Seeking Advice: Direct Entry Blues

Specialties NP

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I am a graduate of direct entry accelerated BSN/MSN program for non nurses.

I came into the role of APN, specifically NP as a very green graduate. I did very well in my program, but am finding clinical practice as an APN to be quite challenging. Academic knowledge and clinical expertise are very different. I've been in my present position about a year and have been directed to seek a position elsewhere but permitted to continue working while I search. It was also mentioned I try to seek a specialty area instead of primary care so I can focus my knowledge development.

I'm looking at specialties but wondering about my best options on where to go from here. I am not against applying to bedside RN positions. I've worked so hard but have wondered about leaving nursing altogether for something else.

Any guidance appreciated

It's roughly (~) eight months depending on which field. I am considering FNP, and the program is through Emory. I've applied but will not hear back until the 15th at the earliest.

Also, anyone's thoughts on it costing about $170k?

Specializes in Family Nurse Practitioner.

Also, anyone's thoughts on it costing about $170k?

My thoughts would be there clearly must by a typo in that figure. I'm wondering if predatory university practices might be the next controversy to hit our country's radar.

It's roughly (~) eight months depending on which field. I am considering FNP, and the program is through Emory. I've applied but will not hear back until the 15th at the earliest.

Also, anyone's thoughts on it costing about $170k?

Not sure where the 8 months came from because Emory's website says that it is a 15 month accelerated BSN followed by a year or two for MSN, which sounds much more reasonable.

My thoughts would be there clearly must by a typo in that figure. I'm wondering if predatory university practices might be the next controversy to hit our country's radar.

This is a whole different problem in itself unfortunately. My MSN-DNP program is roughly $250k for 4 years, which is a fortune. But if I had chosen to go to an accelerated BSN I would have had to pay it out of pocket or take private loans with a huge interest rate because the government only gives student loans for undergraduate degrees once, but they will give out graduate loans alllll day. It's awful

Not sure where the 8 months came from because Emory's website says that it is a 15 month accelerated BSN followed by a year or two for MSN, which sounds much more reasonable.

Yes, sorry. Eight SEMESTERS!! My bad. Thanks.

ABSN = Summer, Fall, Spring, Summer

MSN = Fall, Spring, Summer, Fall then done unless you add to the specialty

Specializes in Occ. Hlth, Education, ICU, Med-Surg.
This is a whole different problem in itself unfortunately. My MSN-DNP program is roughly $250k for 4 years, which is a fortune. But if I had chosen to go to an accelerated BSN I would have had to pay it out of pocket or take private loans with a huge interest rate because the government only gives student loans for undergraduate degrees once, but they will give out graduate loans alllll day. It's awful

That's an obscene amount of money!

How do you plan on being able to repay that amount and still afford rent/mortgage, gas, utilities, food, insurance, etc?

Specializes in Family Nurse Practitioner.
This is a whole different problem in itself unfortunately. My MSN-DNP program is roughly $250k for 4 years, which is a fortune. But if I had chosen to go to an accelerated BSN I would have had to pay it out of pocket or take private loans with a huge interest rate because the government only gives student loans for undergraduate degrees once, but they will give out graduate loans alllll day. It's awful

Or save up for school then work while getting your degrees? As someone who worked the entire time from my LPN to MS and post masters I seriously can't fathom justifying that amount of money for a nursing degree especially with the anticipated numbers who will be graduating and competing for jobs in upcoming years.

Hello MK,

I received your message, but when I tried to write back, I could not. I am new on this forum, and I think I have not been active enough.

I am so glad to hear that you are looking into new things and feeling optimistic. I am in the Chicago area. All hospitals here are seeking both MD and NP in DB Peds. Wait list for appointments are close to one year. There is a serious shortage of providers for this population. The director of the LEND program here is a very talented Developmental Behavioral Pediatrician, and a lovely person. She would welcome an inquiry, and I would encourage you to contact her with questions. I do not think that I can include any personal information or an email address through this forum, but you can find her at the UIC LEND program. I wish you the very best of luck, and hope you will keep me posted about your journey!

I find it poor logic to conclude that the OP's situation is the common outcome of most direct entry MSN graduates. I think whatever experience preceded the direct entry admission is what really counts in terms of how one performs later on. Also, which program the person graduated from could have made all the difference. And sometimes, in fact a lot of times, people graduate from programs (nursing or other) and go into careers they have trained for and find they will just not thrive in that position because that's life--sometimes things just don't pan out.

I understand RNs find it frustrating the direct entry exists, but NP work is very different from being a bedside RN and the OP mentioned she is in peds; maybe she is just not a great practitioner for children. Peds is a whole different world from adult care--not to mention you deal with parents and guardians more directly which can be a massive challenge.

Also, if you're all so worried about these programs and their existence, then maybe some more of you BSNs should step up to bat and get your master's, because these programs exist mostly because not enough of you will advance your nursing degrees or your scopes of practice.

The OP asked a question looking for advice not for an open forum to bash direct entry programs.

Specializes in SICU,CTICU,PACU.

I'm not sure if going to work as a bedside RN at this juncture is your best bet. I'm not an NP so hard for me to direct you, a specialty may be hard too since you have no prior experience in that specialty. in the area i live in they offer residencies or fellowships for NPs usually as hospitalists but that may be something to look into.

i also believe direct entry is a bad idea. i see NPs that were RNs in med/surg come into critical care and struggle, nevermind the ones without any RN experience. i don't think direct entry programs exist because not enough BSN RNs want to become NPs so much as healthcare is changing and there are more roles as NPs opening up, people are getting sicker and living longer and there is a shortage of MDs (some so busy they cannot see that volume and some who do not want to practice in primary care without proper compensation). just my 2 cents on this old debate.

Oops meant to reply to above post (error)

The NPs in my specialty area (pediatric urology) are very specialized (and trained on the job) and you could probably do what they do with no problem. In urology, the adult NPs see tons of different things of pts and the peds NPs see only a few kind of pts. With no nursing experience, pulmonology and cardiology specialties would be difficult but urology, nephrology, GI, and endocrine would prob be fine. Cardiology and pulm just seem scarier to me.

More nursing experience may have helped but many skills are different so I don't think you need to become a great nurse to be a great NP.

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