The Entry-Level MSN

SharonH, RN · Aug 18, 2006

Is it worth the effort and cost? Please tell me the reality of things.
Are hospitals really hiring new grad E-MSNs as Clinical Nurse Specialists and Clinical Nurse Leaders? If so, do they generally get respect when put in these positions as compared to those who got there the traditional way. (ie, nursing degree, then nursing experience, then grad school for advanced nursing practice).
Or are they getting hired to do bedside nursing?
I'd mostly like to know what experienced nurses, management, hiring officials, etc have to say...

I don't know about CNLs but CNSs by definition are clinical experts in their specialties so by definition you cannot be a CNS and an entry level nurse.

br107 · Aug 18, 2006

yeah this entry msn stuff is a little confusing. the programs i looked at graduate CNS, Clinical Nurse Leaders (charge nurse?), Advanced Practitioners, and even NPs. just wondering if they really get hired as such...

been considering this route. but not if its a route to bedside nursing. there's more cost-effective ways of doing so...

Trauma Columnist · Aug 18, 2006

You will find many threads on this subject, just do a search.

Gennaver, MSN · Aug 18, 2006

Is it worth the effort and cost? Please tell me the reality of things.
Are hospitals really hiring new grad E-MSNs as Clinical Nurse Specialists and Clinical Nurse Leaders? If so, do they generally get respect when put in these positions as compared to those who got there the traditional way. (ie, nursing degree, then nursing experience, then grad school for advanced nursing practice).
Or are they getting hired to do bedside nursing?
I'd mostly like to know what experienced nurses, management, hiring officials, etc have to say...

Hello,

There are several very long threads from us direct entry MSN students in the student nurse forums, including the graduate student nurse forums, (msn, phd and np).

Nice to read you.

Gen

llg, PhD, RN · Aug 18, 2006

The MSN entry folks that I have known have taken jobs as bedside staff nurses right out of school -- but moved quickly into leadership positions once they had 1 to 2 years of experience.

As a long time nurse (with a PhD) who has spent most of my career in CNS and Staff Development positions, I am comfortable with that approach. I have never seen a new graduate who is a true "expert" or who is ready to be a leader before they have learned to be a productive member of the team. It is necessary to spend some time as a team member before one can be ready to be a leader.

Also, there is a well-documented process of transition that we all must go through as we go from being a "student" to being a "practicing professional." In other fields, such as medicine or law, there are formal periods of "internship," "residency," "fellowship," "clerkship," "associate," etc. before the new graduate becomes accepted as part of the senior level of the profession. The new nurse graduate of an MSN entry program needs a similar period to gain the experience in professional practice before he/she can expect to lead and be a resource to others.

That doesn't mean I don't approve of the MSN entry programs. I support them whole-heartedly. I just believe the graduates of those programs need to have a realistic perception of their strengths and weaknesses. Their MSN education will be quite useful to them and help their careers progress quickly to higher levels -- but they still need to get some experience at the staff nurse level in order to learn how to use their knowledge in the real world practice of nursing.

It's the difference between "knowing that" and "knowing how." School teaches you the theory, the rationale, the facts, etc. and provides a good foundation for practice. But "knowing how" requires experiential learning -- praciticing the skills, learning to adapt as needed, learning to individualize, honing your judgment based on experience with similar cases, etc.

True expertise only comes when you have both -- book learning and experiential learning. You can get them in either order, but you need to get both of them to be a good leader.

llg

br107 · Aug 18, 2006

thanks llg. its application time and i have to make choices. do you think i would build a more solid foundation by doing an adn program first, then doing a bridge to msn program later? i thought i heard somewhere (or read maybe) that adn students generally feel better about their clinical experiences than bsn, accel-bsn, and msn students.

llg, PhD, RN · Aug 18, 2006

thanks llg. its application time and i have to make choices. do you think i would build a more solid foundation by doing an adn program first, then doing a bridge to msn program later? i thought i heard somewhere (or read maybe) that adn students generally feel better about their clinical experiences than bsn, accel-bsn, and msn students.

If it were me, I would choose the MSN direct-entry route because it is the fastest and cheapest in the long run. If you get an ADN first or an accel-bsn ... then you will have to return to school later. So many people say they will do that, but then get side-tracked. I would go for the MSN right away if that were an option.

However ... as I indicated in my post above, graduates of those programs need to understand that they are not graduating with the same level of clinical expertise as the MSN graduates who took the "traditional" route. Those other MSN grads usually have years of clinical experience that help them qualify for leadership roles soon after graduation. The direct-entry MSN needs to get some work experience before they can be considered "equal" to the other MSN's out there in the workforce. So take a year or two and work as a staff nurse and get some experience before you expect to be considered an expert and/or resource for others.

The old wives tale that ADN and Diploma programs offer better clinicals is simply not true. It is true in some cases ... but not for every program. There are good programs and bad programs at every level -- and most programs are somewhere in between the two extremes. Some ADN programs are wonderful: others are horrible. Some BSN programs are wonderful: others are horrible. etc. etc. etc.

1. Go to the school that best meets your needs in the long run.

2. Identify the strengths and weaknesses of whatever school (route) you choose. Be honest with yourself and realistic.

3. Learn as much as you can from what the school has to offer. Don't settle for mediocre performance. The patients don't want a nurse who "barely passed."

4. Compensate for the weak aspects of your program by taking advantage of learning opportunities outside your school experience. For example, if you go to an ADN program, understand that you will need to go back to school for more formal education before you can expect to advance your career. If you go to a program that has weak clinicals, make sure you get a job as a new grad that has a good orientation program that will give you the opportunity to learn the skills you need to do a good job. Take responsibility for your own learning and get yourself whatever it is that you need.

Good luck,

llg

dorimar, BSN, RN · Aug 18, 2006

If you get your ADN first,Most hospitals will pay for your continued education. That is something to consider. I payed for my ADN, but the hospital i worked for later payed for my BS. Now the hospital I work for is paying $5,250.00/year towards my MSN, and will pay $5250.00/year towards my school loans when i am finished.

I also have to add that i believe experience is extremely important. I would honestly not respect much of what you had to offer me, with you being fresh out of school, and me being at the bedside for 20 years. I do not say this to be insulting to you, and wouldn't volunteer this information if you didn't ask.

We just had a huge meeting where i work, to decide on the pre-requisites of our new clinical educator position in our critical care. A minimum of 5 years bedside experience in critical care was agreed upon unanimously by all. Interestingly enough, most people felt a BSN was sufficient. I myself feel that a Masters or at least working towards a Masters degree is important for the position. I do wish you the best of luck in whatever you decide.

sunnyjohn · Aug 18, 2006

There's nothing saying you can't remain humble and teachable after graduating from a direct-entry MSN program ! The folks on the floor don't have to know any more than you are a cool new grad looking to learn all you can. :lol2:

We all know folks whose education have made them jerks. Just don't lord it over anyone and don't be one of them!

After graduating learn as much as you can from those experienced nurses you will work with at the bedside. You're a newbie, just one fortunate enough to have pursued graduate training to ensure timely future advancement.

I say go for that direct-entry MSN (if it is an option). Work for 2-5 years bedside. Use that time to obtain your specialty certifications (CNOR, CCRN, etc) and gather experience in the field. Keep you eyes open and learn (from experience, conversation and observation) what makes a good staff nurse, nurse manager, nurse educator, and nurse administrator. Pay attention to what the nurses in the bedside have to say.

Yeah, most hospitals offer tuition reimbursement, but whose to say the folks you are working for at the time will be offering 100% or even a decent package that makes graduate study feasible.

Get the BEST education NOW that your pocketbook and personal circumstance will allow.

(JMHO and my 2cents)

lannisz · Aug 18, 2006

"There's nothing saying you can't remain humble and teachable after graduating from a direct-entry MSN program ! The folks on the floor don't have to know any more than you are a cool new grad looking to learn all you can. :lol2:

We all know folks whose education have made them jerks. Just don't lord it over anyone and don't be one of them!

After graduating learn as much as you can from those experienced nurses you will work with at the bedside. You're a newbie, just one fortunate enough to have pursued graduate training to ensure timely future advancement.

I say go for that direct-entry MSN (if it is an option). Work for 2-5 years bedside. Use that time to obtain your specialty certifications (CNOR, CCRN, etc) and gather experience in the field. Keep you eyes open and learn (from experience, conversation and observation) what makes a good staff nurse, nurse manager, nurse educator, and nurse administrator. Pay attention to what the nurses in the bedside have to say.

Yeah, most hospitals offer tuition reimbursement, but whose to say the folks you are working for at the time will be offering 100% or even a decent package that makes graduate study feasible.

Get the BEST education NOW that your pocketbook and personal circumstance will allow.

(JMHO and my 2cents)"

EXCELLENT advice!

happygolucky2 · Nov 9, 2006

Hi,

There seems to be some confusion about exactly what a CNL is or isn't? Here is a link to the AACN, which will give you factual and accurate information about this new emerging role:-)

http://www.aacn.nche.edu/CNL/index.htm