Entry into Practice: Direct Entry MSN Programs - page 5

Direct entry masters in nursing programs offer a rapid entrance into both the profession of nursing and advanced nursing practice. These unique programs are also known as entry-level or alternate... Read More

  1. Visit  Moogie profile page
    7
    Quote from kimiij
    Thanks! I just redesigned it a couple months ago.

    I graduated from college several years ago. I was working in my field but somehow (I don't remember the precipitating factor) I got really interested in pregnancy, childbirth, natural living, etc. I became a Lamaze childbirth educator and at first, I thought I wanted to be a physician (OB/GYN). However, while I was applying to and preparing for medical school, I couldn't shake the idea that the philosophies I was teaching through Lamaze exemplified optimal maternity care and that modern obstetrical care was lacking. Through my experiences and training I became more convinced that the midwifery model of care was superior and so I switched my focus to midwifery.
    What you say makes a tremendous amount of sense. I agree with you about the midwifery model---it seems more empowering for women and much more family friendly. Thank you for sharing what got you started on your journey. I think the families you serve will be fortunate to have you.

    Quote from kimiij
    My program is a 3-year DE APRN program. Among the roughly 87 students- 12-15 of us are future midwives. The remaining students are future FNPs, ACNPs, PNPs, and more. The first year is focused on nursing. My school is very direct and let us know that they are providing us the information that is crucial for Advanced Practice Nursing. Makes sense because upon completion of our program, we will be employed APRNs, not RNs. This school does not award a BSN- only an MSN. The second and third years are the specialty years during which your clinical hours are focused on your specialty.

    I can't speak for the other APRN specialties, but from my limited observational experience, it doesn't seem as though being a midwife is "the next step up" from being an L&D nurse. They are two different things. Two different roles and in my experience L&D nurses are often more aligned (in terms of philosophy) with OBs. And as we know, midwives are not OBs.
    Again, what you say makes sense. Your role will be completely different from that of an RN working in a hospital-based L & D environment and, as you know this is what you want. I think you would be wasting your time to do a more traditional educational route and to work in a hospital-based situation before going on to become a CNM.

    My curiosity is piqued because I am a nurse educator, not currently working because I'm headed back to school myself. I do find it fascinating to look at the history of nursing education and I am definitely open to new ideas and new options, especially for those who are pursuing the nurse practitioner route. I also want to be as open-minded as possible because someday I might be teaching students in similar programs.

    Quote from kimiij
    Don't worry- I have no interest in trying to change your mind.
    Too late! Seriously, I have learned a lot from the posters on this thread. You all have definitely broadened my thinking in terms of looking at the ELMSN as a legitimate option for many nurses. Certainly not all nurses---I think those who are able to complete these programs are a special breed.

    Quote from kimiij
    And this is what I think it comes down to - RNs and traditionally trained APRNs feeling Intimidated. I can't understand the sentiment as I am not in your shoes. But, from where I am standing, IMO it doesn't make sense. We should be able to work together even though we had different educational pathways.
    Unfortunately, that seems to be a common feeling among nurses---the intimidation and competition that seems rampant between nurses who have different educational levels. If you have a chance, look at some of the threads about LPNs/LVNs feeling put down by RNs. My initial preparation was at the ADN level and many diploma-educated nurses looked down on us because we went through a "lesser" level of education. Those who went directly into BSN programs had it worse, though, because many were looked down upon because they didn't have as much clinical as did the diploma-educated RNs. I've seen many BSNs be treated with outright hostility on the floors because of their education and, after I got my BSN in the first RN to BSN program at my university, I experienced some hostility, too.

    I will be honest in saying that sometimes I feel frustrated with the notion of the ELMSN program---not anything against the graduates---but I feel frustrated with the system. There are many people who go through more traditional education and jump through a LOT of hoops. I know of MSN programs that won't even look at an applicant who does not have at least two years of experience as a floor nurse---so maybe you can understand why it seems incongruent that while some programs require experience, others don't and even offer entry-level MSNs to non-nurses. Traditional MSN programs can be difficult to get through and impossible if you need to drop out for any reason. I tried to transfer from one program to another for various reasons (GPA was not one of them---I had a 3.75) but most of my credits would not transfer even though I was in the same state university system. I got horribly burned out with the educational process---and then moved out of the area---so I'm probably going to have to start over if I go the MSN route---unless I get accepted into the BSN to PhD program to which I have applied. I don't understand why there is so much inconsistency in nursing education and I sometimes feel like

    I'd be happy to share a little more of my story with you if it helps you to see another side but right now I need to go vacuum the downstairs. I'm stuck between programs right now and have no excuse not to clean the house!

    Thank you again for your thoughtful and informative post.
    Gator Girl 2000, Bree124, VickyRN, and 4 others like this.
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  3. Visit  BCgradnurse profile page
    6
    Just one more note on the negativity towards DE NPs and then I promise I'll be quiet!!! I have been on the other side of the fence....I worked for many years as a medical technologist prior to going to nursing school. The hospital I worked at had a policy of only hiring people with a BS in Medical Technology who were board certified. Over the last 5-7 years the med tech programs at colleges have disappeared, leaving an aging population of techs with no one to replace them come retirement. Three years ago the lab I worked at took a chance and hired a couple of bio majors and sent them for some training. I never said anything about it (I was thrilled to have new bodies to take some of the weekend/evening shifts!!), but I definitely had my doubts about their ability to succeed. I was pleasantly surprised to see how great these people were. They worked so hard to grasp the technology and theory, and turned out to be some of the best, most conscientious techs in the place. So, that was a lesson learned for me and is part of the reason I'm vocal about the DE programs and their graduates, cause I've been a doubter myself. Alternate educational pathways can be very effective. I think it's up to the individual student to make the most of what they learn and put in the work necessary to succeed.
    citymoose, Malefocker, Bree124, and 3 others like this.
  4. Visit  Moogie profile page
    3
    Quote from kanzi monkey
    I'm not sure what the plan is for those that decided not to complete phase 2--I know one is entering another program to get a BSN, and some are just working as RNs at the moment. I imagine most will eventually return to the program if they want to go into advanced practice since having a degree-less RN license may be confusing for other graduate programs. I know when I completed phase 1, I definitely felt as though I was "in the snare"--because it IS really difficult to move on without completing the program. But it is an excellent school, and I have no regrets for finishing. Yes, there is a traditional BSN program at my school (it's pretty big), and during phase 1 most of my classes were combined with BSN students. I took every nursing course that the BSN students took, and did as many clinical hours.

    Oh, and I graduated last spring and got my NP license in July
    Just looking for a new job at this point!
    Thanks for the info---it sounds like a good program for the right person. It would not have been the right kind of program for me because I went into an AD program immediately after high school. Come to think of it, I'm not sure the route I took would be the best for many people. I was an RN at age 20! (If I had to do it over, I would have either done a direct entry BSN program or I would have done an RN to MSN program had they existed back in the 1980s. I wish I would have had a more traditional college experience---maybe that's one reason I feel drawn to academia.)

    And on your graduation. I wish you the very best in finding your job.
    Last edit by Moogie on Sep 7, '09
    VickyRN, >30yrsRN, and kanzi monkey like this.
  5. Visit  Anise1 profile page
    0
    Kimiij, you mentioned that you're in a DE APRN program where a lot of the students are in midwifery... it's not the OSHU program in Portland by any chance, is it?
  6. Visit  >30yrsRN profile page
    0
    Quote from BCgradnurse
    Just one more note on the negativity towards DE NPs and then I promise I'll be quiet!!! I have been on the other side of the fence....I worked for many years as a medical technologist prior to going to nursing school. The hospital I worked at had a policy of only hiring people with a BS in Medical Technology who were board certified. Over the last 5-7 years the med tech programs at colleges have disappeared, leaving an aging population of techs with no one to replace them come retirement. Three years ago the lab I worked at took a chance and hired a couple of bio majors and sent them for some training. I never said anything about it (I was thrilled to have new bodies to take some of the weekend/evening shifts!!), but I definitely had my doubts about their ability to succeed. I was pleasantly surprised to see how great these people were. They worked so hard to grasp the technology and theory, and turned out to be some of the best, most conscientious techs in the place. So, that was a lesson learned for me and is part of the reason I'm vocal about the DE programs and their graduates, cause I've been a doubter myself. Alternate educational pathways can be very effective. I think it's up to the individual student to make the most of what they learn and put in the work necessary to succeed.
    BCGRAD
    Did you go to the Simmons Boston College
    I agree with that Program it is THREE Years plus the Prerequisites
    that is more like a RN to MSN program or EBSN to MSN
    I see you had a BS in Medical Tech now that is a whole other animal
    IMO that is a Simmons Boston College is a Outstanding and great program
    I thought you said you graduated from MS to MSN in two years program?
    IMO that would not me safe for Master to go to MSN
    Oh FIU is Florida International Unversity, This is a tough program also RN to MSN or MD to BSN to MSN program
  7. Visit  >30yrsRN profile page
    0
    Quote from BCgradnurse
    So let me see if I have this right......nobody right out of school should be allowed to practice because they make mistakes...this includes RNs, MDs, PAs, NPs, PTs, etc. Again, you're not presenting concrete examples. And can I assume you have never made a mistake in your 30+ years of practice? You and your colleagues may be experienced and intelligent, but I don't think you speak for everyone in the nursing/medical world. Being stuck in the past and not being open to change and new ways does a disservice to your patients. I'm not sure where your bitterness and resentment is coming from, since you haven't yet given a specific example of where a DE NP caused harm. However, your attitude has only further inspired me to work harder to be an exceptional NP. Not because I have something to prove to those like you, but because that's what my patients deserve.
    Oh you taken what I said out of Context
    Did go ro Boston College or Berea College in Berea, KY.?
    Boston College ELMSN is a three year program and is Excellant it is a three year program and Plus prereqs.
    I thought you wrote you went to Berea College in Berea ,KY ad they do not have ELMSN the last time I check which was 15 minutes ago.
    there is are was another Blogger with the same name who graduated from Berea College
    BCGrad
  8. Visit  Moogie profile page
    2
    Quote from >30yrsRN
    This is a tough program also RN to MSN or MD to BSN to MSN program
    MD to BSN or MSN? Pardon my ignorance but would that be for a foreign-educated physician who was not able to obtain a medical license in the US so he/she could practice as an RN or an APRN?

    Not to go off on a tangent here but I remember hearing about a Hmong refugee who had been a physician but unable to become licensed when he immigrated, so he was working as a maintenance man in a hospital. This was many years ago and it seemed like such a waste---if he couldn't practice as an MD, it would have been a great option for him to have gotten into an ELMSN program to become an APRN.
    kanzi monkey and >30yrsRN like this.
  9. Visit  kimiij profile page
    0
    Quote from Anise1
    Kimiij, you mentioned that you're in a DE APRN program where a lot of the students are in midwifery... it's not the OSHU program in Portland by any chance, is it?
    No, it isn't. OSHU is supposed to have a great midwifery program though! I've heard great things about them
  10. Visit  >30yrsRN profile page
    0
    Quote from Moogie
    MD to BSN or MSN? Pardon my ignorance but would that be for a foreign-educated physician who was not able to obtain a medical license in the US so he/she could practice as an RN or an APRN?

    Not to go off on a tangent here but I remember hearing about a Hmong refugee who had been a physician but unable to become licensed when he immigrated, so he was working as a maintenance man in a hospital. This was many years ago and it seemed like such a waste---if he couldn't practice as an MD, it would have been a great option for him to have gotten into an ELMSN program to become an APRN.
    yes it foreign physcian yes I think it a ABSN program
    FIU and has online to!
  11. Visit  jillgilli profile page
    5
    Thanks for the question it is well stated.
    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.
    I place pediatric nurse practitioners at children's hospitals and clinics nationwide and I work with a lot of direct-entry MSN students. There are a lot of very good reasons why a person would pursue a direct entry degree. The graduates I work with are very well educated and prepared through coursework and clinical experience. The place where a direct entry graduate can find it hard to get a job is when they want to work in a specialty care unit but they do not have any experience in that unit as a RN. You cannot work in a critical care unit if you do not have critical care experience. That is true for a PNP who has 20 years nursing experience in a non-critical care environment or a direct entry candidate who has very little RN experience. That being said, there is a difference between a RN who is recently graduated and certified as a PNP with 4-6 or more years RN experience and one who has graduated with no RN experience. One is considered an experienced PNP by most hospitals and one is not.
    I strongly encourage anyone in a direct entry program to work as a RN as soon as they can in a hospital. Additionally, I encourage them to work in a unit that they think they might want to continue to work in as an advanced practice nurse. If the program takes 3 years and a student receives their BSN after 1 year, they will have 2 years of RN experience by the time they graduate. Many times I encourage new graduates from a direct entry program to continue or start a RN position until they get a job. That could be another 2 years but they are getting the experience necessary to be an effective nurse practitioner in a hospital environment. In one of the comments, working as an RN was referred to as doing time. I would look at it as a gift of being able to learn to provide the best care possible for your patients in the specialty area of your choice.
    One of the exceptions to this can be in a clinic or ambulatory hospital situation. It is possible for a direct entry graduate to receive a job offer as a Nurse Practitioner in a clinic and some ambulatory hospital settings. The overall preparation does prepare a graduate to work successfully as a Nurse Practitioner but cannot possibly prepare every student in every specialty area of the hospital. That is why working in as a hospital RN, especially in a specialty area, is strongly encouraged to build necessary experience for a new graduate. From, Jill Gilliland, President Melnic Consulting Group.
    Collegegal28, MaritesaRN, >30yrsRN, and 2 others like this.
  12. Visit  MaritesaRN profile page
    1
    Quote from vickyrn
    direct entry masters in nursing programs offer a rapid entrance into both the profession of nursing and advanced nursing practice. these unique programs are also known as entry-level or alternate entry nursing masters programs. this type of education is specifically tailored for people with a baccalaureate or higher degree in another discipline who seek a new career as advance practice nurses.

    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?

    references

    accelerated programs: the fast-track to careers in nursing

    accelerated bsn and msn nursing programs

    hi vicky , i think before going into any advance studies , a student must have a leg at least in clinical and years of experience as nurses..........otherwise this accelererated program will be just in theory ----theory becomes alive when bundled w/ understanding by experience........otherwise the study is not going to be practical , and in reality just another paper if unable to apply the knowledge. :typing
    VickyRN likes this.
  13. Visit  hiddencatRN profile page
    1
    If PA's are ok to practice without being nurses first, I certainly don't have a problem with DE MSN programs. The NPs I've had as PCPs or have worked with have a role that is more similar to that of a physician than that of a nurse. It seems appropriate that the bulk of their clinicals are at an advanced practice level since that is the level at which they will be practicing.

    Experience as an RN would certainly be valuable, but not essential.
    VickyRN likes this.
  14. Visit  briang30 profile page
    1
    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.
    VickyRN likes this.


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