Nurse practitioners and physician assistants are advanced healthcare practitioners with similar responsibilities, such as diagnosing illnesses and prescribing medications. However, their training and paths toward certification differ in significant ways. This blog post unpacks the key differences between NPs and PAs to help you determine which career path best aligns with your goals. What Is a Nurse Practitioner? A nurse practitioner (NP) is a licensed clinician who provides comprehensive healthcare to patients of all ages. An NP can work in virtually any healthcare setting, diagnosing patient conditions and prescribing medications. As of October 2022, nurse practitioners have full practice authority in 27 states, meaning that they can practice Read more
Are you wanting something more, something different from your nursing career? Fortunately, many options are available to the enterprising nurse. You don’t have to work in a hospital, clinic, or even for a healthcare organization. You can apply your nursing expertise within a professional niche that you create for yourself.
Keith Carlson, RN, BSN, NC-BC, is a nationally known nurse thought leader and entrepreneur. You may know him as “Nurse Keith,” the nursing career coach, podcast personality, blogger, and author of two books—including Aspire to Be Inspired: Creating a Nursing Career That Matters. We sat down with Nurse Keith over tea in his Santa Fe office to hear about his own creative career and the growing options in the world of nurse entrepreneurship.
Insight into Nursing Entrepreneurship
USAHS: Tell me about your journey toward realizing that a “regular” nursing career was not for you.
NK: In 2005, I became one of the first nurse bloggers. This led to paid writing gigs, speaking engagements, and coaching. I earned my board certification in the only coaching program fully recognized by the American Nurses Association. I started podcasting in 2012 as one of the first nursing podcasters on the Internet.
As a clinician, I served patients in home and community health until three years ago. There were fewer creative career options when I started out in the late 90’s, but the world has opened up since then. Now there’s a huge community of nurse entrepreneurs, and it’s growing every day.
USAHS: Which of your roles do you enjoy most?
NK: I really like providing career coaching for nurses. I’m currently one of only two nurse career coaches that I can identify out there. I help nurses discover what they really want to do. And my other roles support the coaching: in podcasting, blogging, and freelance writing, I can get on my soapbox and share my perspective. Speaking at conferences is a growing area for me. I use these different avenues to reach people. It takes a lot of discipline to keep them all going, but I enjoy the variety and freedom.
USAHS: What are some typical issues that people want coaching for?
NK: People need guidance about what the options are; I help open their eyes. We talk about how to network face-to-face as well as looking at job boards and social media. Some nurses need help with an interpersonal issue on the job, such as bullying or a difficult workplace culture. We talk about how they can navigate that conflict or whether they need a job change. Others want to go to graduate school for their advanced nursing degree, change specialties, get a certification in a nursing specialty—so we talk about how education and continued learning can open up new career options.
USAHS: What do you like most about your alternative nursing career?
NK: I feel like I’m contributing by supporting individuals. If they’re doing what they love, this impacts patient care. It’s good for everybody.
USAHS: Along with the roles you’ve created for yourself, what are some other alternative career possibilities for nurses?
NK: One growing area is health coaching and/or case management, which nurses can do on their own or for insurance companies and within other entities, including the corporate world. Nurses can work from home and coach clients on health and wellness using telehealth technology.
Nurse consultants are often brought into a corporate setting as an expert voice. For example, they might direct content for a tech company that creates healthcare apps.
A friend and colleague of mine founded the Healthy Workforce Institute, whose mission is to eradicate nurse bullying and improve healthcare workplace cultures. A nurse educator friend creates online courses about pediatric nursing. I even know a nurse filmmaker and a nurse artist. Opening your own home health agency is another great option.
Legal nurse consultants (LNCs) collaborate with lawyers, reviewing medical charts for trials and appearing as expert witnesses. Most LNCs are self-employed.
Writing is a huge opportunity. Nurses can write for universities, healthcare news services, or any number of health-related websites. They can give clinical advice, career advice, or write about nursing technology, education, and other salient subjects.
Concierge nursing is an interesting option. Wealthy people hire nurses, often on a retainer basis, to make house calls. Concierge nurses are typically nurse practitioners, because NPs have full practice authority in more than 20 states. I’ve also run into RNs and NPs who work as contractors for concierge doctors.
Nurse innovation is another area that’s really exciting. Who is more knowledgeable in creating a product than the people who use them at the bedside? Some colleagues of mine invented a pad that fits inside the rails of a hospital bed to protect patients during seizures. I know a slew of nurse inventors and innovators who are truly disrupting the healthcare tech space.
USAHS: Do you have advice for those who are curious about taking a similar step?
NK: You can start by joining the National Nurses in Business Association (NNBA), the flagship organization and community for nurse entrepreneurs. They have an annual conference with a “shark tank” competition where nurses with innovative business ideas can win cash, business coaching, and other prizes that move them toward making their ideas come to life.
Use Google to see what other nurses are doing. Hang out on social media, especially Facebook, Twitter, Instagram, and LinkedIn. When you find a nurse who’s doing something cool, ask them for an informational interview. Take them out for breakfast if they’re local or jump on Skype for 15 minutes to pick their brain and ask advice. Most people like talking about what they do.
If you want to be an entrepreneur, ask yourself: Are you willing to learn new skills, hire the people you need to hire, and take risks? Working for yourself is great, but it’s not exactly easy. You might have to work seven days a week and be married to your business endeavor. The trade-off is nearly total control over your life and schedule.
My message is that you can do anything you want. You can leverage your nursing credentials to inspire trust in decision makers and clients, and maybe you’ll create a new role that no one has even thought of yet!
The University of St. Augustine for Health Sciences (USAHS) offers Master of Science in Nursing (MSN), Doctor of Nursing Practice (DNP), and Post-Graduate Nursing Certificates designed for working nurses. Our degrees are offered online, with optional on-campus immersions* and an annual interprofessional trip abroad. Role specialties include Family Nurse Practitioner (FNP), Nurse Educator, Nurse Informaticist, and Nurse Executive. The MSN has several options to accelerate your time to degree completion. Complete coursework when and where you want—and earn your advanced nursing degree while keeping your work and life in balance.
*FNP track requires two hands-on clinical intensives