Direct-entry MSN programs

BCzito · Dec 14, 2005

Hehe -yah, I had actually heard / thought of this before, BCzito. And pretty much any reason to stay / not to stay under the sun. I was being facetious.
In all seriousness, it's not an easy decision and I *may* end up requesting a deferment from NP school for a year to finish the PhD. Having that deadline of going to nursing school will hopefully get me out of here sooner that I would otherwise. My program tends to draaaag on forever (6.5-7 years is the average grad time), partly cause the grad students are good cheap labor and partly because most of my classmates want really competitive postdocs and stick around until they get their Science or Nature paper. So the standards end up being pretty high. I gues it IS harvard, afterall. Having the plan to go to NP school will hopefully lower those standards a bit with my committee if I choose to stay and attempt to finish.
Just out of curiosity, what is your background, BCzito? (and do you go to BC? or from BC?) I haven't met many people who have made this kind of transition and would love to hear your story.
Genn - thanks for the words of advice! I will definitely keep an open mind as to which school I want to attend. For now I'm just relieve the application process is (mostly) over with. I say mostly because one school contacted me yesterday wanting yet more transcripts and syllabi from two of my classes to make sure they fit their requirements. Come on - A+P 1 and 2 may not fit your requirements???!!!

I go to BC right now in the direct entry masters program. I have a BS in neuroscience and before this I worked with women with borderline personality disorder, and I also did neuroscience research on DA pathways related to cocaine addiction in rats writing papers etc.., I also dabbled in pharmaceutical research and clinical research at Brigham and Womans (it was actually the harvard endocrinology/sleep lab with Dr. Cziezler, know him?). I find its a diffificult transition into nursing, but one I am happy with. I thought that being from a biological background would give me an advantage in my classes, but I find although I am glad to have that background knowledge it is not helpful on tests for the most part. Its basically like learning a totally new language. You need to embrace it or you will find yourself at a loss. I think one thing that often holds me back is that I am constantly thinking about things in a test tube instead of clinical situations (if that makes sense). Its definately doable though, but my best words of advice would be to go into it thinking that your bio backround is not pertinant once you are in a program (at least at first, I'm not at the NP part yet) and be open minded about a new field. Study everything even if it is biologically familiar because its guarenteed to be presented in a way that is foreign to you. I learned my lesson after having a slightly cocky attitude about exams that I felt would be very biologically based only to find everything is related to a clinical situation, and sometimes the lab data takes a back seat to a pt's immediate needs. Its also hard to get used to the idea that at least for your first year (maybe second) depending on the program, you are learning to be a bedside RN NOT an NP or CNS. You are not giving the orders. But its also important to embrace this role because it is an extremely important part about learning to be a nurse, and I think you need to feel comfortable in those shoes before you can move on to the CNS or NP role. Hope thats helpful. Feel free to ask me any other questions you have. As far as BC, I am really happy with it. I also think MGH seemed like a great program as well although that is a 3 year program as opposed to the 2 at BC. However, many people at BC take a year to go part time the second year to get more RN floor experience before they move on to the NP role, but this differs from person to person, and prbpably from specialty to specialty as well.

Take care,

BCZIto

Gennaver, MSN · Dec 14, 2005

I go to BC right now in the direct entry masters program. I have a BS in neuroscience and before this I worked with women with borderline personality disorder, and I also did neuroscience research on DA pathways related to cocaine addiction in rats writing papers etc.., ...BCZIto

Hi BCZito,

Since neurology, personality, and the phsyco-social influence on cognition is something I have been unnoficially researching for a little bit. Do you think my naive belief in a possible connection between the broader spectrum of biplar/hypomania somehow having a connection with the combination of Reactive attachment disorder possibly creating a type of borderline personality disorder?

See, I do not know if there is any pharmaceutical treatment is required anyhow for the lower level of the broad spectrum of hypomania yet, do know that if an undiagnosed bipolar patient is treated with antidepressants then it is neurotransmitter overload and tripped up circuitry.

I think the required treatment for RAD is congnitive behavioral therapy, not medication.

Sooo, reactive attachment disorder seems to create neural nets which are then attracted to repeating their own pathways, leading a person to continue lifestyle choices which continue angst. Like a rat hitting a button for cocaine, also, a woman with RAD may engage in risky relationships, predisposing her to end up in abusive situations...

Do you think that some cases of BPD may also be in reality RAD combined with hypomania? I know its far but, possibly plausable.

My explanation is simple and rudimentary here and loosely linked together but, will hopefully suffice.

I am also interested in how emotions influence the addiction of bad behavior choices, (such as with RAD or adult childrens of parents who had personality deficits or substance abuse).

I am equally interested in how cognition and choice can break an addiction and create new neural pathways and increase/decrease neurotransmitter receptors sites.

Combined with this is also an interest in recovery from emotional trauma, (how it trips our brain's pathways) and physical trauma to the brain and how it shakes up our functions through externally induced trauma too.

Gen

p.s. wouldn't that be cool if anything at all that is mentioned helps anyone nudge along on their phd?

BCzito · Dec 15, 2005

Hi BCZito,
Since neurology, personality, and the phsyco-social influence on cognition is something I have been unnoficially researching for a little bit. Do you think my naive belief in a possible connection between the broader spectrum of biplar/hypomania somehow having a connection with the combination of Reactive attachment disorder possibly creating a type of borderline personality disorder?
.......
You just might get a couple people going on their Phds with all that info!. Its definately interesting. As far as RAD I don't know too too much about it, however I do know the the attachment issue with the borderlines is more that they totally fear being abandoned. Even as adults, by whoever they may have formed relationships with, and they are very aware of this emotion (for the most part). It seems from what I know that people with RAD are not quite as cognizant that they have attachment issues, but that may be incorrect. However many People with BPD have experienced trauma and abuse as children (allthough not all), It would seem logical that under the right environment that a child with RAD could possibly develop the signs of BPD. You are right about both involving themselves in harmful behaviors, but borderlines usually purposely full knowing the act they are about to do is harmful and they will not only continue to do that activity but purposely persue it (such as cutting, ED's, swallowing things, burning themselves, drug use) they are usually doing the action because they WANT to hurt themselves even when it involves risky sexual behavior. Although many Borderlines are comorbid so they may also have bipolar disorder as well (which I have seen). Its seems like with RAD they are not trying to hurt themselves, but sorta end up making bad choices that end up hurting them. Same with the hypomania, usually people who are bipolar or experience mania or someone who experiences hypomania, are not trying to hurt themselves, but are in such a state that they end up doing so. As far as the neuro pathways, I wish it were that simple, but anywhere is a start when it comes to the brain! I have my theories about mental illness and nervous system development, but really who knows. Just gotta find out piece by little piece of research. which is why I donate to NAMI (national alliance for mental illness) they try to raise money to help those with mental illness as well as raise money for neuroscience research, maybe if lots of people do we'll get answers sooner! anyway I feel that with emotional trauma comes stress (obviously) and we already know that stress has numerous effects on hormones and body systems, now when you are developing at a rapid rate (when your a child) and you have stress come into play you are totally changing the chemical environment for your nerves (among other things) to develop in. I feel personally (and this is broad and subject to change) that these chemical changes effect neurotropic factors that lead to incorrect connections in the brain, particularly in the temporal/parietal areas (long story why). I am really looking forward to continuing to see neuroscience evolve because there is just so much unknown territory, and because I really can't wait for the stigmas of mental illness to be taken off the individuals and be given a more straightforward biological cause. Anyway its nice to day dream and talk shop about brain stuff feel free to shoot me a message anytime. Are you in the boston area?
bczito

Gennaver, MSN · Dec 15, 2005

... I feel that with emotional trauma comes stress (obviously) and we already know that stress has numerous effects on hormones and body systems, now when you are developing at a rapid rate (when your a child) and you have stress come into play you are totally changing the chemical environment for your nerves (among other things) to develop in. I feel personally (and this is broad and subject to change) that these chemical changes effect neurotropic factors that lead to incorrect connections in the brain, particularly in the temporal/parietal areas (long story why).
...
bczito

BCZito,

I am in the Chicago area. My interest formed even more after I worked at two children's residential facilities, (many abused) and through learning how they grow through this and sometimes never do. Stress, hormones and how they affect body systems is another biggie to me. I am very certain that both my masters thesis and my future dissertation with be on psychoneuroimmunology. I just have not tweaked it narrow enough. I am interested mostly in maladaptive connections which are either learned and reinforced through emotional trauma or which come from external physical trauma, (which also relates to emotions and stress as well.)

Nice to read you.

Gen

p.s. I thought I was a student member of the pnirs psycho neuro immunology research society but, must have glitzched when I applied-especially in the not sending my $60, I hope to rejoin so I can attend their June 2006 pni symposium in Florida

Jess RN · Dec 17, 2005

best words of advice would be to go into it thinking that your bio backround is not pertinant once you are in a program (at least at first, I'm not at the NP part yet) and be open minded about a new field. Study everything even if it is biologically familiar because its guarenteed to be presented in a way that is foreign to you. I learned my lesson after having a slightly cocky attitude about exams that I felt would be very biologically based only to find everything is related to a clinical situation, and sometimes the lab data takes a back seat to a pt's immediate needs.

BCZito is right on with this advice. We are in the same program- and I have been so frustrated this semester by the exams that force you to think like a nurse! It does not come naturally to me- and the way we are tested requires you to have a only a very basic understanding of the underlying biology/chemistry/physiology and rather, really focus on the *nursing* implications of the drugs you are administering, side effects you are noticing, lab values you are interpreting. Somehow it seems like cheating to me- if you know the red flags to look for- you can just wing it from there without knowing exactly how a drug works in the body, for example. But when you think about a clinical setting- it doesn't really matter if you understand the chemistry of a morphine overdose if you can't recognize the clinical signs and be able to calculate a dose of narcan to counteract it, you know? Our program sooo encourages hands-on and priorities-driven thinking. I am more analytical, and like really understanding the background stuff of what is going on in the body- so this has been pretty frustrating for me.

I am hoping the NP part of the program is more challenging in ways I want to be challenged. I think learning how to be an RN is really important- but I see myself being happier in the NP role, ultimately.

-Jess

janony · Dec 18, 2005

Hey Jess and BCzito

Thanks for telling me a bit about the "theme" at BC. Are you both first-year? (i wonder if it's any different in the second year).

I don't know what the PC way to put this is. But, do you feel the program has a lot of "fluff" in its coursework? Are you learning stuff you think you'll need, or is it a waste of time? I'm a bit concerned having seen some of the posts here (and on other forums) complaining about the theory classes.

I love understanding biological mechanism and I think I would be very frustrated to be in a program / career field that entirely ignores that. Academic science is not for me (I need more people interaction / direct application), but I also don't think I'll be happy giving the scientific way of thought up entirely.

Now that I've got my applications done, I'm getting cold feet. Maybe nursing is not for me afterall. Maybe my advisor is right, and I should finish my phd and apply to medical school. The reason I don't want to be an MD is largely lifestyle, to be honest... I want to be a primary care provider and I feel like the NP path will be a better fit than the MD path. But maybe I'm wrong and I'm "selling myself short" (in quotes because I soooo don't think nursing is selling oneself short!!) and I'll regret these decisions.

I got an email from Hopkins that I need to call them to schedule my interview, so of course I'm a bit freaked out now. Having to verbally explain myself is frightening, I think mostly because I've gotten so much **** from so many people over these decisions recently.

Anyhow - that's enough rambling for a sunday. Thanks again guys, and I hope you all have a wonderful holiday.

janony

Jess RN · Dec 18, 2005

Hi Janony,

I have had the same thoughts about whether I should have gone to med school. But, like you, a the lifestyle of an MD is not appealing to me. Nor is 4 years of school and then residency so I can then work part time in a primary care setting (my ultimate goal). No, I think I will like the *work of an NP* but I'm not really loving the *training* of being an RN. I should mention- I am a first year (as is BCZito) and only part time in my program, so I have not done any of the clinical piece yet- I only took Patho and Pharm/Nutrition this term. So, I'm not sure if I would feel differently about those two classes if I also had a clinical experience to go along with it.

I don't want a high powered prestige career- I have two little kids and I need a lot of time with them as well- I want a part-time career where I can help people and make a difference in thier lives, and one where I will be able to constantly learn. I want a fair amount of autonomy, but I don't want the buck to stop with me in terms of life or death decisions. I want to be part of a team. I may want to teach. I think I can get all that as an NP.

I don't think what we are being taught is fluff or busywork. I think it's just a different type of training, a different way of thinking, and one that feels a little foreign to me. Inspite of the tests feeling like 'taking the easy way out' or 'learning the shortcuts' I was not able to make a straight A in either of my classes, and that is unusual for me. I think it is a question of learning nursing priorities- and at this point, I'mjust begining to get a feel for it.

So,I'm planning on sticking with it and hoping for the best. I am confident that med school would have been the wrong path for me. In retrospect, I think I should have looked at PA programs more carefully, only because I think I would have enjoyed the education more (it's like mini-med school) but at the end of the day PAs do much of the same work as NPs. My big advantage right now is to be able to do my program part time, and I'm not sure I would have gotten that deal anywhere else.

So, those are my rambling thoughts- for whatever they help you. I think these are excellent things to be working through before making a big decision and change of course. In my opinion, I would think really closely about whether you would like the work of an NP- and go from there- school is only two years of your life (it won't drag on and on like your current program) and it may not be super enjoyable- but if it gets you where you want to be, I'm sure you can endure.

-Jess

BCzito · Dec 19, 2005

Hey Jess and BCzito
Thanks for telling me a bit about the "theme" at BC. Are you both first-year? (i wonder if it's any different in the second year).
I don't know what the PC way to put this is. But, do you feel the program has a lot of "fluff" in its coursework? Are you learning stuff you think you'll need, or is it a waste of time? I'm a bit concerned having seen some of the posts here (and on other forums) complaining about the theory classes.
I love understanding biological mechanism and I think I would be very frustrated to be in a program / career field that entirely ignores that. Academic science is not for me (I need more people interaction / direct application), but I also don't think I'll be happy giving the scientific way of thought up entirely.

I definately don't think its fluff. I think I may have had that attitude a little bit at first, but quickly found that that was not the case. I think its hard to make the MD or NP decision (I was originally thinking MD too), ultimately if you can be ok with the differences in "hierarchy" than I think Nursing is just what you are looking for as far as being a primary care provider.

I think you are going to get this same stuff anywhere you go to nursing school, because any nursing school is going to want you to "learn to be a nurse" and its not easy.

As far as the second year, I have heard from 2nd year students that the only thing that really bothers them is the theory course which many just don't care for. The second year they say they are pretty much writing out the prescriptions in their clinicals and having their preceptor just check them to make sure its safe. SO it def seems like allot changes in the second year, with more autonomy, and more individual decision making about patient care, which you don't get too much of your first year. All through the beginging of the first semester I kept thinking , is this right for me? Did I make the right choice? I'm really happy now that I did make this choice, it just took allot of adjusting and I still come accross frustrating situations and dilemmas, but I am not doubting my decision any more.

AND I am going to celebrate now because I just finished my last final woohoo and I got my grades back (good news! whew)

hope that all helps! yay the semesters over!!!!!!!!

janony · Dec 19, 2005

Thank you so much, Jess and BCzito. Hearing from you has made me feel a lot better about all this. I've had a rough couple of days (just found out my gram has breast ca mets in lungs and brain, and that my parents are getting divorced) and I think all the stress kinda just blends together.

When I sit down and make a pros/cons list, going to nursing/NP school really does make sense for me. It's just hard sometimes when everyone else seems to think you're making the wrong choice.

CONGRATS on the end of the semester and on the grades!!!

BCzito · Dec 19, 2005

Thank you so much, Jess and BCzito. Hearing from you has made me feel a lot better about all this. I've had a rough couple of days (just found out my gram has breast ca mets in lungs and brain, and that my parents are getting divorced) and I think all the stress kinda just blends together.
When I sit down and make a pros/cons list, going to nursing/NP school really does make sense for me. It's just hard sometimes when everyone else seems to think you're making the wrong choice.
CONGRATS on the end of the semester and on the grades!!!

Sorry to hear about all that bad news, that certainly can't help the stress factor.

And as far as people telling you its the wrong choice, don't listen to them, most people have no idea what it means to be an RN let alone an NP. And especially in MA (and all over the country) the scope of practice of NPs is growing, people often report better care from NPs and the docs are pissed and trying to dec the scope of practice we will have, but they keep getting told to be quiet (they keep losing all the political fights) and NP have had a ton of publicity (both good and bad) the bad mainly by docs trying to limit their practice, but also through Tv shows like scrubs, etc. SO basically.... just rely on yourself. Nursing is a great field.

Jess RN · Dec 19, 2005

Thank you so much, Jess and BCzito. Hearing from you has made me feel a lot better about all this. I've had a rough couple of days (just found out my gram has breast ca mets in lungs and brain, and that my parents are getting divorced) and I think all the stress kinda just blends together.
When I sit down and make a pros/cons list, going to nursing/NP school really does make sense for me. It's just hard sometimes when everyone else seems to think you're making the wrong choice.
CONGRATS on the end of the semester and on the grades!!!

So sorry to hear your bad news. Hang in there.

It's hard to ignore (mostly well intentioned) negative comments about nursing. When I told my mom I was applying to nursing school, she literally laughed at me. Nice.

It is a bummer that you cant at least take a master's degree from your current program. It's a shame to have done so much work and not have a degree to show for it. If it's not possible, then I would just move on- life's too short to keep working at something that your heart isn't into, you know?

Good luck and keep us posted!

Jess

Jess RN · Jan 8, 2006

Hey guys! How is everyone doing out there? I am enjoying my month long break - even though I wasn't full time- it is much needed one! :)

-Jess