the most is making a plan that ultimately provides the best practice in caring for the child.  Knowing that I was involved in making the decisions in care that made that patient better is so uplifting!  I was very worried about my fellow RNs handling my transition to the provider role, but they have all been very supportive.  They respect the decisions I make, as they have all worked with me for so many years and respected me as a bedside nurse. Again, this goes back to my feelings about needing experience before going back to school.
4. What experience in nursing do you recommend getting during nursing school that would provide the best learning before graduation?
   • Work as patient care assistant (PCA)/nursing assistant while in school.  Just like I recommend having a few years of nursing experience for grad school, I believe you need some time as a PCA to learn the fundamentals.  You get to see firsthand what a hospital environment is like.  While you do get this obviously from your practicums, it is different when you are working the long 12 hours in the hospital.
5. What job did you get when you first graduated and what was the process for applying/getting the job?
   • As a nurse, I started in surgery as a PCA.  I was hired on about 3 months before I graduated with the promise of a nursing job in the OR when graduated.  I got the job when I was doing my pediatric rotation.  I approached the nurse manager one day when I was in clinicals and asked if they were hiring nurses.  My preceptor I had in the OR gave me a great recommendation.

     About a month after I graduated I was approached by my medical director of the PICU.  I have worked with him for 14 years and he asked if I would be interested in staying on in the PICU as an NP.  Originally, I had planned to work with a friend of mine who is a vascular surgeon as his NP.  I was blessed with two job opportunities. Since my first love is obviously the PICU, I chose to stay!

     My biggest suggestion is to find a place that you want to work and start as a PCA.  This is the best way to get your foot in the door.  The next best option is having someone you know give you a recommendation!

I was able to directly talk to two nursing students these past two semesters. First, was my LAMP leader, Devon Bartlett. We met often and talked about how to study best for classes, talked a lot about backup plans, and also how to get involved in organizations and programs that best prepare me for nursing. She told me about how she got involved in NSPIRE, an organization for nursing students that helped prepare her for different things you have to do as a nurse, such as taking blood pressure. She was able to give me a lot of insight on the nursing classes she is in right now and talked to me a lot about clinical. She told me what to expect, such as having to do things you don’t necessarily want to, such as catheters. Devon also told me about her service trip she did after her first year at OSU. She said it really helped her see what she wanted to do as a nurse. I was able to get a better sense of the nursing major and also what I should do to prepare myself individually.

I was also able to talk to Sarah Cain, a current second-year in nursing as well as Devon. We talked a lot about clinical and how I was nervous to start them. She told me that her first day she was so nervous and patients noticed but assured me that once you started going more, it got easier and she became more comfortable. She also told me that nursing classes are definitely harder than classes I have ever taken before. She was able to give her own insight on how much she has to study and work. It was very obvious to me after talking to her that nursing classes take up a lot of time and energy. It seemed like most of her time was devoted to some class she was taking at the time. Sarah also was very helpful with telling me how to handle scheduling with nursing and how to handle what comes in the next couple of months. Talking to Sarah definitely made me more confident as she assured me that I had a good chance of getting in. She also gave me the motivation to work really hard as I realized how soon the next year will come.

I loved talking to both of these girls and found myself excited and ready for what is to come. Now, I just have to wait and see if I get in! Fingers crossed.

As I came to The Ohio State University, I wanted to get involved as much as possible with service. I knew Health Science Scholars would help lead me on the path to getting the service I desired. This year, I was able to do a wide variety of service, ranging from washing homeless individuals feet to helping Girl Scouts sell their cookies to helping clean cat cages for a cat shelter. The most memorable service experience for me had to be washing homeless peoples’ feet. I was able to see the change directly and right away. It really opened my eyes to the troubles that are around us and allowed me to appreciate my life as these individuals appreciated a simple foot bath so much. My role in this was to bring a positive attitude and give these people a safe place to relax, enjoy their time, and also be pampered, as everyone deserves that every now and then. I gained a new understanding of appreciation and gratitude after this experience.

The service opportunities I had were volunteering for 5 hours at a cat shelter for Community Commitment with people from scholars, helping with a blood drive for 1 hour for Red Cross outside classrooms, made bracelets for children in hospitals for a total of 4 hours with Buckeyes for a Cause in a classroom, washed homeless peoples’ feet at Saint Sophia’s shelter with nursing students for 2 hours, made packed lunches for the homeless with girls from my sorority for 2 hours in our sorority house, sold Girl Scout cookies with an organization for 1 hour on High Street, welcomed future students with Welcome Buckeyes for 2 hours in the Union, and watched children whose parents have cancer for 3 hours with Camp Kesem at a park. As you can see, my year was full of service, and I couldn’t be happier with how it turned out.