October 26, 2023 • 29 mins
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
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hi everybody.
Just a quick announcementbefore we get into today's show,
in case you missed it last weekwe are moving to once a week
podcast episodes every Thursdayinstead of every Tuesday and
Thursday, because I wanted totake that time that has been
going into that second episodeand put it into some new and
(00:22):
exciting projects we have comingyour way things like one-on-one
coaching, group coaching,online courses and seminars and,
of course, farmsimple RN, whichis a pharmacology study tool
that will be available in thecoming months.
So you have 20 Nursing StudentCoach podcast episodes that have
(00:43):
already been released and wewill be having new ones every
Thursday.
Thanks so much, everybody, andnow on to today's show.
Speaker 2 (00:53):
Nursing School is a wild ride, but that doesn't mean
you have to run and hide whenthe going gets tough.
Don't leave your stressundiagnosed.
You gotta call the NursingStudent Coach.
Real-life tips from aregistered nurse, in school and
(01:13):
out.
She's seen the worst.
Now, without further ado, yeah,here is your host, the Nursing
Student Coach.
Speaker 1 (01:26):
Hello everybody and welcome to Nursing Student Coach
.
My name is Lauren Chapnick andI am your host, and I want to
thank you so much in yoursupport.
As you know, it is my personalmission with this show to help
put more great nurses into theworld.
So the more listeners that wecan reach, the more future
prospective nurses who can hearthe show, the better.
(01:49):
So if you're watching onYouTube, if you could subscribe
to the show, make a comment.
It really helps to put the showin front of more prospective
listeners.
And if you're listening onApple podcast or watching on
Spotify, it is also so helpfulif you take out your phone and
give us a quick five-star ratingand write a quick review, just
(02:13):
one or two sentences, what youlike about the show, and I would
appreciate that so much.
Today we are talking about whatit means to be a nurse
practitioner, an NP.
What exactly does an NP do andwhen is it a good time to go
back to NP school if that'ssomething that you're thinking
(02:35):
about doing as an RN?
Furthering our education asnurses is something a lot of us
think about.
So today we are speaking withthe director of the Family Nurse
Practitioner Program atManhattanville College.
Her name is Dr Karen Bourgeoisand she is a PhD, she's an RN,
(02:59):
she's an FNP and she has been innursing education for over 25
years.
So if anybody can answer thebig questions about what this
degree is all about, what aresome of the differences between
FNP and the different NPspecialties, what can you do
(03:19):
with this degree and what aresome other advanced degrees and
what makes them different we arehere to answer all of these
questions today and speak to oneof my favorite people, so I
would like to welcome Dr KarenBourgeois.
Hi, dr Bourgeois, thank you somuch for joining us, hi.
Speaker 3 (03:40):
Hi Lauren, I am so happy to be here.
Speaker 1 (03:42):
Good, so if you could just for a few minutes walk us
through your background.
How did you get into nursingand then education and then into
what you're doing now?
Speaker 3 (03:54):
Sure.
So growing up it was myself, mysister, my mom and dad very
traditional nuclear family.
My grandparents live downstairs.
My mom was the third generationof nurses.
My grandmother was a nurse.
She was a nurse.
Subsequently I became a nurseand we actually have a fourth
generation that I'll tell youabout in a minute.
Wow, my dad was also.
(04:16):
He served in Vietnam and hecame back and, through the GI
Bill, paid for his nursingschool.
So my parents were both nurses.
So everything at the dinnertable from when I was very, very
young had to do about nursing.
The friends that they had werenursing.
You know, you have a lot ofnursing friends because you can
all talk, and so everything wasnursing and my sister and I
(04:38):
hated it and I used to tellpeople that I would rather be, I
think, a sanitation worker thana nurse.
Until I, when I was 16, Istarted dating a 21 year old who
was in college, much to my poor, poor parents I'm sorry, mom
and dad.
Anyway, subsequently he waskilled a year after we.
(04:59):
He was my first love and he waskilled in a car accident on the
Bronx Road Parkway and oh, wow,I'm so sorry it was.
It was tragic, but it wastransformational in the way that
we went to the emergency roomand I walked in not knowing what
had happened, because I had methis passenger and his passenger
was fine.
And when we got to the hospital,you know, it was the nurse that
(05:20):
came out from the inner sanctumof the ER and she told me and I
, she grabbed me and held me andI 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 allI thought about at that moment
was how, how amazing this womanwas to be able to to give that.
(05:46):
You know, first of all, what ahorrible, hard job to have to do
that and how gracefully she didthat and how, how impactful it
was.
And I'll never forget.
You know how she supported methrough that first 90 seconds.
Speaker 1 (06:00):
What a powerful story about that nurse.
Speaker 3 (06:03):
I mean that, that yeah, she was my angel.
You know she had to come outand deliver that news to a 16
year old girl.
I cannot imagine and it was ithad to be.
You know.
I'm sure she could have chosena different career path that
didn't involve such agut-wrenching kind of revelation
(06:24):
.
But I'll never forget her.
Yeah, and then all of a suddeneverything kind of clicked.
You know all the nursing in mybackground, which would
apparently be why I went intonursing, plus that encounter.
All I wanted to do was be anurse.
So I was fortunate enough to goto the college amounts in
Vincent and I got my RNundergrad there.
(06:47):
I started working at New YorkHospital in the city as a
orthopedic nurse and that wasquite an interesting job.
I kind of felt like I threwpeople on and off stretchers all
day.
I found myself not using allthe wonderful parts I learned in
nursing school.
You know, teaching, healthpromotion, health protection.
(07:08):
So while I was at New YorkHospital I took a per diem job
at the visiting nurse service inNew York and I started doing
home care and absolutely fell inlove with home care because of
the teaching, the one on one Iwas.
This is great.
So during that time VNSNY wasnice enough to send me back to
(07:30):
school to get my nursepractitioner.
Now that I had my master's Icould officially lecture and do
clinical and I started doingthat per diem and I also worked
as a nurse practitioner threedays a week in internal medicine
.
I started working at Mount StVincent as a professor and then
I was approached by ConcordiaCollege who had developed this
(07:51):
accelerated program where youcould become a nurse in 15
months and they wanted me towork there.
And I thought to myself youcan't make someone a nurse in 15
months, prove me wrong.
And I went over there and itwas the most amazing,
transformative program and Ifell in love with the idea of
(08:15):
taking someone who now knowswhat they want to do, you know,
had tried some other career andnow really wanted to pursue
nursing.
I started new learning curve,right, I started learning how to
do administration and then theyasked me to be the permanent
dean and I was the permanentdean until Concordia
unfortunately closed down and Imoved over to Manhattanville
(08:38):
College and I thought to myself,what haven't I done?
So Manhattanville offered methe chance to become the
founding director of theirfamily nurse practitioner
program, which I jumped at, andcurrently we will be graduating
our first cohort of 10 nursepractitioners in December, this
December of 2023.
Speaker 1 (08:57):
That's very exciting, that's incredible.
So you are the director of theFNP program.
So I think what a lot oflisteners are wondering is what
exactly does an NP do?
Because I know in undergradthere's a lot of talk like, oh
yes, I'm going to go for my NPafter this long and I'm not sure
(09:19):
.
A lot of people I'm not evensure if I fully understand.
What is the difference betweenan NP and an RN?
What can you do with one versusanother?
That's a great question.
Speaker 3 (09:29):
One of the wonderful things about NP that I profess
is nurse practitioners take thebest of nursing and combine it
with the best of medicine.
So they come at patient carefrom a dichotomy of journeys how
to talk to people, how to teachpeople to change behaviors, how
(09:50):
to help people be their ownagent or advocate and then
medicine.
You know, the best of diagnosis, the best of treatment, the
best of referral comes on thatside.
So a nurse practitioner kind oftakes all these things medicine
and nursing and puts themtogether and presents forward.
I find that my role as a nursepractitioner I've been at my
(10:10):
private practice for 22 years,still with the same doctor is
more when the patient needs alittle bit more health promotion
, a little bit more healthteaching.
I find that these are thepatients that I do best with in
primary care.
I'm able to take that nursingedge and tell people OK, you
have diabetes.
All right, what are we going todo about this?
What does diabetes look like inyour life?
(10:30):
And OK, so this medicine isworking for you, but this one
isn't.
Why don't we try this?
Or I see you're not getting theinsulin 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, evenif it's at five minutes in one
direction and five minutes back?
Oh look, it's time we have tocheck your A1C again.
(10:52):
Have you gone to the podiatrist?
Have you gone to the retinalspecialist specialist this year?
So a lot of what I do is thatcombination of medicine and
nursing.
Nurse practitioners practice inso many areas that our scope of
practice is not as evident.
So that's why a lot of peoplehave questions about what
(11:15):
exactly nurse practitioners do.
We kind of I don't like theterm extender, but I like the
term encompasser we reallyencompass that best of medicine
and best of nursing.
And wherever you put a nursepractitioner, it's an addition,
it's not just the addition of,let's say, a physician, it's the
addition of medicine andnursing, together with all those
(11:38):
factions playing at the sametime.
You know, I find that a lot ofmy medical colleagues don't
think you know, think you knowto the, to the other stuff.
They don't think about diet asmuch, they just tell the patient
OK, no concentrated sweets, noprocessed foods.
I find that my approach tendsto be OK.
Let's talk about your favoritefoods.
Yeah, all of them are processed, all of them are sugar.
(12:01):
How can we moderate this sothat you feel better?
Speaker 1 (12:05):
and so that they'll actually adhere to it.
Speaker 3 (12:08):
Right, because I know about.
I know if someone said to meyou can't have ice cream anymore
, I mean, literally the firstthing I would do after I left my
appointment was go get icecream, because I know yeah, I
don't like to be told that Ican't have something but let's
talk about OK, let's have icecream once a week instead of
once a day.
So nursing gave me thatbackground to be able to ask or
(12:28):
approach things in that way, andI think it's a lot more
palatable to our patients.
Speaker 1 (12:32):
Yeah, I would agree with that, and I've never heard
NP nurse practitioner describedas the the marriage between the
best of nursing and the best ofmedicine.
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, youhave the ability to diagnose and
to prescribe, but you are,first and foremost, an educator.
Speaker 3 (12:57):
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 andthen go through five or six or
seven things it could be.
We are just focused onrelieving the problem, right,
whereas in for the medical angleI have to figure out what's
causing it, treat it and thenfollow up on it.
(13:20):
So it was tricky in thebeginning because the medical
diagnosis or the differentialdiagnosis model was new to me.
Right, that's a different role.
Speaker 1 (13:30):
So a couple questions .
At what point would you thinkthat an RN would be ready to go
back to NP school?
How soon is too soon?
Should you have a certainnumber of years of experience as
a working RN before you apply?
What's your opinion on that?
Speaker 3 (13:45):
That's a really great question.
When I first started as a nursepractitioner I graduated in 94
from Mount St Vincent and Iwaited until the summer of 1998
to go back.
I really felt at the time thathaving those years of experience
prepared me better to go backto school.
So I was very judgmental of thenewer programs that have come
(14:10):
along that basically said youcan graduate in May and come
back in August and we'll makeyou a nurse practitioner.
I kind of felt that iteliminated a lot of the nursing
part and we're nursepractitioners so you need that
nursing part.
But I have to go back to when Ialso thought you couldn't make
a nurse in 15 months aftercoming through a four year
(14:31):
program.
You know I knew two years waspossible, I knew four years was
possible.
I thought to myself 15 monthsis ridiculous.
But I think already it changedmy view on that.
So now looking at the currentenvironment, especially at a
program like Manhattanville, westart with advanced theory,
advanced research, leadershipand ethics.
(14:53):
That encompasses two semestersof our program.
So theoretically if someonegraduated in May and started in
August or September of the sameyear, they would just be
advancing kind of their bookknowledge advanced theories,
advanced research techniques,advanced ethical issues and
(15:15):
advanced leadership.
That gives them a wholeadditional year of core courses
to get all that nursingexperience.
That year full and your firstyear is definitely full of
experiences.
As you, lauren, probably wouldattest to, it's an overwhelming
year and by the time they comethrough that year and they have
(15:41):
these core courses with them andthey approach advanced health
assessment, I am happy to reportthat they are ready.
They are ready to take on theadvanced diagnosing, the
differential diagnosing.
They are ready to have reallypoignant conversations about
nursing, about being a nursepractitioner.
From what they've observed fromthe doctors and the teams
(16:04):
they've worked with, they have alot of insight.
So when they get into familynursing practice theory one,
they are really handling it well.
We are getting wonderfulfeedback about their evaluations
and their ability to practiceas an independent practitioner.
Lauren, once again I have beenproven incorrect.
(16:26):
That I really do think, if youfind the right program that
gives you that time, that wholefirst year, to kind of grow as a
nurse by the time you get tothe advanced portion, I really
do find that students are readyfor this.
Speaker 1 (16:41):
That makes a lot of sense.
I never thought of it that way,because you're going to be
working while you're going tothe NP program.
So, your first year, at leastin this program and I would
think it's similar everywhere isyour foundational core courses.
Speaker 3 (16:55):
And I would encourage students not to rush.
Make sure when you, if you'relooking into a nurse
practitioner program, make sureyou find the program that fits
you and lets you function as aworking RN, as a partner, maybe
as a parent or as a caregiver ofdifferent generations.
(17:17):
You don't want to commityourself to a program that's
going to be all encompassingyour RN.
We always talk about this.
Right, it's 15 months.
Say goodbye to your family andwe say it rather, you know, I
don't know snarkily you know,say goodbye to your family and
friends because you can see them.
Yeah, you were able to do otherthings, but it was life changing
(17:40):
.
Yes, this should be life.
I truly believe that a master'sdegree should be life adding,
not changing, you know love that, added on experience, that's
going to take you forward.
But there's no rush to goforward, trust me.
The salaries are not that muchdifferent.
There's other benefits, thingslike hours and and the different
(18:01):
things that make the nursepractitioner really a wonderful,
wonderful career.
But no one should really be inmy opinion.
Don't rush it.
You know, savor the moment.
Move forward in the journey toyour nurse practitioner and then
figure out what some peoplegraduate with their masters and
they decide to go into teaching.
(18:22):
I can tell you, after threedays of academia I am so ready
to go back into my practice modeand after about eight hours to
10 hours of practice I'm veryexcited to get back into
education.
So it keeps me fresh andexcited most of the time.
Speaker 1 (18:35):
Right, right.
How long is the total time ofthe NP, the FNP program?
Is it two years?
Speaker 3 (18:42):
Our program at Manhattanville is part time,
seven semesters, so it's fall,spring, summer, fall, spring,
summer, fall.
Most part time programs cantake.
It's about three years, okay,and then a year and a half full
time Again, if you wanted topursue something like that.
Speaker 1 (19:02):
Right.
So what is the difference thenif you get your MSN versus your
NP, your masters of science andnursing, is that really so you
can teach?
Is that so you could basicallyteach clinical at that point?
Speaker 3 (19:15):
Yeah, most of the time.
Now it's interesting state tostate things are different.
So most of the time, if you'regetting 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 amaster's program or a
baccalaureate, mostly in abaccalaureate program.
(19:35):
Excuse me.
And in the hospital to pursue anadministrative career.
This is where it gets tricky.
If you get an FNP in New Yorkstate, you can teach because you
have inherently have yourmasters, or work as a family
nurse practitioner.
Where it gets really tricky iswhen you want to go on.
(19:57):
So New York state is one of twostates where, if you get an FN,
the only people in New Yorkstate schools that can get a DNP
a doctorate of nursing practiceis an FNP.
So if you have an MSN ineducation or an MSN in
administration and you wouldlike to pursue doctoral
(20:17):
education in New York state, youwould not be able to enroll in
a DNP program.
Now that's only New York state.
In Alabama, I believe in everyother state in the United States
anyone can become a DNP.
Speaker 1 (20:32):
What is the advantage of getting your DNP versus FNP?
Speaker 3 (20:38):
Oh boy, you can give me the short answer.
I have not come up with a goodanswer for that.
A DNP is a great degree for anurse practitioner who wants to
stay in education, okay, or callthemselves doctor Correct,
which is a big, big debateconstantly.
(20:58):
I have a PhD.
I when I knew that I wanted tobe in education fully, at the
time everyone recommended thePhD and not the DNP.
Now they're pretty muchinterchangeable.
If you want doctorate educationand you're an FMP, you can
either go for a PhD or a DNP,and sometimes you'll find the
(21:20):
DNP program is more manageable.
At times they do a projectinstead of a thesis, and so what
I would say to anyone inpursuing that, do your homework,
look in the direction you wantto go with and find what works
best for you.
But I don't have a really greatanswer.
Speaker 1 (21:39):
No, that's fine.
So would you say, working in ahospital setting as a nurse
practitioner versus primary care, would you say?
You said before, you have moreone-on-one patient interaction
with and more opportunities foreducation in the private
practice setting versus hospital.
Speaker 3 (21:58):
Yeah, I think in the hospital setting sometimes the
nurse practitioner is the PAs,the residents and the doctors
kind of get their roles overlapso they become very performative
as to what needs to get doneand I have X number of patients
to see so I always hope thatthey take their nursing and
integrate it into everythingthey do.
(22:19):
I find in primary care I'm ableto spend time doing a lot more
teaching in health promotion andprotection.
Speaker 1 (22:27):
So with the FMP it's family nurse practitioner.
It's from birth to earth.
Birth to earth is what you hadtold me.
So would you recommend thatversus one of the highly
specialized areas?
Speaker 3 (22:43):
Yeah, unless you're really sure what you're, unless
you're really sure that this issomething that you wanna pursue
hands down.
So here's an example For familynurse practitioner you have to
do 90 hours in our program inpediatrics.
That's definitely a hardpreceptorship to find and if you
(23:04):
don't ever plan to work withkids, you may feel that it's not
going to serve you.
I will tell you this forcertain facilities like PM
pediatrics will only let nursepractitioners pediatric nurse
practitioners train at theirfacilities because there are
only so many spots and they'relooking for people who are going
to be pediatric nursepractitioners.
So, in that respect, if youknow you wanna work with
(23:24):
children under 21, I believe itis now and you never really want
to take care of adults, that'san excellent opportunity for you
to fulfill your passion.
That being said, as a pediatricnurse practitioner, you can go
back and get a family nursepractitioner certificate.
It's usually one, usually it'sfour semesters, part-time, and
(23:47):
you would get a certificate andthen certify for that and you
could take care of adults aswell.
So it's not.
You're not backed into a corner, okay.
So figure out to the best ofyour ability what you wanna do
and pursue it that way.
Speaker 1 (24:02):
Right.
So in that sense, working forat least a year might make more
sense versus going right into it.
Speaker 3 (24:08):
If you don't know, the core courses are the same
for every program theory,research, ethics, leadership,
right and a lot of programs willlet you transfer them in and
out too not all, but most, so ifyou decide.
After a year in a family nursepractitioner program I've had a
couple students say to me Ireally wanna pursue pediatrics
exclusively and they've moved toa different program.
(24:29):
Oh, okay.
Speaker 1 (24:31):
Well, they figured it out.
That's good, okay.
So, dr Bourgeois, you spentsome time teaching undergraduate
nurses a long time, and this isa podcast for undergraduate
nurses.
You happened to be my professorfor about three weeks and it
was a great time.
You filled in for our healthassessment class and you
(24:51):
actually did my check off for myhealth assessment final, and I
will never forget where theangle of Louie is, because of
you.
You stumped me on that one.
Speaker 3 (25:06):
One whole second interval of space.
I love it.
Yep, I'm on mark yes.
Speaker 1 (25:10):
So if you could give undergraduate nursing students
one piece of advice, onetakeaway for how to be
successful in nursing school,what do you think it would be if
you could just give them onepiece of advice Get more sleep.
Speaker 3 (25:28):
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 pieceof advice, I say get a B or a B
plus, and make sure that you'readdressing your self-care needs.
(25:49):
Sleep exercise, get your nailsdone, have an ice cream cone.
You do not need to get an A innursing, you just need to get
through nursing with yourselfintact, and that can be a
challenge.
So I would just my one piece ofadvice is self-care, and make
sure you're in a situation thatyou can provide yourself with
(26:13):
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 firsttime, it may not work out the
second time.
Life has a way of kind ofchanging our trajectory.
Don't let it derail.
You.
Go with the trajectory it'sbringing you in and then come
(26:33):
back to it.
I've had so many students whoeither ran out of money or had a
problem at home or whatever itwas, and they felt derailed and
rejected and that their dreamwould never come true.
No, just not right now.
It's not always a straight lineand it'll happen.
So if you're not in a positiondue to funding, due to pressure
(26:59):
or due to family, whatever it isjust don't try to lean into
that.
Get that done and then pursueit.
Don't try to do both, becauseyou lose yourself in that
process and you can't doself-care and it's not good for
you.
Speaker 1 (27:16):
That's so true.
It'll happen when it's supposedto happen, correct?
Speaker 3 (27:21):
And don't let anyone tell you that it's not going to
happen.
You know, if that's what youwant, it'll happen, but you have
to be in the right framework.
Speaker 1 (27:29):
I couldn't agree more .
Well, Dr B, thank you so muchfor taking the time to speak to
us today.
I appreciate it so much and wewill talk to you really soon.
Speaker 3 (27:40):
Thank you again, thank you so much for having me
and I think you're going to postmy information if anyone has
any questions or just wants tovent, or I would love to
participate.
Thank you, Absolutely.
Speaker 1 (27:51):
I will put your email in the description of the show
if anybody wants to contact DrBourgeois.
And thanks again, I reallyappreciate it.
Oh, thank you, lauren All right.
Well, that is a wrap for today.
Dr Bourgeois, thank you so muchfor speaking with us.
That was so helpful, soinsightful, and it is always
(28:12):
such a pleasure.
And to everybody out therelistening, thank you so much.
As always, you can follow us onsocial media.
The handle is atnursingstudentcoachcom and you
can go to nursingstudentcoachcomto join our mailing list and
get all the latest updates.
Until next time, have anamazing day.
Bye-bye.
Hi everybody.
Just a quick announcementbefore we get into today's show,
in case you missed it last weekwe are moving to once a week
podcast episodes every Thursdayinstead of every Tuesday and
Thursday, because I wanted totake that time that has been
going into that second episodeand put it into some new and
(00:22):
exciting projects we have comingyour way things like one-on-one
coaching, group coaching,online courses and seminars and,
of course, farmsimple RN, whichis a pharmacology study tool
that will be available in thecoming months.
So you have 20 Nursing StudentCoach podcast episodes that have
(00:43):
already been released and wewill be having new ones every
Thursday.
Thanks so much, everybody, andnow on to today's show.
Speaker 2 (00:53):
Nursing School is a wild ride, but that doesn't mean
you have to run and hide whenthe going gets tough.
Don't leave your stressundiagnosed.
You gotta call the NursingStudent Coach.
Real-life tips from aregistered nurse, in school and
(01:13):
out.
She's seen the worst.
Now, without further ado, yeah,here is your host, the Nursing
Student Coach.
Speaker 1 (01:26):
Hello everybody and welcome to Nursing Student Coach
.
My name is Lauren Chapnick andI am your host, and I want to
thank you so much in yoursupport.
As you know, it is my personalmission with this show to help
put more great nurses into theworld.
So the more listeners that wecan reach, the more future
prospective nurses who can hearthe show, the better.
(01:49):
So if you're watching onYouTube, if you could subscribe
to the show, make a comment.
It really helps to put the showin front of more prospective
listeners.
And if you're listening onApple podcast or watching on
Spotify, it is also so helpfulif you take out your phone and
give us a quick five-star ratingand write a quick review, just
(02:13):
one or two sentences, what youlike about the show, and I would
appreciate that so much.
Today we are talking about whatit means to be a nurse
practitioner, an NP.
What exactly does an NP do andwhen is it a good time to go
back to NP school if that'ssomething that you're thinking
(02:35):
about doing as an RN?
Furthering our education asnurses is something a lot of us
think about.
So today we are speaking withthe director of the Family Nurse
Practitioner Program atManhattanville College.
Her name is Dr Karen Bourgeoisand she is a PhD, she's an RN,
(02:59):
she's an FNP and she has been innursing education for over 25
years.
So if anybody can answer thebig questions about what this
degree is all about, what aresome of the differences between
FNP and the different NPspecialties, what can you do
(03:19):
with this degree and what aresome other advanced degrees and
what makes them different we arehere to answer all of these
questions today and speak to oneof my favorite people, so I
would like to welcome Dr KarenBourgeois.
Hi, dr Bourgeois, thank you somuch for joining us, hi.
Speaker 3 (03:40):
Hi Lauren, I am so happy to be here.
Speaker 1 (03:42):
Good, so if you could just for a few minutes walk us
through your background.
How did you get into nursingand then education and then into
what you're doing now?
Speaker 3 (03:54):
Sure.
So growing up it was myself, mysister, my mom and dad very
traditional nuclear family.
My grandparents live downstairs.
My mom was the third generationof nurses.
My grandmother was a nurse.
She was a nurse.
Subsequently I became a nurseand we actually have a fourth
generation that I'll tell youabout in a minute.
Wow, my dad was also.
(04:16):
He served in Vietnam and hecame back and, through the GI
Bill, paid for his nursingschool.
So my parents were both nurses.
So everything at the dinnertable from when I was very, very
young had to do about nursing.
The friends that they had werenursing.
You know, you have a lot ofnursing friends because you can
all talk, and so everything wasnursing and my sister and I
(04:38):
hated it and I used to tellpeople that I would rather be, I
think, a sanitation worker thana nurse.
Until I, when I was 16, Istarted dating a 21 year old who
was in college, much to my poor, poor parents I'm sorry, mom
and dad.
Anyway, subsequently he waskilled a year after we.
(04:59):
He was my first love and he waskilled in a car accident on the
Bronx Road Parkway and oh, wow,I'm so sorry it was.
It was tragic, but it wastransformational in the way that
we went to the emergency roomand I walked in not knowing what
had happened, because I had methis passenger and his passenger
was fine.
And when we got to the hospital,you know, it was the nurse that
(05:20):
came out from the inner sanctumof the ER and she told me and I
, she grabbed me and held me andI 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 allI thought about at that moment
was how, how amazing this womanwas to be able to to give that.
(05:46):
You know, first of all, what ahorrible, hard job to have to do
that and how gracefully she didthat and how, how impactful it
was.
And I'll never forget.
You know how she supported methrough that first 90 seconds.
Speaker 1 (06:00):
What a powerful story about that nurse.
Speaker 3 (06:03):
I mean that, that yeah, she was my angel.
You know she had to come outand deliver that news to a 16
year old girl.
I cannot imagine and it was ithad to be.
You know.
I'm sure she could have chosena different career path that
didn't involve such agut-wrenching kind of revelation
(06:24):
.
But I'll never forget her.
Yeah, and then all of a suddeneverything kind of clicked.
You know all the nursing in mybackground, which would
apparently be why I went intonursing, plus that encounter.
All I wanted to do was be anurse.
So I was fortunate enough to goto the college amounts in
Vincent and I got my RNundergrad there.
(06:47):
I started working at New YorkHospital in the city as a
orthopedic nurse and that wasquite an interesting job.
I kind of felt like I threwpeople on and off stretchers all
day.
I found myself not using allthe wonderful parts I learned in
nursing school.
You know, teaching, healthpromotion, health protection.
(07:08):
So while I was at New YorkHospital I took a per diem job
at the visiting nurse service inNew York and I started doing
home care and absolutely fell inlove with home care because of
the teaching, the one on one Iwas.
This is great.
So during that time VNSNY wasnice enough to send me back to
(07:30):
school to get my nursepractitioner.
Now that I had my master's Icould officially lecture and do
clinical and I started doingthat per diem and I also worked
as a nurse practitioner threedays a week in internal medicine
.
I started working at Mount StVincent as a professor and then
I was approached by ConcordiaCollege who had developed this
(07:51):
accelerated program where youcould become a nurse in 15
months and they wanted me towork there.
And I thought to myself youcan't make someone a nurse in 15
months, prove me wrong.
And I went over there and itwas the most amazing,
transformative program and Ifell in love with the idea of
(08:15):
taking someone who now knowswhat they want to do, you know,
had tried some other career andnow really wanted to pursue
nursing.
I started new learning curve,right, I started learning how to
do administration and then theyasked me to be the permanent
dean and I was the permanentdean until Concordia
unfortunately closed down and Imoved over to Manhattanville
(08:38):
College and I thought to myself,what haven't I done?
So Manhattanville offered methe chance to become the
founding director of theirfamily nurse practitioner
program, which I jumped at, andcurrently we will be graduating
our first cohort of 10 nursepractitioners in December, this
December of 2023.
Speaker 1 (08:57):
That's very exciting, that's incredible.
So you are the director of theFNP program.
So I think what a lot oflisteners are wondering is what
exactly does an NP do?
Because I know in undergradthere's a lot of talk like, oh
yes, I'm going to go for my NPafter this long and I'm not sure
(09:19):
.
A lot of people I'm not evensure if I fully understand.
What is the difference betweenan NP and an RN?
What can you do with one versusanother?
That's a great question.
Speaker 3 (09:29):
One of the wonderful things about NP that I profess
is nurse practitioners take thebest of nursing and combine it
with the best of medicine.
So they come at patient carefrom a dichotomy of journeys how
to talk to people, how to teachpeople to change behaviors, how
(09:50):
to help people be their ownagent or advocate and then
medicine.
You know, the best of diagnosis, the best of treatment, the
best of referral comes on thatside.
So a nurse practitioner kind oftakes all these things medicine
and nursing and puts themtogether and presents forward.
I find that my role as a nursepractitioner I've been at my
(10:10):
private practice for 22 years,still with the same doctor is
more when the patient needs alittle bit more health promotion
, a little bit more healthteaching.
I find that these are thepatients that I do best with in
primary care.
I'm able to take that nursingedge and tell people OK, you
have diabetes.
All right, what are we going todo about this?
What does diabetes look like inyour life?
(10:30):
And OK, so this medicine isworking for you, but this one
isn't.
Why don't we try this?
Or I see you're not getting theinsulin 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, evenif it's at five minutes in one
direction and five minutes back?
Oh look, it's time we have tocheck your A1C again.
(10:52):
Have you gone to the podiatrist?
Have you gone to the retinalspecialist specialist this year?
So a lot of what I do is thatcombination of medicine and
nursing.
Nurse practitioners practice inso many areas that our scope of
practice is not as evident.
So that's why a lot of peoplehave questions about what
(11:15):
exactly nurse practitioners do.
We kind of I don't like theterm extender, but I like the
term encompasser we reallyencompass that best of medicine
and best of nursing.
And wherever you put a nursepractitioner, it's an addition,
it's not just the addition of,let's say, a physician, it's the
addition of medicine andnursing, together with all those
(11:38):
factions playing at the sametime.
You know, I find that a lot ofmy medical colleagues don't
think you know, think you knowto the, to the other stuff.
They don't think about diet asmuch, they just tell the patient
OK, no concentrated sweets, noprocessed foods.
I find that my approach tendsto be OK.
Let's talk about your favoritefoods.
Yeah, all of them are processed, all of them are sugar.
(12:01):
How can we moderate this sothat you feel better?
Speaker 1 (12:05):
and so that they'll actually adhere to it.
Speaker 3 (12:08):
Right, because I know about.
I know if someone said to meyou can't have ice cream anymore
, I mean, literally the firstthing I would do after I left my
appointment was go get icecream, because I know yeah, I
don't like to be told that Ican't have something but let's
talk about OK, let's have icecream once a week instead of
once a day.
So nursing gave me thatbackground to be able to ask or
(12:28):
approach things in that way, andI think it's a lot more
palatable to our patients.
Speaker 1 (12:32):
Yeah, I would agree with that, and I've never heard
NP nurse practitioner describedas the the marriage between the
best of nursing and the best ofmedicine.
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, youhave the ability to diagnose and
to prescribe, but you are,first and foremost, an educator.
Speaker 3 (12:57):
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 andthen go through five or six or
seven things it could be.
We are just focused onrelieving the problem, right,
whereas in for the medical angleI have to figure out what's
causing it, treat it and thenfollow up on it.
(13:20):
So it was tricky in thebeginning because the medical
diagnosis or the differentialdiagnosis model was new to me.
Right, that's a different role.
Speaker 1 (13:30):
So a couple questions .
At what point would you thinkthat an RN would be ready to go
back to NP school?
How soon is too soon?
Should you have a certainnumber of years of experience as
a working RN before you apply?
What's your opinion on that?
Speaker 3 (13:45):
That's a really great question.
When I first started as a nursepractitioner I graduated in 94
from Mount St Vincent and Iwaited until the summer of 1998
to go back.
I really felt at the time thathaving those years of experience
prepared me better to go backto school.
So I was very judgmental of thenewer programs that have come
(14:10):
along that basically said youcan graduate in May and come
back in August and we'll makeyou a nurse practitioner.
I kind of felt that iteliminated a lot of the nursing
part and we're nursepractitioners so you need that
nursing part.
But I have to go back to when Ialso thought you couldn't make
a nurse in 15 months aftercoming through a four year
(14:31):
program.
You know I knew two years waspossible, I knew four years was
possible.
I thought to myself 15 monthsis ridiculous.
But I think already it changedmy view on that.
So now looking at the currentenvironment, especially at a
program like Manhattanville, westart with advanced theory,
advanced research, leadershipand ethics.
(14:53):
That encompasses two semestersof our program.
So theoretically if someonegraduated in May and started in
August or September of the sameyear, they would just be
advancing kind of their bookknowledge advanced theories,
advanced research techniques,advanced ethical issues and
(15:15):
advanced leadership.
That gives them a wholeadditional year of core courses
to get all that nursingexperience.
That year full and your firstyear is definitely full of
experiences.
As you, lauren, probably wouldattest to, it's an overwhelming
year and by the time they comethrough that year and they have
(15:41):
these core courses with them andthey approach advanced health
assessment, I am happy to reportthat they are ready.
They are ready to take on theadvanced diagnosing, the
differential diagnosing.
They are ready to have reallypoignant conversations about
nursing, about being a nursepractitioner.
From what they've observed fromthe doctors and the teams
(16:04):
they've worked with, they have alot of insight.
So when they get into familynursing practice theory one,
they are really handling it well.
We are getting wonderfulfeedback about their evaluations
and their ability to practiceas an independent practitioner.
Lauren, once again I have beenproven incorrect.
(16:26):
That I really do think, if youfind the right program that
gives you that time, that wholefirst year, to kind of grow as a
nurse by the time you get tothe advanced portion, I really
do find that students are readyfor this.
Speaker 1 (16:41):
That makes a lot of sense.
I never thought of it that way,because you're going to be
working while you're going tothe NP program.
So, your first year, at leastin this program and I would
think it's similar everywhere isyour foundational core courses.
Speaker 3 (16:55):
And I would encourage students not to rush.
Make sure when you, if you'relooking into a nurse
practitioner program, make sureyou find the program that fits
you and lets you function as aworking RN, as a partner, maybe
as a parent or as a caregiver ofdifferent generations.
(17:17):
You don't want to commityourself to a program that's
going to be all encompassingyour RN.
We always talk about this.
Right, it's 15 months.
Say goodbye to your family andwe say it rather, you know, I
don't know snarkily you know,say goodbye to your family and
friends because you can see them.
Yeah, you were able to do otherthings, but it was life changing
(17:40):
.
Yes, this should be life.
I truly believe that a master'sdegree should be life adding,
not changing, you know love that, added on experience, that's
going to take you forward.
But there's no rush to goforward, trust me.
The salaries are not that muchdifferent.
There's other benefits, thingslike hours and and the different
(18:01):
things that make the nursepractitioner really a wonderful,
wonderful career.
But no one should really be inmy opinion.
Don't rush it.
You know, savor the moment.
Move forward in the journey toyour nurse practitioner and then
figure out what some peoplegraduate with their masters and
they decide to go into teaching.
(18:22):
I can tell you, after threedays of academia I am so ready
to go back into my practice modeand after about eight hours to
10 hours of practice I'm veryexcited to get back into
education.
So it keeps me fresh andexcited most of the time.
Speaker 1 (18:35):
Right, right.
How long is the total time ofthe NP, the FNP program?
Is it two years?
Speaker 3 (18:42):
Our program at Manhattanville is part time,
seven semesters, so it's fall,spring, summer, fall, spring,
summer, fall.
Most part time programs cantake.
It's about three years, okay,and then a year and a half full
time Again, if you wanted topursue something like that.
Speaker 1 (19:02):
Right.
So what is the difference thenif you get your MSN versus your
NP, your masters of science andnursing, is that really so you
can teach?
Is that so you could basicallyteach clinical at that point?
Speaker 3 (19:15):
Yeah, most of the time.
Now it's interesting state tostate things are different.
So most of the time, if you'regetting 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 amaster's program or a
baccalaureate, mostly in abaccalaureate program.
(19:35):
Excuse me.
And in the hospital to pursue anadministrative career.
This is where it gets tricky.
If you get an FNP in New Yorkstate, you can teach because you
have inherently have yourmasters, or work as a family
nurse practitioner.
Where it gets really tricky iswhen you want to go on.
(19:57):
So New York state is one of twostates where, if you get an FN,
the only people in New Yorkstate schools that can get a DNP
a doctorate of nursing practiceis an FNP.
So if you have an MSN ineducation or an MSN in
administration and you wouldlike to pursue doctoral
(20:17):
education in New York state, youwould not be able to enroll in
a DNP program.
Now that's only New York state.
In Alabama, I believe in everyother state in the United States
anyone can become a DNP.
Speaker 1 (20:32):
What is the advantage of getting your DNP versus FNP?
Speaker 3 (20:38):
Oh boy, you can give me the short answer.
I have not come up with a goodanswer for that.
A DNP is a great degree for anurse practitioner who wants to
stay in education, okay, or callthemselves doctor Correct,
which is a big, big debateconstantly.
(20:58):
I have a PhD.
I when I knew that I wanted tobe in education fully, at the
time everyone recommended thePhD and not the DNP.
Now they're pretty muchinterchangeable.
If you want doctorate educationand you're an FMP, you can
either go for a PhD or a DNP,and sometimes you'll find the
(21:20):
DNP program is more manageable.
At times they do a projectinstead of a thesis, and so what
I would say to anyone inpursuing that, do your homework,
look in the direction you wantto go with and find what works
best for you.
But I don't have a really greatanswer.
Speaker 1 (21:39):
No, that's fine.
So would you say, working in ahospital setting as a nurse
practitioner versus primary care, would you say?
You said before, you have moreone-on-one patient interaction
with and more opportunities foreducation in the private
practice setting versus hospital.
Speaker 3 (21:58):
Yeah, I think in the hospital setting sometimes the
nurse practitioner is the PAs,the residents and the doctors
kind of get their roles overlapso they become very performative
as to what needs to get doneand I have X number of patients
to see so I always hope thatthey take their nursing and
integrate it into everythingthey do.
(22:19):
I find in primary care I'm ableto spend time doing a lot more
teaching in health promotion andprotection.
Speaker 1 (22:27):
So with the FMP it's family nurse practitioner.
It's from birth to earth.
Birth to earth is what you hadtold me.
So would you recommend thatversus one of the highly
specialized areas?
Speaker 3 (22:43):
Yeah, unless you're really sure what you're, unless
you're really sure that this issomething that you wanna pursue
hands down.
So here's an example For familynurse practitioner you have to
do 90 hours in our program inpediatrics.
That's definitely a hardpreceptorship to find and if you
(23:04):
don't ever plan to work withkids, you may feel that it's not
going to serve you.
I will tell you this forcertain facilities like PM
pediatrics will only let nursepractitioners pediatric nurse
practitioners train at theirfacilities because there are
only so many spots and they'relooking for people who are going
to be pediatric nursepractitioners.
So, in that respect, if youknow you wanna work with
(23:24):
children under 21, I believe itis now and you never really want
to take care of adults, that'san excellent opportunity for you
to fulfill your passion.
That being said, as a pediatricnurse practitioner, you can go
back and get a family nursepractitioner certificate.
It's usually one, usually it'sfour semesters, part-time, and
(23:47):
you would get a certificate andthen certify for that and you
could take care of adults aswell.
So it's not.
You're not backed into a corner, okay.
So figure out to the best ofyour ability what you wanna do
and pursue it that way.
Speaker 1 (24:02):
Right.
So in that sense, working forat least a year might make more
sense versus going right into it.
Speaker 3 (24:08):
If you don't know, the core courses are the same
for every program theory,research, ethics, leadership,
right and a lot of programs willlet you transfer them in and
out too not all, but most, so ifyou decide.
After a year in a family nursepractitioner program I've had a
couple students say to me Ireally wanna pursue pediatrics
exclusively and they've moved toa different program.
(24:29):
Oh, okay.
Speaker 1 (24:31):
Well, they figured it out.
That's good, okay.
So, dr Bourgeois, you spentsome time teaching undergraduate
nurses a long time, and this isa podcast for undergraduate
nurses.
You happened to be my professorfor about three weeks and it
was a great time.
You filled in for our healthassessment class and you
(24:51):
actually did my check off for myhealth assessment final, and I
will never forget where theangle of Louie is, because of
you.
You stumped me on that one.
Speaker 3 (25:06):
One whole second interval of space.
I love it.
Yep, I'm on mark yes.
Speaker 1 (25:10):
So if you could give undergraduate nursing students
one piece of advice, onetakeaway for how to be
successful in nursing school,what do you think it would be if
you could just give them onepiece of advice Get more sleep.
Speaker 3 (25:28):
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 pieceof advice, I say get a B or a B
plus, and make sure that you'readdressing your self-care needs.
(25:49):
Sleep exercise, get your nailsdone, have an ice cream cone.
You do not need to get an A innursing, you just need to get
through nursing with yourselfintact, and that can be a
challenge.
So I would just my one piece ofadvice is self-care, and make
sure you're in a situation thatyou can provide yourself with
(26:13):
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 firsttime, it may not work out the
second time.
Life has a way of kind ofchanging our trajectory.
Don't let it derail.
You.
Go with the trajectory it'sbringing you in and then come
(26:33):
back to it.
I've had so many students whoeither ran out of money or had a
problem at home or whatever itwas, and they felt derailed and
rejected and that their dreamwould never come true.
No, just not right now.
It's not always a straight lineand it'll happen.
So if you're not in a positiondue to funding, due to pressure
(26:59):
or due to family, whatever it isjust don't try to lean into
that.
Get that done and then pursueit.
Don't try to do both, becauseyou lose yourself in that
process and you can't doself-care and it's not good for
you.
Speaker 1 (27:16):
That's so true.
It'll happen when it's supposedto happen, correct?
Speaker 3 (27:21):
And don't let anyone tell you that it's not going to
happen.
You know, if that's what youwant, it'll happen, but you have
to be in the right framework.
Speaker 1 (27:29):
I couldn't agree more .
Well, Dr B, thank you so muchfor taking the time to speak to
us today.
I appreciate it so much and wewill talk to you really soon.
Speaker 3 (27:40):
Thank you again, thank you so much for having me
and I think you're going to postmy information if anyone has
any questions or just wants tovent, or I would love to
participate.
Thank you, Absolutely.
Speaker 1 (27:51):
I will put your email in the description of the show
if anybody wants to contact DrBourgeois.
And thanks again, I reallyappreciate it.
Oh, thank you, lauren All right.
Well, that is a wrap for today.
Dr Bourgeois, thank you so muchfor speaking with us.
That was so helpful, soinsightful, and it is always
(28:12):
such a pleasure.
And to everybody out therelistening, thank you so much.
As always, you can follow us onsocial media.
The handle is atnursingstudentcoachcom and you
can go to nursingstudentcoachcomto join our mailing list and
get all the latest updates.
Until next time, have anamazing day.
Bye-bye.
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