This as-told-to essay is based on a conversation with Sarah Michelle Boes, the founder of Sarah Michelle NP Reviews (SMNP), which was acquired by Blueprint Test Prep in 2022. Boes currently serves as the chief nursing officer for Blueprint Test Prep and hosts the podcast Becoming A Stress-Free Nurse Practitioner. She earned her BSN from the University of Kentucky, her MSN in Nursing Education from Western Governors University and her post-MSN-FNP from Eastern Kentucky University. The piece has been edited and condensed for clarity.
Image Credit: Courtesy of Sarah Michelle Boes
I grew up in rural Eastern Kentucky, and I always had this passion for being a teacher. I had my heart set on it. But my parents are teachers, and they’re like, “Absolutely not. You can’t do that.” There are a lot of politics and bureaucracy within teaching. It’s a lot more than just being an educator. Then, when I was a teenager, my grandmother was diagnosed with stage four lung cancer. Without great access to premium healthcare in our area, we had to travel two hours to Lexington to get that diagnosis and receive a care plan that she could take back home. That was over the summer, so I went with her, and that was my first introduction to nursing at the Markey Cancer Center.
Those nurses were incredible. I feel like oncology nurses, in general, are kind of angels. Not only did they take care of her, but they also took care of me. It was just a great experience. So, knowing that I wasn’t going to be able to be a teacher, I was like, Well, nursing — I feel like I could get something done. And there would be a teaching aspect because there’s a lot of patient education, but I’d also get a human connection with people, which I thrive off of. So it was a no-brainer, and I attended the University of Kentucky, which guaranteed me admission to their program — and that’s a really big deal.
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I grappled with anxiety during nursing school. A class was notorious for weeding out people, and everyone dreaded taking it. I had a ton of anxiety in that class in particular, so much so that my instructor was like, “I don’t think nursing is for you. You’re too anxious to be a safe nurse.” I had to choose to stay. The grading scale in nursing is also very different: In most programs, anything less than a 76 means you fail — and on the first exam in that class, I got a 74. I literally failed the first exam by one question. So I had to figure out how to contend with my anxiety, to think about the tools I could use.
So, I started to figure out how to manage that class and my anxiety. Then, I began tutoring, ultimately quitting my full-time job as a manager to help students full-time. I taught them the skills that had helped me tackle that challenging class in a different way, and my anxiety didn’t pick up again until I was a nurse practitioner — because it had been a long time since I’d taken a high-stakes exam. There was no one to turn to get perspective because I was the first nurse in my family, and I didn’t know many people who were nurse practitioners.
What’s more, I took my nurse practitioner exam in the prime of Covid, May 2020. So it was chaos. Testing centers were down, and some places would let you take it online at home, but others wouldn’t. By the time I took the exam in the middle of May, it had been canceled five times, three of which I’d already arrived at the testing center. So, there was a lot of anxiety involved. I was like, Am I ever going to take this test? My job is riding on this.
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I was so stressed that I ended up breaking a tooth in my sleep because I was grinding them so hard. I was going to have to get a dental implant to the tune of $7,000; my hair was also falling out. But I finished the 175-question exam in less than an hour, and I passed. I was like, I can’t believe I was stressing over this thing. This was so much easier than my nursing exam. All I needed was confidence in myself because I’d spent years in schools and hundreds of hours in clinical preparing. None of my reviews had given me that confidence.
That realization — and the fact that I still had to pay for a $7,000 dental implant — motivated me to put together my first review course. I started my business because I was like, I can’t afford this $7,000 implant. I figured if I put together a little review course and even just earned $500, that would help pay for it. And I started to think about how it could be done differently — how it could be less like someone lecturing you and more like studying with a friend. So, I came up with a Q&A approach, which I’d used as a tutor in nursing school and when I taught nursing students at the collegiate level.
Within a week of passing the exam, I made my first three-hour course. I actually gave it out to all of my classmates for free. There were 30 of us, and I was like, “Hey guys, I’ll give you this course for free if you invite someone else into the group when I give it to you.” I gave the course to the first 100 people who came into the group. Then, not even a couple of days later, someone who had taken the course went on to pass, and it kind of exploded through word of mouth. It got wild really quickly. The first person I tried to sell it to for $25 got mad because her friend had gotten it for free, so she haggled me down to $15. Still, I made $1,000 on the first day I started selling, and I didn’t even make $1,000 in a week as a nurse. I was like, What if I made $1,000 a day, every day? What would life look like?
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By the end of June and July, I’d surpassed what I used to make annually as a nurse. I told my nurse practitioner job I wouldn’t be coming. I wanted to see how far I could take the business, but being reasonable and never having run a business before, I kept my full-time teaching job, just in case. But every spare hour I had, every weekend, was all about the business. Because I was so anxious about it being a startup, fragile and new, I waited to quit my teaching job until I made $1 million. We hit seven figures in seven months.
About a year and a half in, I was still using third-party software to host my courses — nothing was in-house or really in unison. It got to the point where my students were literally breaking the software; I needed my own. We actually spent $100,000 trying to build an app that ended up completely falling apart. That was really hard, but we just kept running up against technology, and I realized I was the bottleneck to this thing. The business wanted to grow, so I started looking into other options.
We considered a sale and put out some teasers, hoping to get constructive feedback. As it turned out, the test prep provider Blueprint had some internal meetings about the prospect before I even sent out the teaser. They had medical stuff, and they had LSAT stuff, but they didn’t have any nursing material at the time. And I wanted to take some pressure off myself because a week into sending out the teasers, I found out I was pregnant. I never want people to think I sold because I was pregnant; it just coincided with the timing.
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We loved the Blueprint team, but the deal just wasn’t right at first. My husband and I had decided on a number before we had a single conversation, and I’d recommend any entrepreneur do the same. Otherwise, it can be hard to navigate a deal when emotions are running high. So the first deal wasn’t our number, and we walked away. Then they came back with our number, and we ended up selling around the two-year mark. That money has been life-changing.
At 36 weeks pregnant, we found out that my daughter was going to have a congenital heart defect. We had no idea. So everything kind of flipped on its head really quickly. When I gave birth, the money gave us the flexibility and ability to be with our daughter when she needed it the very most. She had six surgeries in her first five months of life, two of which were open-heart surgeries. So, very crazy, chaotic times, and what a blessing to be able to have not only a maternity leave, but also a medical leave, and to be able to be fully present for that — and not only me but also my husband. We could be there together and support one another.
Now, my daughter is 19 months old, and for the past year, we’ve been working to do a legacy gift to our local children’s hospital, where they literally saved her life. Hopefully, next month, fingers crossed, everything’s going to be finished, and they’re actually going to dedicate the Norton Children’s Heart Institute to my daughter. They are trying to build out a premier heart program there, and you have to have the funds to be able to do that. So the money gives us a lot of freedom and flexibility — my husband’s also starting up his own business — but our work with the children’s hospital is the most meaningful and impactful accomplishment.
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