The Dilemma

There are two kinds of nursing programs (in addition to the community college ADN or transferring as a junior into a traditional BSN) for people like me, who are diving into a new career after already earning a degree in something else. One is the accelerated BSN, which condenses a 4-year undergraduate degree into about 16 months. Since you already have a college education, they figure you only need the nursing courses and clinical experience. You get out quickly and are ready to practice as an RN, assuming you pass your boards. The program at Duke was an ABSN.

The other option is the entry-level Master’s in nursing. Also known as “alternate entry”, it is a three-year program that ultimately ends with a graduate degree and the opportunity to enter advanced practice nursing immediately. The curriculum prepares you for work as a nurse practitioner, clinical nurse specialist, clinical nurse leader or other options higher up on the nursing totem pole. It also qualifies you to teach at most nursing schools. Typically the first year provides clinical training and coursework to prepare you for the NCLEX (nursing boards); you take the exam at the end of that year, hopefully pass, and can work part-time as an RN while you are in your second and third years of graduate study.

So here’s the question that’s been nagging at me for some time. Are the entry-level MSN programs doing an injustice to their students, and to the field of nursing, by transforming individuals who have never given a bed bath or started an IV into advanced practice nurses three years later? Isn’t clinical experience the cornerstone of nursing? Then again, this country is in a nursing drought and the field is in desperate need of individuals who can get their graduate education completed and turn around to teach the next generation of students. There are a number of incentives and scholarships for students who agree to become nurse educators within a few years of graduating. But again on the flip side, can we be good educators if we’re barely out of the gates ourselves?

As nursing schools across the country become accredited to offer entry-level MSN programs, will we sacrifice clinical expertise for those few extra initials we get to put behind our names? I am struggling mightily with this question personally and professionally. I am 27 and have been in school forever. The thought of getting my nursing degree, practicing and then having to go back to school to get my Master’s is daunting. And there’s no question that I want to go back and get my Master’s, heck maybe even my Ph.D. By the time I’m a nurse practitioner, I could be in my mid-30s and facing a whole new dilemma: when to start a family of my own. Damn, it’s great to be a woman. The entry-level graduate programs I am considering (and I have applied to three of them) are tempting in that I will reach my goal that much sooner and be able to become a leader and teacher in my field that much more quickly. But my hands-on experience will be limited. As much as I am a nerd, I am interested in nursing not only for what I get to learn in the classroom. I want face time. Am I seeking authority I don’t deserve and for which I am not prepared or am I simply trying to move along in my own vocation? Do I need more patient contact before I can claim that I am advanced in my profession?

Medical students have to go to school for one year more than I would, and they get to be called doctors. But they have years more of training before they garner the respect and authority of a chief resident or attending.

Can you tell I have NO idea what to do???!!!

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