Direct Entry Programs/Masters Entry

humiliated · Aug 6, 2004

Hi Everyone,
I've enjoyed this forum and hope that I can get help from all of you regarding starting a career in nursing.
I can understand your dilemma after talking to various nurses. I do not know of any direct entry CRNA programs since the programs usually want you to have a year or two of critical caree experience. I have heard of master entry programs for those with bachelor degrees who would like to be a RN. I don't think you should necessarily take the comment about paying your dues too seriously from others though. I feel like sometimes people say that because they suffered and want others to do the same. I am not in your particular situation, however, I am very driven and before finishing nursing school I knew I would be back in school immediately pursing my masters. Personally I do not prefer to work in the hospital setting as an RN and desire leadership type/ administrative positions. I graduated in May and plan on getting three masters; Masters of Public Health, Masters of Nursing Leadership, and Healthcare management. Many of my commrades and others tell me I should work in the hospital for at least a year or two to gain experience, however I keep on trying to figure out why is it so important to work in a position I am not interested in doing. Originally I signed on to work at a hospital because I was trying to conform to what others wanted me to do, however I failed the NCLEX. That is another embarassing story. But, anyways currently I am in the process of interviewing for a director of nursing position, which am I happy about. Some think I am not ready for this type of position, I disagree. I am ready other than the failing the NCLEX part, however now that I am pursuing something I really want in nursing I am more motivated to pass the NCLEX. In fact I am looking forward to testing again so I can be a DON. I think you should follow your heart and maybe ask someone for advice that doesn't necessarily know anything about nursing, so they can maybe not be as biased. I wouldn't recommend going againgst other nurses opinion, however it is you that must live with the choices you make. So follow your dreams despite what others say, why should you be miserable in a job you don't want for any amount of time. I think people need to remember that nurses have a variety of jobs that aren't at the bedside. That's what makes nursing so unique. One day I plan on being a CEO of some health organization, however I will still say I am a nurse first and a CEO second. Good luck with your ambitions.

elkpark · Aug 6, 2004

Although I was a "traditional" MSN student myself, I attended a school with a direct entry MSN program and took all my classes along with the direct entry students. The school was v. competetive, and we all had excellent academic records, GRE scores, and references in order to get accepted, but that was true of the university in general.

The direct entry students I knew in school and have kept up with since graduation have all gotten good jobs, and have felt themselves to be well-prepared to practice in an advanced practice role.

Most of my fellow students were receiving generous scholarship assistance -- many were signed up for VA or PHS scholarship programs that paid for their schooling (and, in some cases, a stipend for living expenses) while they were in school in return for a commitment to work for a certain amount of time after graduation. There are also lots of other scholarship programs out there, and many states have their own programs -- I was able to receive scholarship money from my state that I could work off after graduation instead of paying back. And, of course, one can always fill in the gaps with student loans.

One note of caution I can't resist mentioning -- many nursing students start out thinking that they are confident they want to specialize in a particular area of nursing, and, by the time they've rotated through all the specialties in nursing school, they find that their most serious interest is in something else entirely (I had that experience myself, many moons ago). It's one thing to have that experience in a "basic" nursing program -- it's quite another to have it in an expensive graduate program. It would be a shame to decide part way through that, now that you're starting to experience nursing in "real life," you're not as interested as you thought you were in whatever specialty track you're in, and would rather do something else entirely ...

Best wishes on whatever you decide.

vickynurse · Aug 6, 2004

Sorry, I just don't know how you can be a "Master" at something if you have never been in a basic role such as "Staff". To me, it is like jumping into being a school administrator without ever having been a classroom teacher.

euqenna · Aug 6, 2004

Hi guys,

Thanks for your emails. I think I will have to think about it some more and visit the various schools and departments. I understand Vickynurse's concerns though which is something I've tried to ask around when I contact schools. There are schools, Northeastern for one, who emphasize that even though you may start with one specialty interest, they encourage you to rotate at various floors to get a more well-rounded approach to finally picking a masters specialty. I'm leaning towards that kind of philosophy.

I hope others will come and share their own thoughts. I'm looking forward to hearing more about other's experiences in choosing their career specialties.

Also, will anyone comment on "ranking" of masters-entry programs? Is there really validity to choosing "the best" nursing schools? Or should we not worry about school name/reputation? Will finding jobs be easier for those who came from well-known big schools like columbia, yale, upenn, johns hopkins, georgetown, etc? Or will the costs of tuition be the real issue?

Thanks again!

elkpark · Aug 6, 2004

You need to be aware that the "national rankings" of nursing schools published annually in the news magazines are based on some fairly odd criteria that have little to do with how good an education you would get at a particular school. There has been at least one thread about this subject here in the past, which I'm sure you could search and find.

All of the direct entry MSN programs will incorporate a (quick and dirty!) basic nursing education (just enough to qualify you to sit for boards to get licensed -- in my program, the direct entry students didn't write the NCLEX until the end of their second year (first year of the MSN component), and, when I asked about this, I found out it was because the first year didn't provide enough clinical hours to qualify them to write boards, so the program counted the clinical hours they did in the first year of the MSN program toward the total required in a basic nursing education program. That seemed kinda like cheating to me, but I guess it was kosher enough ... :rolleyes: )

You will rotate through a variety of clinical specialties and areas during that first year, but not in the detail (amount of time in each) that you would in a "regular" nursing program -- and, unlike a "regular" nursing program, in which the outcome will be a generic RN license that will enable you to pursue whatever specialty interests you and move freely among specialties if you choose, you'll be locking yourself in to a particular specialty/role in the MSN program. In my program, you were accepted into a specific track within the program (e.g., child psych, in my case) and you did not have the option of just switching to another program. I'm surprised to hear that there are programs that let you wait to "declare a major" (what would happen if, say, everyone in the program that year decided they wanted to be a CNM??)

I think that choosing a school is a v. personal decision. Don't be terribly swayed by a particular school's prestige or reputation -- the best school for someone else, or the most prestigious school, may not be the best school for you. Cost is certainly a significant concern, and my experience has been that, in the long run, people are not going to be terribly concerned about where you got your degree. However, you may feel (as I did) that the extra $$$ is worth it for personal/professional reasons. Feel free to pm me if you want to discuss any of this further! :)

monnelise · Aug 7, 2004

i do know of one private school here in cali that has an msn-e program. the first year or so prepares you to get your rn and then the last two years are on a part time basis. this is so you can work in the field and gain experience. if you're interested in the website here it is:

http://www.westernu.edu/nursing/msn-e.xml

good luck

Kabin · Aug 11, 2004

If I recall correctly, the University of San Diego has an MS entry program as well at least one school in the San Francisco area.

mischievium · Aug 13, 2004

euquenna--

I just finished the first year of the Columbia direct entry program (they call it their "Entry-to-Practice" or ETP program) and I just wrote you a big long post about it that disappeared:rolleyes:, I will retype it again tomorrow:).

Until then, if you have any specific questions about Columbia feel free to ask!

-m.

mischievium · Aug 18, 2004

So *finally*, my thoughts on Columbia's Entry-to-Practice (ETP) program.

1. It is VERY expensive. It is about $75K for the first year (June- May) including cost of living expenses for New York City--it breaks down to about 50K for tuition and 25K for living expenses. Almost all of the incoming class for my year (about 98%, I think), received a $25K scholarship, but $50K is still a LOT of money. Also, the $25K scholarship is NOT available for the master's phase. So, if you are interested in going to Columbia and are not independently wealthy, look early and often for scholarships.

2. You get a (second) bachelor's degree in nursing after the first year. I consider this to be a considerable advantage over other programs that give you the RN training, but don't give you the degree. It gives you more freedom to stop after the first year if you decide to.

3. You ARE eligible to take the NCLEX after the first year-- and actually, if you are continuing with the master's phase, you have to take it and pass it sometime between the end of the first year (mid-May) and the beginning of the master's phase (September). This is particularly helpful if you want to do the Master's portion part-time and work as an RN and have the hospital you are working for provide tuition- reimbursement (as of last year you could go part time in the master's phase for all of the specialties EXCEPT ansesthesia and midwifery, more on this in a minute).

4. You ARE asked to declare a specialty on your application to the program-- BUT, it is not difficult to switch specialties, UNLESS you want to switch into ANESTHESIA or MIDWIFERY. Anesthesia is a VERY competitive specialty to get into and requires pre-requisites that are not required for any of the other specialties (see their website for more details). Midwifery is also competitive, but became even more so starting last year due to the closure of two very large midwifery practices in Manhattan that served as clinical training sites. They let you know when you are accepted into the ETP program if you have been accepted into your specialty of choice or not-- and like I said, it's no problem to switch if you change your mind, unless you want into Anesthesia or Midwifery.

In my case, I applied and got into the program, but not into the Midwifery specialty. My options were-

1) attend the ETP program anyways and hope that a space opened in the Midwifery program

2) attend the ETP program and choose a different master's specialty-- I wasn't too optimistic I'd change my mind, but it could have happened.

3) get my BS in nursing after the first year and go on my way.

As it turned out, a space opened up in the Midwifery program and I did get in, but I decided to stop after the BS/RN portion anyway. This was literally one of the hardest decisions I've ever had to make, I agonized about it for months before notifying the school and even now I'm not sure I made the right one. I really DO want to become a midwife, but financially could not afford to do it at Columbia--especially since Midwifery students are required to go full time and are, therefore, not able to take advantage of tuition-reimbursement offered by many of the hospitals in the area.

Other random thoughts about the program--

I think the program was experiencing *a lot* of growing pains last year. They jumped from 90 students the year before to 160 in our class. It was obvious that the administration was, at times, struggling to meet the needs of that many more students. However, I must say that mid-year the director resigned and was replaced and things became much better and more organized after that point. The current director is a really great lady-- and a really good teacher. Also, for all of the problems we (as students) had with the program, the administration (especially with the new director) was really good about listening to us and making changes. Our class even established a student council, which, to my surprise, didn't exist before my year.

That all said, the first year, and especially the first summer, is really hard. It is an accelerated program, so they try and squeeze in as much as possible. This is not to say it's not doable, just that you should prepare yourself for a tough year. One really nice thing about the program is that they provide a lot of clinical experience in the first year. Assuming it is structured the same way as last year, in the summer (10wk) you have about 6 classes and are in the hospital 1 day/ wk. (this is really just meant to be a general introduction to the hospital and basic patient care). Then, in the fall, you start the 5X5s--five, five-week clinical rotations. You have 2 classes, one of which is directly related to the rotation you are currently in,--and are in the hospital 3 days/ wk. The 5X5s finish up around Spring Break and then you have an 8wk "integration" clinical where you work +/- 30 hrs/ wk one-on-one with a nurse. For me, the integration period was the highlight of the program-- but that can really depend on who your nurse-preceptor is. Mine was fabulous (for me, anyway) and I got to work on an L&D floor.

That's all I can think of, for now. If you have any specific questions, feel free to ask.

-m.

BeenThereDoneThat74, MSN, RN · Aug 29, 2004

i don't think you should necessarily take the comment about paying your dues too seriously from others though. i feel like sometimes people say that because they suffered and want others to do the same. i personally i do not prefer to work in the hospital setting as an rn and desire leadership type/ administrative positions.
many of my commrades and others tell me i should work in the hospital for at least a year or two to gain experience, however i keep on trying to figure out why is it so important to work in a position i am not interested in doing. originally i signed on to work at a hospital because i was trying to conform to what others wanted me to do, however i failed the nclex.
but, anyways currently i am in the process of interviewing for a director of nursing position, which am i happy about.
some think i am not ready for this type of position, i disagree. i am ready other than the failing the nclex part, however now that i am pursuing something i really want in nursing i am more motivated to pass the nclex.
in fact i am looking forward to testing again so i can be a don. i think you should follow your heart and maybe ask someone for advice that doesn't necessarily know anything about nursing, so they can maybe not be as biased. i wouldn't recommend going againgst other nurses opinion, however it is you that must live with the choices you make. so follow your dreams despite what others say, why should you be miserable in a job you don't want for any amount of time. i think people need to remember that nurses have a variety of jobs that aren't at the bedside. that's what makes nursing so unique. one day i plan on being a ceo of some health organization, however i will still say i am a nurse first and a ceo second. good luck with your ambitions.

so you think you're ready to be a don, but haven't passed nclex yet? hey i have no problem with the second part (been there, done that). but how can you be a director of nursing without being (or even wanting to be) a nurse!!! maybe nursing isn't for you, but perhaps some kind of hospital/healthcare administration. there is one thing that nurses always look for in their administrators/managers or supervisors: their ability to 'relate' to what it's like to be a staff nurse. you will not have that at all, and it will be obvious.

BeenThereDoneThat74, MSN, RN · Aug 29, 2004

Hi Everyone,
My question is really a ploy to get a general survey of what other students, nurses think about Direct Entry programs. Which ones do you think are good or bad. Specifically, I am looking into Columbia, Georgetown, Northeastern U. and I think I want to work in the field of acute care or anesthesia.
Some nurses I've talked to tell me that I should respect the field and pay my dues, which is to work on the floor for a few years like most RN's before getting the masters degrees. I also have heard others with opposing views who tell me that if I know what I want to do and have seen what the nursing field looks like, then I should go and do the direct entry and be focused. I'd like help sorting through all of this.
Thanks in advance. Please any little bit of input will help- I'd love to hear from everyone- former direct entry students, current students, RN's, CRNA's, ACNP's, everyone!
PS. Let me know if this is better posted elsewhere!

One of my co-workers graduated from one of the above programs last year (with the BSN), an will be an NP next year. Amazing huh!! I don't think so. Although she doesn't really let on to it, she admitted to me that she really feels uneasy about her skills and her experience. She told me what her clinicals were like, and it seemed all to quick to me. For that money, I think you should be getting more out of your education.

At 29 I'm sure you feel like everyone else- you just want to finish school!! That's how this girl feels, except she's 23!! I'm sure after being in school with other degrees, you get tired of being in school. I'm 30, and getting my Masters, after my first BSN and first ADN. I just don't think nursing is something you should 'rush through', and that's how my co-worker felt.

And as far as 'paying your dues', true, some of us had no choice. But I think it has made me a better nurse. New grads in their specialties can not imagine what it's like to have 12 patients on the floors. I couldn't get the job of my dreams walking out of school. But then again, your dreams change. I didn't know what I wanted then. You need to be flexible (which many nurses are not). Look around, try different areas. I don't think being a NURSE before being a NURSE midwife or anesthesist is settling, or paying dues. It's all a learning experience.

BTW, the program my co-worker went to is basically geared to 'make' Advance practice nurses- they don't care what kind of staff nurse you are (at least that's what she told me).

I've been a nurse for 10yrs. A year ago, I was ready to get knee deep into a PNP program. I did two semesters, and realized that that was not what I wanted to do. I transferred into education. As it was, I lost a couple of credits form the NP. Thank God I didn't do any clinicals.

Just keep your eyes wide open. There are tons of opportunities out there.