Trying to decide between accelerated BSN, entry-level MSN-NP, and ADN

ToTheStudent · Jul 23, 2014

All I will say is that UCSF is really excellent, like mouth watering excellent, it's worth the money and just think hundreds of other students are applying with the same loan risks you are. With that said why not apply to both? Also have you considered the University of Washington? They rock. You can always say no if you don't get what you want, or heck they might say no the first time around since these types of programs are highly competitive, either way no matter what you decide, I'd decide very soon the application process takes a lot more effort and time than most think!

HouTx, BSN, MSN, EdD · Jul 23, 2014

Bottom line? Hospitals are only hiring BSN grads except for rural areas. And rural hospitals are quickly moving to adopt the same standard. There are a number of factors driving this issue - searching AN or Googling will bring them to light.

Be sure to do a very thorough investigation to uncover realistic job prospects for brand new (no clinical experience) nurses with advanced degrees. In my area of the country, no one is hiring them. NP jobs require significant levels of clinical expertise because they are expected to function autonomously. Entry-level masters grads are very disillusioned to discover that they are overlooked in favor of generic BSN grads rather than being offered the 'clinical leader' jobs outlined in the school brochure.

Its a fairly common thread here on AN - aspiring NPs, CRNAs, CNMs, etc. stampeding into nursing from a less lucrative career & wanting only to practice at a very high level without providing actual nursing care to patients. If you want to get an accurate picture of the reality, take some time in the 'first year after licensure' forum.

phoenoryker · Jul 25, 2014

Don't let anyone discourage you from picking a route that starts you off with the highest confirmed degree. Pick a program that is credible in the area you intend to practice. In my area, the requirement to apply for a DNP is a MSN. That is my career goal. I will be beginning an entry level MSN program this fall. Will I be top heavy in terms of education vs experience... Of course, but in the long term my experience will lend credibility to my degrees as well as credibility to the field of nursing. There is and will continue to be a push for lower paid personnel to take on more responsibility... Many are of the opinion NP and PA will replace many MDs and medical assistants will replace many RN positions. Who knows what the future holds, but I know I plan on taking the quickest route for the highest credentials. If my time was prior to the addition of entry level MSN options, for non nursing bachelors, I would probably have hard feelings too. However, I would also recognize that an influx of highly educated professionals prompts additional respect, and subsequently compels others to achieve higher degrees. It is undoubtedly recognized that there is no substitute for experience, but people feel more comfortable when they see letters after people's names.

akulahawkRN, ADN, RN, EMT-P · Jul 25, 2014

If an ABSN and an ELM will cost you about the same amount and you'll be able to transition over to an NP program, more power to you. One worry I have about the ELM is that it might not be looked at as being essentially similar to a BSN. There's also the experience issue with going directly from an entry level program to an advanced practice program with very little experience as a working nurse. That's not to say you won't be a good NP, just that you need to be sure you're getting as much out of your clinical time as possible.

Hope you find a good path to your goals!

CantDecideUsername · Jul 25, 2014

Many many people on this site (some who have insider knowledge on the hiring process/HR) have said that hospitals strongly dislike the entry level masters degrees in nursing

They want a BSN. Period

There are many reasons for this which I don't remember exactly, but feel free to do a quick search

Also remember the cost... You don't want to spend $75k getting an MSN and then another $50k (or more?) for your NP. (Or do you?)

chartreuse · Jul 25, 2014

I have to chime in because I feel that some of these responses (in many other threads, not just this one) are incomplete or have inaccurate info.

There are different masters programs that offer you a MSN degree. Some take you straight to a NP and take somewhere around 2-4 years to compete depending on the pace. Others provide a generalist MSN degree that prepares you to practice as an RN with the title of "Clinical Nurse Leader" (if you pass that licensing test). The CNL positions are attainable after getting experience as a RN. I have heard of people struggling to find jobs after a direct entry NP programs, but have not heard of (around my area and from internet browsing) anyone with a generalist MSN degree struggling any moreso than new BSN grads. In my CNL program, we have more clinical hours than the BSN program and our grads are very well prepared after graduation and have no problem finding jobs. That could be possibly be different in various areas, but I don't see any legit reason why it would.

If you want to do a generalist MSN degree on your way to becoming a NP, there are post-masters certificates you can work on after you graduate and while working. These do not have to cost an additional "50k" as stated above. The one I plan on doing is $15-20k and grants you a certificate (not another degree) to take the NP licensing test.

I was in a similar position as you. I strongly encourage you to search the forums for these types of questions and responses. There are dozens. The deciding factor for me was qualifying for loans I needed but only at the graduate level.

PG2018 · Jul 25, 2014

I think you should first address whether you want to work as a RN. If you want to be a NP and have the options to immediately enter a NP program then do so. You can get an ADN fairly easily, and you can do a RN-BSN program online fairly easily. If you're wanting to be a NP, however, you're adding some time into the picture, and while in school more time spent means more money lost. You'll have to take typical RN coursework in the direct-entry NP program, but you'll dual count a lot of things. You can also be a successful NP without ever having worked a day as a RN so don't let the experience debate concern you.

There is a great deal of clarity in this for me.

ixchel · Jul 25, 2014

I never understood why someone with a prior bachelors degree and end game goal of masters would choose ADN. You've mentioned cost, but have you added up the amount of time?

Where I am, there are two schools to choose from - a university and a community college. The community college starts with LPN and then goes to RN, each taking a year in non-traditional semesters spanning 12 months instead of the traditional spring/fall semester structure. The university has a regular BSN and a second degree accelerated BSN. The traditional is 4 semesters (using regular semesters) after all gen eds and prereqs, the accelerated lasts 3.

The difference in cost is maybe $3-4k, which seems huge. If you think about it, though, you finish 4 months sooner, which means potential for income 4 months sooner. You will earn more than you will invest in that degree. The real kicker, though? MSN (regardless of type) requires BSN, so if you're going back to school, you'll have 2 semesters of classes at the university anyway. The ADN-BSN program ultimately costs MORE money, and takes 2 more semesters.

I have a friend who just got admitted in the community college's program and she says she's going to go back for a BSN when she's done. *sigh* I actually had no idea she had a bachelors degree already, otherwise I would have been jumping up and down screaming, "DON'T DO IT!!!!" The LPN and ADN programs have a much later application deadline than the BSN, making it too late to change her mind if she wants to start this fall. So I'm supportive of her choice. I'm bummed out for her, though. And of course the advisors don't mention this. They want enrollment, not there is a shortage of applicants.

phoenoryker · Jul 26, 2014

We have a couple entry level MSN schools in the area that go the NP route and a couple that go the generalist entry with CNL. The direct entry NP programs in the area prepare you to sit for the NCLEX but the student will not have a BSN or MSN...At that point they can practice as a RN and complete the NP portion of their schooling part time if they choose. But these students are rumored to be having a hard time finding jobs because they do not have the minimum BSN that employers are looking for....plus the employer will know that this student has intentions of moving on... Why hire them? The generalist entry schools in my area prepare students to sit for NCLEX but they are awarded MSN not MS in nursing degrees.. The CNL certificate can be obtained as well. Change is difficult for people to handle, and skepticism can be anticipated. It is unfortunate when we see the potential for progress through change, but refuse to embrace it due to a fear of the unknown.

windsurfer8, BSN, RN · Jul 26, 2014

I would say get on with something. You are 34 and for the cost of a NP you will have major loans to repay so the quicker you get on it the better. Also don't go by "what you hear". CALL or EMAIL hospitals you are interested in working at and find out if they hire ADNs. When I got my BSN in 2007 magnent status hospitals already were only hiring ADN. Also remember by the time you graduate things could be different. And last...don't put the cart before the horse. Getting an NP is the long term goal. Got it. Now focus on a nursing license and nothing else. Whether it is ADN or BSN. You will be amazed at the challenge of just completing that alone. Focus on what you need to get done today. Day by day and you can get there. Good luck.

PG2018 · Jul 28, 2014

We have a couple entry level MSN schools in the area that go the NP route and a couple that go the generalist entry with CNL. The direct entry NP programs in the area prepare you to sit for the NCLEX but the student will not have a BSN or MSN...At that point they can practice as a RN and complete the NP portion of their schooling part time if they choose. But these students are rumored to be having a hard time finding jobs because they do not have the minimum BSN that employers are looking for....plus the employer will know that this student has intentions of moving on... Why hire them? The generalist entry schools in my area prepare students to sit for NCLEX but they are awarded MSN not MS in nursing degrees.. The CNL certificate can be obtained as well. Change is difficult for people to handle, and skepticism can be anticipated. It is unfortunate when we see the potential for progress through change, but refuse to embrace it due to a fear of the unknown.

An employer may know they're going to move on so why hire them?

Funny you mention that. I start a new position this week for the express purpose of better accommodating my NP school schedule. It's an ER position so a lot of orientation on the front end. The first thing I told them in the interview was that in May I'll be graduating a NP program and plan to move on in short order to take a NP job. They were fine with it. In fact, no one batted an eye over it. The personnel rep sitting in the room during the interview even said something to the effect of "It's natural for people to want to move on and better themselves." So never let that preclude you from seeking a job.