Some random thoughts on school. You give up a lot when you decide to go on for a Nurse Practitioner degree (or any degree, for that matter) - even if you are a relatively young nurse when you start the program. (Although most NP students are older. Statistics show that the average age of a Nurse Practitioner is 47 and she (96% female) has been practicing for 10 years).

1) It is already a given that you will lose income. Even those students who work full time are only able to do so for a portion of the program. Once you are at the point of starting your clinical rotations, you will lose one full day or more. Most primary care, OB-GYN, and peed offices are Mon-Fri daytime hours. Some students will work weekends or nights, but this takes it's toll after awhile. It will be reflected in your health, in your relationships at home and work, and in your school performance.

2) You will spend more money than planned for tuition, books, computers, printers, paper, ink, and "other" expenses. Even if you are very fiscally responsible, and have a savings account or money somewhere else that you've earmarked for school, the unexpected always pops up. The furnace will break, a deer will run out in front of your car, a tornado will throw a tree limb through your roof, your hard drive will crash... You WILL spend money on the unexpected, usually at the most inconvenient times.

3) You will do damage to your body. Stress and worry takes it's toll. You will lose sleep, miss meals, eat junk, develop carpal tunnel, a stiff neck or some other ailment related to studying.

4) You will lose a portion of your life AND the lives of those around you. This is by far the most difficult of all losses. After graduation, I wanted to get back to my life. Unfortunately, while I was spending all of my free time studying, life went on without me. The friends I used see for lunch or drinks every few weeks moved on. There've been divorces, new babies and, in some cases, new friends that have filled the spots left when I went off to study.

The hardest thing is what is lost in terms of those closest to you. Exactly one year ago, I was spent Christmas break frantically working on my Capstone project. Even though I was "off" for a month, I was consumed trying to meet deadlines for the required final project. Last year, we didn't even put up a Christmas tree. I didn't have time to really shop, so it was gift cards for nearly everyone. Last year, I went to some of the usual celebrations, but my mind was on school. I was there and involved, but I really wasn't "there." Now I find the tree is dirty, very dusty, and spider-filled from 2 years of sitting. Lights don't work, ornaments are missing, probably from hurriedly putting the tree away two years, in a panic, with a new semester looming.

Most painful (yet wonderful) of all, my nieces and nephews have grown up. Now officially teenagers, they don't want to sit and talk to me while there are friends to text and music to listen to. They now know that there is no Santa. They don't play with toys anymore. That is the thing, oddly enough, that really hit me hard. With more time and more money than previous years, I began my Christmas shopping early. As I looked at the colorful ads in the Toys-R-Us circular, I was completely overcome by sadness. Suddenly it hit me like a ton of bricks and I realized that those days are over. No more toys for the kids…ever. I missed it…It all happened without me…I totally and completely missed those last few magical Christmas' when the kids were still "kids." While I was studying and focusing on school, they were growing up. How incredibly sad I felt. I was finally "ready and able" to jump right in and be the "Auntie Jessie" they always knew and loved BEFORE school. For them, however, those days are in the past. The last few Christmases are nothing but old memories for them. Memories that do NOT include me.

All I can do from this day forward is embrace the "here and now." Instead of toys for the girls, it's pretty nail polish and makeup. For my nephew, it's a Razor Sole Skate (some kind of one-footed skate board/ rolling skate thingie). All gifts easily returnable, as their taste changes day to day. Here's my advice: It's important to remember that life doesn't wait for you while your in school - it goes on without you. No matter how busy you are, you must make time for the people you love. If you don't, you will truly regret it. You can trust me on that one!

 Helpful hints for the last 6 months of the NP program:

) Buy a copy of an audio version of an NP review course. A new 15 CD set from FHEA (Margaret Fitzgerald) costs around $400. The 12 CD APEA version costs around $269. The 18 CD Barkley review costs around $400. An alternative is buying a used set of CDs. The Fitzgerald reviews can be easily found on Ebay for $150- 300. Also on Craigslist and occasionally Amazon. APEA is harder to find but cost less at $100-150. The “peak” season to find these is June-September and again in December-February. You can also find out if a recent graduate from your school is willing to sell their copy. For most grads, once the exam is done, they never want to listen to the CDs again. Try to get the most recent copy (new versions are released every year) and try to get the workbook that comes with the audio set. Listen to the CDs in your car, while running errands, while cleaning, vacuuming, folding laundry, doing dishes, etc. It will help you immensely in your classes as well as prepare you for the exam.

2) Buy a review book. While in school, commit to doing at least FIVE questions EVERY day. Keep the book next to your bed and do this EVERY night. My personal favorite is Fitzgerald’s latest review book (usually $35-55 on Amazon, Borders, etc). Two other excellent review books are by Maria Leik (Family Nurse Practitioner Certification: An Intensive Review) and JoAnn Zerwekh (Family Nurse Practitioner Certification Review). Both of these are older books and cost $30-50 but both are extremely helpful. Zerwekh comes with A CD of practice tests- absolutely the BEST way to prepare for the exam.

3) Request official transcripts from all of the previous schools you’ve attended. I would suggest having TWO official copies sent to your home- one for you to review and the other to keep in a safe place, completely sealed. Don’t wait until after graduation. The registrar gets very busy after graduation processing transcript requests and usually has limited summer hours. You will need to submit these for the ANCC exam.

4) In the last 4-6 weeks of the program, begin the ANCC or AANP application. Also find out what your state requires for licensure. There are forms that need to be filled out and/or signed by the school. Don’t wait too long. After graduation, professors and administrators are typically “off” for the summer and harder to reach.

5) Start saving for the costs associated with the certification process. Even putting away $5 per week will make a big difference. It can cost around $1500 or more by the time you’re done. For example,

Audio CDs = $300- 400
Review books = $100- 150
Transcripts = $30
Graduation fee = $125
ANCC/AANP exam fee = $240- 360
LIVE review course = $400
State license fee =$200
State controlled substance application = $50
DEA federal controlled substance application = $591