Direct-entry CNS programs: ridiculous idea?

[guest464345]

Hi everyone -

I'm applying to direct-entry MSN programs after many years working in hospitals and clinics as a non-nurse (I'm a clinical social worker). Having worked very closely with advanced-practice nurses for years, I have a pretty good understanding in particular of differences between the traditional CNS and NP roles, though it seems the boundaries have blurred a bit in recent years.

I know that some nurses have strong feelings against direct-entry programs generally, and even as an applicant I acknowledge there are disadvantages to jumping into an APN role without years of RN experience. Putting that issue aside for a moment...

My first preference is to get into an FNP program, because I suspect that role will provide the most opportunities for my circumstances/interests. The FNP programs I've applied to are expensive and far away; there's no direct-entry option in the state where I live. On the other hand, a local university offers a direct-entry CNS program that I'm considering as an alternative.

My question is this: somehow, to me, going straight into practice as a CNS seems even crazier than going straight into being an NP. With the NP role, one can at least argue that the job tasks, role, scope of practice, etc. are quite different from those of a bedside RN - years of bedside experience are helpful to an extent, but you're still in a whole new ballpark. I think of the traditional CNS role as one of educator, teacher, supporter of staff nurses, go-to-nurse-helper, process improver....a person who needs to intimately understand how nursing works...how the heck can you credibly do those things as a newb?

Does anyone actually hire direct-entry CNS's? Is this just a crazy idea? What do y'all think?

[LynnLRN]

I don't understand how you can be a "clinical" nurse specialist if you have never had "clinical" experience. You will be at a huge knowledge deficit. I guess it depends on what area you are looking to be a CNS for. But I have no clue how you could ever be a CNS in the hospital if you have never been an RN working on a unit.

Plus, I guess it depends on the curriculum for the MSN program you are applying to but it seems as though you would have trouble with some of the advanced practicum if you have not been a practicing RN.

Also, I know the MSN program will teach you a lot, but I feel like the best RN knowledge actually comes from working as an RN for multiple years. Where I currently work, I would not want a CNS making clinical changes who has no idea what us RN's face everyday. CNS should be improving our practice and making it safer, I do not know how you could do that if you do not understand the work arounds nurses do.

Lets say you become a CNS for a general med-surg floor. If you have not had LOTS of experience placing NG's, doing dressing changes for multiple types of wounds/drains, starting IV's, administering certain medications, I have no idea how you could possibly help develop best clinical practices and then be expected to teach others.

But, these are just my thoughts I could be completely wrong.

I think you would be at a huge disadvantage for hiring without the previous RN experience.

[guest464345]

Yes, that's exactly the problem I imagined...how the heck would I be improving processes I don't understand myself? I would likely have some RN work experience by the time I finished (you can take NCLEX after the first year, and then the MSN takes two more years to complete), but every CNS I've known was an RN for many years first.

I realize that NP's also finish direct-entry programs as novices, and are in need of mentoring by more experienced NP's or MD's initially....but a new NP is not in the role of telling other NP's or RN's how to manage their clinical practice, just figuring out how to manage their own. Going straight to a CNS seems questionable.

But I guess schools will gladly take your money if you're willing to try :/