DNP in 2015? Forreal?

[jiwonkim89]

I posted this on the graduate forum as well.

So I am in the middle of finishing prereqs and applying to nursing school. At first, I wanted to apply to aBSN schools only. But I would like to become a NP eventually, after a few years working as an RN. I wanted to take the more traditional route i guess of having a BSN then an MSN (NP). But I've been reading about the possible change of requirement for a DNP in order be a practicing NP in 2015. I'm 21 right now, so chances are...I'm not going to be completing an NP program by 2015.

So my question is...is it better for me to apply to entry level MSN programs (allowing me to be an RN...possibly CNL)...since DNP programs will require a masters when it's time for me to apply? Gah~ this is all so complicated! Any advice? Is the RN with MSN more common these days? I think the worst thing that could happen is if I get a BSN..and can't even apply to an NP program because I had only have a BSN, not an MSN!!!!!

[PMFB-RN, RN]

I'm curious. When the MSN gives way to DNP across the land, will that mean that Masters Entry Level Programs will turn into DNP entry level programs? That is, will someone without a lick of actual patient care experience with a BA degree in French Upholstery Design now be able to go from "never touched a patient in my life" to a RN-DNP prepared NP in 4-5 years?

*** Uh, one could do that right now. 1-1.5 year accelerated BSN then either a year as an RN or direct entry into a DNP NP program of (let's say) three years long.

[PMFB-RN, RN]

And since a master degree is more research based than a bachelor or associate program (at least for the program I'm joining), it will also help prepare me for when I finally decide to for a DNP.

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*** Yes but less clinically based, at least in my experience as a preceptor of new grads in the SICU. I admit my direct experience is only with 6 or 7 direct entry masters grads but so for I have found low levels of clinical preparation and a high level of entitlement attitude as compared to the ADN & BSN grads I usually precept.

So far direct entry grads have not left a great impression in our ICU, though as I say my / our experience is fairly limited.

[elkpark]

I'm curious. When the MSN gives way to DNP across the land, will that mean that Masters Entry Level Programs will turn into DNP entry level programs? That is, will someone without a lick of actual patient care experience with a BA degree in French Upholstery Design now be able to go from "never touched a patient in my life" to a RN-DNP prepared NP in 4-5 years?

I'm sure that will happen -- why not??? The PTB think it's fine now for someone with no healthcare experience and a BA in French Upholstery Design to become an NP, why would it be any different just because the name of the degree has been changed and a few extra courses added?

(Please note I'm not saying I think that's a good idea, just as I'm no fan of direct-entry programs now -- just that I consider that the next logical development, given the widespread existence and acceptance of direct-entry MSN programs.)

[ADEcstatic]

I'm not sure how standardized the requirements are for direct-entry programs but the direct entry Master programs I applied for weighed direct patient care experience heavily, sometimes to the point of it weighing more or equal to the applicants' undergrad & prereq grades. Since so many people are switching careers (making the nursing education even more competitive) I've seen schools use direct patient care experience to weed out applicants. At the very least, it can't be generalized that direct entry programs produce inadequate nurses.

I do agree though that there are way too many expedited nursing programs out there and that too many students are spending tens of thousands of dollars to get a fast education. These new grads disperse out to the fields ill-prepared, bringing a bad name to a type of nursing program that could bring innovation and fresh ideas to patient care. I think it's the future nurse's responsibility to do research on the school(s) that he or she is applying to. When I started looking into direct entry programs, I wasn't focus so much on how fast the program is but how well prepared their students adjusted to the actual nursing jobs after graduation. I knew it was going to mean fiercer competition and rejection was a risk I was willing to take. I was confident that in the end, getting in would mean getting a high quality education.

PMFB-RN: I'm sorry that the new grads you came across with had low levels of clinical preparation and a high level of entitlement attitude. Sense of entitlement should NEVER be a trait in healthcare, where the focus should ALWAYS be on improving patient care. I've seen the same attitude with new doctors or medical students. I think it's sad. I would blame poor clinical preparation to the schools they attended. Nursing boards should really be more stringent on their education standards. Mass production of nurses isn't going to solve the predicted nursing shortage if it means turning loose batches of unprepared caregivers.

That's mho.

[Dr. Tammy, FNP/GNP-C]

I'm sure that will happen -- why not??? The PTB think it's fine now for someone with no healthcare experience and a BA in French Upholstery Design to become an NP, why would it be any different just because the name of the degree has been changed and a few extra courses added?

(Please note I'm not saying I think that's a good idea, just as I'm no fan of direct-entry programs now -- just that I consider that the next logical development, given the widespread existence and acceptance of direct-entry MSN programs.)

That's really odd. Someone without basic skills experience going from no experience to an advanced level. For those medics out there, that's kind of like an EMT going to paramedic school without BLS experience or every working on an ALS car with a role.

They must be much sharper on the up take than I. There is no way I could have delivered the same quality of primary care without first having a chance to hone my basic nursing skills and knowledge over more than a decade--just in the assessment category alone. Some at my practice think I'm some master diagnotician, when in reality, its the exposure and experience from my basic RN past that clued me in.

I wonder if the educators in the entry level advanced programs think years of RN exp is equivalent to less than 1000 hours of supervised clinical training. I can't help to think that I'm missing something.

[elkpark]

That's really odd. Someone without basic skills experience going from no experience to an advanced level.

I agree with you completely on this, but the direct-entry programs are everywhere now, so, clearly, the "movers and shakers" in nursing have no problem with the idea.

[Dr. Tammy, FNP/GNP-C]

I agree with you completely on this, but the direct-entry programs are everywhere now, so, clearly, the "movers and shakers" in nursing have no problem with the idea.

You know, I've had my head buried in books, patients, teaching and research over the last 8 years or so. I presumed that these entry program took people with BA's in other fields, got them to the RN status, then they worked as a RN, then came back with at least some experience to finish off their advanced practice education.

As a zealot advocate for APRN's and particularly the DNP, I couldn't, until now, understand the medical establishments beef with our profession and our ever-increasing scope independence throughout the US, other than simple turf protection in the form of power, profits and control. This deal, however, might serve as a legitimate beef and a challenge for us all.

[elkpark]

You know, I've had my head buried in books, patients, teaching and research over the last 8 years or so. I presumed that these entry program took people with BA's in other fields, got them to the RN status, then they worked as a RN, then came back with at least some experience to finish off their advanced practice education.

As a zealot advocate for APRN's and particularly the DNP, I couldn't, until now, understand the medical establishments beef with our profession and our ever-increasing scope independence throughout the US, other than simple turf protection in the form of power, profits and control. This deal, however, might serve as a legitimate beef and a challenge for us all.

Well, you may have been too busy to notice :), but these programs are well-entrenched throughout nursing and across the country. I attended grad school 15 years ago, as a traditional, experienced-RN student, at a well-known, well-respected school that also offered a direct-entry program and most of my classmates were the direct-entry students. They had done a full calendar year of a "quick 'n dirty" basic nursing education (largely self-study, according to them, except for the minimal clinicals they had) and then entered the MSN portion of the program with us traditional students (so my first year of school was their second year). At my school, specifically, the DE students didn't write the NCLEX until the end of their second year (the first year of the specialty, MSN portion of the program), and the program was so rigorous and demanding that v. few of the students worked at all, doing anything (I worked prn in the uni medical center throughout the program, although I did v. few hours when school was in session, and I knew one other experienced-RN student who was also working prn at the med center). I know for a fact that none of my DE classmates worked a single day as an RN before they graduated and started looking for advanced practice jobs.

[PMFB-RN, RN]

As a zealot advocate for APRN's and particularly the DNP.

*** I have never heard a real (as in actually worked as an RN before grad school) nurse advocate for the DNP before. I would be interested to hear your rational.

[linearthinker, DNP, RN]

I am also a staunch advocate of the DNP. The requirements for the MSN already exceed the norm for a masters degree, and it doesn't need much additional course work to merit awarding a doctorate. Terminal degrees are already required by other health occupations, nursing is lagging behind. Only when we are as well educated and prepared as the other members of the team can we command an equal respect and an equal place at the table.

I think the brouhaha surrounding the DNP will shake out over a few more years, standards will be established. I'm looking forward to being a leader in the movement.

[Dr. Tammy, FNP/GNP-C]

Well, you may have been too busy to notice :), but these programs are well-entrenched throughout nursing and across the country. I attended grad school 15 years ago, as a traditional, experienced-RN student, at a well-known, well-respected school that also offered a direct-entry program and most of my classmates were the direct-entry students. They had done a full calendar year of a "quick 'n dirty" basic nursing education (largely self-study, according to them, except for the minimal clinicals they had) and then entered the MSN portion of the program with us traditional students (so my first year of school was their second year). At my school, specifically, the DE students didn't write the NCLEX until the end of their second year (the first year of the specialty, MSN portion of the program), and the program was so rigorous and demanding that v. few of the students worked at all, doing anything (I worked prn in the uni medical center throughout the program, although I did v. few hours when school was in session, and I knew one other experienced-RN student who was also working prn at the med center). I know for a fact that none of my DE classmates worked a single day as an RN before they graduated and started looking for advanced practice jobs.

The more I ponder this issue, the more i realize that I don't know one direct entry NP graduate working anywhere in my area. I wonder if this is the deal with new NP grads not being able to get a job, as in it is due to them not having any patient care exp besides the limited exposure that is provided in NP training. I can't even imagine how a direct entry would put the clinical and academics in context without experience. I know I would have been completely lost. Kind of like learning cook book type care - one size fits all, versus experienced, what works for the subtle nuances of the individuals make up based on past experiences. The third triad of EBP includes provider preferences. How can someone use preferences to guide care based on the evidence without an experience frame of reference?

[AshleyPCA]

I'm curious. When the MSN gives way to DNP across the land, will that mean that Masters Entry Level Programs will turn into DNP entry level programs? That is, will someone without a lick of actual patient care experience with a BA degree in French Upholstery Design now be able to go from "never touched a patient in my life" to a RN-DNP prepared NP in 4-5 years?

I was actually wondering the same thing if they were going to now have entry level DNP programs, it actually wouldnt make much of a difference from the MSN entry levels since they're changing the requirements now for advanced practice (maybe).

Just so you know, YES, someone with a non-nursing Bachelor's degree CAN become an advanced nurse within 4 to 5 years now with these cutting-edge entry level programs. These people without non-nursing degrees are WELL capable of becoming advanced practice nurses because these programs don't just let these students in without preparing. You do need certain nursing pre-requisites included in that bachelor's degree to get into the entry level, as well as a good GPA. So these aren't easy programs to get into either, so you know the people applying with a French Upholstery Design degree aren't just getting in without any previous undergrad nursing coursework. Then in the program they are prepared to take the NCLEX and gain experience and the same nursing education as anyone else, just at a faster pace (which the pre-req's and undergrad GPA verify that they will be able to keep up with the pace).

So in a nut shell, these entry level nurses are JUST AS GOOD as any other nurses out there! They're prepared in a different way (just more rapidly), but with all the same things.