Nurse practitioners are advanced practice nurses that fulfill a variety of roles in the healthcare setting. Having an NP license enables a nurse to write orders, prescribe medications, diagnose health conditions and, in some states, can even operate independently without physician oversight.
I had the great pleasure of interviewing Latrina Walden, CEO and founder of Latrina Walden Exam Solutions. You can listen to the interview here in episode 235 of the Straight A Nursing Podcast, or read the transcript below. I hope this inspires you to pursue your dream of becoming an NP!
Note this transcript has been edited to remove all the “umms,” repeat words and unclear language. To hear the unfiltered interview, click the link above!
Nurse Mo: Okay, I’m so happy to have Latrina Walden here today. She’s a nurse practitioner here to graciously answer all the questions that you guys asked about what it’s like to become a nurse practitioner, what the job is like, how do you get there, all the good stuff.
So Latrina, I want to start by getting an overview from you. I’d love to hear about the trajectory that your nursing pathway took, what that looked like, how you started, and how you got to where you are today.
Latrina: Absolutely. So hey, guys, I’m Latrina Walden of Latrina Walden Exam Solutions. I am a practicing nurse practitioner, and my trajectory for nursing is such a journey. But the short version is I did not go to school to become a nurse. Initially, I went for my Masters in health administration. I always knew I wanted to work in healthcare. So that’s what I did.
I ended up becoming a nursing home administrator first. And so I worked in that role for many, many years…about eight years or so. And then moved to Georgia, where my mother was, and decided to keep working as an administrator. And I worked for Da Vita and had a very supportive boss, because I was in an environment where every administrator was a nurse.
And I said, “Hey, what do you think about me going to nursing school?” And she looked me dead in my face and said, “I think that’s a great idea.” And so I was always very nursing-curious. I had initially wanted to go to medical school and just didn’t want to pay all that money, to be honest.
But this VP said, “Yes,” and I was in school the next semester at one of the two year state colleges down the road from my clinic. I got my ADN, took the NCLEX, passed, and continued working as an administrator.
And then finally, after about a year and a half said, “I think it’s time that I work as a nurse on the floor.” And that’s what I did. I left that position and I went to Grady Hospital. If you know anything about the southeast, it is the largest hospital in the southeast. Since it is a teaching hospital, it is where everything goes. If you want to learn, and you want to learn fast, that is where you go.
So I am an ER nurse by trade and probably saw everything you ever wanted to see in that ER. It was an amazing experience…I can’t say enough good things about it. So then I got my bachelor’s. And then since it is a teaching hospital, that means I have residents. And so my residents were great, but I also started anticipating what they would order and why they were ordering it. And so that is kind of the natural progression.
And I like autonomy. I came from being an administrator, so I like being in charge. I like running things. That is my comfort level. So what can I do to utilize my skills and progress to the next level? Well, naturally, I can become the provider, I can become a nurse practitioner. And so that’s what I did.
I entered into school, and I went to a local state school here in Georgia. I was also a professor at a four year university. And that’s how I became a nurse practitioner but also how I started my company as well.
Nurse Mo: You’re a busy lady I can tell right now.
Latrina: But I love it!
Nurse Mo: I love that you have that support from the very beginning, you had mentors, you had people that were role models and you went through it. And then you just never stopped learning. And, you knew yourself really well, because you obviously said, “Hey, I like autonomy. I like being in charge. I like anticipating what the patient needs and writing the orders. So hey, this is the perfect career choice for me.”
So what area of practice do you specialize in? Do you work in the ER?
Latrina: No. I initially wanted to work in an ER, but I am a family practitioner and right now I work in a volunteer kind of capacity. So I work at a free clinic where I’m able to volunteer my time because, obviously with running my company, I don’t have to work that full time role. But it’s also very fulfilling for me because I get to work in that type of environment, helping lower income patients, and I’m their last stop.
So my patients don’t have any money. Telling them to go get an x-ray is a thing, you know…it’s a big deal. So I relish in it, and I love it.
Nurse Mo: Okay, I love that there’s so many different things that somebody can do with a nurse practitioner degree and we’ll get into that, because I know a lot of times students maybe don’t realize the very many things that you can do. But I want to start even before that. What can a student do at the very early stages to prepare for this career? I feel like if you know you’re going to go for an advanced degree, you’ve got to be pretty high achieving from the get-go. But that’s my perception, I would love to hear your actual knowledge.
Latrina: I tell you that I am very “pro nurse practitioner.” Clearly, that’s what my company was built on. However, I do understand that it is not the natural progression for everyone. You do not have to become a nurse practitioner in order to go to the next level of nursing, and I want to be very clear about that. People feel like they want to be an NP and then they get in NP school and they hate it , or they’re just not having a good experience. Or, they become an NP and they don’t like it. And you can do other things! But, if you are choosing that journey, and that is what you think that you really want to do, please understand that you will have someone’s life in your hands. It is you that will be making the decisions. It is you that will need to confirm or deny any diagnosis.
Nurse Mo: I’m so thankful that there’s other people that want to do that!
Latrina: Being that final word…that’s a lot of responsibility. And I think that we don’t need to take that lightly. That’s where you get questionable practitioners as they think they know. And, you know, I get a lot of students sometimes saying, “I’m starting my first job and I am very nervous about it.” And I’m like, ”You should be. You should be nervous.”
But at the end of the day, you do trust your training. You have gone through clinicals, you have gone through school, and you have your nursing background behind you. And most of us are coming from some type of hospital setting, so you can rely on that. But then couple it with your nurse practitioner skills that allow you now to diagnose and get labs and things like that. And you will be fine. It’s like running a marathon. Trust your training,…you did the work.
And then find mentors. Find a community where you can be around like-minded folks so that you can ask those questions. Because we all have those times where we’re like, “Listen, I don’t know what’s going on with this patient. Have you ever experienced this? Do you know what lab I should run?” So in addition to looking things up, obviously, find your community and find your people. And I don’t think it’s too early for someone to start out. I actually have a community. It’s called NP Collective and it’s an area where we can commune together.
Nurse Mo: So let’s say you were talking to a nursing student, and you were trying to convey the traits that would make for a successful NP student and nurse practitioner. Now you already said autonomy, and I think you touched on loving to learn. Anything else that you would say?
Latrina: I would say be inquisitive. I just told some folks this the other day, because when we’re trying to find that diagnosis, you cannot be afraid to talk to your patients. And sometimes, that may be with uncomfortable things. So you need to be asking all the questions. So being inquisitive is important. So you have to be able to be approachable and collaborative and be really good at putting together puzzles.
Nurse Mo: Okay, I love it. I think that’s great. I think, you know, a lot of students that I meet fit that criteria. A lot of nurses I work with meet all of those things, and they would make great nurse practitioners. I wish more people looked into it. I know a lot of times, especially once you’re working and you think about going back to school, the thought of taking that on can feel overwhelming.
Latrina: You know, I understand it. Sometimes I tell people all the time that the thought of going back to school gives me a visceral reaction.
Nurse Mo: Oh, yeah, me too. I did a graduate program in nursing education, which is, in my opinion, probably nowhere near as difficult as a nurse practitioner program. And I still say, “I’m good. I’m done.” Okay, so here’s another thing that comes up all the time. Like there’s been a debate, right? People get heated about this one. Direct entry nurse practitioner versus “you’ve got to have some experience first.” What do you say?
Latrina: You are so right, Maureen, you are getting into it! Are you trying to get me in trouble?
Nurse Mo: No, no, no, I’m just really curious! Because, I know people that have done both.
Latrina: Yes, so do I. I really think…so, all old school nurses are going to tell you you need experience. Right, you need to get out there. You need to practice a little bit. I’m going to be honest. My personal preference is that you do get experience, that you work on the floor. And why is that? Not to say that anything’s wrong with going to direct entry. But those assessment skills?
Nurse Mo: Absolutely.
Latrina: That is the key.
Nurse Mo: It’s your number one job…it’s the number one job.
Latrina: Yes ma’am…that is it. And as an NP, that is so key to you figuring out this diagnosis. Oh, man, it is so key to you figuring out what is going on with your patient because you know, patients don’t talk in concrete words like we want them to. It’s like, “How long have you been using your inhaler?” “I don’t know. I use it a couple of times, I guess.” Right…a couple of times. “Is that two? Give me a number two or three?”. So yeah, you know, it’s the assessment skills.
However, I do know that the direct entry programs are becoming more and more popular. And it is something that people are doing, I just highly encourage that if that is what you do…and I understand why people do it, so why that’s why I’m not completely against it, you know what I mean? But if you do, make sure that you do work on the floor for a bit, or you get some kind of experience on the floor, because it’s the assessment skills…that’s where your strength is. I don’t care if you’re a nurse or you’re a nurse practitioner. Your assessment skills are where you’re gonna walk into that room and be like, “I don’t know what it is. But something’s wrong with this patient.”
Nurse Mo: Yep. That will make or break you. That one skill right there.
Latrina: Yeah. So it’s being able to do that. This is where we’re finding we want the experience, you know.
Nurse Mo: Okay. Great. Can you give an overview of what a program is like?
Latrina: Yeah, it sounds funny, but I want you to imagine taking your entire nursing school and putting it online. And basically, adding in learning how to diagnose… what labs to do…
Nurse Mo: And pharmacology…
Latrina: Yeah, that goes along with it. Most NP schools are online…you have some schools that are out there that do intensives, meaning they meet, on the weekend, or maybe meet once a month, or something like that. But by and large, most NP schools are online, which means you may not ever see your classmates except for at graduation.
Nurse Mo: Oh, my goodness
Latrina: A lot of schools…you do not get a lecture every week or anything like that.
Nurse Mo: Oh, man, I’m already feeling nervous. And I’m not even considering it. You have to have that tenacity…
Latrina: Yeah, to really do it. A lot of these programs are what a lot of NPs consider “self taught.”
But there are some very, very great programs out there at brick and mortars that do make it a point to have lectures…if not every week, then every two weeks. And that do try to make sure they give you as many touch points as they can, and are almost over communicative about the information that you are getting and the learning that you’re receiving. So you really have to do your research when you’re choosing a program.
Nurse Mo: And I imagine, for some people, a fully online program…if they are juggling work and a family… that could be great for them if they’ve got that discipline to do it. That’s where I would be like, “I don’t know if I feel like doing it today.” So I know that about myself. I would probably do better showing up and being in person, but some people do better in the other programs. So that’s nice to know that there are options.
And then I know there’s clinical…how does that work? Correct me if I’m wrong, but nurse practitioner students arrange their own clinicals?
Latrina: Okay, so this is a big hotbed of controversy these days. Because, again…by and large, probably about 80% to 90% of the programs out there…you do have to arrange your own clinicals. You will likely do a minimum of 500 hours and could be up to 600 hours.
Nurse Mo: That’s a lot.
Latrina: Yeah. And it’s spread out over the semesters. But the kicker is…a lot of these programs are making you find your own preceptor. So what does that mean? That means I have to call before every semester or line them up a year in advance…all these doctors clinics, you know, finding other NPs, and hospitals, and approaching these providers and saying, “Hi, I’m Latrina. I’m a student in NP school. Do you have room for me as a preceptee?” And that’s where the struggle comes in. Because if you don’t find one, that you can have sitting out a semester
Nurse Mo: It concerns me for the student who’s in an area where there isn’t a lot of access to health care.
Latrina: Yeah, so they might have to travel.
Nurse Mo: Yeah, there might be like one clinic in their town and that would be tough. It’s probably easier in a big city, a big metropolitan area. But then you’ve got a lot of competition because there’s probably a ton of other nurse practitioner students! So you’ve got to network and you’ve got to advocate for your own education…
Latrina: If you’re a good nurse, and you’ve been at your facility for eight, nine years, I hope you’re a good nurse who knows the physicians as well. Or you’re the good nurse who knows the NPs that are coming on your floor or in your clinic as well…because those are the people you need to be asking. And they will book up to a year in advance.
Nurse Mo: Oh, my goodness. I have a friend who had to change paths completely because she did not get a clinical placement during COVID.
Latrina: It is very common, it is very common to get frustrated. Now there are absolutely schools out there who will find the clinical preceptors for you. But that means you have to live in the area. So Emory is one of those schools. So Emory University…if you want to go to Emory University NP school, it’s super competitive and very, very expensive, and honestly a great program…they have a whole hospital and all these multiple clinics, they’ll find your preceptor for you, they will place you. However, if you don’t live here, let’s say you live in California and you’re going to Emory…what are you going to do? You’re going to find your own stuff. So you have to think about things like that and some people have to pay. I mean, it gets a little dicey.
Nurse Mo: Okay. So there’s a lot of things to take into consideration.
Latrina: Absolutely. Absolutely.
Nurse Mo: Thank you for that, because that is an eye opener for me. So my next question was going to be, “What do you look for when choosing an NP program?” So I imagine that’s one, right…will they help you find your clinical placements or are you on your own? Is there a fee involved?” I’m sure there’s other things too. What else would you look for… online versus brick and mortar?
Latrina: Yeah, I would look at that. So I’m a big proponent of not having to pay an arm and a leg for education, if you can help it, so I would absolutely include price. I would include the kind of didactic learning, which is basically, “Are you getting the lecture or not?” Those are questions that you can ask admissions, because that’s important…do you want to be doing it on your own or do you need some guidance? So those are really the top points…can you help me find my clinicals, the price, and what does the lecturing situation look like?
Nurse Mo: So let’s talk a little bit about the many different kinds of environments where an NP could work. My experience is just what I’ve seen…NPs at the hospital and at my doctor’s office, but I know even within that there’s specialties, and you can start your own business and all kinds of things. So what would be some career opportunities with a nurse practitioner background?
Latrina: Quite frankly, it is all of those things you mentioned and probably things we can’t even think of right now. But kind of the top ones…obviously hospitals…that is a big one. And how that works is they’re working with the physicians in their office and they’re rounding on the patients in the hospital. Medical clinics, nursing homes…nursing homes are getting kind of big, actually. So instead of the doctors rounding in the nursing homes, we’re finding that the nurse practitioners are rounding in the nursing home…the doctors are hiring the nurse practitioners. So that’s a big one.
You can work in pharm…in sales. That’s a big thing. I’m seeing a lot of school nurses being NPs as well.
Nurse Mo: Oh, really? Well, you know what, it kind of makes sense because being a school nurse, you’re out there. Talk about being on your own, and anything could happen, right? Anything can happen. There’s kids going to school with all kinds of comorbid issues, allergies, diabetes, seizure disorders, like anything… traumas could happen. So I think that’s probably good. I
Latrina: So that’s a big one. But also if the school nurse is not the NP, the person over the school nurses is usually. So that’s a popular one. And obviously, instructors… teaching. That is also a big one, a lot of NPs teach as well.
Nurse Mo: Yes, I got a lot of my nursing school undergrad education, from some great nurse practitioners was fantastic. I just loved that they could really bring that clinical side and they have the best patient scenario stories, because that’s the sort of thing that brings it to life.
Latrina: That’s how the students remember right? You tell a story. And they’re like, “That’s not true. And it’s like, “Oh yeah.”
Nurse Mo: “And there’s more where that came from.”
Latrina: And then the one that you said, which is a big one that people are doing, which is opening their own practice. As of late, everyone wants to be an entrepreneur.
Nurse Mo: Yeah. And it can be all kinds of practice. It could be a women’s health clinic, it could be a family practice, it could be the place where I get my Botox…it’s run by a nurse practitioner.
Latrina: That’s actually really common because, in many states, if you’re an NP you are the person, you do all the things, yeah, to do all the things, right, so this is super common. But even if you don’t want to own your own clinic, just opening up any kind of entrepreneurial space is a really big deal for NPs right now…it is wide open.
Research is a big one as well, because they’re always research. So if working with the patients is typically not your thing, but you still want that clinical education, we always have clinical trials and things going.
Nurse Mo: You just opened my mind to the whole…I mean, I’m not going back to school…but it excites me to think about all the opportunities that my listeners are hearing about, and I think you probably just inspired quite a few people.
I do want to hear more about your company and how you help nurse practitioners.
Latrina: Absolutely. So my company’s name is Latina Walden Exam Solutions. And so when you are in school, and you are at one of those schools where you’re maybe not getting the lectures that you need or you’re not quite understanding, that’s where I step in. Because the way that I teach is I’m able to take these big concepts and bring them down, and we use layman terms, and the light bulbs go off.
I call it a digital study guide. So my main thing is to help you while you are in school…it just basically goes along with your schooling. You can listen to me, you can watch the PowerPoints and all that kind of stuff. And then when you’re ready to test for boards, it is very different from the exams that you get in school. And so when you are ready to pass your boards, that’s where you reach out to me and say, “Hey, what do you got?” We have several programs that can help you pass boards. So that’s what I do. I just try to help transition folks from school into an NP and then from NP into an expert Np.
Nurse Mo: Fantastic. And where can people find you on the world of the internet?
Latrina: You can go to latrinawaldenexamsolutions.com. And I just do want to point out that if you do have questions, please reach out. You can find me on Instagram, LinkedIn, it’s all the same. _Walden_NP. On LinkedIn, it’s just Latrina Walden. But on Instagram, it’s with the underscore.
If you have questions, I constantly am talking about the education that we need to know as clinicians, as nurses, just in general. So come hang out with us and learn all the things.
Nurse Mo: That sounds fun.
Latrina: Yeah, it’s a lot of fun.
Nurse Mo: I’ll put a link to your site in the episode notes. And I just want to thank Latrina for taking the time out of her busy schedule to share so much about the whole world of being a nurse practitioner and all the cool things that you’re doing to help people reach that goal. Thank you so much.
Latrina: You’re very very welcome.
I hope this interview gives you an idea of what the transition from RN to NP looks like!
Latrina Walden is the Founder and CEO of Latrina Walden Exam Solutions where she provides board exam resources for aspiring NPs looking to take the AANP, ANCC, or AGNP! You can visit her website to learn more at www.latrinawaldenexamsolutions.com.