Entry into Practice: Direct Entry MSN Programs

[VickyRN]

Direct entry MSN programs are approximately three years in length. They provide basic nursing curricula during the first year or so of the program (pre-licensure phase), with graduate core courses and specialty course work during the remainder of the program (graduate nursing concentration phase).

The first masters program for non-nurse college graduates was instituted at yale university in 1974. These programs have grown slowly over the ensuing years. In 2008, the American Association of Colleges of Nursing reported 56 direct entry MSN programs.

Entry-level MSN programs are very demanding, as they not only provide students with a general foundation in nursing, but masters-level courses for leadership or advanced practice as well. These programs are fast-paced, usually involving five-days a week intense study, with a combination of classroom theory and clinical coursework interwoven throughout.

Some programs award learners a BSN at the halfway point of the program, and then an MSN at the end of the program; others only confer one degree: an MSN upon graduation from the program. In the latter case, students forgo a second bachelor's degree. In either type program, students must pass the NCLEX-RN after successfully completing the pre-licensure component, before progressing to the graduate-level courses offered during the second half of the program. Following program completion, students are then eligible to sit for national certification exams for advance practice nursing specialties.

Areas of study in direct entry MSN programs include nurse practitioner, clinical nurse specialist, clinical nurse leader, executive nurse leader, nursing administration, health care systems leadership, and certified nurse midwife. I have even heard of some programs offering nurse anesthesia by way of direct entry. An example is Georgetown university direct entry to advanced practice program. Another surprise is nursing education, which is offered in some direct entry programs.

A big controversy remains concerning entry-level MSN programs: are graduates adequately prepared for advanced practice nursing? What is the job market for advanced practice nursing graduates from these programs? Are they taken seriously by prospective employers? Many people are of the opinion that advanced practice nursing is just that - advanced practice. Critics assert that registered nurses need at least 2 years' experience at the bedside before entering into advanced practice.

What do you think?

[kanzi monkey]

rockinRN1975 said:

I've applied to the only other reputable MSN program that will accept a nurse like me, but it is a CNL program so if I want to become a NP I will have to do another 32 credits after that for a post masters certificate.

Does this school require you to go through the CNL program before going the NP route? I would think if you could be accepted into the CNL program (which is an MSN, right?) that you could just as easily be accepted into the NP track. I may be equivocating CNL with CNS since I don't know much about CNL programs, so maybe I'm missing something. An old coworker of mine completed her CNL program during her first year as a nurse--it may have been the program you are talking about since I think it's in the same region. Could you get a BSN from this program? Thus opening up more MSN program and job opportunities...

rockinRN1975 said:

If I'd done an accelerated BSN or even a ADN instead of DE it would have made a world of difference (cost, financial aid, marketability, graduate study options). I wish I'd had someone experienced to offer me such an opinion while I was making my decision about the best way into nursing for me. If any other DE MSN dropouts are reading I would LOVE LOVE LOVE you to post what you've been doing (or planning) for work and education since leaving!

I hear your frustration. I would have thought that a DE dropout with an RN license would be considered equally for positions that require a BSN since any DE student has at least the equivalent amount of training and education. It is foolish to be guided blindly by alphabet soup when making hiring or admissions decisions.

[LuLu2008]

Please bring me up to speed... what is a DE program? What is a CNL program? Just as a point of information, where I live I HIDE the fact that I am a BSN level nurse because the majority of nurses with whom I work, and in fact those that supervise me, do not have that degree yet! With some people, using a RN, BSN title may be interpreted as snobbish. Believe it or not. :)

[rockinRN1975]

DE= direct entry or master's entry, a bridge program for students with a non nursing BS to enter into a nursing MS program. Usually an accelerated RN component (phase 1) and then entry into a regular MSN program (phase 2).

[MaritesaRN]

Considering the time and money for masters, is this program transferable to another state? It takes aout 18 - 24 mos to finish , but if one moves to another state, one should not lose thsoe credits and be transferable ?:)

[rockinRN1975]

I'm not sure if you are asking about educational credits earned in a master's entry program or the end degree and license? As far as a final degree and license goes - if the program is accredited and you complete the MSN program and successfully pass the boards then you take your credentials wherever you go. But keep in mind that different state BON have different rules regarding advanced practice roles so you might find the role drastically different from one state to another. If you're asking about individual classes and credits earned while working toward a degree and transferring those to another program in another state - that is basically up to the institutuion you are asking to accept the credits. Different schools have different policies. Most limit the number of transferrable credits and most require a good number of credits earned on their campus before they will award a degree. Also, as you probably read in previous postings, the state BONs have their own requirements regarding the credentials required as prerequisites to enter a MSN program. For instance, the ME BON does not allow a non nursing BS for entry to a MSN program, while the MA BON does (though not all MA schools offer programs accomodating a non nursing BS student)...hopefully I answered some questions instead of creating more - the world of nursing credentials is awfully convoluted, isn't it?

[jasonakaremy]

there are many good programs like this. also accelerated arnp programs are coming to be a big hit since the recent adoption of phd

[MaritesaRN]

Thank you for the answer, and yes it is convoluted. It is also nice if Universities get together and have some reciprocities on the courses, so one does not lost credits if they move to another state. It is the samd thing w/ the nurses license...this especially should have a reciprocity, some sort of standardized accepted discipline and studies and nurses licenses should be acceptable to other states !!!!

[tsipareht]

melmarie23 - if you don't me asking, which school did you attend? and how much longer is the NP route post Entry-MSN?

[tsipareht]

melmarie23 - which DE MSN program did you complete your schooling with? And how much longer is it post DE MSN?

Thanks!

melmarie23 said:

I am a DE MSN student. I just finished my first year and have one more to go.

Ours is year round (Summer semesters included) for two years. We receive "provisional" status into the graduate school once accepted. Our status will change once we pass NCLEX, which we sit for after a year and half. So for me, I will be sitting for the boards this upcoming June.

The program is front loaded with the basics: fundamentals, patho, pharm, psych, OB, Pedi, Med/Surg, community health....as well as some of our master's courses. In my first year, I've completed 585 clinical hours. This Spring, we have our immersion, in the specialty we're planning on going in upon the programs completion, which is 400 clinical hours. The last Summer and fall semesters is mostly dedicated to our research, which will be in the same hospital/unit as our immersion.

After passing the NCLEX we're expected to start working. It's not mandatory, but its strongly encouraged. Additionally, many past cohorts have been hired from their immersion placements, contingent on passing the boards. So needless to say, this upcoming Spring is huge for me.

My school's DE MSN is for the CNL role. We were told at the beginning that we mostly likely won't be hired into this role, but rather we'd matriculate into it after a year or two experience under our belt. To help us gain that experience, we sit for the boards 6 months before graduating and are then encouraged to work as we wrap up the program.

I will likely sit for the CNL exam when I graduate next December. I can also continue on, and become an NP as my school also has a certificate program. However, I plan on working for at least a few years before I continue my education.

Why did I chose my particular school and program? Initially it was to both go to graduate school, and to become a nurse. I already had a Bachelors, so I didn't want to work backwards so to speak. What I liked about the CNL role is that is bridges what I did in my past life (my Bachelors is in Biology and I worked in research for three and a half years before starting the DE program), but still allows us to work at the bedside. Yes, the CNL is still a bedside nurse. I still want to work with patients, but also solve problems, improve patient outcomes and advance the profession as well. Additionally, at my school, I have the option to continue on and become a practitioner, which is a long term goal of mine.

I know this thread is a old, but I still wanted to share my story.

[tsipareht]

Which program did you get into if you don't mind me asking. Thanks.

[tsipareht]

Hi - can you tell me which program you are in? Good/bad?

briang30 said:

I just started a direct entry program. Our first year is focused solely on the BSN aspects of nursing. We are 5 weeks in and already in our second week of clinicals. We will do about 500 hours of clinicals as students during our first year. In addition to doing RN duties, we are also doing a lot of work that is often delegated to nursing assistants.

In June and July we will do a 250 hour internship working 4 days a week on a floor. We take our NCLEX in the fall. During our last two years of school, we are required to work a minimum of 500 hours a year while taking master's level courses.

So while we will not have 2 full years of RN nursing under our belt by the time we graduate, we will have seen our share. I believe that this will prepare us adequately. There are also two nurses on my floor who are graduates of my program. While not working as NPs, they obviously are able to perform at the level required for a acute care floor.

[PMFB-RN, RN]

In the last several years my hospital has hired several (6 or 7) direct entry masters new grad RNs for the Nurse Residency program. The Nurse Residency is a 7 month program desined to train new grads to be ICU nurses and has been highly sucessful since it was started.

I serve as both an instructor and preceptor in the Nurse Residency program. I have to say that the direct entry MSN grads have not left a good impression on me, the experienced ICU nurses, or on the managers of our hospital. They seem to come with far less clinical training than the ADN and BSN grads we have traditionaly hired and with far more entitlement attitude. I admit that our opinion has been formed after experience with only 6 or 7 direct entry GNs from only two programs. Grads from other programs may be much different. Initialy there was a lot of excitment in our hospital to hire them as it was though that unlike the new grad BSNs they would not be in a hurry to rush off to CRNA school. I remain open minded and open to experience with more direct entry MSN grads but the desire to hire them into the Nurse Residency has cooled considerably in this hospital.