Direct-Entry NP Success Stories

allnurses Guide · Nov 18, 2017

I'm a Direct Entry grad, and have no regrets about going this route. I've never had any issues obtaining jobs as a NP, and never had an employer that was concerned about my lack of RN experience. I'm an FNP, and work in a specialty outpatient practice.

I did a brick and mortar program at Boston College. I learn better face to face than online, and I felt it was valuable to know and spend time with my cohort. We studied together and were a good support for each other. The program was pretty intense and you needed to be be motivated and take initiative to search out information on your own. Still, I never felt it was unmanageable, but school was my entire life while I was in the program.

You will find a lot of naysayers on this forum. It's frustrating, but I see that I have been successful and my cohort have been successful as NPs. I let my patient outcomes and peer/supervisor reviews speak for my abilities and competence-not someone who has never met me or might not even have a good understanding of DE programs. Choose your program wisely. Go to the best program you can afford, and pick one that will help you find preceptors for your clinicals.

Best of luck to you. Feel free to PM me if you have further questions.

Advanced Practice Columnist / Guide · Nov 18, 2017

I've worked with a handful direct entry ACNP's from a number of well known programs (UCSF, Yale, Columbia, Case Western Reserve U). Some of the programs required students to take a break after the BSN portion and seek acute care employment as an RN for at least a year and then return for the NP portion later. The other programs didn't require this so the graduates never worked as an RN in the acute care setting at all. To be honest, I've not heard any complaints about their competence as an NP.

yogagal · Nov 20, 2017

Me. I went to Columbia, my background was similar to yours. I'm a damn good NP, PCP to an extremely challenging patient panel at an FQHC and have been since I graduated. Most of my cohort are all equally successful, at least the ones I'm still in contact with. No one has ever questioned my education. In fact lately I have been interviewing to see what's out there and I was told directly by one interviewer that they have 3 Columbia NPs working for them and that they are fantastic and some of the smartest NPs she's encountered and was assuming I would be the same and that was one of the reasons she wanted to talk to me. Sooo NO do not let the naysayers on here discourage you! I did go straight through BS to MS but I also did work as an RN during the master's portion, but not everyone did so. That experience was helpful of course, but mostly with just becoming familiar with the healthcare industry in general, as I worked in oncology and most of what I did clinically does not inform my practice as an FNP in any really practical way beyond the fact that when my patients do have cancer I'm familiar with a lot of the treatments they are on without looking them up.

Success as an NP in my experience is as individual as anything else. I have seen multiple NPs with 10+ years of RN experience completely unable to transition to a provider role and quit in tears after just a few weeks. I am not aware of this happening with any of the DE grads that I personally know and work with (I'm sure it's happened I just haven't seen it). In general in my personal experience, most DE NPs who make the huge decision to pursue this degree are very smart and motivated and make it work. The one regret I see among some of my cohort is the huge cost and gigantic loans. That's the thing I would think the hardest about. I got lucky with the NHSC but that was 7 years ago and I've heard it's harder to get these days.

Good luck!

yogagal · Nov 20, 2017

Oh and to answer you last question the program was time consuming but I did not find the material any more challenging than my first bachelors, in fact I would venture to say the material was actually a bit easier? There was just a lot of material to learn very quickly. But honestly many of my upper level physiology, physics, and chemistry classes that were required for my first degree were in my opinion far more "difficult" material. Most of my classmates who already had a science degree (bio, physiology, microbio etc) thought the same thing. My friends who did not have science degrees but just took the nursing pre-reqs thought the program was a bit more challenging but still did fine they just had to study a bit more.

myelin · Nov 23, 2017

I guess myself and pretty much my entire direct entry NP class would be considered a 'success' story. We are pretty much all practicing with no issues whatsoever. Just go to a reputable program.

Guest123456788, MSN, RN · Nov 24, 2017

I'm not done with my direct-entry program so I can't speak on how successful my cohort will be in finding jobs, but I just wanted to share that I think it varies significantly from program to program and you need to be wise about picking a program. I currently go to Columbia and as posters above me have shared graduates from my program have not had a hard time finding jobs. That will not be true of every direct entry program, not saying you need to go to an expensive or famous school, just make sure to find a reputable one. I also think it's really important to remember that your program is mostly going to be what you make of it. There are people in my program doing the bare minimum to get by, not seeking out clinical opportunities or getting involved, and those people will likely have a harder time after graduating than those who are networking and seeking out experiences apart from the basics our program offers.

JenTheSchoolRN, BSN, RN · Nov 28, 2017

I was in one, but left with my BSN. But it was because I wanted RN experience and fell in love with school nursing, an area where my NP wasn't as usual, to be honest. I did complete part of the program part-time before deciding this. I also attended a brick-and-mortar program in the Boston area as I am a hands-on, in person learner. The program did have a couple of online theory classes and I hated them because I preferred the classroom, but others loved them.

But several of my friends continued onward and are very successful NPs. Most did work as RNs during the Master's portion and completed the NP part-time (highly encouraged by my program), but not everyone. Finding NP work in the Boston area, however, was stressful for some of my friends. Those that worked as RNs also made some contacts, which helped them also find job connections.

RottylvAPRN · Nov 28, 2017

I also did a brick and mortar direct entry program in Boston, but we were required to work a minimum of a year as an RN. Most of us continued to work and waited a little while to go back to the NP portion of the program. I worked for 3 years on a medicine step down unit while finishing the NP program, and I just accepted a Palliative Care position. Most of the people in my program had NP jobs within a couple of months of graduating.

NurseAtoZ · Feb 6, 2018

Would love to discuss this further with you as I am considering this program (got in but price tag is leaving me a bit overwhelmed and I have some questions). What is the best way to contact you please (new to board)? Basically what final options does this program provide? Is there a good amount of career help nearer to graduation? Thank you!

buttercup9, ASN, BSN, MSN · Feb 27, 2018

I am currently in an AG ACNP program (brick and mortar) and my program requires that anyone in the acute care specialty have experience prior to admittance. The school does have a direct entry program for FNP, PCP, AGPCP and many others but anything hospital based must have experience. I know that many posters have stated that they have done well with their Direct Entry program, but I really don't expect a different response. There might be some really great NP's out there who don't have bedside experience but I would have never chosen that route. I have a B.S. in something else, got an ASN in Nursing and finished the BSN online (that part took forever but life kind of got away from me. I didn't need to take as long as it did!) In the meantime, I worked in multiple hospitals from a tele floor in a community hospital to thoracic surgery and solid organ transplant in a large medical center. I now work in the ED in another large medical center (per diem while I am in school). As an ACUTE CARE NP, these experiences have an incalculable benefit to me. I've gotten to know people, their families and how they live with their illnesses, I have gotten SO much better at teaching and especially recognizing when people are saying "yes" when they really don't understand what is going on and I have seen how illnesses progress and myriad of complications with surgical patients. This kinds of experience can't be taught in school, it is something you learn by doing it and unfortunately it is really difficult to explain.

One of the reasons that I wanted to become an Acute Care NP (I had thought about FNP but had no desire to be office based) is when I had worked with a few who were in the Thoracic surgery department. This was my 1st experience with NP's on a specific service and they were such a huge asset to the team. As they had been bedside RN's they knew why I was asking the questions that I was asking them, they were MUCH more approachable and available than the surgeons were and were FANTASTIC teachers to patients, families and bedside RN's. I do not think they would have been as effective had they not been RN's first.

I know I am biased, but I do have very strong opinions about NP's needing RN experience first and it isn't because that is the route I chose.

To be honest, and it is NOT about how smart you are or how "difficult" you thought the course work was, there is a certain level of trust I have with NP's who have years of experience and I do not have that level of trust with direct entry NP's. Experience matters.

allnurses Guide · Feb 27, 2018

This kinds of experience can't be taught in school, it is something you learn by doing it and unfortunately it is really difficult to explain.
One of the reasons that I wanted to become an Acute Care NP (I had thought about FNP but had no desire to be office based) is when I had worked with a few who were in the Thoracic surgery department. This was my 1st experience with NP's on a specific service and they were such a huge asset to the team. As they had been bedside RN's they knew why I was asking the questions that I was asking them, they were MUCH more approachable and available than the surgeons were and were FANTASTIC teachers to patients, families and bedside RN's. I do not think they would have been as effective had they not been RN's first.

That is a fairly large assumption isn't it? How familiar were you with their prior RN experience? Do you think there are other factors involved other than RN experience? Doesn't nursing and the NP model kind of hang their hat on treating both the disease and the individual, spending more time, being more approachable? Is that soley tied to prior experience as an RN or is it part of the education and practice model?

I know I am biased, but I do have very strong opinions about NP's needing RN experience first and it isn't because that is the route I chose.

This is a very honest comment but it also points out exactly what the problem is: personal bias not a lack of competency or outcomes data or a lack of adequate preparation.

To be honest, and it is NOT about how smart you are or how "difficult" you thought the course work was, there is a certain level of trust I have with NP's who have years of experience and I do not have that level of trust with direct entry NP's. Experience matters.

But understand that "lack of trust" you have is completely based on your own bias. One day when you enter advanced practice, I hope you don't have to deal with nurses with extensive personal bias impacting your work like some DE grads do right now.