Entry into Practice: Direct Entry MSN Programs

[VickyRN]

Direct entry MSN programs are approximately three years in length. They provide basic nursing curricula during the first year or so of the program (pre-licensure phase), with graduate core courses and specialty course work during the remainder of the program (graduate nursing concentration phase).

The first masters program for non-nurse college graduates was instituted at yale university in 1974. These programs have grown slowly over the ensuing years. In 2008, the American Association of Colleges of Nursing reported 56 direct entry MSN programs.

Entry-level MSN programs are very demanding, as they not only provide students with a general foundation in nursing, but masters-level courses for leadership or advanced practice as well. These programs are fast-paced, usually involving five-days a week intense study, with a combination of classroom theory and clinical coursework interwoven throughout.

Some programs award learners a BSN at the halfway point of the program, and then an MSN at the end of the program; others only confer one degree: an MSN upon graduation from the program. In the latter case, students forgo a second bachelor's degree. In either type program, students must pass the NCLEX-RN after successfully completing the pre-licensure component, before progressing to the graduate-level courses offered during the second half of the program. Following program completion, students are then eligible to sit for national certification exams for advance practice nursing specialties.

Areas of study in direct entry MSN programs include nurse practitioner, clinical nurse specialist, clinical nurse leader, executive nurse leader, nursing administration, health care systems leadership, and certified nurse midwife. I have even heard of some programs offering nurse anesthesia by way of direct entry. An example is Georgetown university direct entry to advanced practice program. Another surprise is nursing education, which is offered in some direct entry programs.

A big controversy remains concerning entry-level MSN programs: are graduates adequately prepared for advanced practice nursing? What is the job market for advanced practice nursing graduates from these programs? Are they taken seriously by prospective employers? Many people are of the opinion that advanced practice nursing is just that - advanced practice. Critics assert that registered nurses need at least 2 years' experience at the bedside before entering into advanced practice.

What do you think?

[>30yrsRN]

"i am sorry but have to judge this as not good path or safe enough education to take care of patients as a fnp right out of college. i would request a physician instead. oh, i have arnp and md, and lawyers in my family also. if you ask me , we should follow the money trail on this. the cheap and short cut way has always cost this world in every area of expertise. no wonder usa ranks 37 healthcare. the most of public does not know the differance between a cna,lpn,rn,arnp or nursing phd in the first place, god help us.

oh gee,i think i will become a lawyer and work in nj with detox waste law sues is there a two year program for that? rofl"

you are certainly entitled to your opinion, but please tell me about your personal experience with direct entry grads. i'd like to hear some concrete basis for your bias.

i certainly don't regard my direct entry program as the cheap, short cut way. i had to take 3 years of pre-requisites, despite the fact that i have a bs in another health care profession plus an mba, plus my de program. and god knows it wasn't cheap....my huge student loan debt will attest to that. from my experience, my program consisted of highly intelligent, incredibly motivated people (myself included..lol) who were willing to put all else on the back burner to devote themselves to being the best caregivers we could be.

i have to say i'm dismayed at the hostility i've encountered both here and out in the world towards de grads. i never thought the nursing profession would be like that, but maybe i'm naive. i thought only lawyers ate their young....:wink2:

yes ,it is my opinion that i am entitled to and i like the idea that a emsn for fp works as a rn while obtaining the emsn arnp. without the experiance i think the emsn for fp is producing a rn with a piece of paper saying fp. that is my opinion. good luck i wish you all the best and gb.

[kanzi monkey]

Yes it is my opinion that I am entitled to and I like the idea that a EMSN for FP works as a RN while obtaining the EMSN ARNP. Without the experiance I think the EMSN for FP is producing a RN with a piece of paper saying FP. That is my opinion. Good Luck I wish you all the best and GB.[/quote']

This opinion is not based in reality. Why judge something when you don't understand it or know anything about it? With all due respect (and I do indeed have respect for your >30 years), I think it's odd that you include yourself in a conversation where you have nothing but judgement to offer.

Many folk have objections to DE MSNs that are based on experiences they have had. Those are useful for one who many be considering starting a DE nursing program. But opinions that are not backed by actual information aren't helpful. If you have a reason for objecting to these programs, I would be happy to hear it.

[Anise1]

Please come work with me......my patient population desperately needs the expertise and services social workers provide!! I'd also welcome a psych NP with open arms!!!

!!!! (ahem) Where on earth are you?

Some days, it's just hard. I went back to school after several years with half an undergraduate degree; I had no family support whatsoever, many years of rehab after a near-fatal car accident where I had broken almost every bone, suffered neurological damage, and gone through 10 operations, and many people predicted I would never make it (I wasn't sure I would either). I got through and went all the way to graduating with a masters' degree... and then, nothing. 75 people in the class, and very few have a job except for those who were kept by their internships. Everything was going so well at mine (a large mental health provider), my hopes were high, and then, on literally the last day of the internship, over 1/3rd of the employees were laid off. So that was that. Thanks for letting me vent a bit. :typing

Nothing will ever make me give up, but I've always known that I would go on to additional higher education eventually-- it's just that I now believe it will not be a PhD in social work. If I can eventually work most effectively with my chosen population facilitated by something like a direct entry program, then I'll choose that.

[BCgradnurse, MSN, RN, NP]

Kanzi,

I couldn't have said it better. As I said before, I would like to see some concrete evidence for the prejudice. Unfortunately, prejudice is usually based on fear/insecurity or ignorance, so there aren't any good solid reasons that can be presented. It's unfortunate-that's how a lot of problems in this world get started.

[BCgradnurse, MSN, RN, NP]

Anise,

I think a direct entry psych NP program would be lucky to have you. And when you're done please come to Boston and work at my health center!!! Seriously, I wish you the best in whatever field you decide to pursue.

[Moogie]

!!!! (ahem) Where on earth are you?

Some days, it's just hard. I went back to school after several years with half an undergraduate degree; I had no family support whatsoever, many years of rehab after a near-fatal car accident where I had broken almost every bone, suffered neurological damage, and gone through 10 operations, and many people predicted I would never make it (I wasn't sure I would either). I got through and went all the way to graduating with a masters' degree... and then, nothing. 75 people in the class, and very few have a job except for those who were kept by their internships. Everything was going so well at mine (a large mental health provider), my hopes were high, and then, on literally the last day of the internship, over 1/3rd of the employees were laid off. So that was that. Thanks for letting me vent a bit. :typing

Nothing will ever make me give up, but I've always known that I would go on to additional higher education eventually-- it's just that I now believe it will not be a PhD in social work. If I can eventually work most effectively with my chosen population facilitated by something like a direct entry program, then I'll choose that.

Wow---what an inspirational story. I certainly hope either you find something in social work or do the ELMSN for psychiatric NP. I certainly think you will be an asset to whichever field you eventually enter.

Thank you for sharing. :icon_hug:

I think a lot depends on the individual who is going through an ELMSN program. I have learned a great deal from the posts from the current and prospective students choosing this particular path.

[>30yrsRN]

BCGRADNURSE

If you want to see examples go to any Medical College Hospital settimg and See even the New MD starting in June each year. As you stand there and watch the Live Reality you will see all the Mistakes they make and what they have not grasp or been exposed to before. You will see their Peers, yes their Peers come and rescue the patient. DO no Harm! I do not know how you have a conscious to think a new EFP can hit the office acting as ARNP in Family Practice. We all Feel the same.

I was in Risk Management for Years and still work in Critical Care Arena I can not begin to tell the you Incidences that ARNP and MD have made and the other hand the Great Achievements they made.

I do not trust the medical judgement ENP practicing right out of college with no Healthcare experiance as a PA or RN or MD. FIU has a Program for Physician MD to BSN then MSN ARNP.This is my final note on the topic with you with input from a very wise and Intelligant Group of Nurses and a NUC MED Manager.GB >30yrsRN

[VickyRN, MSN, DNP, RN]

I have a quick question for those in DE MSN programs that do not award a BSN at the halfway point - If you do not go on to finish the program after completing phase 1(i.e., do not get the MSN at the end), do you keep your RN license or are you required to give up your RN license after a certain amount of time? Just curious...

[kanzi monkey]

I have a quick question for those in DE MSN programs that do not award a BSN at the halfway point - If you do not go on to finish the program after completing phase 1(i.e., do not get the MSN at the end), do you keep your RN license or are you required to give up your RN license after a certain amount of time? Just curious...

Oh, you keep the license absolutely. You just don't have a degree to support it. There are a handful of people from my program that aren't planning to go further at this point. One of them is now enrolled in another program to get her BSN. It's an odd position to be in to be a nurse, but to not have a BSN or associate's degree. I feel like many programs keep you from getting a BSN simply so they don't lose you. For example, my program was very expensive. When I started, I definitely wanted to go the Master's route since I already have a bachelor's. So even though traditional BSN programs were cheaper, my school seemed the better choice. By the time I completed phase one of my program, I had at least the equivalent of a BSN since I already had 4 years of college and research behind me, but I wasn't given a BSN. Had I chosen to stick with bedside nursing and not take out more loans to complete phase 2, then I would be stuck...licensed, but degree-less. And with more debt than I would have had from a BSN program (already).

So, programs that offer the BSN are nice in that you have that flexibility. As far as I know, all DE MSN programs are painfully expensive. I will be in debt for many years.

[kanzi monkey]

BCGRADNURSE

If you want to see examples go to any Medical College Hospital settimg and See even the New MD starting in June each year. As you stand there and watch the Live Reality you will see all the Mistakes they make and what they have not grasp or been exposed to before. You will see their Peers, yes their Peers come and rescue the patient. DO no Harm! I do not know how you have a conscious to think a new EFP can hit the office acting as ARNP in Family Practice. We all Feel the same.

I was in Risk Management for Years and still work in Critical Care Arena I can not begin to tell the you Incidences that ARNP and MD have made and the other hand the Great Achievements they made.

I do not trust the medical judgement ENP practicing right out of college with no Healthcare experiance as a PA or RN or MD. FIU has a Program for Physician MD to BSN then MSN ARNP.This is my final note on the topic with you with input from a very wise and Intelligant Group of Nurses and a NUC MED Manager.GB >30yrsRN

I think BCgrad can actually tell YOU what it's like to be new and in this position, since she's already doing it. You haven't done this before. What you've seen is only that--what you've seen. BCgrad has the experience in this case. You do not.

FIU has a Program for Physician MD to BSN then MSN ARNP.This is my final note on the topic with you with input from a very wise and Intelligant Group of Nurses and a NUC MED Manager.GB >30yrsRN

What does this mean?

[BCgradnurse, MSN, RN, NP]

So let me see if I have this right......nobody right out of school should be allowed to practice because they make mistakes...this includes RNs, MDs, PAs, NPs, PTs, etc. Again, you're not presenting concrete examples. And can I assume you have never made a mistake in your 30+ years of practice? You and your colleagues may be experienced and intelligent, but I don't think you speak for everyone in the nursing/medical world. Being stuck in the past and not being open to change and new ways does a disservice to your patients. I'm not sure where your bitterness and resentment is coming from, since you haven't yet given a specific example of where a DE NP caused harm. However, your attitude has only further inspired me to work harder to be an exceptional NP. Not because I have something to prove to those like you, but because that's what my patients deserve.

[BCgradnurse, MSN, RN, NP]

In my DE program once you sit for NCLEX and have your license, it is yours to keep, as long as you do what is necessary to keep it active.