Direct entry MSN/CNL without nursing experience - page 2

by rstigers 12,538 Views | 20 Comments

Hello, I've been poking around the site for a couple months and can only find old posts relating to CNL certification. Have attitudes towards it changed yet? I'm in the middle of a MSN, CNL program for non-BSN students. I... Read More


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    To function as a bedside nurse and as a nurse manager, you must have hands on clinical experience. Nothing else will subsitute. I do not think the entry level MSN-CNL programs have been vetted in the real world. Nursing is not a theory or academic subject but rather an evidence based practice discipline. What all nurses need is a strong clinical foundation. These programs do not provide this type of training. My impression is that they should be reserved for nurses who have met an experience criteria. You build on experience. A well trained Associate degree nurse is a better candidate then the EL MSN-CNL as they can be brought in and trained. The MSN is supposed to be a finished product ready for leadership.
    Szasz_is_Right and B52-H like this.
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    Quote from DNS on the go
    What all nurses need is a strong clinical foundation. These programs do not provide this type of training. My impression is that they should be reserved for nurses who have met an experience criteria. You build on experience. A well trained Associate degree nurse is a better candidate then the EL MSN-CNL as they can be brought in and trained.

    Wait, why on earth would you say that "a well trained Associate degree nurse is a BETTER candidate than the EL MSN-CNL" (emphasis mine)? That is ridiculous and ignorant. In general, I think how good a nurse is when s/he has just graduated has far more to do with who the person is than what degree they've attained. We are all starting from the bottom clinically, whether ADN, BSN, EL-MSN, or diploma. That said, I don't think more education can ever be considered a bad thing, and all else being equal, hopefully the nurse with more education will have something to show for those extra years, especially after the first few months or first year at the bedside.

    EL-MSN programs do provide a strong clinical foundation. I assure you, the Nurse Practice Act would not permit them if they didn't meet the required number of clinical schooling hours that every other program in the state has to meet.

    The strength of any individual nursing program is a different issue. Some are stronger than others. But it does not make any sense to make a blanket statement saying that an ADN nurse is a better candidate than an EL-MSN nurse.
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    Quote from DNS on the go
    What all nurses need is a strong clinical foundation. These (DEMSN/CNL) programs do not provide this type of training.
    At least some of them do. Mine did. From what I've been reading on these boards for the last 3 years, in fact, our program provided a stronger clinical foundation than some of the ASN programs that I see discussed.
    melmarie23 likes this.
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    Quote from ♪♫ in my ♥
    At least some of them do. Mine did. From what I've been reading on these boards for the last 3 years, in fact, our program provided a stronger clinical foundation than some of the ASN programs that I see discussed.
    They gave you a strong enough clinical foundation to start working as a CNL on your first day?

    I am skeptical
    Szasz_is_Right and DNS on the go like this.
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    Quote from B52-H
    They gave you a strong enough clinical foundation to start working as a CNL on your first day?

    I am skeptical
    If you'll re-read my post you'll see that I was responding to another post in which someone asserted that DEMSN/CNL programs do not provide the strong clinical foundation needed by all nurses.

    I'm not sure from where you derived the viewpoint which you're falsely ascribing to me; I said nothing of the sort.
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    My pediatric hospital struggles to find people with MSN's qualified for leadership positions in the staff education and clinical practice domains. We have recently hired a few nurses with CNL degress into staff nurse positions because they don't have enough clinical experience to be considered for leadership positions.

    After they get some experience -- and assuming they turn out to be good nurses, of course -- they will be considered strong contenders for positions in Staff Development, unit-level clinical leadership, etc. We see the degree as being a good fit for our desire to have a MSN clinical/education leader on each unit. But we won't consider anyone for those positions without at least a few years of actual practice as a nurse.
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    Thanks all for the replies. I wish I had checked back sooner, but school is, well, busy. Nothing new there I suppose.

    A couple of you pointed out that I said the ADN programs in my area don't do much with EBP. I have not attended them, but I used to work at a community college and spent a lot of time working with nursing students. Based on my conversations with them, I do not think that the community colleges here give much instruction on that. It could be that I just caught them at the wrong time in the program, but I don't think that's the case. I worked as a tutor there for a couple years and developed pretty good friendships with some of them. They never mentioned EBP, and focused much more on the practical side of things.

    I'd like to say that I'm not saying that's bad. In no way! Not worse, not better, simply different. And that's completely fine. The strength of the ADN programs here are that they impart excellent technical skills for a bedside nurse. However, the hospitals here are starting to only hire BSN's and above now.

    Thank you all for honest assessments of the CNL programs. It isn't exactly what I wanted to hear, but that's life, right? Never precisely how I want it.
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    Quote from DNS on the go
    To function as a bedside nurse and as a nurse manager, you must have hands on clinical experience. Nothing else will subsitute. I do not think the entry level MSN-CNL programs have been vetted in the real world. Nursing is not a theory or academic subject but rather an evidence based practice discipline. What all nurses need is a strong clinical foundation. These programs do not provide this type of training. My impression is that they should be reserved for nurses who have met an experience criteria. You build on experience. A well trained Associate degree nurse is a better candidate then the EL MSN-CNL as they can be brought in and trained. The MSN is supposed to be a finished product ready for leadership.
    With all due respect, the CNL's at UVA get 1000 clinical hours which by far supersedes most places so I want to say this is not a factual statement. To have leadership experience coupled with hands-on seems like an ideal position for any entry level nurse in my opinion.
    BusyBee91 and shayjackson11 like this.
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    I have been reading posts about CNLs, and it sounds like most people are fearful of Direct Entry MSN graduates not having the leadership/experience/training of a traditional nurse. They won't. No one expects them to. The programs are not anticipating having leadership positions handed to new grads. You get your MSN, you get your CNL cert, you work as a staff nurse, you learn, you charge, you learn some more, and then you are already qualified to do the higher level CNL functions.

    If your intent is to work at the bedside and hand out meds forever, then an ADN will suit you well. You will make the same bedside money as a BSN or MSN. If you ever intend on working as a manager, get your BSN or MSN. Most hospitals are at some phase of obtaining Magnet, and they will push all leadership to obtain higher degrees. If you want to teach, look at DNP or PhD. Most CNOs and admins have or are working towards their doctorate.

    Higher degrees don't make better nurses. It does teach you to think differently, to encompass the whole picture, to approach a problem with outside the box solutions. You start to think not just in terms of what but why. Read a book by Spencer Johnson called "Who Moved my Cheese?" - it's about complacency in a complex work environment and how you need to constantly adapt, told through the story of two mice trapped in a maze. It's cute. Healthcare needs people at the "lower" levels of hierarchy (bedside) to solve complex problems and think about systemness and efficiency from the ground up, not the traditional top down approach. It works better that way. Who knows a nurse's practice better than the nurses themselves? The problem is time. How many of you have time to pull an understaffed 12 hr shift, plus huddle, plus a code, handle your patient families and then sit down to map the admissions process? I'm betting none. Which is why all of the changes are handed from the top down. And that's why we still use outdated modalities and procedures. "Acedemia" (which seems to be held in the highest regard) is right - let's redesign the maze itself. Forget the traditional ways and lets get nurses to start asking why. We can transform healthcare, have better outcomes for our patients and save a lot of money in the process.
    BusyBee91, salvadordolly, scwolf, and 1 other like this.
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    Quote from brianprimm
    I have been reading posts about CNLs, and it sounds like most people are fearful of Direct Entry MSN graduates not having the leadership/experience/training of a traditional nurse. They won't. No one expects them to. The programs are not anticipating having leadership positions handed to new grads. You get your MSN, you get your CNL cert, you work as a staff nurse, you learn, you charge, you learn some more, and then you are already qualified to do the higher level CNL functions.

    If your intent is to work at the bedside and hand out meds forever, then an ADN will suit you well. You will make the same bedside money as a BSN or MSN. If you ever intend on working as a manager, get your BSN or MSN. Most hospitals are at some phase of obtaining Magnet, and they will push all leadership to obtain higher degrees. If you want to teach, look at DNP or PhD. Most CNOs and admins have or are working towards their doctorate.

    Higher degrees don't make better nurses. It does teach you to think differently, to encompass the whole picture, to approach a problem with outside the box solutions. You start to think not just in terms of what but why. Read a book by Spencer Johnson called "Who Moved my Cheese?" - it's about complacency in a complex work environment and how you need to constantly adapt, told through the story of two mice trapped in a maze. It's cute. Healthcare needs people at the "lower" levels of hierarchy (bedside) to solve complex problems and think about systemness and efficiency from the ground up, not the traditional top down approach. It works better that way. Who knows a nurse's practice better than the nurses themselves? The problem is time. How many of you have time to pull an understaffed 12 hr shift, plus huddle, plus a code, handle your patient families and then sit down to map the admissions process? I'm betting none. Which is why all of the changes are handed from the top down. And that's why we still use outdated modalities and procedures. "Acedemia" (which seems to be held in the highest regard) is right - let's redesign the maze itself. Forget the traditional ways and lets get nurses to start asking why. We can transform healthcare, have better outcomes for our patients and save a lot of money in the process.
    Very well said! My unit is having a very difficult time adjusting to CNLs who have no clear role definition and lack the hands-on experience as an oncology nurse since they're classified as "generalist".


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