Danner 1

Lauren Danner

Dr. Cassel

ENG 1201

6 July 2020

I was having a lot more headaches than normal for a 9-year-old, I would only be outside

for about an hour before I was inside in tears having to take Tylenol and lay down. My mom

finally took me to the Doctor, and he saw a tumor through my eyes. At the time my mom had no

idea that he had seen the tumor. We just knew that he ordered a Cat Scan for me to have done

( A way to get images of the brain by laying down in on a table and holding still and being put

through a machine). Back when I had this done they only had small machines that terrified me. It

was like being stuck in a tunnel. You got to listen to music on headphones which was the only

good part. They went to do my IV in my hand and it blew as soon as they went to push the dye

for me. I remember it hurting so bad and I was just terrified because no one could answer the

questions I had. I remember sitting in the room with my family and my grandma promising we

would go to breakfast as soon as we got the results because I wasn’t allowed to eat before the

procedure. I did not leave the hospital for 3 weeks. My mom and dad came back into the room

with a doctor and were crying, I knew something was wrong, but no one would answer me once

again. I had to have Brain Surgery and stay for recovery. One of the nurses in the ICU spent

extra time with me and came at the end of her shift a few times to braid my hair for me. I had no

idea what was going on at the time just that I was scared and missed my friends. That made such

an impact on my life that has made me want to be a Nurse ever since. Now that I have worked in

the hospital some and see how busy they are and how she really went out of her way it just adds
 Danner 2

to my desire to be a nurse. So that like her I can make a difference in a child’s life. Since then I

have realized I want more than being an RN just not sure what exactly that was. I am trying to

decide how I want to pursue my master’s degree in Nursing. I have wanted to be a Nurse

Practitioner for quite some time now. I am also interested in being a Certified Registered Nurse

Anesthetist or a Nurse Midwife. I wanted to learn more about each of the areas to try and help

me decide which path to take. I have three years from now if I stay on track before I will

complete my bachelors. I am trying to figure out which route I am going to take to help me better

prepare. Although, I am not sure which path I want to take for my master’s I think Nurse

Practitioner is going to be the way for me.

Not only has that nurse played such an important role in my life I have since discovered

one of my spiritual gifts is to take care of others. Spiritual gifts are gifts are something that you

are given from God when you accept Christ into your life. My faith was always important to me.

When I was in the hospital with that brain tumor I had so many people praying for me and the

doctor even told my mom, he didn’t believe in God but when he cut me open the tumor slid right

out into his hands. He said that the only way to explain that was a miracle. I know I was given

another chance at life so that I could help others just like those nurses and doctor helped me that

time in my life.

A person can go many ways when it comes to getting a master’s degree as a Nurse. There

are a few different ones a person could look at and this paper was the reason to do so. While I

have personally wanted to be a NP for such a long time, I knew there were many other path’s I

could take with a master’s in nursing. I know that I do not want to be behind a desk and want to

still work in patient care and one on one with patients.

 Danner 3

In 2016 the Department of Veteran Affairs established APRN’s were able to practice

without the supervision of a Physician. The first NP education was at the University of Colorado

in 1965. In 1967 at Boston College the first masters level program was established. By 1973

there were more than 65 NP programs in the U.S. In 1994 Mary O’Neil Mudinger founded the

first clinical nurse doctorate in the country. Yale Nursing Nurse-Midwifery program was started

in 1956 and is the second oldest of its land in the U.S. They got their first year of funding from

the federal division of nursing in 1976. There is evidence of the role of midwives in ancient

Hindu and biblical writings. It became popular in the U.S in the early 1900’s. The Certified

Nurse Midwife can practice under an NP in 45 states. CRNA’s can be seen in history back to the

late 1800’s. They can work under a NP in 44 states. (Raines)

The NP role came about in the 1960’s they are “protected “title” in all 50 states and in

DC. Regulatory authority is vested in boards of nursing in 45 of the states and shared with the

board of medicine in 5 others.: (Phillips 2007) Discussed to require doctorate level degree for all

NP to be able to practice in 2015 but it is still a discussion. Surveys are completed to get info

through various methods, all 50 states. Started in 1977 and are done every 3-4 years. Most jobs

are at hospitals and doctors’ offices. In 2006 the salary for NP is around 70,000.

The need for healthcare workers keeps increasing. NP/APRN is defined as a “Registered

Nurse who has acquired the expert knowledge base, complex decision-making skills, and clinical

competencies for expanded practice, the characteristics of which are shaped by the context and

or country in which s/he is credentialed to practice.” The DNP is being pushed for all APRN’s to

be required to have and practice. If this is pursued after a master’s degree has been obtained it

will take 2-3 years with 500 clinical hours. You could also get this after your BSN, and it will

take 4-5 years with 1,000 clinical hours. You just must decide if you are willing to risk having to
 Danner 4

go to school longer after getting your master’s degree, or if you think you should take the time.

They have been pushing for the DNP since 2015 with nothing being set yet.

Nurse Practitioners go over patient medication history, symptoms, do exams and observe,

perform, and order diagnostic tests. They can also diagnose health problems as well as treat

patients for them. They can evaluate responses to medication and treatments, consult with other

physicians and APP’s. They also educate patients. NP can work alone or under the supervision of

a physician. They focus solely on patient care. When going to school to become a Nurse

Practitioner your focus is more on the nursing side of being a provider for patients. When going

to school to be a D.O ( Doctor of Osteopathic Medicine) , M.D (Medical Doctor), or PA

(Physician’s Assistant) you focus on the doctoral part of the studies. These are different focuses

that in the end have the same goal which is to be a primary provider for patients. The schooling

for a PA is about the same time it is for a NP, but in offices and hospitals they tend to be called

Assistants often which is degrading due to them going to school for so long.

A CRNA administers anesthesia and cares for a patient before, during and after whatever

the reason they are administering the anesthesia for. They can do pain management, monitor

vitals, go over medications and history. The CRNA has the highest job satisfaction among

nursing careers. The salary for a CRNA is around 140,000 but the schooling is much longer than

it is for a NP. A CRNA works in teams most of the time and they are usually working with an

anesthesiologist. You must have a good concept of team work to be in this position. There is a

projected job growth of 26% in the next 8 years. This is a pretty good growth, but the medical

field is always growing.

The Certified Nurse Midwife care for patients in the women’s health specialty. They can

deliver babies but also able to help basic women’s health needs such as yearly pap smear, or any
 Danner 5

other issues women may have with their hormones or reproductive organs. They are more

holistic than a regular OBGYN. This path can be intriguing to a person because women’s health

is very important as is helping to bring another human being into this world. All stages of the

pregnancy and conceiving can be stressful, and it would be a great place to help other women.

Certified Nurse Specialist (CNS) require a masters or doctoral degree. They are focused

on a specialty, setting or population. It takes 36 graduation credits, 500 clinical hours and can

take anywhere from 2-4 years. The salary for an Adult Clinical Nurse Specialist, Board Certified

ACNS-BC is 78,000-110,000. More information about this is available at www.nacns.org. A

CRNA takes 2-3 years full time and 56-110 credit hours to complete, plus the board certification

is required as well. You also must have at least one-year ICU experience as an RN at most

schools. Some require OR experience and that is where you mostly would work as a CRNA in

the field. Certified Nurse Midwife graduate program is accredited by American College of

Nursing Midwifes on women’s health. You must pass a national certification exam. The median

pay is around 69,000 and 90,000. If this is a specialty is something you are considering it is wise

to work on the labor and delivery department. You can work at the hospital or at people’s homes

as a Nurse Mid-wife.

NP’s work a lot of places such as primary care, specialty offices, schools, hospitals, LTC

facilities just to name a few. They can prescribe meds and treat patients with out physicians

working over them in most states. It is 36-60 credit hours and will take 18 months full time to

complete the program or 36-48 months part time. There is a minimum of 500 clinical hours that

must be completed, and you must pass a National Certification exam. They make anywhere from

85,000 to 120,000 a year for their median salary.

 Danner 6

Certified Nurse Midwifes work mostly in reproductive practices, while others work in

women’s healthcare in general. The things like yearly exams, birth control and other things you

would go to the OBGYN for. While they do a lot of home birth’s more than 90% of them do

hospital births. The Certified Nurse Midwife is more of holistic position, but you do not have to

practice holistic medicine to become a Certified Nurse Midwife. Certified Midwife is a new title

that can practice in five different states, but Ohio is not one of them. It is a different path as far as

schooling goes but they are not recognized many places yet. A person really needs to think about

what they personally can handle as far as patients go in this field. Most of your time will be

spend examining women’s vaginas. They can have many different smells and infections, so

when you aren’t doing the baby part of the care are you going to be able to handle all that could

and probably will come out of your patients? Can you deliver a baby? Are you good under

pressure and with others yelling at you?

Working in the Emergency room is probably the best place to go when you are trying to

figure out what to do with your continuing education. Not only do most hospitals offer tuition

assistance but you get a lot of different experience. There is a chance you could help deliver a

baby, you could have a patient code on you and have to perform CPR on them, you could have

someone die one you, you can have someone throwing punches and cussing you out, you could

have a sweet old lady who is just having a really bad UTI and is so confused she doesn’t even

know which way is up. There are many different patients you will encounter working here.

Another place that would help is working in the ICU or Med Surg floors. Surgery would be a

great place to go if you are considering being a CRNA. Most of the patients you will be treating

will be patients going in for surgery, so having the experience knowing what to expect as a Nurse

will help you to have a better work flow and relationships with people you could potentially
 Danner 7

work with in the future. Unless you go the route of pain management, which is a very stressful

place to work if you are dealing with patients with chronic pain. These tend to be the patients

who yell the most, get upset the easiest and just hardest to deal with. More than half of the ones

you encounter will be in tremendous amounts of pain daily and their quality of life isn’t what it

used to be, that is no way to live and most people can’t take it.

When you are looking at getting your master’s degree you must make sure to go to an

accredited school. There are many schools who offer these programs, but they do not have the

right accreditations. A lot of places will not take transfer credits unless they come from an

institution that is Regionally accredited. A lot of this information you can get from the website

itself on the college sites. It would be a good idea to talk with an advisor from your current

school before transferring schools. If you know you are already in a regionally accredited school,

then your advisor will be able to help you to transfer to the appropriate school. It is a lot of

money to get your master’s degree so making sure the school you are going to has the right

accreditations is so important. Not only do you invest so much time into this but if you end up

not being able to use the degree in the end then there really isn’t any reason for this.

You can become a teacher of nursing by getting your master’s in nursing. This is just a

focus on nursing in teaching. You must have a master’s degree to become a teacher for nursing.

The salary for a teacher in nursing is just under 80,000 in Ohio. This varies like other professions

from state to state. You can make around 70,000 being a nurse with your bachelor’s degree so if

money is something that is important in your decision for furthering your education it probably

wouldn’t be a wise decision for you to choose teaching. The world needs more teachers but

doesn’t have as many as is needed due to them being so underpaid. A lot of colleges offer ten
 Danner 8

year and other packages to help to pay their instructors better benefits and have their families to

come to the college they are teaching at.

There is the option to be a floor nurse while having a master’s degree as well. You will

still be getting paid around the same as someone with a bachelor’s degree but sometimes they

will pay you more from having a master’s degree. Most places require a bachelor’s degree for

being a nurse. As a nurse you can assess patients, give them meds, go over their medication, you

cannot prescribe medication or create a plan of care for patients. That is something only APP’s

or Doctors can do. An Advance Practice Provider is a NP, or PA.

A lot has been learned from doing this research into different nursing degrees. Depending

on your personality and what your end goal in life is will depend on which path is the right one

for you. For every path that is described in this paper you are going to more than likely be

working at a hospital. This means 12 hour shifts and holidays will be worked. Another down fall

to working in the hospital is usually you must work night shift and work your way up the ladder

to be able to move to days. When you move up they go by seniority, so you must put your time

in working nights unless you get lucky and get to start on day shift.

It is a hard decision to make on what a person wants to do with the rest of their life. It is

such an important decision but at the same time is so scary. A lot of people want to help other

people. That is the main reason for most people going into the nursing field. No matter which

path someone takes in Nursing they will be helping others. While it’s easy to learn working in

the pediatric field does not pay as well as the others, it is on my heart to work with kids. A

person think that I am going to end up going the path of a Nurse Practitioner. There are still so

many different paths I can take with this. But now at least I know which path to take as far as my

Master’s. I will start the process of figuring out the rest of it shortly. The only scary thing about
 Danner 9

committing to be a provider is wondering if you will be able to keep your work at work and not

bring it home. I know a lot of people just care to much and it is hard for them to not bring their

work home. When having a family, it is important to be able to keep your work at work. I know

for me working in the hospital seems more appealing since you don’t have the same patients

daily. You go to work take care of the people that come in then you go home and have your

home life. There is call involved when you are a nurse or even a NP but that is the case in most

cases when you are working in any part of the medical field.

To be a pediatric nurse or NP the care given is going to be different than the care given to

an adult. When you are taking care of a child you must make sure you are talking in a language

that they understand, you must be able to “dumb it down” and explain things to them in ways

their little brains will understand. This can sometimes be difficult and make you must work a

little harder, so you can not only have their parents understand what you are going to do but the

patient themselves as they are gong to want to know what’s going on. Making sure to establish

with the parents what you can and can’t say first is important as well. Earning trust from children

can be harder than an adult as well. If you are a primary care provider for a child their

relationship with you is very important. You must make sure to engage the parents to make sure

they are ok with the plan and engaging with the kids.

The salary has some to do with figuring out the rest of your life. Especially when you

have a family like I do. Not only do I have to give time up with them to finish school, but I will

be giving time up with them while working as well. Giving up time with your kids is not an easy

thing to do especially when working full time as well. A person must make sure they are willing

to sacrifice the time to get to their end goal in life. It isn’t the best thing in the world making

them sad because you must get this done and when they are young they don’t understand why
 Danner 10

you must give up the time with them. Therefore, its best to finish school before starting a family.

However, this isn’t an option for everyone. The only down fall to be a nurse is having to work on

holidays, but someone must do it. I know when I worked in the hospital before in the past that

the girls did not like that, I was not off on holidays. The good thing is there is usually a rotating

schedule and you don’t work every holiday every year. Most places have alternating holidays, so

you are on one off the next and every year these changes and you work the opposite holidays you

did the first year. Working in a provider’s office right now I am off on holidays. However, I do

feel like working five days a week versus three twelves doesn’t give me the flexibility I need

sometimes. The time with my family is one of my main reasons for wanting to pursue my MSN

in NP.
 Danner 11

Works Cited

Ament, Lynette PhD. “The evolution of midwifery faculty practice: Impact and outcomes

of care”. Science Direct Nursing Outlook, Volume 52 Issue 4, August 2004.

Pages 203-208, https://doi.org/10.1016/j.outlook.2004.04.005. Accessed 5 July

2020.

Different families. “How Midwives Experience the Birth of a Child.” 8 December 2017,

YouTube. Accessed 26 June 2020

https://www.registerednursing.org/. Accessed 26 June 2020

Emerson, E. Ea., Fitzpatrick, Joyce. “201 Careers in Nursing” Springer, 2012.

Erlandsson, Kerstin, 1961, et al. “Evaluation of an Online Master’s Programme in

Somaliland. A Phnomenographic Study on the Experience of Professional and

Personal Development among Midwifery Faculty.” Nurse Education Practice,

volume 25, January 2017, pp 96-103, EBSCOhost, doi:

10.1016/j.nepr.2017.05.007.

Fowler, Andrea. Personal interview. Future 6/27/2020

Fullerton, Judith T. PhD, Sipe, Theresa Anne PhD, Schulling, Kerri Durnell PhD.

“Demographic Profiles of Certified Nurse-Midwives, Certified Registered Nurse

Anesthetist, and Nurse Practitioners: Reflections on Implications for Uniform

Education and Regulation.” Science Direct Journal of Professional Nursing,

 Danner 12

Volume 25 Issue 3, May-June 2009. Pages 178-185,

https://doi.org/10.1016/j.profnurs.2009.01.002. Accessed 5 July 2020.

Raines, Fay, and Elaine Taglaireni. Career Pathways in Nursing: Entry Points and

Academic Progression, 3 Sept. 2008,

ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/

OJIN/TableofContents/vol132008/No3Sept08/CareerEntryPoints.aspx. Accessed

26 June 2020

Kowarski, Ilana. “Pick the right graduate degree in Nursing.” 15 December 2016,

https://www.usnews.com/education/best-graduate-schools/top-nursing-

schools/articles/2016-12-15/pick-the-right-graduate-degree-in-nursing. Accessed

26 June 2020

Mckenna, Lisa, and Brooks, Ingrid. “Graduate Entry Student’s Early Perceptions of

Their Future Nursing Careers.” Nurse Education in Practice, volume 28, January

2018. Pp 292-295, EBSCOhost.doi: 10.1016/j.nepr.2017.11.010.

Keaton, Larrena. Personal interview. Future 7/13/2020