I am an undergraduate student studying a non-nursing major and would like to ultimately pursue a MSN via direct entry program. For a good chunk of my life, I always thought I wanted to go to medical school until my mother grew chronically ill. After spending a lot of time with her at so many different hospitals and in various settings, I discovered what NPs do and have never looked back since--I knew this is what I wanted to pursue after graduating.
With that being said, I've gotten a lot of mixed opinions about direct entry MSN graduates ranging from "yes, they're great, there is a great lack of APPs in the US" to "don't even think about getting your master's without having X amount of years of experience as a bedside nurse first." Honestly, after doing the math, I figured that it would be more reasonable for me to just get my MSN rather than a second bachelor's and then having to eventually having to reapply to get my master's when I'm much older.
I know for a fact there are a lot of successful APPs who never had experience being a bedside nurse, but are still thriving as providers. However, it just seems like I get a LOT of backlash from some students/older nurses who are incredibly critical about my ambitions and it borderline feels like they're bullying me into becoming "one of them first" by telling me that my current plans are "not respectable in their field".
I guess what I'm wondering is--is this what the majority of the healthcare industry thinks of NPs who did direct entry programs? I already know I'm gonna get bombarded with the "you need bedside experience first" on this post, but my question is, why do established universities like UCSF, Johns Hopkins, Yale, Columbia, Vanderbilt, Emory, (the list goes on) offer these programs if they didn't produce well-rounded, competent individuals?
Are there any NPs who went through one of these direct entry programs? Am I gonna have to spend my entire career justifying my academic/career decisions to people who can't handle that nursing is changing? I'm not even in the program yet and I already feel like I have to keep my plans on the "down low" from fear of backlash.
Here is my analogy. I studied a foreign language for seven years in traditional classes, high school and college. I got excellent grades. I was considered well above average.
But when I went to the country, it was quickly apparent that I did not know how to correctly pronounce the numbers from 1-10 in conversation.
Here I am, knowing a fair amount of advanced vocabulary, and I am stumbling over the pronunciation of phrases like "six books".
I figured it out. It isn't in most books. And in health care it could be dangerous.
The question I have for you is what is it about nursing that draws you toward the field? As you know medical school and NP school are not the only options. PA programs are more structured to be consistent and admits students from a variety of both non-health care and health care fields (albeit exposure to health care is required in a volunteer capacity for those who don't have a healthcare background). You come out of the program trained as a generalist provider whose scope of practice requires close relationship with a physician and there is no specialized restrictions such as those in the NP field (i.e, primary care, acute care, mental health).
This right here. If you aren't going to get a BSN for your first degree, why not go the PA route? You will come out the same in the end, as far as time goes. And you don't have to pick your specialty if you choose PA, which is a big advantage if you don't go through nursing school prior to jumping into an MSN program. Plus, you talk about clinical hours - I hate saying it, but PA training includes far more clinical hours than NP training does (like, 2,000 vs 600 or so). Frankly, if I wasn't going to have nursing experience under my belt, I would rather go to PA school. In fact, sometimes I still think about it.
I struggle to this day with choosing a specialty, and I am almost done with my BSN. It's tough to lock yourself in like that. I was in an ER clinical the other day, and their "APP" was a PA. It's easy for them to use PAs. NPs have to have dual certifications in order to be truly functional in an ER. It's like, geez!
Bullying is never okay. The bullies will be bullies regardless of the letters or number of years you carry. It's a character flaw common of insecure people.
A fundamental value system in nursing is the personalization of everything. When considering nursing dynamics, this is fine. But as we try to practice as providers where science and outcomes rule, we really should set some standards. Either you know what you're doing, or not. It's simple. If you can breeze through some (any) degree program and then sign up for a 12/14/18 or whatever month course of NP training and come out trusting yourself to make decisions for your patients as you would for yourself or someone you care about with that disease process, go for it.
The interesting thing, we have our own great experiment where we can watch the outcomes.
This right here. If you aren't going to get a BSN for your first degree, why not go the PA route? You will come out the same in the end, as far as time goes. And you don't have to pick your specialty if you choose PA, which is a big advantage if you don't go through nursing school prior to jumping into an MSN program. Plus, you talk about clinical hours - I hate saying it, but PA training includes far more clinical hours than NP training does (like, 2,000 vs 600 or so). Frankly, if I wasn't going to have nursing experience under my belt, I would rather go to PA school. In fact, sometimes I still think about it.
I struggle to this day with choosing a specialty, and I am almost done with my BSN. It's tough to lock yourself in like that. I was in an ER clinical the other day, and their "APP" was a PA. It's easy for them to use PAs. NPs have to have dual certifications in order to be truly functional in an ER. It's like, geez!
To answer your question, PA programs are super competitive, you won't find their students working full-time and fitting in school on the side, and you actually do have to have health care experience in some capacity (mostly, making up for the lack of fluff courses which dominate NP school...to develop humanities).
Bullying is never okay. The bullies will be bullies regardless of the letters or number of years you carry. It's a character flaw common of insecure people.
I don't know, I guess I just have a hard time seeing what the OP has described as bullying. It's entirely reasonable to express a viewpoint that differs from the OP in a respectful way, and there are many valid arguments to support gaining experience before NP school.
If the OP plans to do a direct entry program, she needs to prepare herself for (and be ok with) the fact that many, if not the majority of nurses have some concerns about graduate programs that don't require experience. That said, I don't think expressing that viewpoint is bullying, nor does that mentality mean that she will necessarily be bullied. When she's in her program, she'll be surrounded by other people who are doing the same thing (and they presumably won't be bullying one another). When she starts as a new grad NP, she may (or may not) have a steeper learning curve than other new grad NPs with nursing experience, but that's to be expected. Once she has experience, nobody will care whether or not she graduated from a direct entry program.
People do direct entry programs all of the time and can go on to be great NPs (although they may have a harder time starting out). However, it sounds like the OP is feeling personally victimized by a viewpoint that honestly isn't personal. People complain on this site all of the time about being bullied, when in fact they are simply receiving honest, rational feedback that they don't agree with or prefer not to hear. Just my two cents.
To answer your question, PA programs are super competitive, you won't find their students working full-time and fitting in school on the side, and you actually do have to have health care experience in some capacity (mostly, making up for the lack of fluff courses which dominate NP school...to develop humanities).
I do know these things you mention. But does the OP need to work through school? I would assume not, she/he is pursuing direct entry, and since they are not nurses, they don't work and the programs are FT. DE also tend to be competitive, considering there are less schools offering options for people who don't want to be nurses first. HCE for PA amounts to things like a few months of CNA experience. Not that big of a deal.
Besides...those are your answers. I'm not sure what the OP thinks?
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I am an undergraduate student studying a non-nursing major and would like to ultimately pursue a MSN via direct entry program. For a good chunk of my life, I always thought I wanted to go to medical school until my mother grew chronically ill. After spending a lot of time with her at so many different hospitals and in various settings, I discovered what NPs do and have never looked back since--I knew this is what I wanted to pursue after graduating.
With that being said, I've gotten a lot of mixed opinions about direct entry MSN graduates ranging from "yes, they're great, there is a great lack of APPs in the US" to "don't even think about getting your master's without having X amount of years of experience as a bedside nurse first." Honestly, after doing the math, I figured that it would be more reasonable for me to just get my MSN rather than a second bachelor's and then having to eventually having to reapply to get my master's when I'm much older.
I know for a fact there are a lot of successful APPs who never had experience being a bedside nurse, but are still thriving as providers. However, it just seems like I get a LOT of backlash from some students/older nurses who are incredibly critical about my ambitions and it borderline feels like they're bullying me into becoming "one of them first" by telling me that my current plans are "not respectable in their field".
I guess what I'm wondering is--is this what the majority of the healthcare industry thinks of NPs who did direct entry programs? I already know I'm gonna get bombarded with the "you need bedside experience first" on this post, but my question is, why do established universities like UCSF, Johns Hopkins, Yale, Columbia, Vanderbilt, Emory, (the list goes on) offer these programs if they didn't produce well-rounded, competent individuals?
Are there any NPs who went through one of these direct entry programs? Am I gonna have to spend my entire career justifying my academic/career decisions to people who can't handle that nursing is changing? I'm not even in the program yet and I already feel like I have to keep my plans on the "down low" from fear of backlash.
You're still in school and already complaining of being bullied? WOW. Just WOW. Is it bullying because you don't like what they're saying? Or are they following you around trying to ruin your working relationships or get you dismissed?
I've never been a nurse practitioner nor aspired to be one. I've worked with many, many brilliant nurse practitioners who I'd trust with my life or my patients' lives any time. Most of them had at least five years of bedside experience before becoming nurse practitioners, although two of them started out directly as NPs, realized they needed bedside experience and stepped down from the NP role to get the experience. I have enormous respect for all of those individuals.
I've also known a number of nurse practitioners (and worked closely with them) who had no bedside experience before becoming NPs. Some of them graduated from prestigious MSN programs such as Duke, Yale, Johns Hopkins, Vanderbilt, Emory. Almost without exception, the lack of bedside experience was detrimental to their role as nurse practitioners. One or two of them was blessed with excellent listening skills and managed to overcome that handicap. Most, however, flat out stated that they "didn't have to listen to the experienced bedside nurse" because they "had more education" and, occasionally, "because I went to Duke (or Johns Hopkins or Vanderbilt". As one might guess, they had a very long and difficult road ahead of them. Some actually learned to listen to the bedside nurse, the RT, the PT or the pharmacist and eventually did OK. Others lost their jobs. One NP who graduated from Hopkins was overheard on her cellphone telling someone that "The nurses here don't like me because I'm better than them."
Many direct-entry nurse practitioners will tell you that they didn't need the bedside experience, that they're doing just as well as their classmates or colleagues who had the experience. I wonder what their colleagues would say.
Established and prestigious universities have those direct entry programs so that they can collect the tuition money. Or so I hear from friends who teach in those programs.
Many direct-entry nurse practitioners will tell you that they didn't need the bedside experience, that they're doing just as well as their classmates or colleagues who had the experience. I wonder what their colleagues would say.
Probably would depend of if their colleagues new ahead of time what their prior RN experience was.
For a good chunk of my life, I always thought I wanted to go to medical school until my mother grew chronically ill. After spending a lot of time with her at so many different hospitals and in various settings, I discovered what NPs do and have never looked back since--I knew this is what I wanted to pursue after graduating.
What were the NPs doing that the doctors weren't that made you want to go that route instead?
With that being said, I've gotten a lot of mixed opinions about direct entry MSN graduates ranging from "yes, they're great, there is a great lack of APPs in the US" to "don't even think about getting your master's without having X amount of years of experience as a bedside nurse first."
You will get that same response here. It is a very personal issue for many nurses.
I know for a fact there are a lot of successful APPs who never had experience being a bedside nurse, but are still thriving as providers. However, it just seems like I get a LOT of backlash from some students/older nurses who are incredibly critical about my ambitions and it borderline feels like they're bullying me into becoming "one of them first" by telling me that my current plans are "not respectable in their field".
As above, you will get the same responses here. Are you surprised that experienced nurses don't like the idea of another nurse with less (or no) experience getting to "call the shots"? This is a very personal thing for many nurses.
I guess what I'm wondering is--is this what the majority of the healthcare industry thinks of NPs who did direct entry programs? I already know I'm gonna get bombarded with the "you need bedside experience first" on this post, but my question is, why do established universities like UCSF, Johns Hopkins, Yale, Columbia, Vanderbilt, Emory, (the list goes on) offer these programs if they didn't produce well-rounded, competent individuals?
There are many long-standing quality direct-entry NP programs (some that have existed since the beginning) that have long track records of producing top quality NPs. In general the direct entry candidates are much stronger applicants than the RN-to-NP candidates and the programs are quite selective.
Please bear in mind that just because a program is a DE program doesn't mean they don't require RN experience prior to graduating as an NP: a number of quality programs do have this stipulation.
Some markets are flooded with NPs, thus salaries are decreasing, even for PMHNPs. Make sure you evaluate your desired market prior to doing this. If it seems ok, go for it
kids, bullying has been around for eons. Get used to it..it aint going away. No matter what degree you have. The bullying has been around because its been allowed & no one has challenged them! Have fun with the bully, they will never know what hit them! Meanwhile develop GOOD bedside manner. your NOT the doctor, your his assistant.
Oldmahubbard
1,487 Posts
Here is my analogy. I studied a foreign language for seven years in traditional classes, high school and college. I got excellent grades. I was considered well above average.
But when I went to the country, it was quickly apparent that I did not know how to correctly pronounce the numbers from 1-10 in conversation.
Here I am, knowing a fair amount of advanced vocabulary, and I am stumbling over the pronunciation of phrases like "six books".
I figured it out. It isn't in most books. And in health care it could be dangerous.