Accelerated BSN vs Direct-Entry MSN option

Nursing Students Post Graduate

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Hello everyone,

I'm new to this forum and to the field of nursing. I have a BS degree in Biology and was recently enrolled in a physician assistant program for 6 months but withdrew for personal reasons, one of which was the fact that the program was not a good fit for me at all. I am interested in becoming an NP after recently shadowing and networking about the profession and would like some insight as to what some of you may think is the better route to take. What are some advantages/disadvantages of completing an accelerated BSN first and then applying for MSN programs rather than a direct-entry MSN program for a non-nursing major like myself? After being in PA school, I am very used to an extremely rigorous curriculum and have succeeded in all of my classes. Therefore, the workload isn't quite what I'm concerned about. Any insight would be greatly appreciated!! Thank you very much in advance!

If you're wanting to just get on with it, I'd recommend the BS-in-anything-to-MN route. You will get clinical experience along the way, and you'll be able to get more after you graduate. Mass General Hospital in Boston has a great program in their Institute of Health Professions.

If you are sure you will be continuing your education and go on to become Nurse Practitioner, some of your Direct Entry MSN courses will transfer. Also, it will not be necessary to obtain another Master's; you will only need to complete a post-master's certificate in your NP program. This means you will not need to write another thesis. The downside of the direct entry MSN program is that it is more expensive b/c it is grad school. Also, IMO, it is more challenging b/c you are studying at the graduate level. I did the direct entry MSN program; I only regret the student loan debt.

Thank you both so much! I really appreciate your opinions. I definitely agree with you about the loan debt. I am in a deep hole right now with PA school debt so that is definitely something I am taking into consideration when I figure out where I'd like to apply.

As far as "healthcare" experience is concerned for applications to an MSN program, would either of you suggest I gather more volunteer/shadowing hours under an NP? I've worked for 2 years as a patient care technician under 10 ophthalmologists at a busy clinic (2,500 hrs). I have my previous GRE score (1220) and recommendation letters lined up as well. I'm just wondering if I lack experience toward nursing directly despite my exposure to patient care in PA school.

I don't think that direct experience related towards nursing is too important. If an applicant happened to have it, then it would probably help them, but a lot of people don't have a lot of exposure to nursing or experience directly related to nursing so I don't foresee it hurting you. What is important is that you do have some type of healthcare experience and/or healthcare related volunteer work, and a deep understanding of what nursing is and how NP differs from other types of health practitioners such as PA and physician. What field are you interested in? I am not sure if you are aware or not but you actually specialize during NP school when you are working on your masters, which is very different from PA school.

As for the benefits of a direct entry MSN program as opposed to an accelerated BSN, honestly, the main difference is you only have to apply once so it's a lot easier than worrying about applying somewhere later on, so you're guaranteed to get in. Many of these programs that are considered direct entry still require you to get bedside RN experience, which a lot of people don't realize. Some of them make you take time off and work, and some programs do go straight through, so they are shorter programs for sure, but a lot of these programs will still require you to work full time and do the MSN portion part time. Most of the programs consist of an 18 month long accelerated BSN program and have you do the MSN part time, taking around 2 years. You definitely want to get bedside nursing experience anyways, because a lot of places won't hire you as an ARNP without it and it's certainly essential to being a good NP.

PS - I was pre-PA for the first few years of undergrad, until I began to volunteer in an area that REALLY opened my eyes up to nursing. I had even taken almost all of my prerequisites, besides orgo. So I dropped the chemistry class I was taking, started to do some research, and I changed my mind. I knew for sure that nursing, and working in this specific field, was most definitely my calling. And I've never looked back! Let me know if you want more help, advice or specifics :)

Thank you SOO much for your wonderful response!! I really appreciate your input! You are absolutely correct. In PA school, we were being trained in every specialty due to the option to switch at our own convenience later down the road. I've been able to shadow and talk to several NP's and my experiences have been so different but so eye-opening each and every single time. I loved witnessing such a solid, compassionate interaction between them and their patients. It's wonderful. Your reply has absolutely helped me confirm that I would like to go the direct-entry route and jump right in. I'd love to not have to worry about applying again later!

If you don't mind me asking, have you entered a direct-entry MSN program? If so, are you on an NP track? I am very interested in applying to a few programs to start next year. It has only been a few months since I withdrew from my PA program and so I am still in school mode mentally. I would love to jump back in as soon as possible but I think I'm too late to begin at any school this coming fall so now I am aiming for January of 2014. I am just not sure what is emphasized more as far as the application process is concerned. For PA school, many programs stress that you have a sufficient amount of direct-patient care experience. As you mentioned, nursing "experience" isn't something someone can obtain beforehand. Therefore, I think my healthcare experience is sufficient (at least I hope so!).

As far as recommendation letters are concerned, should I try getting one from one of the NP's that I have shadowed? The only reason I ask is because I am positive that my professors in PA school would be able to write me stronger letters since they know me so well and can attest to the fact that I can handle a rigorous curriculum based on my work ethic and grades. Not only that, they understand exactly why want to make this transition and support me immensely. I am positive that they can write me outstanding letters. Thank you again for your help!! This forum is amazing!

As for the benefits of a direct entry MSN program as opposed to an accelerated BSN, honestly, the main difference is you only have to apply once so it's a lot easier than worrying about applying somewhere later on, so you're guaranteed to get in. Many of these programs that are considered direct entry still require you to get bedside RN experience, which a lot of people don't realize. Some of them make you take time off and work, and some programs do go straight through, so they are shorter programs for sure, but a lot of these programs will still require you to work full time and do the MSN portion part time. Most of the programs consist of an 18 month long accelerated BSN program and have you do the MSN part time, taking around 2 years. You definitely want to get bedside nursing experience anyways, because a lot of places won't hire you as an ARNP without it and it's certainly essential to being a good NP.

This only applies to MSN programs with an NP track, and not all direct entry MSN programs are designed that way. I did the CNL program, a generalist degree for entry into practice.

Just to give you another point of view...I applied to both direct-entry and accelerated BSN programs. I was accepted at some really great programs, and it was a struggle to figure out what to do. I had worked in hospitals for years, and I know a lot of RN's and NP's, so I asked them for advice. Every single one of them advised me to go the BSN route and work for a while before taking the next step. It wasn't what wanted to hear - I'm a strong student, confident about my plans/preferences for advanced study, and in a hurry to get on with things since I'm in my 40s. As you said, I also liked the idea of applying once and having a guaranteed path to the MSN.

However, now that I'm halfway through my BSN program I realize what my friends meant. There is a LOT you need to learn to be a competent nurse. Even working side by side with nurses for 12 years, I didn't appreciate that at all. I now understand that when I finish my BSN program, it's going to take me at least 6-12 months to feel reasonably capable just handling the basic med-surg stuff. I can't imagine being a provider making independent treatment decisions in just two more years; it seems like a bad idea.

The other thing is - I think that direct-entry NP's might struggle in the real world. Even if you go to a fantastic program and have great clinicals, credibility entering the working world is something to consider (especially credibility with the seasoned RN's for whom you'll be writing orders).

I am truly relieved that I didn't go the direct-entry route. I'm at a nursing school with a great graduate program, connected to a hospital with a generous tuition assistance program. My plan is to work for a year, start some MSN classes part time (ideally with my employer footing part of the bill), and hopefully have 3-4 years of work experience under my belt when I become an NP. LOTS of regular MSN programs allow you to work full-time, but that's not the case with most direct-entry programs.

Another option to consider :) Feel free to PM me if you want more info.

ky88, I am in the midst of the application cycle now. I applied to 1 regular accelerated BSN with the option to continue onto the MSN program part time immediately after graduation as long as I work full time (Duke), 2 direct entry programs where you get your BSN and then work while you do the masters part time (Johns Hopkins and NYU), 1 direct entry program where it is required that I take a minimum of 2 years off and work before I begin the masters portion (UPenn, and this is a rule for my particular specialty), and one legitimate direct entry program where you get everything done all at once, with no BSN degree at all (Marquette). I have a lot of knowledge about these programs after doing a lot of research, and since I am in the application process currently. I will be hearing from Penn on Tuesday if I am accepted or not, and was picked for an interview for Duke and Johns Hopkins. With all of these programs (except for Marquette), I would get my BSN first. And in all of these programs, I would work before and/or during the program, while I work on my MSN degree (to become an NP, not to receive a generalist masters degree or to become a CNL).

I did not look at any programs where I would be prepared as a generalist (UVA is one of these programs). I was not referring to any of these programs - I never really considered any of these programs as I am not interested in becoming a CNL, since it does not fit with my goals and career aspirations. I was only referring to programs that would put one on the track towards becoming an NP. Most of the programs I have applied to are direct entry in the sense that I would only have to apply once and would be guaranteed admission to the masters specialty of my choice - out of all of the schools I've applied to, Marquette is the only true "direct entry" program, where I would go straight through. However, even that program would be done very part time once I am in the masters portion due to limited course offerings throughout the year - so I would have the opportunity to gain plenty of RN experience as I went through the program. So ky88, these programs could work for you. There are many different types of programs and I would be willing to give you any advice or guidance you may need! I am available by PM if interested.

PS - If you hurry, you could apply to NYU's fall start program. I think priority deadline is March 1st and the regular deadline is April 1st. And I would ask people who you feel could write you a strong letter of recommendation, no matter who they are.

I applied to pediatrics, but eventually would like to work in a pediatric ward of a hospital (not primary care). Looking more closely at the MGH website though, it seems that their pediatric program is more primary care, even with all their hospital associations... Is anyone else in the same boat or have any suggestions? Not many schools (except UPENN, where I didn't get in) have specific pediatric acute care NP programs so I applied for pediatrics for some and acute care for some... Any thoughts would be appreciated!

Specializes in OB/GYN.

I also did PA school (most of it) before realizing it wasn't a good fit. Unfortunately, it took me awhile to realize that nursing was the perfect career for me. I actually finished a BA and an MSW, but I am now starting an ABSN...

I looked at a lot of options, but I'm not able to relocate and the only direct entry MSN locally is at a very expensive private university so it wasn't even an option w/ my current loan debt and minimal govt loan eligibility left.

I'm also 98% sure that I want to take the CNM route after hopefully getting a few years of L&D experience. So I felt like the ABSN at a state university was a good starting point for me.

I did the direct MSN program with a CNL concentration. Honestly in my personal experience, it doesnt matter what program you do because you really need to have the basic RN skills before you can advance. The only way you can get the skills is by working as a RN.

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