Entry into Practice: Direct Entry MSN Programs

Perhaps your >30yrsRN experience has given you a skewed view of what training for advanced nursing practice entails. BCGrad's post seems very reasonable. Working as an FNP is not necessarily related to working as a nurse. For me, I learned how to be what I am today from from ALL of my RN and non-RN work experience--paper route, retail, baby-sitting included. These things help me because that's how I am--but not everyone will gather the foundation of their advanced training on every grain of life experience. It's certainly not required.

Also, BC is a highly esteemed institution, and I don't believe it would jeopardize its reputation by graduating NPs who were not adequately prepared. BC also doesn't accept students who are not exceptional prior to beginning their nursing training. Their graduates are quite capable of assuming advanced practice roles--and knowing when to ask for assistance.

So, maybe not a program for everyone. But then again, most people won't get in.

"I am sorry but have to judge this as not good path or safe enough education to take care of Patients as a FNP right out of College. I would request a Physician instead. Oh, I have ARNP and MD, and Lawyers in my Family also. If you ask me , we should follow the Money trail on this. The cheap and short cut way has always cost this world in every area of expertise. No wonder USA ranks 37 Healthcare. The most of Public does not know the differance between a CNA,LPN,RN,ARNP or [COLOR=green !important][COLOR=green !important]Nursing[/color][/color] PHD in the first place, God Help us.
Oh gee,I think I will [COLOR=green !important][COLOR=green !important]become [COLOR=green !important]a [/color][COLOR=green !important]Lawyer[/color][/color][/color] and work in NJ with Detox waste law sues is there a two year program for that? ROFL"

You are certainly entitled to your opinion, but please tell me about your personal experience with direct entry grads. I'd like to hear some concrete basis for your bias.

I certainly don't regard my direct entry program as the cheap, short cut way. I had to take 3 years of pre-requisites, despite the fact that I have a BS in another health care profession plus an MBA, plus my DE program. And God knows it wasn't cheap....my huge student loan debt will attest to that. From my experience, my program consisted of highly intelligent, incredibly motivated people (myself included..lol) who were willing to put all else on the back burner to devote themselves to being the best caregivers we could be.

I have to say I'm dismayed at the hostility I've encountered both here and out in the world towards DE grads. I never thought the nursing profession would be like that, but maybe I'm naive. I thought only lawyers ate their young....

I am currently in an alternate entry program. I have just completed phase one (pre-licensure). It was 2 semesters and 2 summer sessions that were the most intense schooling I've ever been in (I have a previous bachelors and masters degree). I just took NCLEX-RN and passed! I felt we were well prepared through our classes, clinicals, and independant study. Some of you may not realize that during phase 2 (graduate classes), we are working as RN's gaining experience. Some of the advanced practice programs at our school require 2 years of experience before starting, so you are taking core classes while working. So I do feel that we are gaining the experience we need to be advanced practice. I do think that working as a RN first before working as a advanced practice nurse is important. This distinguishes us from a PA or MD. I will be starting my nursing career on Sept 14 and working on my graduate work as I gain my RN experience. Best of luck to all that are starting direct-entry programs!

Congrats on passing NCLEX!! I remember what a relief that was! And rest assured that there are none of those horrible "choose all that apply" questions on the NP boards!!
I find it very interesting that even among DE prgrams there is so much variance. We were not required to work as RNs before starting our MSN portion, but some of my classmates chose to deccelerate their schooling so they could gain some RN experience. Much to their dismay, there were no RN postions available in the area!! I heard this from the BSN grads, too. So, several did an about face and went back to school full time for their NP, and immediately went to work as NPs. Not what they originally wanted, but economics dictated their choice. I had looked into finding a per-diem or part time RN position at the hospital I was employed at during that time (I had worked in the lab part-time while I was going to school), and there was nothing available. I would have worked evenings, weekends, and nights, but there were no openings. So, I stayed in the lab where they were happy to have me for what ever hours I could give them.
I'm not sure how the current economy will affect certain program requirements for DE students to spend time working as an RN. For those of you who did it, did your school help you find a job?
As an aside, my career switch to nursing happened in my mid 40s. People thought I was crazy to "start over" at that "advanced age", but it was the best thing I'd ever done. I think waiting that long gave me a chance to gather a lot of valuable life experience (including mom experience) that has helped make me successful today. If nursing, be it is an RN or NP, or whatever, is your dream, don't let anyone talk you out of it. Go into it well-informed, but turn a deaf ear to the nay sayers and cynics who will try to discourage you. There's nothing cheap or easy about going through a direct entry progam. Those who think we enter these programs to save money or take the easy way to a degree are sorely mistaken.

I'm not trying to be argumentative, but just want to point out that this is not true of all programs. At the school from which I graduated, the direct entry students are not even eligible for licensure until they've completed the second year of the program, and, at the time I was there, none of the direct entry students I knew worked even a single day as an RN during the third year of school (the program was so rigorous and demanding that few students worked at all). They all graduated and went directly into advanced practice (those who could find jobs, that is -- quite a few them had trouble finding jobs). In fact, at that particular school, many of the direct entry students were quite open about how they had no interest whatsoever in nursing in the larger sense, and were certainly never going to work as bedside nurses (I was always amused to note that many of them could hardly bring themselves to say the word "nurse," they insisted they were going to be "clinicians," not nurses.) But, hey, it was a kinda weird place. I got an excellent graduate education in my specialty, which was what I was there for and really all I cared about.

Well considering the fact that NP's dont practice nursing, they practice medicine, so yes I support direct direct MSN programs. Much like I support PA's who usually dont have nursing experience, I support direct entry NP's.

Something I find troubling---not only in ELMSN students but in many nursing students who aspire for advanced practice roles and graduate education---is that many don't seem to care a whit about nursing. I can't tell you how many graduate students I've met who say they really don't care whether they become nurse educators, NPs, CNSs, managers, whatever---their primary reason for going to graduate school for an advanced practice role is because they "hate" nursing, particularly bedside nursing. They want better hours. They want more prestige. They want more pay. While those motivations are certainly understandable, those should never be the ONLY reasons someone wants to assume an advanced practice nursing role. There has to be an underlying desire to be a NURSE and respect for and interest in the issues of the profession.

There are many other health careers that offer greater status, better pay, better hours and less stress. If someone "hates" nursing but still wants to remain in a health care field, why get an advanced degree in NURSING? Why not become a pharmacist or physical or occupational therapist, a social worker? I think a nurse should only get an advanced degree in nursing if he/she LOVES nursing. Now, that's not to say that every person needs to be enamored with the bedside role. Bedside isn't everyone's cup of tea, and, even for those who truly love being at the bedside, there often comes a day when the physical demands become too great on the aging or injured body. Also, even those who love bedside nursing often find the stresses are too much after so many years. Those nurses don't leave the bedside because they "hate" it but because they need a different direction in their careers.

If a student nurse at ANY level, without any nursing experience whatsoever, goes into a program "hating" nursing, he/she is doing the profession no favors. If students have disdain for being called nurses and want to be called clinicians, why not become physicians' assistants instead?

I also think that when people who "hate" nursing get into advanced practice roles, they contribute to this nasty sniping and one-upmanship that hurts our profession---the MSN vs. BSN, BSN vs. ADN or diploma, RN vs. LPN/LVN, everyone dump on the CNA crap. I've seen a lot of managers and educators who "hated" nursing do a tremendous amount of damage to their staff and students. I've also had to deal with nurses who "hate" nursing in graduate school (a traditional program, not ELMSN or even RN to MSN). Let's just say that, as a student, I didn't feel a whole lot of camaraderie among my classmates and it made my experience not as positive as it could have been. Sorry, but I think if someone truly "hates" nursing, do everyone a favor and find a different profession in which one might be happier.

I finished the pre-licensure phase of my direct entry MSN program in August, and am currently going part time through the grad portion to become a CNM.

The majority of students in my cohort are planning to go part-time through the graduate portion in order to get some experience at the bedside. This isn't required by our program, but strongly encouraged. There are only about 3-4 people that I know of who don't plan to work as an RN for at least two years while finishing the program. Most direct entry programs strongly encourage or require RN work during the grad phase, so I find that the "but they have nooooo experience!!" argument does not tend to be relevant.

As for finding a job with this type of degree - I would say that my classmates are having about the same amount of luck finding RN jobs as the traditional BSN grads from my school. Jobs are scarce right now, so everyone is struggling a little bit. Grads who have finished the MSN work and are seeking positions as NPs in this area have not had trouble finding jobs.

Moogie,

I completely agree with you. No one should be at any level of nursing if they hate it. I am very proud to be a member of the nursing profession and always correct people if they call me doctor. I love the nursing philosophy and approach to patient care, and that's why I went the NP, and not the PA route.

I was thinking a little more about your post, JD2nurse. FNPs are well-equipped to serve those areas in which access to health care is limited because of distance. I realize that the colleague with whom you spoke worked as an RN in the ER for four years even though she had completed her FNP. You know, if it works into your schedule and if you can sit for NCLEX before graduating, it might be a good move for you to work part-time in the ER (as an RN) while you're finishing your program. I think that right now, because so many people who lack primary care providers go to the ER for non-emergency care, the clients you see will be quite similar to those you would serve as an FNP. Moreover, FNPs are often the providers on call in rural emergency rooms that don't have enough physicians on staff. Depending on what kind of setting you might prefer, working in a rural health clinic and taking ER call might be a great option for you.

The only caution I would raise regarding an NP working in a staff nurse role is that one would need to be very careful not to overstep the scope of one's practice in the role. I also know that an RN who is employed in an LPN role is accountable as an RN, not an LPN, and any nurse who works in a CNA/PCT role is accountable as a nurse, not as an unlicensed direct care worker. Do you know if NPs who work as staff nurses would be held to the standards of NPs rather than staff nurses? Just something to consider.

Here's to you and a great career ahead of you!