Nursing Student Coach
Join Lauren Chapnick, RN, as she takes you through the journey of becoming a nurse! On Nursing Student Coach, Lauren, who is a new nursing professional, along with her knowledgeable guests will give you the tools to succeed in your nursing career. They will discuss ways to reduce anxiety and stress, share tips on studying and preparing for your NCLEX, and so much more - you won't be alone in this adventure! New episodes air every Thursday.
Nursing Student Coach
The Making of a Nurse Practitioner: Insights from Dr. Karen Bourgeois
Ever wondered about the journey of becoming a nurse practitioner? Join me as I sit down with Dr. Karen Bourgeois, the esteemed director of the Family Nurse Practitioner Program at Manhattanville College, to peel back the curtain on the ins and outs of this rewarding career. We traverse her personal career path, from her first steps into nursing to her years spent imparting wisdom in nursing education. We tackle the different nurse practitioner specialties and the potential paths that could lead you to a similar career—all the while weighing up the pros and cons of advancing your nursing education.
But our conversation goes beyond the professional sphere - we delve deep into the heart and soul of nursing. Dr. Bourgeois shares a touching tale of how her nursing career has not only changed her life, but those of her patients. We also discuss the pivotal role of nurse practitioners in promoting healthy habits, teaching patients, and advocating on their behalf. Whether you're curious about the differences of working in a hospital setting versus primary care, or simply want to know what it takes to succeed in nursing school, our conversation promises invaluable insights from this seasoned professional. Tune in for an enlightening discussion that spans from self-care tips for future nurses to the value of Family Nurse Practitioner certification. You won't want to miss Dr. Bourgeois's words of wisdom!
Contact information for Dr. Karen Bourgeois: Karen.bourgeois@mville.edu
Hi everybody. Just a quick announcement before we get into today's show, in case you missed it last week we are moving to once a week podcast episodes every Thursday instead of every Tuesday and Thursday, because I wanted to take that time that has been going into that second episode and put it into some new and exciting projects we have coming your way things like one-on-one coaching, group coaching, online courses and seminars and, of course, farmsimple RN, which is a pharmacology study tool that will be available in the coming months. So you have 20 Nursing Student Coach podcast episodes that have already been released and we will be having new ones every Thursday. Thanks so much, everybody, and now on to today's show.
Speaker 2:Nursing School is a wild ride, but that doesn't mean you have to run and hide when the going gets tough. Don't leave your stress undiagnosed. You gotta call the Nursing Student Coach. Real-life tips from a registered nurse, in school and out. She's seen the worst. Now, without further ado, yeah, here is your host, the Nursing Student Coach.
Speaker 1:Hello everybody and welcome to Nursing Student Coach. My name is Lauren Chapnick and I am your host, and I want to thank you so much in your support. As you know, it is my personal mission with this show to help put more great nurses into the world. So the more listeners that we can reach, the more future prospective nurses who can hear the show, the better. So if you're watching on YouTube, if you could subscribe to the show, make a comment. It really helps to put the show in front of more prospective listeners. And if you're listening on Apple podcast or watching on Spotify, it is also so helpful if you take out your phone and give us a quick five-star rating and write a quick review, just one or two sentences, what you like about the show, and I would appreciate that so much.
Speaker 1:Today we are talking about what it means to be a nurse practitioner, an NP. What exactly does an NP do and when is it a good time to go back to NP school if that's something that you're thinking about doing as an RN? Furthering our education as nurses is something a lot of us think about. So today we are speaking with the director of the Family Nurse Practitioner Program at Manhattanville College. Her name is Dr Karen Bourgeois and she is a PhD, she's an RN, she's an FNP and she has been in nursing education for over 25 years. So if anybody can answer the big questions about what this degree is all about, what are some of the differences between FNP and the different NP specialties, what can you do with this degree and what are some other advanced degrees and what makes them different we are here to answer all of these questions today and speak to one of my favorite people, so I would like to welcome Dr Karen Bourgeois. Hi, dr Bourgeois, thank you so much for joining us, hi.
Speaker 3:Hi Lauren, I am so happy to be here.
Speaker 1:Good, so if you could just for a few minutes walk us through your background. How did you get into nursing and then education and then into what you're doing now?
Speaker 3:Sure. So growing up it was myself, my sister, my mom and dad very traditional nuclear family. My grandparents live downstairs. My mom was the third generation of nurses. My grandmother was a nurse. She was a nurse. Subsequently I became a nurse and we actually have a fourth generation that I'll tell you about in a minute. Wow, my dad was also. He served in Vietnam and he came back and, through the GI Bill, paid for his nursing school. So my parents were both nurses.
Speaker 3:So everything at the dinner table from when I was very, very young had to do about nursing. The friends that they had were nursing. You know, you have a lot of nursing friends because you can all talk, and so everything was nursing and my sister and I hated it and I used to tell people that I would rather be, I think, a sanitation worker than a nurse. Until I, when I was 16, I started dating a 21 year old who was in college, much to my poor, poor parents I'm sorry, mom and dad. Anyway, subsequently he was killed a year after we. He was my first love and he was killed in a car accident on the Bronx Road Parkway and oh, wow, I'm so sorry it was. It was tragic, but it was transformational in the way that we went to the emergency room and I walked in not knowing what had happened, because I had met his passenger and his passenger was fine.
Speaker 3:And when we got to the hospital, you know, it was the nurse that came out from the inner sanctum of the ER and she told me and I, she grabbed me and held me and I crumbled to the floor and she crumbled to the floor with me. I don't know her name. I have a vision of her, but all I thought about at that moment was how, how amazing this woman was to be able to to give that. You know, first of all, what a horrible, hard job to have to do that and how gracefully she did that and how, how impactful it was. And I'll never forget. You know how she supported me through that first 90 seconds.
Speaker 1:What a powerful story about that nurse.
Speaker 3:I mean that, that yeah, she was my angel. You know she had to come out and deliver that news to a 16 year old girl. I cannot imagine and it was it had to be. You know. I'm sure she could have chosen a different career path that didn't involve such a gut-wrenching kind of revelation. But I'll never forget her. Yeah, and then all of a sudden everything kind of clicked.
Speaker 3:You know all the nursing in my background, which would apparently be why I went into nursing, plus that encounter. All I wanted to do was be a nurse. So I was fortunate enough to go to the college amounts in Vincent and I got my RN undergrad there. I started working at New York Hospital in the city as a orthopedic nurse and that was quite an interesting job. I kind of felt like I threw people on and off stretchers all day. I found myself not using all the wonderful parts I learned in nursing school. You know, teaching, health promotion, health protection. So while I was at New York Hospital I took a per diem job at the visiting nurse service in New York and I started doing home care and absolutely fell in love with home care because of the teaching, the one on one I was. This is great. So during that time VNSNY was nice enough to send me back to school to get my nurse practitioner. Now that I had my master's I could officially lecture and do clinical and I started doing that per diem and I also worked as a nurse practitioner three days a week in internal medicine.
Speaker 3:I started working at Mount St Vincent as a professor and then I was approached by Concordia College who had developed this accelerated program where you could become a nurse in 15 months and they wanted me to work there. And I thought to myself you can't make someone a nurse in 15 months, prove me wrong. And I went over there and it was the most amazing, transformative program and I fell in love with the idea of taking someone who now knows what they want to do, you know, had tried some other career and now really wanted to pursue nursing. I started new learning curve, right, I started learning how to do administration and then they asked me to be the permanent dean and I was the permanent dean until Concordia unfortunately closed down and I moved over to Manhattanville College and I thought to myself, what haven't I done? So Manhattanville offered me the chance to become the founding director of their family nurse practitioner program, which I jumped at, and currently we will be graduating our first cohort of 10 nurse practitioners in December, this December of 2023.
Speaker 1:That's very exciting, that's incredible. So you are the director of the FNP program. So I think what a lot of listeners are wondering is what exactly does an NP do? Because I know in undergrad there's a lot of talk like, oh yes, I'm going to go for my NP after this long and I'm not sure. A lot of people I'm not even sure if I fully understand. What is the difference between an NP and an RN? What can you do with one versus another? That's a great question.
Speaker 3:One of the wonderful things about NP that I profess is nurse practitioners take the best of nursing and combine it with the best of medicine. So they come at patient care from a dichotomy of journeys how to talk to people, how to teach people to change behaviors, how to help people be their own agent or advocate and then medicine. You know, the best of diagnosis, the best of treatment, the best of referral comes on that side. So a nurse practitioner kind of takes all these things medicine and nursing and puts them together and presents forward. I find that my role as a nurse practitioner I've been at my private practice for 22 years, still with the same doctor is more when the patient needs a little bit more health promotion, a little bit more health teaching. I find that these are the patients that I do best with in primary care. I'm able to take that nursing edge and tell people OK, you have diabetes. All right, what are we going to do about this? What does diabetes look like in your life? And OK, so this medicine is working for you, but this one isn't. Why don't we try this? Or I see you're not getting the insulin or blood sugar control that you need. Let's up your medicine. Or let's add a medicine. Let's talk about exercise. Are you out moving around, even if it's at five minutes in one direction and five minutes back? Oh look, it's time we have to check your A1C again. Have you gone to the podiatrist? Have you gone to the retinal specialist specialist this year? So a lot of what I do is that combination of medicine and nursing.
Speaker 3:Nurse practitioners practice in so many areas that our scope of practice is not as evident. So that's why a lot of people have questions about what exactly nurse practitioners do. We kind of I don't like the term extender, but I like the term encompasser we really encompass that best of medicine and best of nursing. And wherever you put a nurse practitioner, it's an addition, it's not just the addition of, let's say, a physician, it's the addition of medicine and nursing, together with all those factions playing at the same time. You know, I find that a lot of my medical colleagues don't think you know, think you know to the, to the other stuff. They don't think about diet as much, they just tell the patient OK, no concentrated sweets, no processed foods. I find that my approach tends to be OK. Let's talk about your favorite foods. Yeah, all of them are processed, all of them are sugar. How can we moderate this so that you feel better?
Speaker 1:and so that they'll actually adhere to it.
Speaker 3:Right, because I know about. I know if someone said to me you can't have ice cream anymore, I mean, literally the first thing I would do after I left my appointment was go get ice cream, because I know yeah, I don't like to be told that I can't have something but let's talk about OK, let's have ice cream once a week instead of once a day. So nursing gave me that background to be able to ask or approach things in that way, and I think it's a lot more palatable to our patients.
Speaker 1:Yeah, I would agree with that, and I've never heard NP nurse practitioner described as the the marriage between the best of nursing and the best of medicine. I love that. I've been using that. I like it. Yeah, it's good, it's great, and I think so. As a nurse practitioner, you have the ability to diagnose and to prescribe, but you are, first and foremost, an educator.
Speaker 3:I? That's not. That's the role I truly embrace. Yeah, the diagnosing is tricky, you know, we're not taught as nurses to see constipation and then go through five or six or seven things it could be. We are just focused on relieving the problem, right, whereas in for the medical angle I have to figure out what's causing it, treat it and then follow up on it. So it was tricky in the beginning because the medical diagnosis or the differential diagnosis model was new to me. Right, that's a different role.
Speaker 1:So a couple questions. At what point would you think that an RN would be ready to go back to NP school? How soon is too soon? Should you have a certain number of years of experience as a working RN before you apply? What's your opinion on that?
Speaker 3:That's a really great question. When I first started as a nurse practitioner I graduated in 94 from Mount St Vincent and I waited until the summer of 1998 to go back. I really felt at the time that having those years of experience prepared me better to go back to school. So I was very judgmental of the newer programs that have come along that basically said you can graduate in May and come back in August and we'll make you a nurse practitioner. I kind of felt that it eliminated a lot of the nursing part and we're nurse practitioners so you need that nursing part. But I have to go back to when I also thought you couldn't make a nurse in 15 months after coming through a four year program. You know I knew two years was possible, I knew four years was possible. I thought to myself 15 months is ridiculous. But I think already it changed my view on that.
Speaker 3:So now looking at the current environment, especially at a program like Manhattanville, we start with advanced theory, advanced research, leadership and ethics. That encompasses two semesters of our program. So theoretically if someone graduated in May and started in August or September of the same year, they would just be advancing kind of their book knowledge advanced theories, advanced research techniques, advanced ethical issues and advanced leadership. That gives them a whole additional year of core courses to get all that nursing experience. That year full and your first year is definitely full of experiences.
Speaker 3:As you, lauren, probably would attest to, it's an overwhelming year and by the time they come through that year and they have these core courses with them and they approach advanced health assessment, I am happy to report that they are ready. They are ready to take on the advanced diagnosing, the differential diagnosing. They are ready to have really poignant conversations about nursing, about being a nurse practitioner. From what they've observed from the doctors and the teams they've worked with, they have a lot of insight. So when they get into family nursing practice theory one, they are really handling it well. We are getting wonderful feedback about their evaluations and their ability to practice as an independent practitioner. Lauren, once again I have been proven incorrect. That I really do think, if you find the right program that gives you that time, that whole first year, to kind of grow as a nurse by the time you get to the advanced portion, I really do find that students are ready for this.
Speaker 1:That makes a lot of sense. I never thought of it that way, because you're going to be working while you're going to the NP program. So, your first year, at least in this program and I would think it's similar everywhere is your foundational core courses.
Speaker 3:And I would encourage students not to rush. Make sure when you, if you're looking into a nurse practitioner program, make sure you find the program that fits you and lets you function as a working RN, as a partner, maybe as a parent or as a caregiver of different generations. You don't want to commit yourself to a program that's going to be all encompassing your RN. We always talk about this. Right, it's 15 months. Say goodbye to your family and we say it rather, you know, I don't know snarkily you know, say goodbye to your family and friends because you can see them.
Speaker 3:Yeah, you were able to do other things, but it was life changing. Yes, this should be life. I truly believe that a master's degree should be life adding, not changing, you know love that, added on experience, that's going to take you forward.
Speaker 3:But there's no rush to go forward, trust me. The salaries are not that much different. There's other benefits, things like hours and and the different things that make the nurse practitioner really a wonderful, wonderful career. But no one should really be in my opinion. Don't rush it. You know, savor the moment. Move forward in the journey to your nurse practitioner and then figure out what some people graduate with their masters and they decide to go into teaching. I can tell you, after three days of academia I am so ready to go back into my practice mode and after about eight hours to 10 hours of practice I'm very excited to get back into education. So it keeps me fresh and excited most of the time.
Speaker 1:Right, right. How long is the total time of the NP, the FNP program? Is it two years?
Speaker 3:Our program at Manhattanville is part time, seven semesters, so it's fall, spring, summer, fall, spring, summer, fall. Most part time programs can take. It's about three years, okay, and then a year and a half full time Again, if you wanted to pursue something like that.
Speaker 1:Right. So what is the difference then if you get your MSN versus your NP, your masters of science and nursing, is that really so you can teach? Is that so you could basically teach clinical at that point?
Speaker 3:Yeah, most of the time. Now it's interesting state to state things are different. So most of the time, if you're getting a masters and not becoming a nurse practitioner, you're either getting in an education administration and, yes, that enables you to be teaching in a master's. You know, teaching in a master's program or a baccalaureate, mostly in a baccalaureate program. Excuse me.
Speaker 3:And in the hospital to pursue an administrative career. This is where it gets tricky. If you get an FNP in New York state, you can teach because you have inherently have your masters, or work as a family nurse practitioner. Where it gets really tricky is when you want to go on. So New York state is one of two states where, if you get an FN, the only people in New York state schools that can get a DNP a doctorate of nursing practice is an FNP. So if you have an MSN in education or an MSN in administration and you would like to pursue doctoral education in New York state, you would not be able to enroll in a DNP program. Now that's only New York state. In Alabama, I believe in every other state in the United States anyone can become a DNP.
Speaker 1:What is the advantage of getting your DNP versus FNP?
Speaker 3:Oh boy, you can give me the short answer.
Speaker 3:I have not come up with a good answer for that. A DNP is a great degree for a nurse practitioner who wants to stay in education, okay, or call themselves doctor Correct, which is a big, big debate constantly. I have a PhD. I when I knew that I wanted to be in education fully, at the time everyone recommended the PhD and not the DNP. Now they're pretty much interchangeable. If you want doctorate education and you're an FMP, you can either go for a PhD or a DNP, and sometimes you'll find the DNP program is more manageable. At times they do a project instead of a thesis, and so what I would say to anyone in pursuing that, do your homework, look in the direction you want to go with and find what works best for you. But I don't have a really great answer.
Speaker 1:No, that's fine. So would you say, working in a hospital setting as a nurse practitioner versus primary care, would you say? You said before, you have more one-on-one patient interaction with and more opportunities for education in the private practice setting versus hospital.
Speaker 3:Yeah, I think in the hospital setting sometimes the nurse practitioner is the PAs, the residents and the doctors kind of get their roles overlap so they become very performative as to what needs to get done and I have X number of patients to see so I always hope that they take their nursing and integrate it into everything they do. I find in primary care I'm able to spend time doing a lot more teaching in health promotion and protection.
Speaker 1:So with the FMP it's family nurse practitioner. It's from birth to earth. Birth to earth is what you had told me. So would you recommend that versus one of the highly specialized areas?
Speaker 3:Yeah, unless you're really sure what you're, unless you're really sure that this is something that you wanna pursue hands down.
Speaker 3:So here's an example For family nurse practitioner you have to do 90 hours in our program in pediatrics.
Speaker 3:That's definitely a hard preceptorship to find and if you don't ever plan to work with kids, you may feel that it's not going to serve you. I will tell you this for certain facilities like PM pediatrics will only let nurse practitioners pediatric nurse practitioners train at their facilities because there are only so many spots and they're looking for people who are going to be pediatric nurse practitioners. So, in that respect, if you know you wanna work with children under 21, I believe it is now and you never really want to take care of adults, that's an excellent opportunity for you to fulfill your passion. That being said, as a pediatric nurse practitioner, you can go back and get a family nurse practitioner certificate. It's usually one, usually it's four semesters, part-time, and you would get a certificate and then certify for that and you could take care of adults as well. So it's not. You're not backed into a corner, okay. So figure out to the best of your ability what you wanna do and pursue it that way.
Speaker 1:Right. So in that sense, working for at least a year might make more sense versus going right into it.
Speaker 3:If you don't know, the core courses are the same for every program theory, research, ethics, leadership, right and a lot of programs will let you transfer them in and out too not all, but most, so if you decide. After a year in a family nurse practitioner program I've had a couple students say to me I really wanna pursue pediatrics exclusively and they've moved to a different program. Oh, okay.
Speaker 1:Well, they figured it out. That's good, okay. So, dr Bourgeois, you spent some time teaching undergraduate nurses a long time, and this is a podcast for undergraduate nurses. You happened to be my professor for about three weeks and it was a great time. You filled in for our health assessment class and you actually did my check off for my health assessment final, and I will never forget where the angle of Louie is, because of you. You stumped me on that one.
Speaker 3:One whole second interval of space. I love it. Yep, I'm on mark yes.
Speaker 1:So if you could give undergraduate nursing students one piece of advice, one takeaway for how to be successful in nursing school, what do you think it would be if you could just give them one piece of advice Get more sleep.
Speaker 3:Yes, take care of yourself. Take care of yourself. You know it's. The best nurse is not the A. The nurse who gets the A. If I could give you one piece of advice, I say get a B or a B plus, and make sure that you're addressing your self-care needs.
Speaker 3:Sleep exercise, get your nails done, have an ice cream cone. You do not need to get an A in nursing, you just need to get through nursing with yourself intact, and that can be a challenge. So I would just my one piece of advice is self-care, and make sure you're in a situation that you can provide yourself with that self-care. Like I said, there's no rush. If you wanted to be a nurse, you will be a nurse. It may not work out the first time, it may not work out the second time.
Speaker 3:Life has a way of kind of changing our trajectory. Don't let it derail. You. Go with the trajectory it's bringing you in and then come back to it. I've had so many students who either ran out of money or had a problem at home or whatever it was, and they felt derailed and rejected and that their dream would never come true. No, just not right now. It's not always a straight line and it'll happen. So if you're not in a position due to funding, due to pressure or due to family, whatever it is just don't try to lean into that. Get that done and then pursue it. Don't try to do both, because you lose yourself in that process and you can't do self-care and it's not good for you.
Speaker 1:That's so true. It'll happen when it's supposed to happen, correct?
Speaker 3:And don't let anyone tell you that it's not going to happen. You know, if that's what you want, it'll happen, but you have to be in the right framework.
Speaker 1:I couldn't agree more. Well, Dr B, thank you so much for taking the time to speak to us today. I appreciate it so much and we will talk to you really soon.
Speaker 3:Thank you again, thank you so much for having me and I think you're going to post my information if anyone has any questions or just wants to vent, or I would love to participate. Thank you, Absolutely.
Speaker 1:I will put your email in the description of the show if anybody wants to contact Dr Bourgeois. And thanks again, I really appreciate it. Oh, thank you, lauren All right.
Speaker 1:Well, that is a wrap for today. Dr Bourgeois, thank you so much for speaking with us. That was so helpful, so insightful, and it is always such a pleasure. And to everybody out there listening, thank you so much. As always, you can follow us on social media. The handle is at nursingstudentcoachcom and you can go to nursingstudentcoachcom to join our mailing list and get all the latest updates. Until next time, have an amazing day. Bye-bye.
