Podiatry student looking at NP or PA

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allsop123

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Long story short, I was not happy in the field of Podiatry because I chose it for the wrong reasons. I have been miserable since first year ended. I officially withdrew few days ago. I was in my 3rd year. Because my desire was dwindling over the years, my grades progressively dropped lower and lower which culminated in me not passing boards this July. Talking with the dean, he mentioned that this will be an uphill battle with residencies. It would be a tough road...which would be fine if the fire to become a Podiatrist was still burning inside me.

I have racked up a little over $100k in debt but I know I made the right choice. This was a hard choice but it was the first choice I was able to make myself and not pushed into something by my family. It has been an amazing learning experience!

I am now deciding between NP and PA programs and I would like to ask some insight from this forum. The school I went to for Pod had an integrated program with DOs for the first year so I was able to do well in the science type courses. I was able to talk to the dean and the PA director at my school who were both willing to write letters of recommendations. I have already begun studying for the HESI and GRE exams as I want to do the best possible.

I have also started looking at my options for HCE. I have no Paid Patient Experience only volunteering, shadowing and the little 3rd year clinic I did while in Podiatry. This means I would need to get a CNA certification (or PCT, CMA, etc) first and then start my HCE hours. Some schools require 2,000 hours which would put a detriment on applying to these schools. Unless I'm missing something, this is one factor that is pushing me away from PA school or at least limiting my options.

Other pertinent information would be the debt I am in and possibly my age, 29 years old with no family obligations.

Any advice you may have for either programs, I would greatly appreciate it as it would help me make an informed decision!

Thanks!

edit:
I figure I would add this as it may bring in some new insight.

My brother is in his fellowship for cardiothoracic surgery and is currently working nearly 100 hours/wk. I thought I could be like him, hence why I applied for DO/MD and had a "passion" for surgery. Being in Podiatry, I realized that surgery isn't for me and that I could never do foot wound care nor could I work insane hours. I have other interests like raising a family, focus on myself emotionally and physically.

I am now actually considering OT school as well. It was a distant 3rd on my priority list but it's something I am further looking into. I read the following post by a member and it intrigued me to put OT school higher on my list:

"... In fact, due to the long term therapeutic relationships you may develop with your OT patients, that might even be a more satisfying environment where you will see lives become more impacted by the work you do than the urgent care patient that comes in to have you write them a prescription and send them on their way to recover."

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Long story short, I was not happy in the field of Podiatry because I chose it for the wrong reasons. I have been miserable since first year ended. I officially withdrew few days ago. I was in my 3rd year. Because my desire was dwindling over the years, my grades progressively dropped lower and lower which culminated in me not passing boards this July. Talking with the dean, he mentioned that this will be an uphill battle with residencies. It would be a tough road...which would be fine if the fire to become a Podiatrist was still burning inside me.

I have racked up a little over $100k in debt but I know I made the right choice. This was a hard choice but it was the first choice I was able to make myself and not pushed into something by my family. It has been an amazing learning experience!

I am now deciding between NP and PA programs and I would like to ask some insight from this forum. The school I went to for Pod had an integrated program with DOs for the first year so I was able to do well in the science type courses. I was able to talk to the dean and the PA director at my school who were both willing to write letters of recommendations. I have already begun studying for the HESI and GRE exams as I want to do the best possible.

I have also started looking at my options for HCE. I have no Paid Patient Experience only volunteering, shadowing and the little 3rd year clinic I did while in Podiatry. This means I would need to get a CNA certification (or PCT, CMA, etc) first and then start my HCE hours. Some schools require 2,000 hours which would put a detriment on applying to these schools. Unless I'm missing something, this is one factor that is pushing me away from PA school or at least limiting my options.

Other pertinent information would be the debt I am in and possibly my age, 29 years old with no family obligations.

Any advice you may have for either programs, I would greatly appreciate it as it would help me make an informed decision!

Thanks!

Go PA. NP is too long a road from where you are now. I wish you the best of luck.
 
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RN vs PA/MD

Reading that post is a bit daunting. I generally do well under pressure but that being a typical day scares me.
 
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I would go RN if I were in your position. There are ABSN programs and direct entry MSN programs for individuals like you. If you were to go for PA then you would need to spend a minimum of 2 years gathering paid HCE to even be considered for an interview. Generally, nursing school admissions are more lax compared to PA school admissions. In the time you were to spend gathering your HCE, you could have a RN license already.
 
I would go RN if I were in your position. There are ABSN programs and direct entry MSN programs for individuals like you. If you were to go for PA then you would need to spend a minimum of 2 years gathering paid HCE to even be considered for an interview. Generally, nursing school admissions are more lax compared to PA school admissions. In the time you were to spend gathering your HCE, you could have a RN license already.

Would I really need to spend 2 years? I would start asap with a paid HCE, perhaps sometime in October and continue until needed. I would have the backing of my dean and the PA director at my Podiatry school. Along with the fact that I could handle the first year of classes in PA school with relative ease as these were the same classes I took in my first year of Podiatry
 
Would I really need to spend 2 years? I would start asap with a paid HCE, perhaps sometime in October and continue until needed. I would have the backing of my dean and the PA director at my Podiatry school. Along with the fact that I could handle the first year of classes in PA school with relative ease as these were the same classes I took in my first year of Podiatry

I know my old PA program wouldn't consider you with your red flag. I would recommend another licensed healthcare profession first and then applying to PA school and even then your chances are low of being accepted.


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$100K in debt already....you've dug yourself into a DEEEEEEP hole! At 4.5% interest your loan repayments are going to be a little over $1K already.

Average RN salary in the US is about $67K, but new nurses probably average $40K/year. You're single, so that's $35K after taxes. You would need 2 more years of school to get to there, hopefully you would be able to go to a very cheap on-line school and work full time (delivering pizzas or whatever) until you graduated and not add to your debt. So at least 1/3 of your income will be going to student loans. Good thing is as an RN you can pick up extra shifts, work 7 days a week, and probably increase your income to $70K/year and pay your debt off in 6 years instead of 10 so you can start living your life.

Average PA salary in the US is about $90K, with new grads probably at about $80K/year. Very, very, very, very difficult for you to get selected into though. Also, many PA schools are exorbitantly expensive...avoid those at all costs cause you're already relegated yourself to poverty for years. If you could get into an inexpensive (<$40K) PA program then this may be the better choice. PAs can also work extra shifts & such and can make $150K+ a year. If you did this you could likely clear your debt in 3-4 years after PA school, which is still 6+ years away but better income after that.

I dunno what the best answer for you is...but stop digging yourself into a debt trap cause you're already wayyyyy deep in that hole.
 
RN salaries vary significantly by location. Expect to start at around 50,000 per year. However, working 3 days a week gives you the ability to work agency and make close to 50 per hour. There are a lot of opportunities to make money as a RN.

If you decide to go RN go a direct entry masters program. After you pass NCLEX get a bedside nursing job while you complete the program. The waiting list for technical schools in my area literally takes years. It's possible to be a NP in 4-5 years, but it won't be cheap.

I would pursue PA first.
 
I'm a little fuzzy about where you want to apply for PA school. Are you gunning to apply at a program associated with your own school?

I think the PA guys might be right about you being red flagged at PA schools. They would have a better grasp of how that works more than anyone else. The only exception to the red flag might be at a PA school directly associated with yours. Other than that, you really can't assume that the letters from your program director or the PA program director will hold as much sway as you hope, because they really should be confidential for them to have impact. You have no way of knowing what they would say in a confidential letter, especially if they pity you because of the situation you are in. A student would ideally want stellar letters, and you should keep in mind that you made it 3/4 of the way through a program and bailed. Any letter from them would be tinged by that fact. They really couldn't give you unreserved support, and you should take a second to imagine what they could possibly say about you that would negate the fact that you are trying to find out what career suits you. For example, they wouldn't be able to speak much towards your academic abilities, because you would have performed better if you had an easy time with school. They can't speak to your passion, because you are letting yourself be blown around by shifting winds in your head as to what you want to do every day at work. Keep in mind, whether you are an NP, PA, or podiatrist in clinic, your day will pretty much involve a lot of the same things. Anyone writing you a letter would have to wonder how much different you would fare as a PA, OT, or NP versus being a POD... the daily grind in each is very similar (with the exception of a POD running the show in surgery, which you said you hate the idea of doing). Day to day you will go in, talk to a patient, work things up, prescribe, and move on to the next. You just walked away from the career that would give you the most income, and are going to substitute it for something that will take more time, money, and effort to pursue so you can go be someone elses employee. I'd go back and try to get back in to POD school.

At the core, you need to change your mindset into one of ownership over your life and career rather than looking for the career or situation you are in to dictate how satisfied you will be. You will never be satisfied unless you do this, because the world around you isn't going to cater to you to make you happy. Your patients certainly will not care about how happy you are. So its concerning that you give the impression that you are looking for the job that will make you happy. Make your own magic here. If you were talking about leaving podiatry to go after something like business, or something a lot different, then sure.... there's going to be a big difference in how the careers play out. But all the options you are mentioning are clinical positions where you work with patients in some form.

But don't despair. Its clear you have some angst surrounding all the issues you are sorting through. Your situation in pod school sounds like you were boxed in, and going back to that and making something out of it might not be an option if internships and residencies are out of reach. Since you asked me in the PM for my advice, I'll lay out my suggestions, and it will be up to you to look into how any of them fit with what you have on your plate.

This is a long post, and will get longer, but I type fast, and its only you who has to read through it.

If I were you....

I'd try to get back into pod school. That may not be an option, and its ok if its not, because then you can skip to the next suggestion. They might not let you go back, or you might not get any good residency if you did because of your grades, or the failure of the boards might have closed that door. I don't know any of those details, but that would be my first choice, mostly because its ground you at least would be familiar with. Only you know, and that's a call that you are best positioned to make. Podiatry isn't as awesome as some folks hope it to be, but it can be if you hustle. Most of the pods I know do well... at least better than most of the PA's and NP's that I know. But the debt can be quite high. For saying you are only 100K in debt, thats really not too bad considering almost all the PAs i know have at least that much, and even some RN's I know have that much. Anyway, its a thought.

Second option I would pursue is NP.... preferably a direct entry program. They aren't cheap, but they are at the very least as cheap as almost any PA program you could hope to get into. Yes, there are cheap state school PA programs, but everyone wants cheap PA school, so those tend to be the most competitive. You aren't in a position where you will want to rely on luck from here on out, so my advice centers on plans that will offer the most certainty. Direct entry NP school will be even easier for you to go through because you have some significant premed and pod school knowledge. Life in DE NP school won't be as hard for you because of what is in your head already, and you can get out and enjoy yourself more. When you complete the RN portion of the DE program, you will be able to work more as an RN and pay down debt. At the end, you are an NP. Find a state where you have independent practice rights (half of states are like this), and start working. Total debt after 3 years is $100,000 added to the $100,000 you already have. You will be able to work after you get your RN, and can use that to offset your debt. Lets assume you can put $15,000 per year for a year and a half working as an RN (say you take it easy and don't work like crazy as an RN so you can focus on school). If you can put $22,000 per year towards your debt you will be looking at roughly $178,000 debt after 3 years, and then you will be starting at around $85,000, and making $120,000 within a few years if you hustle as an NP. I'm assuming that living expenses will mostly be covered with your RN wages once you are done with your RN portion of the RN to NP program. If not, add in living expenses on top of that.

Third option, go to an accelerated BSN program and get your RN in a year. Then go to work and immediately start an NP program while you work. I live in a place where nurses make about average for the nation. If you start at $40,000 a year as an RN, you are making $19 an hour.... I honestly would have to look really hard nationwide to find a place that paid that low for even a new grad. The lowest I've heard of a new nurse making in the last 2 years is $27 dollars an hour as base wage. Any nurse working nights or weekends makes quite a bit more in differential. Where I work is pretty much middle of the road as far as wages... maybe even a bit less, and if I worked nights and overtime one day per week, I'd easily make more than a new grad PA or FNP (and might be working less hours than them), and I've been a nurse less than 5 years. If you do the accelerated BSN and then the NP, you would be out and practicing as an NP in probably just over 3 years. The cost of doing this could be fairly steep if you go to an expensive accelerated BSN program, but NP school after that is very affordable. I've seen them as low as $20,000, but I wouldn't limit myself to ones that cheap. $30,000 is what I would expect. So if you do a $45,000 accelerated BSN, then a $30,000 NP program, and work making $75,000 for two years as an RN through your NP program, you are that much farther ahead financially. You've added $75,000 on top of your $100,000 debt, but made $125,000 in the meantime as an RN (but obviously you have to subtract from that $125,000 for living expenses for 2 years). But then at the end of 2 years working as a nurse, you are looking at NP wages, and in a few years could be making $120,000 as an NP if you are hustling. I think at the core you would be looking at $175,000 in pure debt, and subtract from that what you would have been able to put towards the debt during your two years as a nurse. Assume you could put down about $20,000 per year towards your debt, and you are looking at $115,000 of debt from this route after 3 years.

3rd option is PA. You probably have all the prereqs. I'd give it a try no matter what because its a good option. I would expect to pay at least $100,000 for tuition and fees, and then include in whatever you think your living expenses would be. For me, I would expect to pay at least $50,000-$60,000 on top of that for living expenses for 2 years (which I still would feel like would be low). That puts you $150,000 in debt and added to the $100,000 you already have, thats $250,000 in debt. But you start making $85,000 the first year as a new PA, and then within a few years can be making $120,000 if you hustle.

OT can actually be pretty expensive depending on where you go. It would probably be hard to work during the program as well. I would imagine that you would be going into debt at least $60,000 for tuition and fees, but I really don't know. I don't know how lucrative it is either. I have two friends that are OT's, and they seem to do ok. I would guess that they make between $80k and $100k. I get the impression that if you hustle, you can do even better. I just don't know much overall about the tuition one can expect, or the wages. They do seem to have plenty of jobs out there for them. My friends seem to like their jobs as well. I can't really speak much to the OT thing, but there are boards on here that have plenty of folks that can. But I think that OT school will be a lot different of an approach than what you are used to. They take some decent sciences, but they also deal with a lot of theoretical approaches that might be more akin to what you would see in psychology. Not the same, but just those kinds of classes.... more like PT I guess. I would guess they would be a closer match to PT school than PA or NP school.

I suggest applying to PA school, and to direct entry NP programs, and accelerated BSN programs. I would not waste an time trying to get health care experience for PA school... that's just that much less time and risk of wasted time for you. I'd hate to see you go become a CNA or paramedic, and still struggle to get into PA school. At this point, shoot for sure things. Apply to any PA program that doesn't care much about HCE.... there are PLENTY of them that do not care. There are PLENTY more that just require a very token amount of minimal entry level HCE. Taken together, those "no or low HCE" programs comprise the majority of PA programs. PA is already going to be the most expensive choice you have, as well as the one that will be the least certain. I wouldn't chase it too hard. Applying is arduous, though, and you won't want the same letters of recommendation for nursing schools that you would use for the PA program. Its going to be a pain, to be honest. CASPA is the centralized application service PA programs use, and its a full body cavity search. Honestly, the most bang for your buck will come from either direct entry NP, or an accelerated BSN and then an NP program.

Usually, the money thing points to nursing. Plus, nursing gives you a ton of options if you don't like what you are doing.
 
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$100K in debt already....you've dug yourself into a DEEEEEEP hole! At 4.5% interest your loan repayments are going to be a little over $1K already.

Average RN salary in the US is about $67K, but new nurses probably average $40K/year. You're single, so that's $35K after taxes. You would need 2 more years of school to get to there, hopefully you would be able to go to a very cheap on-line school and work full time (delivering pizzas or whatever) until you graduated and not add to your debt. So at least 1/3 of your income will be going to student loans. Good thing is as an RN you can pick up extra shifts, work 7 days a week, and probably increase your income to $70K/year and pay your debt off in 6 years instead of 10 so you can start living your life.

Average PA salary in the US is about $90K, with new grads probably at about $80K/year. Very, very, very, very difficult for you to get selected into though. Also, many PA schools are exorbitantly expensive...avoid those at all costs cause you're already relegated yourself to poverty for years. If you could get into an inexpensive (<$40K) PA program then this may be the better choice. PAs can also work extra shifts & such and can make $150K+ a year. If you did this you could likely clear your debt in 3-4 years after PA school, which is still 6+ years away but better income after that.

I dunno what the best answer for you is...but stop digging yourself into a debt trap cause you're already wayyyyy deep in that hole.
Current unsubsidized graduate loans are 6-7% so the OP is in a modestly deeper hole than you estimate. Agreed that $100k is nothing to sneeze at, though!
 
My advice is try PA first. If you are unsuccessful start a new thread and the current NP students can give you more specific advice.
 
Another person to ask is your brother. You might have done that already, and that might have gotten you to this point. I think you have good options, though. You might be stressed out and depressed, but take a step back and relax.
 
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Another person to ask is your brother. You might have done that already, and that might have gotten you to this point. I think you have good options, though. You might be stressed out and depressed, but take a step back and relax.

Thank you so much for your amazing insight. I really appreciate it!

I'm actually looking to move in with my significant other. She has graciously opened her home and offered to help pay some of my loans when my forbearance ends in 6 months so I can pick myself back up. With this option, Nursing is my only outlook as there are no PA/OT programs in Reno, NV. One of the schools has a program for BSN (Bachelor of Science in Nursing (BSN) | University of Nevada, Reno) and the other is a CC that has offers only an associates (Nursing Program - Truckee Meadows Community College). Looking at the deadlines, it would be hard pressed to get my withdraw completely finished (some financial aid hang ups), move to Reno, fill out applications for the program, study for HESI and apply. With the short amount of time, it looks like I will not be in school until next Fall because it's a huge time crunch applying for Spring. If I decide to go this route, what potential jobs could I pick up until next Fall? CNA, paramedic, some sort of hospital tech?

Again, thanks so much!
 
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Thank you so much for your amazing insight. I really appreciate it!

I'm actually looking to move in with my significant other. She has graciously opened her home and offered to help pay some of my loans when my forbearance ends in 6 months so I can pick myself back up. With this option, Nursing is my only outlook as there are no PA/OT programs in Reno, NV. One of the schools has a program for BSN (Bachelor of Science in Nursing (BSN) | University of Nevada, Reno) and the other is a CC that has offers only an associates (Nursing Program - Truckee Meadows Community College). Looking at the deadlines, it would be hard pressed to get my withdraw completely finished (some financial aid hang ups), move to Reno, fill out applications for the program, study for HESI and apply. With the short amount of time, it looks like I will not be in school until next Fall because it's a huge time crunch applying for Spring. If I decide to go this route, what potential jobs could I pick up until next Fall? CNA, paramedic, some sort of hospital tech?

Again, thanks so much!
Paramedic is a year of school after you get your EMT. CNA is also more school. In my area it is possible to work as a ER tech without formal education. This may be a good fit for you with your years of education.

If going nursing check out the cc first. Honestly, as cost is an issue, becoming a ADN and letting your future employer pay for your BSN is the smartest route. Make sure you ask the right questions before you enroll, and find out what their petition program consists of. It might be a wait.
 
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I started off nursing by going to a community college associates degree nursing program. The upside is it cost less than 10 grand, and I walked right in because I already had all the prereq classes. The downside to that is that even though there are programs for NP school that allow a bridge between an associates degree and the masters, they are more rare, and it limits your options for NP school vs getting a bachelors in nursing. I went on and got a BSN through a ASN to BSN bridge, which added extra time. Additionally, the BSNisbecoming the preferred degree that employers want, and some even require it. One hospital in my area actually told me they wouldn't process my application as a new grad nurse because I only had an ASN. If I had experience, they would have looked at me, but they still would prefer the BSN. But if you don't mind the extra time and the possibility of some work limitations, the community college nursing option is decent. But for me, it delayed my ultimate goal by a year or two. On the flipside, I have no debt from school (and never have). My employer paid for my ASN and I worked while they paid for my BSN.
 
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CNA can be a 10-15 day course in some places. Some ERs hire CNAs as techs. With your background and a CNA certificate (some states call them licenses, others call them certificate but whatever Nevada BON wants is discussed here) you might have a chance to be hired. I know a current NP who was an ER tech while in nursing school and parlayed it into a prestigious ER RN Residency at a Level I ER and then NP school a year after. As an ER tech, she saw everything and functioned as a triage nurse and student nurse with the docs very happy to help her learn things that student nurses don't normally get exposed to.

@pamac and @IknowImnotadoctor have the right story on CC and ADN programs.

If you get a full-time hospital CNA or tech position and they will pay some for tuition reimbursement, that is hands-down the cheapest way to an RN. But it is slower than a BSN or an accelerated BSN.
 
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CNA can be a 10-15 day course in some places. Some ERs hire CNAs as techs. With your background and a CNA certificate (some states call them licenses, others call them certificate but whatever Nevada BON wants is discussed here) you might have a chance to be hired. I know a current NP who was an ER tech while in nursing school and parlayed it into a prestigious ER RN Residency at a Level I ER and then NP school a year after. As an ER tech, she saw everything and functioned as a triage nurse and student nurse with the docs very happy to help her learn things that student nurses don't normally get exposed to.

@pamac and @IknowImnotadoctor have the right story on CC and ADN programs.

If you get a full-time hospital CNA or tech position and they will pay some for tuition reimbursement, that is hands-down the cheapest way to an RN. But it is slower than a BSN or an accelerated BSN.
Out of curiosity, what is a "RN Residency"?
 
Out of curiosity, what is a "RN Residency"?

It is a program for newly graduated/licensed RNs. Many hospitals won't hire new RNs except through residency programs as they don't consider newly minted RNs to be ready to be on their own immediately. Some are more formal than others, most include classes and assigned mentors. They last 9-12 months or so. The RNs are paid just as normal, accrue sick time and vacation time and are otherwise full employees. Most residency programs only accept BSN grads.

They range in prestige from Vanderbilt, Emory, Mayo, Wake Forest, Baylor and Barnes Jewish to your local hospital that is not affiliated with a university.
 
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RN residency programs are a relatively new thing in the nursing world and, as such, are generally found in the larger, more bureacratic, nurse management-centric areas.

Not sure that the pay is the same for a new nurse vs a nurse going through a residency. My wife did a leadership paper on this subject when working on her BSN (which seemed to be half leadership/management papers), and I seem to recall thinking they were paid less.

As to being "prestigious"....I think that term comes from their marketing committee. To earn the title "prestigious" generally means you have a long track record of proven success so that most people want to be associated with you. Not sure any RN residencies fit that description yet.
 
When I'm talking about prestige, I'm talking about the ranking of the hospital/university and how many applications the residency program gets. Obviously, my definition of prestigious may be different than other people's definitions. And I disagree that RN residencies are unproven, and since it's not a nationwide requirement for licensing like for MDs, I'd venture to say that Barnes Jewish and Vanderbilt consider their own nurse residency programs to be a PROVEN success. Vanderbilt's is 10 years old.

Most nurse residents get paid according to the hospital's pay scale and probably on average make the same as new BSNs that are hired by local hospitals in the same area of town. My main point there was it's a residency but not an unpaid internship - they are full employees earning a wage.

Boatswain - I don't have a problem with you but you seem to want to pick apart anyone who has a pro RN or pro-NP bent or poster who say NPs are good mid-level providers and it gets a bit tiresome. I've said before, I'm not pro NP or pro PA - I try to look at the mid-levels with an unbiased eye.

Anyway, apologies to the OP. I was just answering SpartanWolverine's question with my own knowledge.

RN residency programs are a relatively new thing in the nursing world and, as such, are generally found in the larger, more bureacratic, nurse management-centric areas.

Not sure that the pay is the same for a new nurse vs a nurse going through a residency. My wife did a leadership paper on this subject when working on her BSN (which seemed to be half leadership/management papers), and I seem to recall thinking they were paid less.

As to being "prestigious"....I think that term comes from their marketing committee. To earn the title "prestigious" generally means you have a long track record of proven success so that most people want to be associated with you. Not sure any RN residencies fit that description yet.
 
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Ugh... Nurse residencies. That's an idea that probably should go somewhere and die.

Most nursing initiatives I've been involved in have been thesis or capstone-ish projects for other nurses to use so they can move up the management ladder, or else fulfill a requirement for a degree. Coming in a close third are the academic nurses who want to bolster their credentials so they can land consulting gigs or become a dean. Next thing you know staff nurses are jumping through hoops and wearing trackers to make sure we spend so many minutes in a patient's room, or fill out paperwork in duplicate, or initiate an unnecessary intervention on every single patient.... because some fool did a "research" study with terrible methods that "Surprise!" reinforces an activity that improves patient satisfaction and or saves the hospital a little bit of money. Go figure that most hospital patients these days like lots of pain medication, and want to be treated like they are the center of the universe in the hospital. But on the flipside, now we know it's bad to give patients everything they want at the expense of what they actually need.

Residencies rate up there with other ways hospitals try to hold on to new nurses instead of having to improve working conditions and pay them commensurate to the crap they put up with. "Oh you can't leave to go to a different hospital that pays better and ruin our nurse turnover numbers because we put all these resources and effort into training you in our prestigious residency, so you'll have to pay us back prorated for what we put into you if you jump ship". That's an RN residency, folks. Maybe add in that they pay you less for their trouble, and you get a pin you can add to your name tag like they do for the hospitality residents in training at TGI Fridays. Not long after a nurse residency runs its course and a nurse can then become a free agent, they leave for a better paying job or start working on going to NP school.

Nurse residency....
 
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That's a pretty cynical reply, but overall, I just don't see what the nurse is suppose to get out of that, when a decent orientation is really all a nurse needs (and should expect to get from day one). It's like saying "here's a super duper orientation instead of just merely a good one". Is an institution's way of retaining new nurses who really won't come out of that any better than a nurse with some experience behind them. It's all to help the facility. Would they take a nurse with 3 years experience and say "congrats, let's give you a residency and make you a better nurse". Nope. Because they are already fully competant, except of course for the nurse that boatswain knows that never learned what an EKG was before becoming a DNP.
 
Another thing about new nurses. Yes, we tend to be pretty scary when we are brand new. Why would a hospital risk having them around? Lots of reasons. For one, they are warm bodies. You have a medical floor with 25 patients, that means that you need to come up with 4 or 5 nurses. You can get by with literally 3 new grads, 1 or 2 nurses that know petty much how to do nursing, and one charge nurse that runs around like Mr Magoo's dog trying to keep things from falling off the cliff. Life goes on and you do it again the next night. Experienced nurses know their options, know their worth, and an detect when they being BS'd, and admins don't neccessarily want that around. It's sometimes easier to have a teachable, compliant new nurse that doesn't have work arounds for stupid initiatives, as well as still holding a deep fear of the bosses.
 
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When I'm talking about prestige, I'm talking about the ranking of the hospital/university and how many applications the residency program gets. Obviously, my definition of prestigious may be different than other people's definitions. And I disagree that RN residencies are unproven, and since it's not a nationwide requirement for licensing like for MDs, I'd venture to say that Barnes Jewish and Vanderbilt consider their own nurse residency programs to be a PROVEN success. Vanderbilt's is 10 years old.

Most nurse residents get paid according to the hospital's pay scale and probably on average make the same as new BSNs that are hired by local hospitals in the same area of town. My main point there was it's a residency but not an unpaid internship - they are full employees earning a wage.

Boatswain - I don't have a problem with you but you seem to want to pick apart anyone who has a pro RN or pro-NP bent or poster who say NPs are good mid-level providers and it gets a bit tiresome. I've said before, I'm not pro NP or pro PA - I try to look at the mid-levels with an unbiased eye.

Yes, different description of prestigious. The Medal of Honor is a prestigious award. The Nobel Peace Prize (used to be) a prestigious award. Harvard, Yale, Oxford are prestigious schools. All these have >100 years of history behind their prestige.

I don't pick apart RNs or nurses at all. I'm married to one, and good nurses are worth their weight in gold.

And I don't pick apart NPs. I've said many times some of the best providers I have ever worked with were NPs.

But I do pick apart NP education because it's a joke. Too many leadership papers (see Pamac's post) and ridiculously flawed studies for capstone projects get in the way of learning enough medicine.

It's kinda funny you claim I bag on nurses, then Pamac lays down the truth about RN residencies....
 
It is a program for newly graduated/licensed RNs. Many hospitals won't hire new RNs except through residency programs as they don't consider newly minted RNs to be ready to be on their own immediately. Some are more formal than others, most include classes and assigned mentors. They last 9-12 months or so. The RNs are paid just as normal, accrue sick time and vacation time and are otherwise full employees. Most residency programs only accept BSN grads.

They range in prestige from Vanderbilt, Emory, Mayo, Wake Forest, Baylor and Barnes Jewish to your local hospital that is not affiliated with a university.
Ah, I see. Thanks for your response! There really seems to be pretty intense inflation in the requirements for RNs these days... (for example, my mom a diploma RN with 15 years of experience could not, for the life of her, find a new position that did not have a hard requirement for a BSN.) Guess the 'nursing shortage' isn't as much a thing as they make it out to be.
 
This thread is going off the rails. The typical gas lighters are gas lighting. Going the cc and getting your ADN then letting your employer pay for the BSN is the smartest financial move.

If you go this route, however, you will most likely need to earn your BSN before you can become an inpatient RN, so you may have to start in a clinic. It's the price of a cheaper education.
 
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Yes, different description of prestigious. The Medal of Honor is a prestigious award. The Nobel Peace Prize (used to be) a prestigious award. Harvard, Yale, Oxford are prestigious schools. All these have >100 years of history behind their prestige.

I don't pick apart RNs or nurses at all. I'm married to one, and good nurses are worth their weight in gold.

And I don't pick apart NPs. I've said many times some of the best providers I have ever worked with were NPs.

But I do pick apart NP education because it's a joke. Too many leadership papers (see Pamac's post) and ridiculously flawed studies for capstone projects get in the way of learning enough medicine.

It's kinda funny you claim I bag on nurses, then Pamac lays down the truth about RN residencies....

That's very nice of you to have kind words for the nursing world. As nurses, we like PAs, and likewise feel that a good PA is worth their weight in gold as well. They really are a great supplement to the healthcare team as physician extenders, and definately have a place among the rest of us ensuring patients have adequate care.

RN Nursing education is robust, and RN work is very robust, at least in the acute care setting.
NP education lacks a bit, but then again, I'm someone who has been in on countless codes, whereas the typical PA and PA student has not unless the were a paramedic in a previous life, which fewer and fewer are. But RN residencies are something I'm suspicious of, because I'm rabidly pro me, and I see things through the perspective of a zero sum game between admin and staff. I feel like the residency for nurses should be the orientation, and if there is a hard core residency at a hospital, that should just simply be how they orient everyone rather than play games and call it a residency.

i really don't find myself in fluff classes. The ones that have been haven't been the ones specific to patient care. The classes that should be hard are hard.
 
Just two things about RN residencies and then I'll stop. PAMAC, I seem to recall you had a career prior to nursing (that is, you didn't get your first RN job right out of your first college degree and/or at age 22-23). The target market for nurse residencies are grads who haven't worked before and want a challenge or want to ensure that they start at a hospital that otherwise wouldn't hire a new grad. Yes, it may benefit the hospital more than the new grad and you obviously are looking out for yourself. But I think it would be wrong for some new RNs to adopt your viewpoint and decline residencies just because some admins want to use it to their gain.

That's very nice of you to have kind words for the nursing world. As nurses, we like PAs, and likewise feel that a good PA is worth their weight in gold as well. They really are a great supplement to the healthcare team as physician extenders, and definately have a place among the rest of us ensuring patients have adequate care.

RN Nursing education is robust, and RN work is very robust, at least in the acute care setting.
NP education lacks a bit, but then again, I'm someone who has been in on countless codes, whereas the typical PA and PA student has not unless the were a paramedic in a previous life, which fewer and fewer are. But RN residencies are something I'm suspicious of, because I'm rabidly pro me, and I see things through the perspective of a zero sum game between admin and staff. I feel like the residency for nurses should be the orientation, and if there is a hard core residency at a hospital, that should just simply be how they orient everyone rather than play games and call it a residency.

i really don't find myself in fluff classes. The ones that have been haven't been the ones specific to patient care. The classes that should be hard are hard.
 
I'm cynical about them because I've seen them used mostly for retention purposes, but I'm sure when you see them at upper echelon institutions, it's much less about retention than they would be at a regional medical center trying to use it to manipulate new grads into sticking around. So in the context you presented it, yeah, it's probably about prestige and building impressive nurses from scratch to enhance the image of the school. Out where I'm at, it's to make sure the new grad that feels desperate for their first job doesn't get trained at one hospital and then leave after orientation and go to a different facility that pays better or is closer to home. You leave, and you lose out on whatever the contract stipulated, and it usually had to do with the facility insisting that new grads owe them for the awesome residency training they provided.

New grads are a bit expensive, but having them in the pipeline isn't as much of a drawback as people think. I've heard of one administrator that insisted that they would rather have a floor full of new grads or newer nurses that they trained there as new grads vs experienced nurses because that would make the new folks created in the mold they wanted. And true to that administrator's word, they followed through on that. Experienced nurses tend to know their value, are willing to leave more readily for better opportunities, and don't drink the coolaid.

Losing a nurse is also fairly expensive. It can cost up to $60,000 to train a new nurse hire. And turnover of nurses is fairly high, so plenty of hospitals end up needing to resort to new grads. I know many hospitals around me, including mine, are desperate. When they call me to beg me to fill in for someone on my day off, I don't take them up on it without the obligatory time and a half (obviously), but also a couple hundred dollars on top of that for my trouble, and I've yet to be denied that. If I come in so they can take a critical care admit, that's worth exponentially more than my request. New grads are warm bodies too. Supervisors are magicians. They can move people around to accomodate staffing crunches. The noobs cover the easy stuff while the heavy hitters get floated to make sure all the acuity is matched appropriately. But it's best to keep the new grads thinking they got a great opportunity by getting hired because "we don't usually hire a lot of new grads".

It's not that new grads can go around calling the shots and dictating terms to potential employers, but the whole thing isn't as precarious as they often come out of school thinking.
 
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I'd stick with podiatry. You've already gone through several years and $100k in student loans. It would be foolhardy to cut and run, now. You don't have to be a cutter if surgery doesn't appeal to you. Stick with clipping nails and scraping callouses. Put on the occasional cast / una boot, debride foot ulcers, and take off ingrown toenails. Straightforward, stuff. You won't get as rich, but you also won't have the stress of performing surgeries, either. Orthos will love you because you aren't stealing their surgeries, and will more easily refer to you.

I'd do RN before PT, as PT is pretty limited. And you've already shown yourself to be kind of wishy-washy. I'd go with something that has a larger scope of practice; and that would be nursing. If you don't like patients, you can always go into case management / Utilization review or research.
 
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