Transition: FNP to WHNP

I’m a Family Nurse Practitioner and have been in the profession for about 7 years.  Before that, I was a registered nurse for about 8 years.  I really liked being a nurse most of the time:  I liked my patients in the ICU and ER and loved trying to figure out the puzzles of getting them well again.  I knew I needed to reach and grow and get my Master’s degree, but I put it off for several years because my mom was terminally ill and I didn’t want to add the stressor of going to graduate school into my life (she died at age 62 of early-onset dementia).

I went on to graduate school because it seemed like the next step (other than going to medical school, which I flirted with the idea of, and I would have loved being a general surgeon, which is what I would have chosen, but I’m sort of selfish with my time and my pursuits, and I didn’t want to be “stuck” in a profession where I wouldn’t have the flexibility to go out and run or ski or walk my dogs or not be on-call, so I went to NP school).

I’m not going to lie to you:  I thought nursing school and NP school were not all that hard.  I remember getting my coffee and my snacks together on my desk and listening intently to lectures, then looking stuff up when I got home, and passing all of my tests with a fair amount of studying and writing research papers pretty easily.  I actually really enjoy going to school.  I love the structure of it and meeting deadlines and getting good results from the amount of effort that I put into it.

After several years of being an FNP (Family Nurse Practitioner) at a university student health center, I decided I needed more of a challenge and went into family practice and urgent care.  Ugh.  One clinic was totally disorganized, another was disorganized and super busy (it seems I never could see enough patients, no matter how many I saw.  I typically would see 30 to close to 40 patients over 10 and never got a lunch) and the third clinic was so drop-dead boring (I typically saw 6-10 patients in 11 hours) that I felt that it was kind of a waste to be there and not be seeing more patients.  I wanted a happy medium and wasn’t able to find it.

Along came a job at a federally funded women’s health center (think about it:  you probably know the one… ).  I applied for the job, and with the help of some great references who knew the medical director, I got the job.  Yeah, I probably got it because of my skills and my experience, too, but I like to give credit where credit is due, and I tend to be somewhat self-depreciating (like most nurses).  I’m not a Women’s Health Nurse Practitioner, but I am a Family NP working in Women’s Health (just to clarify).

So here I am, nearly 4 months into my new job, seeing patients and getting the hang of things, and I go home thinking… “I hope they [the patients and the staff] like me, because I love this job.”  Seriously, so rewarding, 99 percent of the time.  And that’s about a 60% increase in enjoyment from my last several jobs.

I never expected to see myself going into women’s health.  My mom never talked about that kind of stuff with me.  I remember when I came “of age” she put a box of maxi pads in the bathroom cupboard and told me they were there if I needed them.  She did stick up for me at my pre-college physical when the MD wanted to do a pelvic exam on me (national protocol from several agencies states that we now start doing Pap smears and pelvic exams at age 21 at the earliest) and I flat out refused.  I was 18 and had never been sexually active and wasn’t going to let some strange MD (even if she was a woman) go down there.  I think they drew my blood and checked my cholesterol too (waste of time:  I was a very active kid and actually ate my vegetables).

So here I am now, looking at va-jay-jays all day long, talking about STIs and discharge and rashes “down there” and what kind of contraception women want and even placing IUDs and implants, and explaining anatomy to women.  Wow, I never would have dreamt it.  And I never would have thought that it could be so rewarding.  The patients are, for the most part, compliant with plans of care and following up on health concerns.  They listen intently and know that they are being listened to.  I’ve never heard so many thank you’s in a day at work.  Never, in 15 years of practice in the medical profession.  I feel like I am empowering women to know more about their bodies and how they function and what they can do to feel better and understand themselves.  I see men, too:  I have had several male patients tell me, “I never felt like anyone listened to me before [at other clinics].”  It’s pretty refreshing to be in an area of medicine where people are not completely entitled (although we get some of those patients, too) and are, for the most part, just nice people who are compliant with their care.

I know some of the staff members at my clinic would probably disagree with me on this view.  But I’ve been in family practice, where patients are quite non-compliant and it seems that most of them aren’t willing to put in the real work to get better.  Many want pain pills.  Many want some sort of pill to fix things instead of exercising and eating healthy.  I guess over time, this patient view just wore me down.  I explained so many times that “you should exercise 30 minutes each day” and “you should eat 5 servings of fruits and vegetables everyday” among other recommendations, and I felt that that’s all they were:  recommendations.  Patients would bounce back all the time, not having taken my advice and said, “Yeah, I know.  I didn’t take your advice.  Sorry.  Things are worse.  Can you help me again?”  And I would, and I would go home from work deflated, frustrated, fatigued, and hungry (from skipping lunch) or feeling guilty from eating a family size bag of Lay’s potato chips for lunch and not following my own advice.  I also felt like many of the decisions made at the family practice clinics are made not by the health care providers, but by either insurance companies (who decide whether or not to reimburse the patient or the clinic) or by the business manager (who decides what equipment to have in the clinic and whether it will meet the budget’s bottom line).

So the job change to women’s health (so far) for me is a great one.  Ask me in 12 months:  see if I feel the same way then.  I can tell you, from the support that I currently have in my clinic from patients and staff, I foresee remaining positive about my change of venue.

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One thought on “Transition: FNP to WHNP

  1. Pingback: Was 2016 really all that bad? | adventures of missy b

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