Extra Credit: Peggy F. on Choosing a DNP Over Medical School

Join Jocelyn Wright, our Director of Community and Market Development, for a conversation with Peggy Fedenia, a nurse practitioner in the Chicago area, as part of our Extra Credit series spotlighting working adults who are continuing (or starting) their education while working.

Peggy Fedenia, Nurse Practitioner

Peggy worked as a nurse for nearly ten years before pursuing a Doctor of Nursing Practice through Rush University. She successfully completed her degree and now works as a nurse practitioner at an outpatient clinic for cancer patients. Today, Peggy is sharing why she decided to go back to school, what worked and didn't work in her DNP program, and why being a nurse is a core part of her identity.

Peggy

Basically, it's the highest degree you can attain without going back to medical school. Growing up, I always knew I wanted to be in medicine in some capacity. Honestly, the medical school path, I've had friends go through it, and it felt daunting, but also it didn't seem like a good financial decision.

Working as a nurse for as long as I did, I had a lot of knowledge that I felt I could further develop to practice autonomously. That was the main reason I wanted to go back to school. I wanted to be able to see and treat my own patients and make my own decisions. Having the background of being a nurse, I felt like I was better able to educate and empower people to make their own health decisions and better help them on that path. That was one of the driving things for me.

Peggy

To be frank, I was working at Rush, so I applied to their program because of the tuition reimbursement. Many of my coworkers and friends were in the program, and it was basically free to go back. So long as I'm working full-time, I'm going to get basically free tuition. So I thought, "There's really no reason for me not to do this."

And it's reputable. It's supposed to be one of the top ones in the country, but I didn't really investigate other programs.

Peggy

There were definitely moments where I thought, "Oh, do I really want to stay in healthcare?" Just because of the political context and all the stupid stuff that was going on. It was very disheartening to see people kind of lose their trust in healthcare, and scientists. Also I didn't know whether I was going to get sick early on, which I did, and I ended up being fine, but there was a lot of weird stigma around it. I had so many friends who were doing the whole bubble thing where they would all just hang out with each other, but then I was kind of the outcast with my friends and my family because of my exposure. So that was tough for a period.

Peggy

A lot of our classes were online. So I didn't meet these people until we were in the simulation lab, practicing our skills and going in to do our OSCEs, which is basically your practical exam.

I was kind of bummed that I didn't meet a bunch of other women in my program until the end of it. It would have helped to have their support because we were all kind of going through the same thing. I still talk to a lot of those people. But I wish I had known them earlier on. That would have been a huge help, but there wasn't really an opportunity to meet other people in the program before then.

Peggy

The professors we had were really great. We had a lot of hands-on practice with the simulation lab and things like seeing a fake patient. We got a lot of time to practice and learn how to hone our skills. I feel like there was good mentorship because a lot of the professors are practicing nurse practitioners and have been for decades. That was a good aspect for me.

Peggy

Rush is very vocal about how their program is a DNP program, while a lot of the NP programs are master's level. So they are all about the doctoral project and the research and all that. But I really wanted to go to school to be a stronger clinician and provider, and not necessarily go into research. I wish it had been more focused on the actual clinical experience.

There was also a shortage of nurse practitioners, doctors, and PAs that wanted to take on students to precept and train them through clinicals. It was hard to find people who wanted to take a student on for a full term, and that kind of hindered my learning experience. I had to search out my own clinical sites, and I wish I had gotten some more experience that I didn't get to have. I don't know how Rush compares with other programs for that, but that was one thing that was kind of a disappointment.

Peggy

I think that a lot of it probably stems from budget reasons and not being able to source enough people to take students on. There's not really much compensation for people to take on students. It's just kind of an expectation. Even now, as a nurse practitioner, we get asked about taking on students, which I've periodically had. You don't want it to be a burden, but it kind of is because it's extra effort.

It's still a problem at Rush, too. I've talked to students that are in the program now, and they're like, "Yeah, it's still an issue." They're being placed in really obscure clinical sites that are just so hyper-specialized. Somebody was telling me she was put in sleep medicine, and she said, "It was fascinating. But at the same time, this doesn't give me a broad enough experience. I'm spending an entire term in this spot, but I'm in primary care as my program. If I'm not going into sleep medicine, a lot of this is not applicable."

Peggy

I feel like my experience as a nurse and the critical thinking I had to use for that probably better prepared me for my current career than my program really did, in a lot of ways. I don't know if it's just the culture surrounding NP programs because, you know, we're on the same bar as physician associates but they get way more clinical experience than we do. I don't know how they structure their programs or if they get more of a priority being matched with physicians.

Peggy

A lot of programs, including Rush, required it. I had to be a nurse for I think it was two years. Although, there were several PA students that I worked with, and they had to get a certain number of clinical hours before they could even apply to PA school. Most of them were medical assistants or certified nursing assistants for a really good chunk of time. I forget how many hours they need, but it's kind of a lot before they can even apply. So two years didn't seem like that much in comparison, but I think a majority of NP programs have some sort of nursing requirement before you can apply.

Peggy

It was challenging for sure. I was planning our wedding, too, in the midst of that. I eventually went part-time, and I don't know, you just find a way to kind of push through. I was definitely a very stressed-out person a lot, and my tolerance for caffeine was pretty high. But yeah, it was tough. There were moments when I thought, "Man, I wish I didn't do this." And certainly during the whole COVID thing, I had that thought kind of a lot. I thought, "I wish I had done something completely different."

"I still have a nightmare that I missed class for an entire semester, and I'm showing up at the end, and there's a giant paper due, and I didn't do it. It's a recurring nightmare. So I guess I'm not through the trauma of it."

How did I juggle it? I don't know. I guess I became super organized. Everything and anything was written down, or in my calendar, every little task.

Peggy

Yeah, I did! I do think working at the same time kind of helped. I didn't get to exactly practice all the things I was learning about, but if I had downtime at work, I could make connections. Like my patient would be on certain drugs, and I'd think, "Oh, OK, that's for this." I was also communicating with the residents about whether a patient should still be taking a medication or where their symptoms were coming from. So I was getting time where I was applying my knowledge from class in my daily workday. It did help me some to retain some of what I was learning, and that helped balance things.

Peggy

I definitely feel accomplished. I feel like I'm doing what I was meant to be doing. Even though I didn't go to medical school, I'm getting to function in that role, and I'm proud of that. My interactions with my patients is a part of who I am. I don't know who I'd be without that, being able to help people on a regular basis. I have a sense of fulfillment from it.

Peggy

It is difficult. It's like, oh my God, I get to come home to another patient. That can be tough, but it's nice because then I get a break when the baby is making me nuts. I'm like, "All right, I get to go see my patients." And then when the patients are making me nuts, I think, "OK, I'm going back to the baby."