Educ./Career Advice Needed from "Direct Entry" MSN trained NP's

[AlyshaAdele]

I've spent hoardes of time reading the boards here but it's time for my first post! I'm a pre-nursing student with a Bachelor's degree in another field. While I could apply to an ABSN or traditional BSN program in order to earn a second degree in nursing; I would then need approx. 3 years of experience working FT as an RN in order to apply for a local MSN program.

I am ultimately interested in becoming a Nurse Practitioner, and do not feel I would be personally disappointed not having experience as an RN first. I do highly respect the vital and needed role of an RN, I just feel personally excited about the role of a NP most (scope of practice, day-to-day duties, the msn education, wanting to finish ALL my education NOW rather than later, etc.)

I currently live in Atlanta but am hoping to move back to my hometown (San Francisco) with my husband. Thus it will make SO much more sense to complete ALL of my education here & NOW where education & cost of living are significantly comparable to that of CA. Thus, we don't really have "3 yrs" for me to work between an ABSN and MSN program; not to mention having to apply to 2 programs rather than 1 (the D.E. MSN) where I can enroll to earn my RN license after first year, followed by 2-3/4+ years to earn MSN, seamlessly.

But instead of proving my reasoning for applying for a "Direct Entry" MSN program, Id like to ask D.E. Trained MSN NP's out there if they felt they were at a severe disadvantage in two specific areas 1. Hirability 2. Experience/Competence having not had experience as an RN prior to working as an NP.

The great news is that Id hopefully enroll at a high quality program like EMORY, so Id be interested to hear your opinion, but also the quality of your program so I can take that into consideration. I'd like to know if it's hard to get hired as a new D.E. MSN grad sans RN experience (aside from that offered by your program) as well as if you felt severely incompetent or at a serious disadvantage without RN work experience once hired and working the floor.

I insinuate nothing of offensive nature by my post. I am not trying to take the "easy path" and skip anything to become an NP. I am prepared to work very hard to get where Id like to go and I've seen this can be a controversial path. I also mean no disrespect to D.E. MSN grads if they have successfully been hired and feel they are just as competent as those with RN work under their belt. My questions are just assuming the worst of a potential path so as to encourage blunt honesty from readers.

I Am a student who needs honest information from you and is asking an honest (possibly uninformed) question. Of great concern is a comment from an NP I met working at a CVS. She advised me to "get experience working as an RN prior to earning your MSN, or you will fail at being an NP". Please agree or disagree with her advice, providing as much support as possible for your opinion.

I am sincerely grateful for your taking the time to read my long post as well as for taking the time and care to help advise me. Thank you!!!!

[Corey Narry, MSN, RN, NP]

I think there are many variables in play here and it's not easy to predict your success and none of us, unfortunately, have a crystal ball to allow us to look into the future. However, I appreciate your thirst for information and your analytical approach in deciding your path. As a full disclosure, I'm an ACNP who worked as an RN for many years in a field relevant to what I'm doing as an NP. I do know DE NP grads some whom I work with in my role. Some of my thoughts:

1. What NP specialty are you interested in? I think that does matter because some primary care NP roles likely will not require extensive acute care bedside RN experience to help you get hired nor will it help substantially with learning the role. In reality, primary care clinic based roles have nothing in common with the kind of work RN's do in an ICU for example.

Acute Care NP positions in many cases prefer NP's with relevant nursing experience at the bedside. The direct entry NP programs in the university we are affiliated with do not include AGACNP which tells me that the university feels that the role itself require relevant RN experience in the acute care setting.

2. I live and work in SF (your hometown!). There are NP's in practice in this area who are DE NP program grads and many are in primary care. The few ACNP's I work with graduated from East Coast DE programs and worked in the East Coast as NP's prior to moving to CA. With their NP experience, I will honestly say that you won't be able to tell them apart from the ones who were RN"s first like myself in terms of skills and knowledge.

3. As I work in the hospital exclusively, I would also mention that there are DE NP program graduates here who are working as RN's at the bedside (in the ICU at least where I work). Some are graduates of reputable programs (Johns Hopkins, Columbia and similar institutions). Many were hesitant to pursue NP roles, feel that the bedside role is not really that bad after all, and are enjoying Northern California's higher salaries and union benefits. This is obviously a case of individuals who end up doing what they didn't plan on doing in the first place but have settled in to the role.

4. What is stopping you from pursuing the alternative which is PA training?

[Riburn3, BSN, MSN, APRN, NP]

I'm asking the same question as Juan...why not just go for the PA in your case? Shorter entry into the market and more job role flexibility due to the type of education you receive. I love being an NP but if I were in your shoes I would really consider the PA.