ICU Nurse to MD?

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GS2011

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Hello there. I will attempt to keep this brief but also provide sufficient information.

I am a 27-year-old RN, CCRN. I work in critical care (pulmonary/coronary), and I've been a nurse for six years. I am partnered and have no kids. I also will not have any kids, as I am with another man (and we do not want kids).

I have been accepted into graduate school for Adult-Gerontology Acute-Care Nurse-Practitioner.

I never actually wanted to become a nurse. In fact, as a child, I always claimed that I would become a physician. Eventually, after high school I went the nursing route, I immediately took my prerequisites, and applied to the associate nursing degree program at my community college. The decision to pursue a nursing degree was fueled by pragmatic reasons. I was the son of a single-mother, she held no college education, and we were also financially disadvantaged. I had three years of schooling and was able to clear 65-70K in Houston.

Time passed and I became complacent. I enjoyed the money I made, and I even stalled on my plans to pursue my BSN. I had eventual plans to become a CRNA or NP, and I knew I needed to get my BSN. So, here I am now. Six years later, I will be done with my BSN in July and start NP school in August.

However, obtaining this BSN has reminded me that I DO NOT like the nursing model. I am so tired of learning "nursing theory", I can't believe how heavily focused my BSN has been on psychosocial theories. I am not saying they have no value, but they absolutely BORE me to death and I feel so uninspired. I am so tired of writing essays about nursing/humanistic and psychosocial theories, and I feel like I am wasting my time, energy, and life on making beautiful papers.

My best experiences with academics so far have been taking my math and science courses (I took the science for science majors courses), and the nursing courses in my ADN that were clinically inclined (pharmacology, complex disease concepts, health assessment). Even THEN, I feel like I was deprived because the depth of learning was never too deep.

I want the education the medical student receives. I want to be challenged academically, I want to learn the human body in depth. I want to understand how we function down to the molecular level, I want to learn the pathophysiology down to the cellular and biochemical level. I want to feel like I am not wasting my time writing useless papers. I am afraid the MSN/NP route will be just an extension of the fluff, with clinical/science knowledge sprinkled in between with a few clinical hours. In fact, my friend is going to NP school and she told me her professor flat out told her not to worry about the details of how the drug works and just know the main points. That shocked me, and it saddened me. I want to know: How does this drug work? WHY is this the drug of choice? I want to understand, not just memorize facts and be a robot.

But I am also scared that I am just in love with the academic pursuit/knowledge of medicine/science, and that I will hate being a doctor. As a nurse, I've been so burned out, especially as an ICU nurse. I am not sure if I am just tired of caring for patients overall? burned out of ICU/critical care? or just bedside work/nursing? Sometimes I truly hate my job, it can be a great deal of stress. As nurses, we have our set of expectations, and I hope everyone reading understands that our responsibilities extend beyond following orders, especially in the ICU at a teaching hospital. Sometimes, it's not even the stress/high stakes of critical care, but dealing with patients, and especially FAMILIES. I realize as an MD I will also deal with families, but I also realize I won't deal with them 12 hours directly/nonstop.

Being that I am so late in the game (27 years old), and still have to take a considerable amount of courses, I am afraid of going down the MD route and finding out I made an error.

I am very much aware doctors are burning out at a fast rate, the demands are increasing, the stress of dealing with the politics of medicine/insurance companies, and the loss of power doctors are experiencing over medicine to men in suits/CEO's. I am aware residency is tough, grueling, and will require all my time, and I am aware I will lose my current financial status (I gross anywhere from 85-90K/ year).

I've been told to do the NP route and learn the science on my own time, to be curious on my own time, and to satisfy my inquiry and curiosity on the side.
I have a true love for science and medicine. I want to know more. I want to know the human body. My A&P teacher once pulled me aside and told me that I needed to apply to medical school, and I think back, and I regret I did not apply. My coworker also keeps telling me I should apply, she says I am wasting my time. I love the idea of being able to learn medicine.

Any thoughts? Would you choose medicine again? or midlevel provider? What burns you out the most?

If someone asked me "why do you want to become a doctor?" I would say:

I want to possess in-depth knowledge about human physiology, disease, and treatments. I want to understand how all these concepts are related/connected. How is the function related to the dysfunction? How does the dysfunction manifest in symptoms? What can we as doctors do to treat/slow/reverse these pathologies? What about the symptoms? I want to be the doctor that gives patients an understanding of their ailments, and their options. I love teaching and I see myself translating the complex nature of medicine into a format that patients understand. I want to rely on science to solve problems, I want to be made to think outside the box. I want to work in a team. I have a nontraditional background, yes. I believe however my experience as an ICU nurse sets me apart because I understand the patients' fears, questions, and concerns once the doctor leaves the room. Being a nurse I have an awareness of how my future orders/treatments will translate at the bedside and the community. I understand that every decision I make involves a first and foremost a human life, but it also involves resources, time, and energy. I want to be judicial in my future practice and be a pragmatic physician, one that incorporates a deep level of science, with a practical approach to patient care. I am also humbled by how much I do not know, and I realize that I will never be capable of knowing everything, but I believe medicine gives me the best shot at having a deeper and thorough understanding.

I just want to make a sound and wise decision, I owe it to myself, and I owe it to my future patients.

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if you want to be able to provide the best care, be a doctor
 
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if you want to be able to provide the best care, be a doctor

I know, I've thought this many times. I do not want to devalue NP whatsoever. I just feel like medicine gives me the best shot at being a good provider.
 
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Some practical information:

I have an A in A&P I and A&P II. I have an A in General Chemistry 1. I have an A in College Algebra. I did get a C in Microbiology & Pathology, and I am willing to retake if necessary. Getting a C was my fault, and I don't want it to reflect negatively, I know that I can get an A this time around.
I have heard that it is best to apply to six-ten medical schools? So most the schools in my state require:
  • 8 semester hours of general chemistry (I am missing the 2nd chemistry).
  • 8 semester hours of organic chemistry (I am missing 1 and 2)
  • 14 semester hours of biological sciences (only BIOL courses I have are the A&P I and II, I think it would be best to take general BIOL 1 and general BIOL 2)
  • 8 semester hours of physics (I am missing both
I would be taking these at a community college or maybe a local university. I am not sure how I would get involved with research? My research shows that nontraditional students should try their best to sell their nontraditional backgrounds. The only background I have is in critical care nursing. I received my certification for critical care nursing, which I know that maybe to medical schools it may not mean anything? I am afraid to mention this? I have also served on multiple quality improvement committees at my hospital.
 
Apart from student debt, I do not have very much debt. I also do not have a mortgage. My boyfriend is completely supportive and is willing to work while I attend school.
 
Hello there. I will attempt to keep this brief but also provide sufficient information.

I am a 27-year-old RN, CCRN. I work in critical care (pulmonary/coronary), and I've been a nurse for six years. I am partnered and have no kids. I also will not have any kids, as I am with another man (and we do not want kids).

I have been accepted into graduate school for Adult-Gerontology Acute-Care Nurse-Practitioner.

I never actually wanted to become a nurse. In fact, as a child, I always claimed that I would become a physician. Eventually, after high school I went the nursing route, I immediately took my prerequisites, and applied to the associate nursing degree program at my community college. The decision to pursue a nursing degree was fueled by pragmatic reasons. I was the son of a single-mother, she held no college education, and we were also financially disadvantaged. I had three years of schooling and was able to clear 65-70K in Houston.

Time passed and I became complacent. I enjoyed the money I made, and I even stalled on my plans to pursue my BSN. I had eventual plans to become a CRNA or NP, and I knew I needed to get my BSN. So, here I am now. Six years later, I will be done with my BSN in July and start NP school in August.

However, obtaining this BSN has reminded me that I DO NOT like the nursing model. I am so tired of learning "nursing theory", I can't believe how heavily focused my BSN has been on psychosocial theories. I am not saying they have no value, but they absolutely BORE me to death and I feel so uninspired. I am so tired of writing essays about nursing/humanistic and psychosocial theories, and I feel like I am wasting my time, energy, and life on making beautiful papers.

My best experiences with academics so far have been taking my math and science courses (I took the science for science majors courses), and the nursing courses in my ADN that were clinically inclined (pharmacology, complex disease concepts, health assessment). Even THEN, I feel like I was deprived because the depth of learning was never too deep.

I want the education the medical student receives. I want to be challenged academically, I want to learn the human body in depth. I want to understand how we function down to the molecular level, I want to learn the pathophysiology down to the cellular and biochemical level. I want to feel like I am not wasting my time writing useless papers. I am afraid the MSN/NP route will be just an extension of the fluff, with clinical/science knowledge sprinkled in between with a few clinical hours. In fact, my friend is going to NP school and she told me her professor flat out told her not to worry about the details of how the drug works and just know the main points. That shocked me, and it saddened me. I want to know: How does this drug work? WHY is this the drug of choice? I want to understand, not just memorize facts and be a robot.

But I am also scared that I am just in love with the academic pursuit/knowledge of medicine/science, and that I will hate being a doctor. As a nurse, I've been so burned out, especially as an ICU nurse. I am not sure if I am just tired of caring for patients overall? burned out of ICU/critical care? or just bedside work/nursing? Sometimes I truly hate my job, it can be a great deal of stress. As nurses, we have our set of expectations, and I hope everyone reading understands that our responsibilities extend beyond following orders, especially in the ICU at a teaching hospital. Sometimes, it's not even the stress/high stakes of critical care, but dealing with patients, and especially FAMILIES. I realize as an MD I will also deal with families, but I also realize I won't deal with them 12 hours directly/nonstop.

Being that I am so late in the game (27 years old), and still have to take a considerable amount of courses, I am afraid of going down the MD route and finding out I made an error.

I am very much aware doctors are burning out at a fast rate, the demands are increasing, the stress of dealing with the politics of medicine/insurance companies, and the loss of power doctors are experiencing over medicine to men in suits/CEO's. I am aware residency is tough, grueling, and will require all my time, and I am aware I will lose my current financial status (I gross anywhere from 85-90K/ year).

I've been told to do the NP route and learn the science on my own time, to be curious on my own time, and to satisfy my inquiry and curiosity on the side.
I have a true love for science and medicine. I want to know more. I want to know the human body. My A&P teacher once pulled me aside and told me that I needed to apply to medical school, and I think back, and I regret I did not apply. My coworker also keeps telling me I should apply, she says I am wasting my time. I love the idea of being able to learn medicine.

Any thoughts? Would you choose medicine again? or midlevel provider? What burns you out the most?

If someone asked me "why do you want to become a doctor?" I would say:

I want to possess in-depth knowledge about human physiology, disease, and treatments. I want to understand how all these concepts are related/connected. How is the function related to the dysfunction? How does the dysfunction manifest in symptoms? What can we as doctors do to treat/slow/reverse these pathologies? What about the symptoms? I want to be the doctor that gives patients an understanding of their ailments, and their options. I love teaching and I see myself translating the complex nature of medicine into a format that patients understand. I want to rely on science to solve problems, I want to be made to think outside the box. I want to work in a team. I have a nontraditional background, yes. I believe however my experience as an ICU nurse sets me apart because I understand the patients' fears, questions, and concerns once the doctor leaves the room. Being a nurse I have an awareness of how my future orders/treatments will translate at the bedside and the community. I understand that every decision I make involves a first and foremost a human life, but it also involves resources, time, and energy. I want to be judicial in my future practice and be a pragmatic physician, one that incorporates a deep level of science, with a practical approach to patient care. I am also humbled by how much I do not know, and I realize that I will never be capable of knowing everything, but I believe medicine gives me the best shot at having a deeper and thorough understanding.

I just want to make a sound and wise decision, I owe it to myself, and I owe it to my future patients.

I was an RN and went to medical school at 27. Best thing I’ve ever done. Go for it!
 
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Would you regret not being a doctor for the rest of your life?
 
You’re 27 for goodness sake you’re barely an adult. Far from too old to follow your dreams.

Shadow some np’s and doctors, figure out which lifestyle will work for you, then proceed accordingly. Are you comfortable not getting the specialty you would ideally want in the match? It could happen. Are you okay with relocating to wherever accepts you for medical school and later residency? Would you prefer the stability of staying where you’re at, becoming an NP, and broadening your knowledge over time? You have a lot of options.
 
I started med school in my 30s after being in healthcare for a few years... I am happy I did.

You don't have to retake your only C...
 
Some practical information:

I have an A in A&P I and A&P II. I have an A in General Chemistry 1. I have an A in College Algebra. I did get a C in Microbiology & Pathology, and I am willing to retake if necessary. Getting a C was my fault, and I don't want it to reflect negatively, I know that I can get an A this time around.
I have heard that it is best to apply to six-ten medical schools? So most the schools in my state require:
  • 8 semester hours of general chemistry (I am missing the 2nd chemistry).
  • 8 semester hours of organic chemistry (I am missing 1 and 2)
  • 14 semester hours of biological sciences (only BIOL courses I have are the A&P I and II, I think it would be best to take general BIOL 1 and general BIOL 2)
  • 8 semester hours of physics (I am missing both
I would be taking these at a community college or maybe a local university. I am not sure how I would get involved with research? My research shows that nontraditional students should try their best to sell their nontraditional backgrounds. The only background I have is in critical care nursing. I received my certification for critical care nursing, which I know that maybe to medical schools it may not mean anything? I am afraid to mention this? I have also served on multiple quality improvement committees at my hospital.
Were these classes taken as part of a regular undergrad curriculum or specifically nursing classes?
 
Apart from student debt, I do not have very much debt. I also do not have a mortgage. My boyfriend is completely supportive and is willing to work while I attend school.

Make sure you can afford the life for next 7-8 years, or your boyfriend is willing to pay for it.
And you will likely take out additional debt for med school, if you dont have additional 200K in your bank.
 
Apart from student debt, I do not have very much debt. I also do not have a mortgage. My boyfriend is completely supportive and is willing to work while I attend school.
Why not do Crna? They make similar $$$ to primary care docs with way less debt. Plus you already have the required icu experience.
 
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Were these classes taken as part of a regular undergrad curriculum or specifically nursing classes?

All the sciences (A&P, Microbiology, Chemistry etc.) I have thus far are from the science department, and my stats course under math department (not psych department, I know some schools offer a psych state that has a less emphasis on “math”.
 
All the sciences (A&P, Microbiology, Chemistry etc.) I have thus far are from the science department, and my stats course under math department (not psych department, I know some schools offer a psych state that has a less emphasis on “math”.
So them it wasn't a nursing program?
That's good.
 
So them it wasn't a nursing program?
That's good.
I went to nursing school but the prerequisites themselves were not offered through my nursing school, they were just part of the science department. Yes.
 
Coming from a current NP student who is kicking herself and wishing she had just gone the MD route, please go for it. I finish my program in December and am still teetering back and forth as to if I should try and go back to medical school. For ALL of the reasons you listed above, the nursing model is not an adequate structure to base education for providers. I am enrolled at a "top NP school" in the country, and the number of flaws within it are shocking. My lectures are not up to date with current practice guidelines. The emphasis on management is also poorly constructed. I find that I spend most of my time reading practice guidelines myself to make sure I have the most current practice.

I'm 28. Pretty close to you. And would also have to take a considerable amount of prerequisite classes. I'm not sure if it's worth it to dig myself into further debt after tacking on this NP degree to my already deep hole of student loans. But, if I were you, I would go for it.
 
As a nurse, these are my thoughts:


Nursing school: teaches you the what and why as it pertains to bedside nursing. Pt has xyz, this is what it is and this what you do as a nurse and why. Expect them to be treated with this TYPE of med. Key meds/doses to watch out for. You learn a lot w/ experience but experience w/o the science behind it isnt helpful.

Mid-level: teaches you disease states and what to do about it....not neccesarily the whys though. Patient has these symptoms, this history, these vitals...what's your ddx? Start to rule out. Figured out what it is? Ok heres first line tx and heres alternative first line based on contraindications. You get some why, but not enough. Its almost like you learn protocols of how to treat.

Physician: you learn the whys. When you know the whys, it's easier to make decisions that fall outside of protocol medicine.

I ask "why" too much to do anything other than MD......should have realized that a long time ago. That being said, my nursing experience will only make me a better physician. Having been a bedside nurse gives us a unique perspective because we have the mind of both sides of the coin. Plus, I've decided the best way for me to advocate for my patient is as a physician. I'm tired of begging for simple things. I'm tired of physicians who wont listen because it's not their body system but wont consult the corresponding service. I'm tired of having to call for orders silly things. All reasons why I left bedside (and then some) and now OR which has it's own host of annoyances.

It's time for me to do more. Plus I told myself that the only way I'd go back to school is if it gave me more autonomy.
 
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