How are RNs with Entry-Level MSN degrees received?

MiahMSN, MSN, RN · Jan 20, 2010

OP,
Be forewarned. And I mean take this seriously.
NICU and the nurses in that specialty are VERY, VERY, VERY, VERY protective of these babies...
Since you've not been around them I can honestly say that is one of the TOUGHEST specialties to become proficient in.
Do not take for granted that minimal experience is going to be enough.
YOU will BE VETTED and I mean VETTED by 20 year NICU nurses...and it won't be easy.
It is a specialty where people from FLA know people in CALI.
Don't think that going straight for your NNP without LEVEL 3-4 experience and I mean A LOT of it....it is a specialty that requires hands-on skill...especially with the micro-preems...they bleed so easily..
If you think being vetted on a new med-surg floor is hard, you will be vetted 50 times over in the NICU.
BE FOREWARNED.

Appreciate the forewarning. In no way am I expecting for this to be a walk in central park. I pray for patience, strength, and discernment over my decision to go into nursing every day and i have yet to even start my program - so I know once I get on a floor, the Most High will be just about ready to tell me to shut it up already!!! Like I said before, I have become a research aficinado around nursing over the last year. I do marketing communciations for one of the largest public health care HMOs in the country and I have set down with doctors and nurse administrators within my organization and sucked their brains of any and every question imaginable - I mean these are folk with 30+ years experience and I still feel I have only scratched the surface. Look, I'm not expecting to take this MSN degree, shine my pearly whites, cuddle a few premies, get 1 year of NICU experience and then go on to become NNP of the decade. I'm a 30 year old "realest" and since I am a pisces, I know I dream a lot, but I typically do it with my eyes WIDE open!

And I want to be challenged, hell if I'm not being put the test I may start to question whether or not I'm at the right hospital. Whether you're dealing with a very sick baby, a cancer patient, or a damn hypochondriac, you should be held accountable to the umpteenth degree - you're dealing with a valuable life, how scarry, yet privileged is that??? ()!

This is what I have my heart set on and I'm willing to take a few side looks, snide comments, 21 questions, and bruises (that can easily be covered with Bobbi Brown's pressed poweder, of course;)) in order to prove myself to future colleagues/mentors, patients and patients' families. I got this! ()

But I do thank you for your honesty - I love a person who can give it to me straight with no chaser, yet in a not so condescending way. :up: (I've lurked this site for a while and the way some judge others and cyber bully, it's sooooo tacky........and well, some of you need to get laid!............I hope I don't get exiled for that one, although it's not like I'd give a fudge!!LOL)

Thanks again all for your honesty and words of reality and support. Again, much respect and luv!

Mya

netglow, ASN, RN · Jan 20, 2010

"But I do thank you for your honesty - I love a person who can give it to me straight with no chaser, yet in a not so condescending way. (I've lurked this site for a while and the way some judge others and cyber bully, it's sooooo tacky........and well, some of you need to get laid!............I hope I don't get exiled for that one, although it's not like I'd give a fudge!!LOL)" -Mya2bRN

:fnypst:

Yeah, most of them know this. LOL. Which leads me to give some more advice... You will have the misfortune to get to know some of the most developmentally delayed folks in the universe on your quest to RN, etc. This in your classmates, your instructors, some staff. It is hilariously funny at first, and it will take everything you've got to squelch the laughter, as these people usually don't know what they've said/done that is so funny?!?!?! The insane rarely do ya know. When you get into your psych rotation, you will be furiously applying the DSM-IV to them for DX, as well as a medication plan that starts with a standing prn Haldol order for all times they are within 50 feet of you. :bugeyes:

allnurses Guide · Jan 20, 2010

Hi Mya,

I'm a 2009 grad of a direct entry program. This was a mid life career change for me, after having working 20+ years in another area of healthcare. I work as an FNP in an outpatient clinic. I honestly feel I was well prepared to work as an FNP, despite my lack of RN experience. To be completely honest, I didn't love bedside nursing when I did my clinicals. I always intended to work as an FNP, and went directly to an FNP job after graduation. I did try to get a part time RN job once I passed NCLEX, but there were none to be had in my area, so I stayed in my program full time. Like any entity, there are good DE programs and not so good ones. However, I think it is really up to the student to make the most of the educational experience. I did lots of extra studying on my own and did way above the required clinical hours, because I thought it would make me a better NP. Quite frankly, I use very few of the RN skills I learned in school, because they're not really applicable to my job setting. I think there are some NP jobs that really need some RN experience 1st, such as critical care for both adults and children. I think an NNP falls into that category.

I have personally been well received at my place of employment. Interestingly, the biggest critics and naysayers have been other nurses. I don't know if it's jealousy, or lack of understanding, or what. And yes, some of them have been on this site. Whatever...I let my job performance speak for itself.

Like others have said, if your goal is to be a NNP, don't waste your time and money getting a CNL first. What is gained by that? You can still go to a direct entry program, get your RN, work as an RN in the NICU or nursery while you finish the NP part of your program, and go from there. Whatever you decide, I wish you success. I'm happy with my new career and I hope you will be, too.

PostOpPrincess, BSN, RN · Jan 20, 2010

Hi Mya,
I'm a 2009 grad of a direct entry program. This was a mid life career change for me, after having working 20+ years in another area of healthcare. I work as an FNP in an outpatient clinic. I honestly feel I was well prepared to work as an FNP, despite my lack of RN experience. To be completely honest, I didn't love bedside nursing when I did my clinicals. I always intended to work as an FNP, and went directly to an FNP job after graduation. I did try to get a part time RN job once I passed NCLEX, but there were none to be had in my area, so I stayed in my program full time. Like any entity, there are good DE programs and not so good ones. However, I think it is really up to the student to make the most of the educational experience. I did lots of extra studying on my own and did way above the required clinical hours, because I thought it would make me a better NP. Quite frankly, I use very few of the RN skills I learned in school, because they're not really applicable to my job setting. I think there are some NP jobs that really need some RN experience 1st, such as critical care for both adults and children. I think an NNP falls into that category.
I have personally been well received at my place of employment. Interestingly, the biggest critics and naysayers have been other nurses. I don't know if it's jealousy, or lack of understanding, or what. And yes, some of them have been on this site. Whatever...I let my job performance speak for itself.
Like others have said, if your goal is to be a NNP, don't waste your time and money getting a CNL first. What is gained by that? You can still go to a direct entry program, get your RN, work as an RN in the NICU or nursery while you finish the NP part of your program, and go from there. Whatever you decide, I wish you success. I'm happy with my new career and I hope you will be, too.

Jealousy? Have you asked?

You should ask these other nurses.

Notice you are in outpatient settings, and doubt you will be able to get into acute areas should you choose to without the experience.

What I am getting from you--in all honesty--is that is the only place where you will probably be allowed to work.

That is not meant to be disrespectful, just realistic.

PostOpPrincess, BSN, RN · Jan 20, 2010

Appreciate the forewarning. In no way am I expecting for this to be a walk in central park. I pray for patience, strength, and discernment over my decision to go into nursing every day and i have yet to even start my program - so I know once I get on a floor, the Most High will be just about ready to tell me to shut it up already!!! Like I said before, I have become a research aficinado around nursing over the last year. I do marketing communciations for one of the largest public health care HMOs in the country and I have set down with doctors and nurse administrators within my organization and sucked their brains of any and every question imaginable - I mean these are folk with 30+ years experience and I still feel I have only scratched the surface. Look, I'm not expecting to take this MSN degree, shine my pearly whites, cuddle a few premies, get 1 year of NICU experience and then go on to become NNP of the decade. I'm a 30 year old "realest" and since I am a pisces, I know I dream a lot, but I typically do it with my eyes WIDE open!
And I want to be challenged, hell if I'm not being put the test I may start to question whether or not I'm at the right hospital. Whether you're dealing with a very sick baby, a cancer patient, or a damn hypochondriac, you should be held accountable to the umpteenth degree - you're dealing with a valuable life, how scarry, yet privileged is that??? ()!
This is what I have my heart set on and I'm willing to take a few side looks, snide comments, 21 questions, and bruises (that can easily be covered with Bobbi Brown's pressed poweder, of course;)) in order to prove myself to future colleagues/mentors, patients and patients' families. I got this! ()
But I do thank you for your honesty - I love a person who can give it to me straight with no chaser, yet in a not so condescending way. (I've lurked this site for a while and the way some judge others and cyber bully, it's sooooo tacky........and well, some of you need to get laid!............I hope I don't get exiled for that one, although it's not like I'd give a fudge!!LOL)
Thanks again all for your honesty and words of reality and support. Again, much respect and luv!
Mya

You sound like a very common sense individual. Good for you...now go get your degree, your Level 3-4 NICU, and get on the road to NNP.

NICU is one of my favorite specialties, and it is a very, very demanding yet fulfilling one.

MiahMSN, MSN, RN · Jan 21, 2010

Jealousy? Have you asked?
You should ask these other nurses.
Notice you are in outpatient settings, and doubt you will be able to get into acute areas should you choose to without the experience.
What I am getting from you--in all honesty--is that is the only place where you will probably be allowed to work.
That is not meant to be disrespectful, just realistic.

Awww JoJo, come on (you don't mind if I call you that, do you??:rolleyes:) I dont' think that is what she meant. I'm sure she is speaking from experience, just like many others have spoke badly about direct-entry RNs based on their experience. It's all subjective at the end of the day. I'm sure she has come across some jealous nurses or those that automatically prejudged her based on her own individual route she took to enter into this profession (I think someone stated on here the other day that they find those that choose to enter nursing through one of these programs a bit pretentous :rolleyes: ........oh gosh, someone give me a bucket!!), so yeah, it is possible that that has been her experience. Yet, that is not to say that some of you haven't run into some horrible direct-entry MSNs.........and some horrible BSNs........and some horrible ADNs (you see where I'm going with this?).

allnurses Guide · Jan 21, 2010

Jealousy? Have you asked?
You should ask these other nurses.
Notice you are in outpatient settings, and doubt you will be able to get into acute areas should you choose to without the experience.
What I am getting from you--in all honesty--is that is the only place where you will probably be allowed to work.
That is not meant to be disrespectful, just realistic.

My case in point..... I have asked other nurses, and most can't come up with a tangible reason why they don't like direct entry grads. One or two have admitted they are jealous and wish they had gone for an advanced degree. I think it's just a new concept and that makes some people uncomfortable. And when some people are uncomfortable, they express it by being petty and mean. Everyone is entitled to their opinion-all I ask is that you back it up with facts, and not just feelings.

Well Jo, I don't choose to work in acute settings, so I didn't pursue a degree that would prepare me for that. As far as only being "allowed" to work in outpatient settings, I beg to differ. Many of my direct entry classmates have jobs that are hospital based doing in-patient care, and they are doing very well.

Mya, you are a breath of fresh air here. I'll gladly hold the bucket for you!! :lol2:

kanzi monkey · Jan 21, 2010

JoPACURN, I've told myself I'd stay out of these conversations from now on, but your strong opinions about DE programs are just so misguided, I have to interject.

Notice you are in outpatient settings, and doubt you will be able to get into acute areas should you choose to without the experience.
What I am getting from you--in all honesty--is that is the only place where you will probably be allowed to work.
That is not meant to be disrespectful, just realistic.

This is inherently disrespectful. You have this notion that acute/critical care is the pinnacle of all nursing, and throw down comments such as this as if you assume that anyone would agree with you. You may have logged many hours of acute care experience, but you seem to lack the basic understanding that there are other specialties in nursing that are equally as important even if they require an entirely different knowledge base and skill set. BCGrad is entitled to work as a FNP based on her educational background and experience. She is "allowed" to work based on her, well, citizenry. From what she says, she is not looking to replace you, or to be your supervisor. And neither are many nurses, including myself. And I'm guessing that BCGrad's patients aren't looking for a critical care nurse to take care of their primary care needs. Unless you have the educational background and clinical experience to work in primary care, you are about as qualified to do her job as she is to do yours.

To the OP, if you want to work in critical care, just like everyone else is saying, experience as an RN is pretty crucial. But to other folk that are interested in pursing DE nursing who may have other interests (ie, public health, primary care, women's health, etc), there are very good programs that will help you get to where you want to be.

jjjoy, LPN · Jan 21, 2010

Warning: Tangential rambling ahead...

I think it might cause less resentment if NP was considered as a nursing specialization or a different branch of nursing, not an advanced version of nursing. There are some nursing interventions that are only used in very specific specialties. Diagnosing and ordering treatments are unique to mid-level nursing.

Acute care bedside nursing is it's own specialty in nursing, isn't it? Certainly not all nurses can be successful there and they needn't be. So perhaps one needn't have mastered acute care bedside nursing to learn and practice the specialty skills of an NP. An oncology nurse, an office nurse, a mental health nurse needn't go back to school to train in and practice their specialty. They get on-the-job training, and start working sooner. NP requires an additional degree and certification to practice in that specialty role, such as oncology NP or FNP or PMHNP. But is that justification to call it "advanced"?

Moogie · Jan 21, 2010

My case in point..... I have asked other nurses, and most can't come up with a tangible reason why they don't like direct entry grads. One or two have admitted they are jealous and wish they had gone for an advanced degree. I think it's just a new concept and that makes some people uncomfortable. And when some people are uncomfortable, they express it by being petty and mean. Everyone is entitled to their opinion-all I ask is that you back it up with facts, and not just feelings.

You know, when I was an AD grad, oh, some thirty years ago, I worked with a number of diploma graduates who didn't trust ADNs. Not enough clinical, they'd say. Not as good as the program WE went through. (Never mind that the ADN program I attended was based on the diploma programs of the two major hospital schools of nursing from which the vast majority of those nurses had graduated...)

Then when I got into an RN to BSN program, I paid a little more attention to what my peers were saying about BSNs. The ADN grads who hadn't gone back to school chimed in with the diploma grads----oh, those BSN grads just got no clinical time at all and only knew theory and couldn't perform technical skills....

And when I went back to work in a clinical setting after doing some graduate-level courses, I got crap from ADN and LPN co-workers who couldn't understand why a nurse who was so "overeducated" would want to work bedside. (Now that I'm a full-time student, my former co-workers are probably saying....oh, never mind.)

If I'm at all envious it's over the sheer number of options that are available today. Not only are there more options available for the entry level nurse, there are also many more options for nurses who want to further their education. Frankly, for the right person I think an entry-level MSN makes sense. I think someone who does this has to be an exceptional candidate, very motivated and pretty mature. For others, an accelerated BSN might be better---maybe in terms of time, geographical location, cost and one's career and professional goals. (In all honesty, though, the only entry level option that I would not recommend for the aspiring RN is the ADN if one already has a bachelor's or higher degree in another field----because you go through all the work to get the ADN, same amount of time more or less as the ELMSN or accelerated BSN---and you end up with an associate's degree and have to go back for yet MORE education if you want to progress past bedside nursing.)

The thing is, sure, while I wish I would have had more options available to me when I decided to go into nursing, no one can take away my education or, more importantly, the years of experience I had working, some of it while going back to school, some of it while being a full-time student. Why should I feel threatened by ANY new graduate of ANY program? No one can take away my professional accomplishments or achievements. So I've furthered my education in increments: ADN then BSN, now MSN and eventually PhD. I've learned a lot about nursing and LIFE along the way. How can anyone's choices or experiences, albeit different from mine, make mine any less valid? And why should my choices, experiences and life circumstances invalidate anyone else's?

An entry-level MSN would NEVER have been an option for me unless I did something else before I got into nursing. In retrospect, sure I sometimes wish I'd done a generic BSN program rather than an ADN program right out of high school. But---would I have gotten as much out of my BSN had I done it that way? Maybe, maybe not. Why waste time dwelling on that, though? What I did worked for me. Others need to do what works for them.

Aside from envy over missed or non-existant opportunities, one reason I can see for nurses not trusting graduates of "other" entry levels is that sometimes the nurses who are wary have been burned. There are some nurses, regardless of educational preparation or practical experience, who are snarky and arrogant and think they "know it all". I've met CNAs and LPNs and new graduates from many different educational backgrounds with bad attitudes as well as experienced, highly educated nurses who think they walk on water. While a "better than you" attitude is nasty no matter who's giving off those vibes, it does seem to be slightly better tolerated from those with experience and education----credibility---to back up their knowledge than from novices. The worst thing any newbie---no matter what his/her educational level may be---can do is to ignore pearls of wisdom given by his/her more experienced peers. (Sorry, I've seen it happen a few times here on AN-- someone asks for advice then gets "mad" at the experienced nurses who voice an opinion and says they're going to do what they want, no matter what anyone says---whatever!) And the worst thing an experienced nurse can do is to prejudge every new nurse as being arrogant simply because he/she is a novice and may have had a very different level of educational preparation. What this leads to is the tired old syndrome of "nurses eating their young", which just stifles any real communication and sharing of knowledge and wisdom and shackles our profession to a rut in which we just keep ******** about each other and never do anything concrete in terms of advancing our profession.

On a side note here, I will admit that one frustration I have with entry-level MSN programs (and that's PROGRAMS, not the GRADUATES of those programs) is that I wonder why the powers-that-be in nursing have complicated the whole entry to practice issue by adding yet one more educational level. I mean, it was 1964 when the ANA endorsed the BSN as the most appropriate educational level for entry to practice. 1964. Think about it. How many of us were in diapers or playing with Barbies in 1964? How many weren't even born yet? If I were the queen in charge of everything nursing, i would have wanted to get that minimal entry to practice level issue settled for once and for all BEFORE adding a direct-entry master's level to the mix. Now, someone who wants to become an RN can do an entry level ADN, a diploma (still available in some places), an entry level BSN or an accelerated BSN or entry level MSN if he/she already has a college degree. One would think that if nursing has been futzing around for FORTY FIVE YEARS with making the BSN THE educational entry level for RNs, it should have happened by now---and please don't further muddle the issue by creating another entry to practice level when we still don't agree on the minimal educational standards for someone to become an RN.

Maybe if we only had one---or two---entry to practice levels for professional nursing there would be less sniping about who went to which program and who's the best at doing what. And maybe we could learn to trust each other and share knowledge without getting angry or defensive or wanting to keep what we know to ourselves.

:spbox:

Moogie · Jan 21, 2010

...there are other specialties in nursing that are equally as important even if they require an entirely different knowledge base and skill set. BCGrad is entitled to work as a FNP based on her educational background and experience. She is "allowed" to work based on her, well, citizenry. From what she says, she is not looking to replace you, or to be your supervisor. And neither are many nurses, including myself. And I'm guessing that BCGrad's patients aren't looking for a critical care nurse to take care of their primary care needs. Unless you have the educational background and clinical experience to work in primary care, you are about as qualified to do her job as she is to do yours.
To the OP, if you want to work in critical care, just like everyone else is saying, experience as an RN is pretty crucial. But to other folk that are interested in pursing DE nursing who may have other interests (ie, public health, primary care, women's health, etc), there are very good programs that will help you get to where you want to be.

Kanzi Monkey, I would like to add to your (very good) post that I do believe it's important for someone planning to teach nursing or do research also have some experience in direct patient care. It's important for nurse educators to have a foundation in direct care because they're teaching aspiring nurses to think and to do. Contrary to the adage "those who can't do, teach", it's fundamental for nurse educators to be able not only to teach (and some cannot teach) and to be able to do in order to teach the physical skills required for nursing as well as the theoretical foundations that underlie why these skills are performed as they are. I also think it's important for nurse researchers to have bedside experience so that their research can be made relevant to nursing practice. I don't doubt for a moment that someone can go from a BSN to a PhD and become an accomplished nurse researcher. However, the point of doing research is NOT simply to do research for it's own sake---it is to add to a knowledge base and impact upon nursing PRACTICE. How can anyone who is unfamiliar with nursing PRACTICE expect to contribute anything meaningful and relevant to nursing practice?

BTW, I would certainly trust an NP who was a graduate of a ELMSN program with my own health, regardless of whether or not he/she has practiced as a bedside nurse. I would also find it fascinating to teach in such a program, but core courses only, not anything specific to NP practice as that is not my area of expertise and probably will never be as I don't have a burning desire to become an NP.

kanzi monkey · Jan 22, 2010

Kanzi Monkey, I would like to add to your (very good) post that I do believe it's important for someone planning to teach nursing or do research also have some experience in direct patient care. It's important for nurse educators to have a foundation in direct care because they're teaching aspiring nurses to think and to do. Contrary to the adage "those who can't do, teach", it's fundamental for nurse educators to be able not only to teach (and some cannot teach) and to be able to do in order to teach the physical skills required for nursing as well as the theoretical foundations that underlie why these skills are performed as they are. I also think it's important for nurse researchers to have bedside experience so that their research can be made relevant to nursing practice. I don't doubt for a moment that someone can go from a BSN to a PhD and become an accomplished nurse researcher. However, the point of doing research is NOT simply to do research for it's own sake---it is to add to a knowledge base and impact upon nursing PRACTICE. How can anyone who is unfamiliar with nursing PRACTICE expect to contribute anything meaningful and relevant to nursing practice?

100% agree with you. I think we have all met a researcher or an educator who wasn't worth their salt as a clinician. One must practice to teach. Absolutely fundamental.