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?

[Moogie]

43 started out in my DE program and only two left-1 for grade issues and 1 for personal reasons. I think the faculty were pretty supportive and certainly did not try to make people fail. They told us they did not accept any student who they did not think would be successful in the program. And it's not like they were begging for applicants-my class had over 500 applications for the 43 spots. We had to maintain at least an 84 average our first year, and there were plenty of resources to help us, if you chose to use them. We didn't have any silly rules about clinical either. If you missed a clinical, you had to make it up, but nothing about stupid things like shoes..lol. That being said, it was a tough program that required a huge commitment, and there wasn't much handholding at all. The one person who did not make the cut because of grades was certainly intelligent, but lacked the commitment and maturity needed to focus. I don't understand why professors/programs would "try" to flunk students. I would think that would be a poor reflection on the school and discourage future students from applying.

Huge to your school! It's only LOGICAL to accept students who are most likely to be successful and, once those students are in the program, to facilitate their learning, not set up a series of hoops through which they must jump in order to get to the next educational level. It also sounds like your school understood what it means to be an adult learner. I think the programs in which students are in constant fear of flunking out are stuck in an outdated, paternalistic educational mode, the old mindset of "nurses' training" of the heyday of the pre-feminist, hospital-based (as opposed to college-based) programs in the 1950s and 1960s that promoted the notion of the physician as captain of the ship and nurse as handmaiden rather than autonomous professional.

Adult learners do not need their hands held or to be spoon-fed what they need to know. They are expected to take ownership of their education and the instructor does not fill their head with information; he/she facilitates the learning process.

I must admit to an ulterior motive for asking this question. I was not real happy teaching in an environment in which faculty seemed more willing to flunk out students rather than try to retain them and help them to learn. The school at which I taught was very competitive and admitted only a fraction of the applicants---indeed the school's reputation did suffer but because it's hard to get into any nursing program these days, there were never too few applicants to fill the open spots. It just seems to me to be a waste of everyone's resources, then, to keep trying to weed out students (other than those who are obviously in the wrong place) rather than to try to help them learn to the best of their abilities. When I finally do finish my neverending degree, I might want to teach in a DEMSN program. It sounds like it could be very satisfying, not only for students but also for faculty. Again, thank you for your input!

[misplaced1]

Huge to your school! It's only LOGICAL to accept students who are most likely to be successful and, once those students are in the program, to facilitate their learning, not set up a series of hoops through which they must jump in order to get to the next educational level. It also sounds like your school understood what it means to be an adult learner. I think the programs in which students are in constant fear of flunking out are stuck in an outdated, paternalistic educational mode, the old mindset of "nurses' training" of the heyday of the pre-feminist, hospital-based (as opposed to college-based) programs in the 1950s and 1960s that promoted the notion of the physician as captain of the ship and nurse as handmaiden rather than autonomous professional.

Adult learners do not need their hands held or to be spoon-fed what they need to know. They are expected to take ownership of their education and the instructor does not fill their head with information; he/she facilitates the learning process.

I must admit to an ulterior motive for asking this question. I was not real happy teaching in an environment in which faculty seemed more willing to flunk out students rather than try to retain them and help them to learn. The school at which I taught was very competitive and admitted only a fraction of the applicants---indeed the school's reputation did suffer but because it's hard to get into any nursing program these days, there were never too few applicants to fill the open spots. It just seems to me to be a waste of everyone's resources, then, to keep trying to weed out students (other than those who are obviously in the wrong place) rather than to try to help them learn to the best of their abilities. When I finally do finish my neverending degree, I might want to teach in a DEMSN program. It sounds like it could be very satisfying, not only for students but also for faculty. Again, thank you for your input!

My program lost a third of the class the first and second semesters and a couple people thereafter each of the next semesters. There was constant fear of flunking out eve when you knew the material well for reasons

I wont even get into here. I dont need to go into more but you get the idea. I learned a lot and faculty was excellent but yes I felt like I was 12 and it was 1950. It kinda scared me off to the whole profession to be honest. I am not interested in being a martyr/handmaiden. Maybe this has been much of my problem deciding what to do now, maybe it was just the program I was in making me feel lik I was not an adult or a professional.

[MaritesaRN]

There may be only a few direct entry Masters programs that offer a gerontological advance practice degree, but such programs do exist. Information about the Gerontological Nurse Practitioner advance practice role:

Gerontological Nurse Practitioner

Gerontological Advance Practice Nurses Association

Gerontological Nurse Practitioner Programs (in US)

Direct entry Masters programs offering a gerontological advance practice degree:

University of Pennsylvania School of Nursing

Seattle University College of Nursing

Marquette University College of Nursing

There are also Gerontological Clinical Nurse Specialist programs. Here is some more information on the Gerontological Clinical Nurse Specialist role. An example of such a program is here and here.

Marquette University College of Nursing offers a direct entry route to gerontological clinical nurse specialist.

Hope this helps and best wishes to you! :)

Vicky , thank you so much !!!!! You are quite an excellent resource !!! You must be a terrific instructor !

[MaritesaRN]

The students in my college's direct entry MSN program are treated professionally. The retention rate is very high in this student-friendly program.

Moogie, in my very limited experience as faculty, I have found ADN programs to be the least supportive to students and most likely to use the "weeding out" philosophy with draconian expectations of students. The vast majority of ADN programs are supportive of their students; I'm just saying that the "Nurse Ratched's" of the educational world are more likely to be found in these type programs.

Generally, the higher up the educational "food chain," the more respect is afforded to students. Most BSN or MSN programs try very hard to be student-friendly and retain their students.

Of course, mean-spirited and abusive individuals in faculty roles may be found anywhere. They just tend not to last very long in institutes of higher learning.

Hi Vicky , I was trying to save those links that you gave us before....but I can not locate it anymore.

Maybe you can nudge me to a direction....I am 63, UR , CM and medical review for Medicare and private insurance, was also a staff ,and at times charge nurse for a lock up psych unit. I would like to be taking some certification towards gerontology. My change of direction is toward geriatrics , preferably in a LTC with rehab ( this way I can re learn and apply some clinical nursing skills again). I was told to get AANAC, maybe some MDS certification ? Long time ago I started taking required undergraduates subjects to get into Domiguez Hills Masters program. I stopped because I was not clear w/ my purpose for the Masters......I really did not have a solid reason why I was taking it, except to compete w/ other VA nurses that carried all sorts of Masters and even PHD's---- I do not want to be an administrator , ( unless I own the place ) . I would like skilss that I could take to another state, since I plan to move my family out of california to Washington State or Oregon ( things are greener and hopefully not as crowded and expensive as California is getting to be.

By the way I am a healthy 63, so my age should not be the reason of not finding work. I like to go to Gerontology , geriatrics to be specific. I do like old people, but I also want to be good professionally at what I do ...so can I go to a geriatrics specialist study? I had RN training in an excellent community college , but I finished Bachelor of Journalism in another country, but to study here, I have to have an international eval company looked at my transcripts. You know the rule for an out of the country degrees are to minus 30 units, then they go through your courses for the US equivalents. After - 30 units, they granted me with an equivalent of Bacheor of Science, so I am good. I stopped taking courses because the place that I worked for before (Veterans Administration , Los Angeles) did not give me any education reimbursement ( as part of the benefits) . It seems like everytime I inquire for the $2,000.00/ year education reimbursement --- they are already "out of funds". Anyhow , not to get distracted , I stopped because Phoenix U. It was costing me a lot of money from student loan --------------I still have a balance of $4,600.00 plus student loan approximately , from the 3 subjects I took via this school ! Are there any other avenues to get educated without going broke for the rest of your life? I know that you can work for a government office for 2 years , and they will forgive your loan, but then getting one, ( I worked in a federal office) , and this was not accounted for ??????? something was not right , but now I am thinking if those loans should be forgiven considering I worked in the VA ???

I am willing to hear your wisdome and advice on this......no you can make it public so others may get something from it too.

[Moogie]

My program lost a third of the class the first and second semesters and a couple people thereafter each of the next semesters. There was constant fear of flunking out eve when you knew the material well for reasons

I wont even get into here. I dont need to go into more but you get the idea. I learned a lot and faculty was excellent but yes I felt like I was 12 and it was 1950. It kinda scared me off to the whole profession to be honest. I am not interested in being a martyr/handmaiden. Maybe this has been much of my problem deciding what to do now, maybe it was just the program I was in making me feel lik I was not an adult or a professional.

Oh my word. Misplaced, was this in a DEMSN program, a BSN program, ADN, LPN? I hope you don't mind but I took a look at the thread on which you'd posted about abusive clinical instructors and am so sad that you---and your classmates---have been through this sort of hell.

A third of the class flunked out? And I'm sure the admission standards were very high. If standards were low and it was easy to get into any nursing program, I could understand the need to weed out people who might be in the wrong place. But when standards are high, it seems so utterly ridiculous and a waste of everyone's time and energy.

Obviously, students who can successfully get through the prerequisites of ANY nursing program show motivation and some degree of critical thinking. To flunk people out on a whim or because of a power trip is simply wrong.

Please feel free to PM me if you'd like. I've had an instructor be unfair to me as well and I decided I would be d****d if I ever did that to any student when I was teaching.

[MaritesaRN]

The students in my college's direct entry MSN program are treated professionally. The retention rate is very high in this student-friendly program.

Moogie, in my very limited experience as faculty, I have found ADN programs to be the least supportive to students and most likely to use the "weeding out" philosophy with draconian expectations of students. The vast majority of ADN programs are supportive of their students; I'm just saying that the "Nurse Ratched's" of the educational world are more likely to be found in these type programs.

Generally, the higher up the educational "food chain," the more respect is afforded to students. Most BSN or MSN programs try very hard to be student-friendly and retain their students.

Of course, mean-spirited and abusive individuals in faculty roles may be found anywhere. They just tend not to last very long in institutes of higher learning.

Hi Vicky ! I never understood the PA program. I heard this is a 4 year program........but is this program clinically involved during the training? I know that they sort of equate Physicians assistant (PA) to nurse practitioner (NP) in some places , but nurse practitioner are way much educated ( have to have Masters now , before you can go NP training for 9 months?) What is the difference of the curriculum between these two? What are the limitations in practice of the NP? Not to put down the PA , I jsut need to understand as to why they equate their functions to a nurse practitioner?

[VickyRN, MSN, DNP, RN]

Hi Vicky ! I never understood the PA program. I heard this is a 4 year program........but is this program clinically involved during the training? I know that they sort of equate Physicians assistant (PA) to nurse practitioner (NP) in some places , but nurse practitioner are way much educated ( have to have Masters now , before you can go NP training for 9 months?) What is the difference of the curriculum between these two? What are the limitations in practice of the NP? Not to put down the PA , I jsut need to understand as to why they equate their functions to a nurse practitioner?

This might be helpful to your inquiry, MaritesaRN:

What is the difference between a PA, NP, and RN?

Also

http://medicaleconomics.modernmedicine.com/memag/article/articleDetail.jsp?id=121168

[VickyRN, MSN, DNP, RN]

Hi Vicky , I was trying to save those links that you gave us before....but I can not locate it anymore.

Maybe you can nudge me to a direction....I am 63, UR , CM and medical review for Medicare and private insurance, was also a staff ,and at times charge nurse for a lock up psych unit. I would like to be taking some certification towards gerontology. My change of direction is toward geriatrics , preferably in a LTC with rehab ( this way I can re learn and apply some clinical nursing skills again). I was told to get AANAC, maybe some MDS certification ? Long time ago I started taking required undergraduates subjects to get into Domiguez Hills Masters program. I stopped because I was not clear w/ my purpose for the Masters......I really did not have a solid reason why I was taking it, except to compete w/ other VA nurses that carried all sorts of Masters and even PHD's---- I do not want to be an administrator , ( unless I own the place ) . I would like skilss that I could take to another state, since I plan to move my family out of california to Washington State or Oregon ( things are greener and hopefully not as crowded and expensive as California is getting to be.

By the way I am a healthy 63, so my age should not be the reason of not finding work. I like to go to Gerontology , geriatrics to be specific. I do like old people, but I also want to be good professionally at what I do ...so can I go to a geriatrics specialist study? I had RN training in an excellent community college , but I finished Bachelor of Journalism in another country, but to study here, I have to have an international eval company looked at my transcripts. You know the rule for an out of the country degrees are to minus 30 units, then they go through your courses for the US equivalents. After - 30 units, they granted me with an equivalent of Bacheor of Science, so I am good. I stopped taking courses because the place that I worked for before (Veterans Administration , Los Angeles) did not give me any education reimbursement ( as part of the benefits) . It seems like everytime I inquire for the $2,000.00/ year education reimbursement --- they are already "out of funds". Anyhow , not to get distracted , I stopped because Phoenix U. It was costing me a lot of money from student loan --------------I still have a balance of $4,600.00 plus student loan approximately , from the 3 subjects I took via this school ! Are there any other avenues to get educated without going broke for the rest of your life? I know that you can work for a government office for 2 years , and they will forgive your loan, but then getting one, ( I worked in a federal office) , and this was not accounted for ??????? something was not right , but now I am thinking if those loans should be forgiven considering I worked in the VA ???

I am willing to hear your wisdome and advice on this......no you can make it public so others may get something from it too.

MaritesaRN, have you talked with a guidance counselor at your local university or community college? This would be the best way to get career advice tailored specifically to your unique life circumstances. The appointment is free and the counselor would know what scholarships, grants, loans, etc., are available in your area and perhaps in other areas of the country. Best wishes to you :)

[>30yrsRN]

Well, It sounds like you know want a inexpensive and Quickest way to get your MSN and have a Certification in Geriatrics. This would be a State University program. Check for online RN to MSN. Also any College you go to if you want a Degree you are going to be paying for the least 30 to 72 credits of their courses and that is at any level AS,BSN,MSN or PHD. It Big Business !

Did you ever hear of WGU? It Online they except Life experiances and I bet alot of those courses you took.

If you work at the VA you have to be accept in a College Before June 2009 or 2010 etc,.. then apply for the Tuition Reimburse Forms by the June Date, Then when you see the emails about it in the Fall and Winter and Spring read it aga

in, you will see that

It really is for the Nurses except in that June Form so that the money is available as the Progress though thier Degree Programs, Also Check to see if the money was divide up even for the BSN and MSN Degrees Nurses Reimbursements if they truely Ran out of the Funds, They were not Following a Magnet Ideal way of sharing the wisdom and wealth of the $ resources, Thats what gives Magnet a bad name when this Happens and all the money goes to the Top Degrees like MSN and PHD in Nursing and not the RN to BSN or RN to MSN Programs. I would also look at ANA for Scholarship Money in your local community. Also what List were you referring about to Vicki? I might still have them for you.

[MaritesaRN]

Well, It sounds like you know want a inexpensive and Quickest way to get your MSN and have a Certification in Geriatrics. This would be a State University program. Check for online RN to MSN. Also any College you go to if you want a Degree you are going to be paying for the least 30 to 72 credits of their courses and that is at any level AS,BSN,MSN or PHD. It Big Business !

Did you ever hear of WGU? It Online they except Life experiances and I bet alot of those courses you took.

If you work at the VA you have to be accept in a College Before June 2009 or 2010 etc,.. then apply for the Tuition Reimburse Forms by the June Date, Then when you see the emails about it in the Fall and Winter and Spring read it aga

in, you will see that

It really is for the Nurses except in that June Form so that the money is available as the Progress though thier Degree Programs, Also Check to see if the money was divide up even for the BSN and MSN Degrees Nurses Reimbursements if they truely Ran out of the Funds, They were not Following a Magnet Ideal way of sharing the wisdom and wealth of the $ resources, Thats what gives Magnet a bad name when this Happens and all the money goes to the Top Degrees like MSN and PHD in Nursing and not the RN to BSN or RN to MSN Programs. I would also look at ANA for Scholarship Money in your local community. Also what List were you referring about to Vicki? I might still have them for you.

Hi , thank you so much for the reply. Vicky gave me some links and did go to see it, and it is good to see other options to be able to make a better decision. One more question ...I was in preparation by taking more undergraduates subjects in Domiguez Hills (State Univeristy) .....what happens if I ahve to move to another state before I graduate.........am I going to lose credits if I pick it up in another state university? I do not want to get committed until I know the hurdles , such as transferable credits?

I was looking also in Kaplan , and they have a certified geriatric case manager certification ( approx $4,500.00 including books --- this covers 7 subjects, and it looks good for a focus study --------but I will not be able to use the credits from this to apply to a university credits.

I will look into the ANA and my daughter will show me how to find grant money ( she is in college finishing her last year up to the fall of 2010.). Ladies and gentlemen, it makes this website really , truly a networking and a camaraderie for nurses.

Sure our opinion do not always parallel w/ each other, but then this is the good to be able to see different opinions, as long as we adhere to civility . :heartbeat

[MaritesaRN]

MaritesaRN, have you talked with a guidance counselor at your local university or community college? This would be the best way to get career advice tailored specifically to your unique life circumstances. The appointment is free and the counselor would know what scholarships, grants, loans, etc., are available in your area and perhaps in other areas of the country. Best wishes to you :)

Vicky, I did have one , when I was took some undergraduates subjects before .....I guess back to track 1 .

Thank you :loveya:much for the advice and nudging me where I should go !

[>30yrsRN]

Is Domiguez Hills online still?

I would think if you are staying in the Same Regional Accreditation of Colleges

They will except all your Credits those other courses

Best Of Luck to you.