Master Level General Nurse - What are your thoughts?

romie · May 6, 2006

The Clinical Nurse Leader is a holder of a "generic masters" in nursing who brings additional leadership beyond the bachelor's level. It recognizes the additional breadth and wealth of experience that the individual brings because of their education and training in an outside field. Sometimes people can become too closed minded to solutions to problems if their education and training is too concentrated in one area. The clinical nurse leader also recognizes his or her limitations in practice compared to the Nurse Practitioner or the Clinical Nurse Specialist, but as long as you have a masters degree in nursing you should be able to pursue a post-master's certificate in a specialty and sit for the national exams for your new chosen specialty.

llg, PhD, RN · May 6, 2006

I think the question to be asking at this point is, "What types of jobs are the recent graduates getting?" "Are the hospitals in your area hiring the graduates for roles beyond that of an entry level staff nurse?"

Not living in California, I don't know the answer to those questions -- and since the school is trying to "sell" the degree, you can't really count on them for a good answer either. Try to find some people in your area who know the real-life job market.

I'd also explore the options/requirements for adding an MSN in a specialty area in case you find you need one for the career path that interests you most after a few years.

Good luck,

llg

GEMINI06 · May 6, 2006

I just graduated yesterday from a graduate entry-level masters in nursing program....:mortarboard: Many of us had careers (I was a teacher) and even Masters in other fields. It is amazing how much of our previous expereinces relate to nursing. Almost everyone in our program has been offered a clinical position. Many of the positions are direclty into critical care placements which does raise a few eyebrows of fellow co-workers :smiley_ab , but once they work with us, they find out that we not only get the same 2 years of hands-on that ALL ADN, and BSN nurses get, we also get all of the theory, advanced practice courses, and did a thesis, along with a 270 hour preceptorship our last semester. Several of our graduates are going directly into certificate programs for advanced practice. I think this is a woderful way to reach new groups of people that bring a variety of knowledge and experience from diverse backgrounds. Most of us know that it is unrealistic to assume that we could graduate-to-hire into a position as a unit director or something like that. You have to work in a unit before you can possibly know how to manage it! How can one expect to manage nurses if one doesn't know what they do on a daily basis??!! But it is not unachieveable! I do believe this is where nursing is headed.

By the way, I heard that the state of New York either did, or is going to, announce that ADN nurses have a certain amount of time to earn their BSN and then the state is not renewing RN licensure for AND nurses. The push is to raise the level of education, which is documented in literature to raise job satisfaction, and most importanly positive client outcomes, which will only further Nursing as a profession instead of a vocation.

RN34TX · May 6, 2006

I struggle with 2 schools of thought here.

One is that I dislike nurses who are resisitant to anything beyond "traditional" routes to becoming an RN. Those RN's that think that you need a traditional BSN and "getting your feet wet experience" before getting an MSN. That's too closed minded for me.

In this day and age, we are needing to come up with more innovative ways to educate and move up rather than shooting down anything other than B&M school education followed by years paying your dues on med/surg floors before the MSN degree.

My local U has a BSN program for those with bachelors in other areas and trains them to become RN's in one year. This year is intense and solid and the students cannot work while in the program, just like how CRNA programs are set up.

I think it's a good thing.

On the other hand, I'm just not seeing how in two years, a graduate with a liberal arts degree, could be taught not only the basic fundamentals of nursing, but also graduate level nursing education to truely be a nurse at a masters level.

And if this is truely the case, then why does it still take me the same two years (or same amount of credits) to get an MSN when I already have the fundamentals down as an RN?

How can you learn to be an RN at the ground level and MSN education at the same time?

I'm sorry, but bachelors degree programs are not all equal. Many liberal arts people take the absolute minimal science that they can get by with to graduate. Most liberal arts graduates do not have 4-8 semester credits of biology, 8 credits of A&P, 4 of micro, and 4 of chem. And those are often the minimum in ADN and BSN programs.

I'm asking because I have a friend who very arrogantly touts his liberal arts bachelors degree. He brags about being a corpsman in the military and has only worked as a CNA in civilian healthcare,yet is somehow under the impression that if he were to get hired at my hospital, that he'd be my superior/boss/manager since I'm still a lowly ADN RN.

His military corpsman training was less than half of my LPN program.

He's hardly prepared to be my boss and I'm just not seeing how a generic MSN program would remedy this.

llg, PhD, RN · May 6, 2006

The development of TRUE expertise requires both "book learning" and "practical experience" with the subject matter. The best occurs when you go back and forth beteen the two -- so that you can use what you are learing in one dimension to enrich your learning in the other, combining the two as you go.

I can see that there can be different pathways to get both. So I have no problems with the entry-level Master's programs. However, the graduates of such programs need to have realistic expectations when they graduate. They need to understand that they may not immediately step into leadership positions. In many cases (most?) they will need to get that practical experience in an entry level position first.

Similarly, people with minimal academic preparation should be willing to go back to school to strengthen their academic side before expecting to advance into leadership positions.

It works both ways. ..... equally

Also, there is the whole issue of working in a specialty area (such as peds, OB, psych, etc.) versus working in adult med/surg. A lot of schools spend little time on these specialties and adult med/surg experience is only partially applicable to these areas of practice. Anyone hoping for a career in such a specialty will need to get both experience and book learning in the specialty before being a serious contender for a leadership position in that specialty.

llg

JaneyW · May 6, 2006

I am still not on either side with this issue. These programs are nationwide (not just here in CA) and are new enough that we don't really know what will happen. I do know the director of the Cal State Fullerton program personally--she was one of my instructors in my ADN program a few years ago--and I have faith that she is setting up a good program there.

I have one issue with the poster regarding the stats about more education showing higher job satisfaction and the situation in NY. I agree that more education can bring about higher job satisfaction (I also think it can give you more satisfaction in daily life!), but if those highly competent ADN nurses are out of a job who does that benefit?? Absolutely NO ONE.

Some background on me: I have BA in psych and an ADN. I am currently pursuing an MSN with an education concentration after being a practicing OB RN for 3 1/2 years. It was difficult to find a program that would not require a BSN first. I am going to Cal State Dominguez Hills and they are requiring me to take several of the BSN courses along with the MSN courses. I think this is appropriate because how can I take, for example, adv pathophys without taking regular pathophys?

I am only one semester in, but I can already say that the process has made me a more professional nurse. I am loving the larger perspective I am gaining and the extra knowledge has been instantly applicable to my current job. So, you might say that I am very pro education and professionalism in nursing. I am getting the MSN to teach at the ADN level and look forward to instilling that attitude in my students.

BUT, I think that my experience on the floor as a staff RN has been invaluable. My old non-nursing degree adds a lot to my view/practice, but it does not equal or even come close to being equivalent to real-life nursing experience. I am talking about being the responsible one in charge of patient care--not student clinical experience. Really having your license on the line daily as you provide care gives you a different perspective that cannot be replaced by classes or clinical education. Being the one in the room with the concrete knowledge when all h## breaks loose cannot be replicated by education or simulation. We all know which nurses and nurse managers/educators we want by our side in those situations and their education level has nothing to do with that decision. There are countless ADN nurses that I would trust with my life and many MSN nurses that I wouldn't want in charge of my care. OTOH, I have been around many ADN nurses that would really benefit from the extra knowledge and wider view that comes with more education.

I am rambling. I'm sorry. This is not an easy issue with an easy answer. The way I am pursuing my career goals has worked well for me in my situation and personality. People are different. I am not a perfect nurse and am still learning every time I show up for work. I feel I need the extra couple of years of floor experience I will be getting before I finish my MSN and begin teaching. I hope to inspire my future ADN students to continue their education, but it isn't for everyone or every specialty.

This debate will not be resolved.

GEMINI06 · May 6, 2006

I should be a little more clear:

My degree was a BA in English with a minor in women and minorities studies.

Although I definately skimmped on the sciences doing this degree, there were still science reqs that had to be met to graduate. Also, our program requires chem, A&P I and II, Micro to even be considered, which I did at our community college. The program is full time M-F, and often has evening and weekend clinicals. It is 5 straight semesters. And it was very tough, but worth it! We often talked about how our degree would be perceived by those who have already achieved RN status, and how we owuld fit into the world of nursing. I have confidence that as more of these programs emerge, and people work with us, they will realise what a wonderful change and opportunity this is!

LilPeanut, MSN, RN, NP · May 6, 2006

I am midway through a direct-entry program in Ohio.

First, direct entry programs have been around for 30 years - I know my Uni has had one for that long, I'm sure other schools have had programs for just as long.

Secondly, to get into the program, you have to have anatomy, physiology, microbiology and pharmacology. Those are pre-reqs. If you took them with your other degree at a high enough level, fine. If not, then you finish them before you start.

Typically, 10 hours/quarter is consideredered fulltime for grad students. Grad-entry students take 18-20. We take the same pathophys that traditional masters students take. We are just expected to be able to handle it. We sit for the NCLEX after 6 quarters of study, then you have anywhere from 1.5-4 years to finish your masters. (the long end is the neonatals, who have to work as an RN for at least 2 years)

Undergrads have classes, whole quarters devoted to careplans. We have 1 session. After which, we are expected to be able to write out appropriate care plans and identify correct nursing dx's.

It's exceptionally accelerated and the people accepted into the program are extremely motivated. If we don't know it, we'll study it to get it, even when it's not required. We're all on the obsessive-compulsive side *LOL*

PANurseRN1 · May 6, 2006

NY is not going to revoke the licenses of diploma/ADN nurses if they don't get a BSN by a certain date. Please...that rumor has been bandied about and debunked many times here.

GEMINI06 · May 7, 2006

I have one issue with the poster regarding the stats about more education showing higher job satisfaction and the situation in NY. I agree that more education can bring about higher job satisfaction (I also think it can give you more satisfaction in daily life!), but if those highly competent ADN nurses are out of a job who does that benefit?? Absolutely NO ONE.

I am sorry if you took this the wrong way- I was just throwing it out there to show that some areas are more aggressive than others when it comes to degrees and licensure. I wasn't trying to say that I support that thinking or not. My husband is an AD RN, so if that happened in Ohio, we would definately be not happy!! LOL! I actually had the opportunity to work in his unit for my adult critical care experience. I saw a side of him that I didn't know even existed- he is so tender and compassionate with his clients. He is also very patient and kind with students and loves to include them in any learning opportunity he can dig up. I don't view myself any better than him because of my degree. If anything, I look up to him, and he inspires me because I have seen what a wonderful RN he is. My personal goal is to practice nursing with the passion and compassion that he does. I just happened to have a BA and qualified for a entry level program, so I figured why spend the money starting from scratch when I can build on what I already have invested in? I also might add, that during my hubby's 2 years of RN school, many of the classes he was req'd to take were classes such as philosophy, sociology, psych, etc. that I had already done in my BA program, so eliminating the cross over is where we get the time to focus on the higher level nursing classes.

If anyone is interested, check out the GEMINI program at www.meduohio.edu that is where I graduated from, and you can check my course of study and program requirements, and compare to other programs.

Peace!!