Direct Entry GRADUATE NPs

mvanz9999, RN · Jul 2, 2007

Did she receive job offers after graduating the direct-entry ACNP program? My only fear is that most places will want at least 1 year RN experience to apply as a ACNP. Thanks!

She did receive job offers after the ACNP program. Actually she is roommates with another direct entry ACNP, and they both got ACNP job offers, no problem.

Trauma Columnist · Jul 2, 2007

I'm glad to hear there is a market for this route to nursing. Good luck guys.

Joe NightingMale, MSN, RN · Jul 2, 2007

Personally, I think it's because they don't post in this board. I know that DePaul has been cranking out NP's for at least 5 years. So.....they gotta be somewhere. Just maybe not here.

Just a minor correction: DePaul doesn't have a direct-entry NP program, they have a direct-entry MSN generalist program.

rnav32 · Sep 25, 2007

I know this thread hasn't had any responses in a while, but I just wanted to comment on some things I have learned from reading so many posts and threads on allnurses.com. I live in TX in a city of about 200,000 and called several hospitals in some of the larger cities. I was suprised to find out that many said they wouldn't hire a direct entry NP. It was somewhat discouraging but the recruiters seemed nice in telling me they wanted the experience. Several recruiters didn't even know the programs existed. Several hospitals didn't hire NPs. Since this seems to be the case, I'm reconsidering the direct entry route. Any recommendations. I wouldn't have a problem working as a nurse for a year or two after graduation from a DE program, but sacrificing a good five to six years is not in my plan as of this time. Another thing that I noticed is that when talking with nurses about the DE NP programs, hostility and caution seemed to permeate the conversation. The old pay your dues attitude seemed prevalent. I actually looked at the PA route and that might be applicable to my goals. Any thoughts or suggestions would be helpful. I also want to thank everyone who contributes to these threads. I have found a lot of info about nursing from many threads and posters on this website. Once again, thank you for the info.

Trauma Columnist · Sep 25, 2007

rnav32 - wanted to comment that with DE programs being so new, it is not uncommon to be met with doubts from the RN staff. Am unsure what you do currently, but nursing is a second career for me. I was in broadcasting for 10 years. If I had said that just because I had a journalism degree (and no experience), my first job would be sitting next to Katie Couric, I would have been laughed out of the room. And...probably met with hostility and doubt.

Nursing is further demeaning our profession by deciding that no RN experience is needed to be an APN. This is my opinion of course.

Good luck.

oldiebutgoodie, RN · Sep 25, 2007

In reply to traumaRus, I think a lot of schools are starting direct entry NP and clinical nurse leader programs for economic reasons. First of all, you have a lower

dropout rate (or flunkout rate) with people who have already gotten a BS in something else. Secondly, you can charge graduate tuition, which is usually higher than undergraduate.

There ends up being a huge disconnect between all the flavors of nurses. I went to a fairly prestigious BSN program (as a second career), but this school is now eliminating its BSN program for MSN direct entry programs instead. I'm sure it's due to competition among universities and money.

I think another issue nurses have with direct entry NPs and direct entry generalists (Clinical Nurse Leaders) is that we don't want someone bossing us around who doesn't know what is involved. I think you have to walk the walk for a little while.

Oldiebutgoodie

czyja, MSN, RN · Sep 26, 2007

I think another issue nurses have with direct entry NPs and direct entry generalists (Clinical Nurse Leaders) is that we don't want someone bossing us around who doesn't know what is involved. I think you have to walk the walk for a little while.
Oldiebutgoodie

DE applicant here - I think you have put your finger on the heart of the hostility of some trad RN's to DE programs. Your observation is quite insightful. Nobody, in any profession, likes/wants/respects a supervisor that does not appreciate the ins and outs of the job.

TraumaRUS -- can you not envision the possibility that a the DE person - say a 40 something y/o with significant management experience and an undergrad degree in cell biology (ie me) - might learn enough nursing nursing in 12 months DE bootcamp followed by two years of p/t nursing while doing the msn portion of the program to be an effective clinician or an effective nurse leader?

Some of the earlier posters were right. AllNurses is not a warm and fuzzy place for DE types. I am an avid reader because I want to educate myself on the profession I am about to enter but I can understand how a casual passer by might be turned off. I respect and understand the suspicions that some nurses have for DE grads but I fail to see how being snarky about it enhances the stature of nursing.

I suspect that DE programs mean what they say - that they want to bring diversity to the profession. The need for diversity is sadly evidenced by what one often reads here.

Trauma Columnist · Sep 26, 2007

czyja - I certainly can see a career changer making it in nursing, but not in a DE program. As I stated above, I went into nursing as a second career also - got my LPN at age 34, my RN at age 36. While I don't advocate the route I took it worked for me with my family's schedule and circumstances.

My concern about DE is my own experience as an APN. I have been an APN for one year and while I did learn a lot in my APN course, I still fall back daily on my experience as a nurse. My nursing experience taught me so much that I would have missed as a DE grad:

Assessment skills - its not just listening to lung and heart sounds and looking in ears and eyes. Its the ability to get to the real reason for their visit quickly and efficiently.

Its the ability to have a working knowledge of doctor/nurse relationships and what you bring to your physician collaborator and what you do on your own. Frankly, without several years of RN experience, I would have been scared of the responsibility.

In my own current practice, I don't see the physicians except maybe once every 3-4 months! I am on my own to see pts, assess them, order tests, ensure the tests get done, interpreted, and the condition treated. I would not have had the confidence that this takes w/o some RN experience.

I have not discussed DE programs with my physicians because it is a foreign concept in the area where I live. However, I do know that when I got this job, they interviewed five candidates and I had the most RN experience (I was a new grad APN) and that was the only reason they even considered me.

As to All Nurses not being warm and fuzzy towards DE students/grads, I do respectfully disagree. We sincerely try to present multiple opinions on the subject because it is such a hot topic. However, as with all new programs, it should be met with some skepticism until it proves itself. There aren't that many grads yet to prove this concept even works.

As to diversity in the nursing field: having inexperienced nurses being called advanced practice nurses demeans our profession in that in what other profession do you start at the top of the career ladder? Also, in medicine it is well known to be very traditional - you start as an undergrad for 4 years, med school for 4 years, then a residency from 3-7 years. When you cross into APN practice, you are sitting on the fence between nursing and medicine: belonging to both sides but not being truly ON either side.

As to the CNL (clinical nurse leader), this is suposed to be some type of "expert" and I doubt that you can be an expert in a field with no experience. This is the definition of CNL from the ANCC (a branch of the ANA):

"The CNL is a leader in the health care delivery system in all settings in which health care is delivered, not just the acute care setting. Implementation of this role will vary across settings."

http://www.aacn.nche.edu/CNL/FAQ.htm

I just don't see how one becomes a leader without being a follower first.

oldiebutgoodie, RN · Sep 26, 2007

I suspect that DE programs mean what they say - that they want to bring diversity to the profession. The need for diversity is sadly evidenced by what one often reads here.

I'm not quite sure what you mean by diversity. For example, on my med/surg floor:

me: 25 years of IT, computer science degree, now BSN working on MSN, 2 years experience

nurse2: CPA, now ADN in nursing

nurse3: Did home day care for many years, now ADN in nursing

nurse4: BSN in accellerated program

nurse5: Truck driver, now ADN in nursing

nurse6: BSN in nursing, 1 year experience

etc etc. I think we are pretty diverse.

I don't think anyone is trying to be snarky, but we are just expressing our opinions here. We still haven't heard from many people who have graduated from DE programs, and what their experiences are. My guess is that university hospitals may be more hospitable to the DE MSN or new DE APN.

Oldiebutgoodie

HealthyRN · Sep 26, 2007

DE applicant here - I think you have put your finger on the heart of the hostility of some trad RN's to DE programs. Your observation is quite insightful. Nobody, in any profession, likes/wants/respects a supervisor that does not appreciate the ins and outs of the job.
TraumaRUS -- can you not envision the possibility that a the DE person - say a 40 something y/o with significant management experience and an undergrad degree in cell biology (ie me) - might learn enough nursing nursing in 12 months DE bootcamp followed by two years of p/t nursing while doing the msn portion of the program to be an effective clinician or an effective nurse leader?
Some of the earlier posters were right. AllNurses is not a warm and fuzzy place for DE types. I am an avid reader because I want to educate myself on the profession I am about to enter but I can understand how a casual passer by might be turned off. I respect and understand the suspicions that some nurses have for DE grads but I fail to see how being snarky about it enhances the stature of nursing.
I suspect that DE programs mean what they say - that they want to bring diversity to the profession. The need for diversity is sadly evidenced by what one often reads here.

CZJA- I am obviously in the minority here, but I do think that you can succeed as a DE NP. If you are working as a nurse for two years, I believe that is enough experience to learn what nursing is all about. It is also enough experience to hone assessment skills. However, be aware that you may have to work f/t for at least six months before an employer will allow you to drop down to p/t. As a new nurse, it is difficult to learn all you need to know only working p/t and most managers will not allow that. Have you considered working f/t and taking the MSN classes p/t?

I think that you have a lot to offer nursing and I am confident that you will succeed as a nurse leader and a clinician.

Joe NightingMale, MSN, RN · Sep 26, 2007

Wow, this thread is still going strong...

Anyway, I'd like to point out that you need to differentiate between an NP, an APN, and a MSN, as they're essentially 3 separate things.

And you need to differentiate between the programs too...some students come out an NP, some a CNS, and some with a plain MSN.

A third thing to consider is that this is part of a debate about the role of nurses that has gone on for years, even decades. Should training be more practical or more theoretical? Should we emphasize learning or on-the-job experience? Check out nursing history.

I'm just starting, so I can't say where I'll end up; I know many of my classmates want to go on and do NP (I don't).

However, I don't plan on getting a management position straight out of school. I've been told that you need to work as a floor nurse for a while before you're ready to manage (which makes sense to me).

I do expect that after getting experience as a floor nurse I'll move to more specialized positions (CNS?) which will involve more teaching and nursing research.

oldiebutgoodie, RN · Sep 26, 2007

It's a little like an MBA program. Some won't accept you unless you have some business experience, and some will accept a new grad right out of college.