Q+A: Certified Nurse Practitioner

Sandy Hunt on the pros and cons of the nursing profession, and the decision to become a nurse practitioner.

~ 11 minute read

The CareerExplorer Discord Community had the opportunity to speak to Sandy Hunt, a Certified Nurse Practitioner, in a live, fireside Q&A.

Sandy Hunt is a Certified Nurse Practitioner, specializing in both aesthetics and acute care illnesses — quite the duality. She has experience taking care of patients in the intensive care setting, and also performs advanced aesthetic procedures in a functional medicine setting (check out @thefrenchinjector on Instagram for her procedures).

Before becoming a nurse practitioner, she spent six years as a nurse in the emergency department as a certified trauma nurse working at a level 1 trauma center in Boston.

The transcript below has been modified and abridged from the original conversation.

First Steps in Nursing

Did you always know you wanted to be in the medical field?

I spent most of college playing volleyball without much direction. I majored in psychology, and after I graduated I decided to get my science prerequisites in the interest of medical school. It has been a long journey, but I’m so happy with my decision to choose the nurse practitioner route instead of medical doctor.

What other careers did you consider before becoming a nurse practitioner?

I tried to be a volleyball coach and I also tried to do commercial real estate. It did not stick.

The nursing profession is very diverse. Do you need to know what field you want to work in right away, or do you have time to decide during your training?

You absolutely can just start your degree and decide later. Getting the RN (registered nurse) designation is quite simple, and you don’t have to narrow down a specialty. Even when you get your NP, you pick a specialty (mine is adult/geriatric critical care) but I can work in any field.

I would recommend starting on a medical surgical floor (which has a very general population of patients) and then working in an ER or ICU.

How did you get your first nursing job after graduation?

I made great relationships during my clinicals when I was in nursing school — I wanted them to remember me. After graduating, I went right up to the geriatric medical surgical unit and asked for an interview. I worked on that floor for eight months and then walked down to the emergency room and asked for a job there.

Is it hard working as a nurse while attending college? How did you manage your time with that?

Just one class at a time. I got married, had kids, moved five times, bought a house, all during my nursing education. I didn’t look too far ahead. I just kept trucking forward.

Would you recommend that new graduate nurses gain at least a year of general medical nursing experience before going into emergency and critical care?

Yes, most emergency depts and ICUs require prior experience on med surgery. But after six to eight months, get down there and start asking for an interview! I can tell you the nurse manager would love it.

The Nursing Environment

Nursing school is notoriously difficult, and it is said that nurses-in-training feel burned out at a higher level than those seeking other career paths. What is the best way to get through this?

You are totally right — you can easily burn out in nursing. You give and give and give. That is why I encourage all nurses to continue in their career, advance their degrees, and switch it up.

You have to start before you burn out. Working in a medical surgical unit is a big place for burn out. Get into the ER, then move to psych, or get into labor and delivery. Just get creative. Travel nursing is AMAZING. You are paid very well to live in places like Hawaii or Alaska for 6–12 weeks on an assignment.

As for school, one class at a time. What’s the saying? “If it were easy, everyone would do it”. Nursing is among one of the most rewarding careers, and worth the struggle. Also, nurses have been ranked for the last 20 years as the most trusted profession — you carry a halo.

In what areas of nursing do you now work?

I now work in a few different fields. I do aesthetics — anti aging, botox, fillers, and lasers. I also work with the critically ill, both in a hospice capacity and the ICU. Finally, I also have a MAT (Medication Assisted Treatment) certification to prescribe drugs like Suboxone to addicts who are seeking recovery.

What is your favorite part of your job?

My favorite part of my job is being able to do exactly what I want without having to ask the doctor. I am treating the exact same patients as the physicians, there is no difference. I make the decisions for my critical patients and use their knowledge to help my patients. The focus always remains the same — what is best for the patient.

What is the most rewarding and the least rewarding part of the nursing profession?

The most rewarding part of my profession is that I get to make a decision (whether that be a medication, an injection, or a referral) and can see an immediate impact. I am able to connect with people from around the world, from all faces of the earth. I feel very grateful to have a job that gives back so much to me.

The least rewarding part of my job is the stigma that nurses are ‘trained monkeys’. Unfortunately, some people have no respect.

Is it true that experienced nurses ‘eat their young’ so to speak?

What a great question. I like to call these young eating nurses the dinosaurs. Yes, they exist, but they don’t last long. There are far too many amazing mentors and preceptors that you meet along the way to be distracted by the naysayers.

Also, the influx of men into the nursing profession has made a tremendous difference in the lateral violence culture in the best way possible.

I’m about to work as a psychiatric technician. What’s your advice for newbies like me?

If you have an interest in the psychiatric field, I cannot encourage you enough to go get your psychNP degree. Not only are they insanely in demand, but they get paid $130k right out of school.

What was it like being a certified trauma nurse? What type of person would do well in this environment?

It is the most exhilarating place to work in the hospital. As a nurse you have the most autonomy, most hands on decision making, most involved role. Your role is to stabilize the critically hurt, and send them up. It’s the perfect job for adrenaline junkies or former athletes who like a team environment.

If you are more of an introvert and prefer to have hands on control and less talking, the ICU is perfect for you.

As a nursing student and a professional, do you become desensitized to people’s trauma and suffering?

As a nurse, and especially a trauma nurse, I have seen many things that have been brutal.

The perspective I have chosen to take with this is that when I get home from work, I really have no real problems. It is all truly spilled milk. The real problems are the ones that blindside you or shock you, like actual trauma. Everything else is just circumstantial.

Is it terrifying when you have to make fast decisions that make a difference?

Yes, it’s absolutely terrifying. Everything is terrifying when you start. You gain experience and confidence. Then you feel like a badass!

I carry the decisions I make with me forever, but I took an oath to ‘do no harm’, and that guides every decision. I also don’t think death is the worst outcome sometimes.

Do you ever disagree with a physician over the diagnosis or treatment of a patient?

All the time. If I know what I’m talking about, I’ll fight and be assertive about it. You gain the respect of your peers (and physicians) when you advocate for your patients and then get a positive outcome. Again, it all comes down to time and experience.

Is it true that new nurses get crummy shifts like graveyards? Is it hard to get day shifts?

I’ve worked every single shift: 7–7; 11–11; 7pm–7am; 3pm–3am. It is so long, but you get used to it. I pursued my NP degree so that I can work the hours I want and not be stuck in shift work.

There is value in working these shifts. Don’t view them necessarily as crummy. You will learn and gain experience, and it is not permanent. You can switch shifts quickly.

Being a Nurse Practitioner

Do you have to go to medical school for psychNP? Is it possible to go from a certified nursing assistant (CNA) to nursing, and then go from there?

You can either get your Bachelor’s of Science in Nursing (BSN) → psychNP or just do a direct entry psychNP program.

If you go from CNA to RN to NP you will be making decisions very easily. You will have learned from the ground up how a medical system works. And honestly, CNA will be the hardest job of them all. You must apply for every position. Every nurse has a different (or multiple) specialties.

I would advise working for six months on a psychiatric floor to make sure it’s for you. Then, if you love it, go hard for the psychNP position. You will probably work alongside some psychiatric nurse practitioners so pick their brains on where to go to school. You can probably get some scholarships!

What is the difference between the nurse practitioner designation and the doctorate of nurse practitioner?

There is the NP or the DNP. In terms of scope of practice (prescribing rights) there is no difference.

DNP is classically a more educational role or administrative role (professors are all DNPs, Chiefs of hospitals are DNPs). The NP is a master’s degree and is very clinical. You are face-to-face with all the patients.

What is the difference between being a nurse practitioner and a physician’s assistant?

An NP has their own license SEPARATE from the MD. Which means that I could open up my own clinic. The physician’s assistant is exactly that, the assistant to the physician. Every order they write is under their supervising physician’s name and license. PAs do work in the operating room and do things like wound closures as well.

NP and PA both prescribe, both treat, and can see patients independently. The method of ordering is just a bit different.

Would you say that being a nurse practitioner is more ‘flexible’ than being a physician?

Being a nurse practitioner is way more flexible than MDs. That is why I chose it over medical school. I wanted a family and to be able to pick up my kids from school, while still having prescriptive authority.

What are the most important traits in being an NP?

It is most important to be compassionate, pay attention to detail, and have the ability to talk to people and gain their trust.

Being an Aesthetic Nurse

What made you decide to work in the aesthetic space? Do you need to be a registered nurse to pursue this avenue?

I love the aesthetic space! After years of working in trauma it has been the most wonderful counterbalance. It is creative, hands on, and you get to make an immediate impact on someone’s confidence.

You need to be an RN to perform injections in the aesthetic field. In some states you must be an NP. So I encourage anyone interested in aesthetics to get their NP.

As an aesthetic nurse, do you work alongside dermatologists and plastic surgeons as they perform clinical and surgical procedures for patients?

I am personally not in the operating room — I perform all nonsurgical procedures. I have a supervising plastic surgeon that I will ask any questions or refer to if nonsurgical will not get the patient what they want.

Advice and Closing Thoughts

What advice do you have for students that want to pursue a nursing career?

Get started! Try not to view the degree in one lump sum. Time and life goes by anyway. Work towards it, don’t stop. Even if you take one class at a time, you will be so grateful with the career you chose. It gives you back 10 times more than what you’d ever imagine. Being a nurse is partially being a superhero and having superpowers.

If you were able to go back and do things again, what would you do differently?

I moved from Jersey to Boston in the middle of my graduate degree. I was enrolled at Rutgers where they had an NP program with an emergency department specialty. When we moved, I switched to an exclusively online program, from which I graduated. I sometimes look back and think I wish I had stuck with that school.

Closing Thoughts

Ever since I became a nurse I have sought to gain every certification possible (maybe call it a chip on my shoulder for not going the MD route). I don’t want to be just good, I want to be the best care that patients have ever received. So I never stop learning, asking questions, and advancing my degree. I can’t emphasize that part enough for all of you.

I believe in this profession so much. If you are thinking about it, just do it!

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