Need advice: Master's or BSN/work exp 1st?

  1. Hi y'all!

    I'm currently finishing my prerequisites to apply to accelerated programs, hopefully for summer/fall 2005 if everything goes well. I know I want to get my MSN, and I want to be a NNP.

    My question is this: as an NNP or a neonatal unit nurse, is it better to go for a Master's Entry Program or get a BSN and some work experience first in a neonatal unit? I know the latter option certainly doesn't hurt, experience-wise, but I wonder if I'll have the opportunities I have now (i.e. no husband, kids, or major obligations) to go full-steam ahead and do it all in 3 years.

    In fact, a lot of Master's Entry programs I've seen have excluded the option of NNP from their curriculum unless you've had at least a year of neonatal unit experience - I only have a BA, not a BSN or ADN. Is it because it's a more difficult field academically or stress-wise (or both)?

    I'd love to hear your opinions, especially if you are or were in a situation like mine...

    Thanks all!
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  2. 24 Comments

  3. by   ayndim
    Quote from Annabelle57
    Hi y'all!

    I'm currently finishing my prerequisites to apply to accelerated programs, hopefully for summer/fall 2005 if everything goes well. I know I want to get my MSN, and I want to be a NNP.

    My question is this: as an NNP or a neonatal unit nurse, is it better to go for a Master's Entry Program or get a BSN and some work experience first in a neonatal unit? I know the latter option certainly doesn't hurt, experience-wise, but I wonder if I'll have the opportunities I have now (i.e. no husband, kids, or major obligations) to go full-steam ahead and do it all in 3 years.

    In fact, a lot of Master's Entry programs I've seen have excluded the option of NNP from their curriculum unless you've had at least a year of neonatal unit experience - I only have a BA, not a BSN or ADN. Is it because it's a more difficult field academically or stress-wise (or both)?

    I'd love to hear your opinions, especially if you are or were in a situation like mine...

    Thanks all!
    I don't know about other areas but in my area the MS for a NNP requires both a BSN and at least one years experience. Seems to be that way for all of the NP fields. If you have an ADN you can do RN to BSN to MS (NP) in about 24 months. But you still must have experience. And they assume you will work while in school as the school is only 1 night per week for the RN to BSN portion. And you must have a BSN to start a MS program, whether through the RN to BSN to MS bridge or entering the MS as BSN. Here they won't accept a BA/BS with ADN in lieu of the BSN.
  4. by   Gompers
    I agree that most nurse practitioner programs require at least a year of work experience, and I think it's a bare minimum honestly. Even after a year as an NICU nurse, most people aren't ready to go for an NNP program. On paper it might look good, but being an NNP is very challenging, and the more experience you have as a nurse the better. I do understand the rush though, as it is easier to get all your schooling and training done while you're young and single. But just keep in mind that being a NICU nurse alone requires a huge amount of education after you get your RN, as you really don't learn a thing about neonatalogy in nursing school. Who knows, you might even see NICU nurses and NNPs in action and decide you would rather not go for the NNP. I work with many nurses who thought they'd go "all the way" to being an NNP but decided against it because they didn't want to leave the bedside. Take your time, and enjoy! Neo is the best!!!
  5. by   gwenith
    Sooo much of nursing is experiential learning. Even something as "simple" as assessment.

    Let me show you what I mean by using assessment as an example.

    A new grad straight out of university has learnt assessment - of normal adults. The underlying (and in my opinion false) concept that most assessment programs are based upon is that "if you know the normal you can recognise the abnormal" this is false. Knowing the normal only teachs you to recognise deviations from normal. It does not teach you how to recognise and interpret individual health data where the underlying co-morbidities skew the data!!! You have to learn "what is normal for a baby at this gestation and with these co-morbidities" This is only learnt through experience.

    To ask if yourself if you already have the requisite knowledge to be able to bypass this experiential learning ask yourself this question.

    In a newly extubated neonate what would indicate that they are failing to cope with extubation??? Can you picture in your mind's eye and infant in this predicament???

    This is only 1 of many many scenarios of clinical assessment that is required of the bedside nurse,
  6. by   Gompers
    Great point, Gwenith. I also think about clinical skills. Practitioners need to have excellent clinical skills, and that takes time and experience as well. If you don't get enough experience to become proficient at IVs and arterial sticks, how will you ever be able to insert PICCs and arterial lines? No one is born with these skills, and they are vital to being a good NNP. Some people are gifted and are great sticks, but even for most of them it took a few years to really get that good.
  7. by   fergus51
    To me, there is a reason for calling NNPs neonatal NURSE practionners. Without at least a year of nursing experience, I can't see anyone making a good NNP. There is just too much to learn and practice.
  8. by   Annabelle57
    A big thanks to all of you - esp Gwenith - for exactly what I sought. It's really easy at my stage of the game to think, "hey, if being a neonatal nurse is great, being an NNP is even better! Let's go for it!" And I might do that... but not all at once, and not until I'd been working at least a few years in the NICU. It would be an absolute nightmare to graduate as a very green, barely-any-experience NNP and feel competely disoriented and confused. No thanks!

    Truthfully, I know deep down inside that if I'm meant to become an NNP, those doors will be opened to me, regardless of the time frame, and wasting any time worrying about current and future situations is just that: wasting time.

    Thanks again! I can't wait to get to the NICU...
  9. by   Tiki_Torch
    In my experience the NNPs who had been NICU nurses for 5 to 10 years before continuing their education to become NNPs were much better NNPs than the ones with less NICU nursing experience. No only were their clinical skills excellent (starting IVs, PICCs, intubating, inserting UAC/UVC lines, attending preterm deliveries, etc.), they also had seen oodles of babies with all kinds of illnesses and were able to use their years of experience when assessing babies, when planning care for the babies, and knowing unusual things to look for that a new NICU nurse wouldn't even think of looking for. I worked with one NICU nurse who went to NNP school after being on our unit for 2 years; she was brilliant and aced the program but confided in me that she felt quite inadequate when it came to performing procedures and thinking fast on her feet sometimes. She told me she understood why more experience before NNP school was best. (Our hospital was in need of NNPs and they set up an incentive for sending two of our NICU nurses to NNP school if they signed a contract that the NNPs would work in our NICU for 2 years.) The one thing that first comes to mind concerning NNPs having expert skills is this: When we have a baby that needs an IV and several of us NICU nurses have stuck once or twice already, we call the NNP to start the IV. We all expect the NNP to be able to start it when our best NICU nurses have been unsuccessful. This is a simple reason why having NICU experience is important for NNPs. In any case, I feel sure that a NNP program would not graduate a NNP they felt was not prepared for the position in both knowledge and clinical skills. I truly believe that.

    Don't give up on your dream!!!! There's not much more wonderful on this Earth than a wonderful NNP who loves to share their knowledge with staff nurses in a way that doesn't make us feel bad. Please try to not be one of the ones who is a know-it-all and talks down to staff nurses.

  10. by   elizabells
    Quote from Tiki_Torch
    In my experience the NNPs who had been NICU nurses for 5 to 10 years before continuing their education to become NNPs were much better NNPs than the ones with less NICU nursing experience.
    Do you suppose it matters which "end" of the training you get this experience on? I'm really asking, by the way, not challenging!!! I'm about to enroll in a direct entry NNP and have every intention of working as a staff nurse for as long as it takes me to feel like I'm ready to take on the more advanced role (if ever!) I'm curious, though, as to whether y'all think it makes a substantive difference whether you get the RN, work for a while, then get the NNP, or whether my plan sounds as "good". Because if I have the option to, I might take a couple years out of my program between the two phases, if you get what I mean.
  11. by   5FrSilastic
    Quote from fergus51
    To me, there is a reason for calling NNPs neonatal NURSE practionners. Without at least a year of nursing experience, I can't see anyone making a good NNP. There is just too much to learn and practice.
    OK, sorry, but I have a more basic question.....( not that I am any where near doing this, but I will be in the future) How does one become a NNP? Do all univ/colleges have a NNP program with their BSN/MSN programs? How long should one expect to go to school for this?
  12. by   elizabells
    Quote from 5FrSilastic
    OK, sorry, but I have a more basic question.....( not that I am any where near doing this, but I will be in the future) How does one become a NNP? Do all univ/colleges have a NNP program with their BSN/MSN programs? How long should one expect to go to school for this?
    From the research I did prior to applying for schools, it's a Master's level specialty that is not necessarily offered everywhere. Most schools I looked at have around ten specialties for their advanced practice programs, and they vary from school to school. It's generally a two-year program done after the BSN. Some programs have an experience requirement, and this varies by specialty and school. I believe there is a federal requirement for two year's work experience prior to getting certified as an NNP.
  13. by   ProfRN4
    Quote from elizabells
    do you suppose it matters which "end" of the training you get this experience on? i'm really asking, by the way, not challenging!!! i'm about to enroll in a direct entry nnp and have every intention of working as a staff nurse for as long as it takes me to feel like i'm ready to take on the more advanced role (if ever!) i'm curious, though, as to whether y'all think it makes a substantive difference whether you get the rn, work for a while, then get the nnp, or whether my plan sounds as "good". because if i have the option to, i might take a couple years out of my program between the two phases, if you get what i mean.
    let me start by saying i have absloutely no neonatal experience, nor am i an np. but i believe that doesn't make a difference in what i'm about to say (or maybe it does). i've seen more people taking the route you are considering, and i'm not sure what the answer is. imho, if i were an employer, looking to hire an np (regardless of the specialty), i think i would prefer the 'traditional' route. i'm not sure how much the np training builds on the rn role, as the reverse does. the people i know that have done this (or are planning to do it) admit theat they do not have enough nursing experience to become an np yet, and just wanted to get school over with. i can appreciate that i guess. but i know, for me, doing the adn-bsn-msn route was not bad (long, but not bad). i was always able to relate my theory to practice, and always worked while in school. but that's just me. i'll be done w/the msn 12 yrs after i got the adn.
    Last edit by ProfRN4 on Feb 28, '05
  14. by   mac23
    Yes you do have to have 2 years experience before you can get certified as an NNP. I'm done with my program (just have clinical time to finish) and I'll tell you the learning curve is HUGE from bedside to calling the shots as an NNP. As far as skills go I was doing PICCs and art sticks as a staff nurse so if your hospital allows you to gain those skills, jump on it. The beside experience is invaluable. I wasn't able to take care of a 1:1 baby until about a year into my career (unit policy). That went for attending deliveries as the stabilization nurse,going on transport and being trained as an ECMO nurse as well. Even after a year's experience I felt like I needed much more. I can't imagine having never done those things and then all of a sudden I'm an NNP giving orders :uhoh21:. On some units I know that at night the NNP is it and a lot of times if there is a resident there she's the one answering the questions for the residents who are unsure of what to do.
    By far the most difficult skill has been intubating. Our neo's are very hard on us just as they are on the residents because they expect us to know our stuff and know it well.

    So take your time and get the bedside experience. Soak up as much as you can. Learn as many procedures as your hospital/state will allow you to do. Good luck in whatever you decide.

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