PatMac,RN

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The Nursing Education Master Post!

Patrick McMurray

Breaking down Nursing education options

Becoming a nurse can be an arduous and complex journey. This is truer today, more than ever, because there are so many options that will lead to licensure as a nurse. The numerous pathways available to become a nurse can be overwhelming, but they don't have to be. Don’t worry, I’ve got you.

Let’s discuss the multitude of educational options in nursing so that you can choose the path that best suits your needs.

For the sake of visual and mental simplicity, I’ve grouped the nursing educational options into various categories, so that they can be easily referenced and remembered.

Let’s get Started…

Traditional Nursing Educational Pathways:

These are the educational programs that have been around the longest and by which the majority of nurses have been educated, historically.

All of these options in this grouping qualify a student to take the nursing licensure exam, NCLEX-RN and lead to initial licensure as an RN.

  • Diploma Programs (typically about 3 years in length)

    • The oldest form of formal nursing education around the world.

    • Typically 3 years in length and sponsored by a particular organization. (i.e. a religious order or a hospital).

    • Also offered at technical and vocational schools.

    • Often don’t require prerequisites for entry as the curriculum typically is comprehensive and includes your relevant science and liberal arts coursework in tandem with nursing courses.

    • Not as common anymore. Only one left in my state of NC, Watts School of Nursing. Update: this program is transitioning to a BSN program from what I understand, thus finished the last diploma RN program in NC.

    • You can receive a diploma and become an RN (3 years) or become a Licensed Practical Nurse (LPN) (1-2years).

  • ADN (Associate Degree in Nursing) (Typically about 2 to 3 years in length):

    • The specific degree can vary according to the granting institution and their degree requirements. Some school offers an Associates of Applied Science in Nursing (AAS), which is most common in my experience, while others offer an Associate of Science in Nursing (ASN).

      • Both degrees are equitable, however, I’ve found that ASN degree holders often have a few more science or math courses under their belt, such as chemistry, statistics, and physics. This can make transitioning into the BSN more smooth, as those are often prerequisites needed for RN to BSN/RN to MSN programs (we’ll talk about these in a bit).

    • For the last few decades or so, this has been the educational option that the majority of nurses have received their initial nursing education.

    • Includes many of the core liberal arts and science courses required for a BSN. Non-nursing courses can be obtained prior to entry into the nursing portion or while enrolled in nursing courses. However, a number of schools use point systems and give more points for having more pre/co-requisite courses completed.

      • Taking prereqs before entering the nursing coursework is appealing to many students because of the rigor of the nursing coursework. Having all or most pre/co-requisites completed beforehand allows the student to focus solely on their nursing driven content.

    • Can be offered at private colleges, universities, technical schools, and most commonly, community colleges.

    • The nursing coursework can be offered in flexible formats, such as at night or on weekends at some institutions.

    • Typically more affordable the many other degree types, especially when obtained from public (or non-private) community colleges. My entire community college education was less than $9,000 and was completely covered by federal Pell grant (I paid $0 for my degree).

    • Many cohorts are a mix of people of all backgrounds and ages.

  • BSN (Bachelor of Science in Nursing or Baccalaureate) (3-4 years)

    • The growing preference among hospitals and countless other nursing and healthcare organizations.

    • Traditionally includes 2 years of liberal arts and science prerequisites that range from courses like English and Psychology to Biology and Chemistry.

    • The typical options for people coming straight out of high school and are pursuing a traditional 4-year college experience.

    • Typically offered at a college or university, but there is a movement to permit community colleges to offer Bachelors degrees in critical access professions, such as nursing.

      • There are community colleges who have already been authorized to offer BSNs in some states. Need proof, check out this article.

      • In the past, it was needed to pursue graduate studies in nursing, but that’s no longer the case, as we will discuss later in this post.

    • Preferred minimal degree for management and leadership positions, although a masters degree is quickly becoming a preference in many places.

    • Can vary, quite significantly, in expense depending on various factors.

    • There are rains institutions that offer a 3-year BSN vs the traditional 4 year. One such school is Chamberlain University. These programs types are becoming more popular and is synonymous with the length of most Bachelors programs in other countries, such as the United Kingdom. These programs can vary in price and typically includes all pre-requisite and Clinical coursework all in one program, to be completed in 3 years. I like this option, personally and hope it becomes more widespread .

Alternative Entry Points to Nursing programs (AEP):

These educational pathways are just like the sound. They include options for accelerated placement because of certain previous degrees or experience. These programs often build on top of previous skills and degrees to allow students to complete a nursing program and become an RN.

  • LPN to RN (ADN) (1-2 years):

    • Eliminates some time and coursework due to licensure and experience as a licensed practical nurse (LPN), also known as a Licensed vocational nurse (LVN) in some states. LPN and LVN are essentially the same.

    • Still must meet liberal arts, science, and math courses in order to complete the ADN degree, in addition to additional advanced nursing coursework.

    • For more info about what an LPN is and the differences between LPNs and RNs (at least in NC), see this document from the NC Board of Nursing Website.

    • Offered at many community colleges and are typically perceived as affordable.

  • LPN to RN (BSN) (2 to 3 years):

    • Same basic concept LPN to RN/ADN option

    • A clever and convenient option for those seeking to obtain as an RN and obtain their BSN simultaneously.

    • Offered at Universities, can vary in regards to tuition costs.

  • Accelerated BSN (ABSN) (12-16 months):

    • Allows those with a Bachelors or masters in another field, outside of nursing, to pursue a BSN and become nurse fairly quickly.

    • This program concept works off the idea that having a previous Bachelors or higher means that you only need nursing specific coursework. If your initial degree program didn’t include the appropriate science and math coursework needed for health science degrees, such as statistics, or anatomy and physiology, students will typically need to complete these prior to being admitted to the ABSN.

    • These programs throw a lot at you in a short amount of time. They are known to be very rigorous. Admission to the program types can often be more rigorous as well.

    • Typically this is a more expensive educational option.

    • Here is an example of a ABSN offered at a college in my state of NC.

  • Medic or Respiratory Therapy to RN (ADN or BSN)  Bridge programs (ADN 1.5 - 2 years, BSN 2-3 years)

    • More recent program type that allows for advanced placement to those with a healthcare license or certification as a paramedic or respiratory therapist.

    • Builds upon knowledge base as a Medic or Respiratory therapist (RRT).

    • Here’s an example of one Medic to RN (ADN) offered in Arizona, but these program types are offered all over the country.

    • Offered at community colleges, private schools, and universities.

    • Can vary in expense, according to institution type, with non-private community colleges being the least expensive.

Transitional and Hybrid program types (THP):

These programs are unique because their purpose is to help RNs transition, seamlessly, from one degree to the next. They can often save the students pursuing these options time on obtaining the degree they are pursuing.

  • RN to BSN (1-2 years):

    • The most common type of degree option in the transitional grouping.

    • Allows individuals who already have a license as an RN, and who possess an ADN or a diploma, to complete the educational requirements to complete a BSN.

    • Does not require supervised clinical that is required in an initial licensure diploma, ADN, or BSN/ABSN programs, as the candidate is already a licensed nurse.

      • However, some schools will require you to complete supervised or documented community health projects in person and similar tasks, though not all.  

    • Can be completed online, in-person, or in a hybrid (half online/half in class) option.

    • Coursework bridges the gap in additional science coursework, according to the applicant's previous educational record. May mean completing chemistry, statistics, and liberal arts courses like history, which aren’t standardly required in many Associate and diploma programs. You will take a few nursing specific courses that cover much of the content that was covered in your diploma or ADN program, such as physical assessment, community health nursing, research, and leadership & management.

    • Can vary in price, though there are a number of reasonably affordable options.

    • Offered at some community colleges in certain states, Universities, and Private schools.

  • RN to MSN (RN to Master of Science in Nursing) (2 to 3 years):

    • The same concept as RN to BSN, except that the end degree, will be a Graduate degree, at the Masters level.

    • Let’s a licensed RN with an ADN or Diploma (whether they have a Bachelors in another field or not) to bypass the BSN and complete a graduate program.

    • Some schools will grant students on this pathway both a BSN and an MSN, however many do not (which I think is strange).

      • BSN can be granted after the equivalent coursework has been completed, for many that at about the halfway mark through their RN to MSN.

    • Can save students time and money on their education, especially in you know graduate school is your ultimate goal and you want to attend a community college to save money.

    • Price varies according to institution type, but a number of reasonably priced programs exist, do your research.

  • Concurrent Enrollment ADN/BSN programs. Known as RIBN (Regionally Increasing Baccalaureate Nurses, but called different things in different areas) in NC (3 to 4 years):

    • This is a new and innovative program type that increase the accessibility of a bachelors degree education to students.

    • Can be explained as a hybrid between an ADN and a BSN program.

    • Are seen a more affordable way to pursue a BSN, as RIBN students typically pay community college prices for about 75% or more of their Bachelor's degree.

    • This program type permits students to be dual-enrolled at an affiliated community college and university, simultaneously. ADN students take courses to complete their BSN while in nursing school at the ADN level.

    • Students typically licensure sooner than a traditional 4 year BSN and thus can finish their BSN in the same 4 year period, but often they also come out with a BSN and 1 year of experience, which is fantastic.

    • To find out more information on this program type, as it's known in NC, visit the RIBN website. Here’s another example at Pima College…

MDE (Masters Direct Entry) Programs (2 - 3 years total, depending masters specialty):

The programs in this grouping permit individuals who do not have a nursing license or degree, yet who have a Bachelors or higher in another field, to become both a registered nurse and obtain a graduate level degree in nursing, with the possibility of gaining specialty certification in an advanced nursing role, such as leadership, care coordination, Clinical Nurse Leader (CNL), or Nurse Practitioner (NP).  

  • Fairly newer educational option.

  • Mimics the ABSN in that you receive basic educational preparation as  Bedside RN in an accelerated format, typically within 12 months. The student is then expected to pass NCLEX-RN and obtain licensure as an RN and immediately continue on to complete graduate coursework, which may take another 1-2 years, according to specialty.

  • Tends to be an expensive educational option, as the student essentially receives both BSN and graduate level education combined, although a formal BSN is NOT offered in many cases.

  • Allows those who want to accelerate to an advanced role in nursing, without having to have bedside nursing experience or education beforehand.

  • Is offered at many well-regarded schools of nursing, but has none of the less been met with controversy and apprehension by some nursing professionals and organizations.

  • Here is an example of an MDE program at John Hopkins that leads to a master of science in nursing (MSN) with the option to pursue a number of graduate specialization options.

Graduate Degree Nursing Programs: Masters

This educational grouping includes your traditional Master's degree programs,  in nursing. They are traditionally for experienced or licensed nurses who wish to advance their educational preparation and level of practice. It is also a method for nurses to demonstrate their expertise as a nurse or within a particular nursing specialty.

  • Master of Science in Nursing (MSN) (1-3 years):  

    • This is the primary degree type in this category. There a few schools, definitely in the minority, that offer a Master of Nursing (MN, not MSN) degree. When you look at the curriculum for this program type, it is virtually the same as your typical MSN.

      • I’m not able to discover why the credentials are different when the education pathways are essentially identical. That’s one of the confusing aspects of nursing education.

    • To my knowledge, there are currently no Master of Arts in Nursing (MAN?) offered, although there was a Bachelor of Arts in Nursing (BAN) at one point.

    • An MSN never stands alone, unlike the ADN or BSN which prepares generalist nursing clinicians. The MSN or MN is always paired with a specialization.

      • Specialties for masters programs can be numerous. A number of combination specialty programs also exist, permitting the student to obtain an education in multiple specialties at once.

      • Side note: So not all nurses who have a Masters are Nurse Practitioners or Advanced Practice Registered Nurses (APRNs). APRN specialties include Certified Nurse Midwives (CNMs), Nurse Practitioners (NP, see below), Clinical Nurse Specialists (CNSs, not be confused with Clinical Nurse Leaders or CNLs), and Certified Nurse Anesthetists (CRNAs).

        • A Nurse must enter graduate school and complete an MSN with a focus in an APRN specialty, such as NP, to become an NP. Specializing in education or other non-APRN specialties does not qualify a nurse to practice as an APRN, without them returning to receive education specific to that degree specialization.

      • Specializations:

        • Nurse Practitioner (NP) (A type of Advanced Practice Registered Nurse or APRN): With NP degree and certificate programs, the nurse must choose what population they want to specialize in for advanced practice APRN, as their basic bedside RN education prepared them as generalists. The NP role is meant to build upon the RN role/licensure and experience. EVERY NP MUST FIRST BE A LICENSED RN, even if they never actually practice at the RN level.

        • Note: This is unlike NPs advanced practice counterparts,  Physician Assistants (PA), as PAs are trained as generalists who can float to a variety of specialties and population without returning for more formal education.

          • Family Nurse Practitioner (FNP): Family/All ages, primarily in the outpatient and primary care setting. The closest thing to a generalist practitioner in the NP world.

            • Can care for pregnant women before and after pregnancy, but may NOT deliver babies.

          • Pediatric Nurse Practitioner (PNP) (Acute Care or primary care): Infants up to age 18 or 21, according to state, in the outpatient or primary care setting or inpatient (acute care) setting. Arguably the oldest and first NP role.

          • Neonatal Nurse Practitioner (NNP): Cares for newborns/infants and up to 2 years old, according to state, in the inpatient and outpatient setting.

          • Adult-Gerontological Nurse Practitioner (Acute or Primary Care): Treats individuals 16 years old and older, according to state, in the outpatient/primary care setting or Acute care (inpatient) setting.

          • Psychiatric/Mental Health Nurse Practitioner (PMHNP) treats those from pediatric and adult populations with psychiatric and mental health conditions, both in the inpatient and outpatient setting. Can complete psychotherapy and other related therapy techniques in addition to the standard role of the NP. This the only group of NPs licensed conduct psychotherapy in its various forms, though other NP types may diagnose a number of psychiatric conditions.

          • Women’s Health Nurse Practitioner (WHNP): APRN specialization where the Nurse practitioners provide ambulatory women’s health services that embrace most of a woman’s health needs throughout her life.

            • The NP specialty only focuses on the female population.

            • They DO NOT deliver babies.

        • Clinical Nurse Specialist (CNS): Expert APRN clinicians with advanced education and training in a specialized area of nursing. Function in a role similar to NPs in some states.

          • Specialty areas include Pediatric CNS(Acute, Primary, or Psychiatric (Retired)), Adult CNS in various adult populations and specialties (Critical Care, Cardiovascular, Public Health (Retired), Psychiatric/Mental (retired), women’s health, diabetes, or oncology).

        • Clinical Nurse Leader (CNL): A recent nursing certification and specialization. A master’s educated nurse, prepared for practice across the continuum of care within any healthcare setting. This role overlaps with the CNS (which is an APRN role) significantly. Read this to understand the difference between CNLs and CNSs.

        • Nursing Education: Trained to teach undergraduate or graduate level nursing and health science students.

        • Nursing Leadership and Administration

        • Nursing Informatics

        • Forensic Nursing

        • Diabetes Specialist

        • Public Health

        • Certified Registered Nurse Anesthetist (CRNA): Advanced practice registered nurses (APRN) with graduate-level education who enjoy a high degree of autonomy and professional respect. CRNAs provide anesthetics to patients of all ages and in every practice setting, and for every type of surgery or procedure.

        • Certified Nurse Midwives (CNM): Registered Nurses with advanced midwifery training in a formal Nurse Midwife program. CNMs are the only type of APRN that is certified and licensed to deliver babies. In addition to delivering low-risk pregnancy babies, CNMs provide health care and wellness care to women, which may include family planning, gynecological checkups, and prenatal care.

    • Most full-time Master programs tend to be more in the 18-24 month range.

    • Costs can vary, but there are a number of affordable graduate school options in virtually all graduate nursing specialties, again do your research.

    • A number of combination programs that combine an MSN with another related master are in existence. The MSN/MBA (Masters of Business Administration), MSN/MHA (Master Healthcare Administration), and MSN/MPH (Master of Public Health) are the most common.

    • There are also unique and specialty combo programs, such as the MSN/MLS (Master of Library Science offered and the University of NC at Chapel Hill scroll down and choose nursing) and MSN/MEd. (Master of Education).

  • Post-Masters Certificate (PMC) (Length varies 1-2 years):

    • This is a program option is not technically a degree program, as this educational designation is offered to someone who already has a relevant nursing graduate degree.

    • People pursuing this educational option is are typically seeking to change specializations or add an additional specialization to their original Master's specialization, without formally pursuing a second masters degree or doctorate. For example, this can include a Nursing Educator pursuing secondary certification as a Nurse Practitioner or in Nursing informatics.

I promise we are almost done! Haha! I never said this would be short and sweet, although I’ve tried to make it as short and sweet as possible.

Doctoral Nursing Degree Programs:

This grouping of educational pathways include the highest levels of nursing educational and clinical preparation. Respectively, their doctoral programs can be classified as clinically/practically focused or research/academically focused.

  • Research/Academically- focused doctorate:

    • Ph.D. in Nursing (3 to 5 years from a BSN or MSN to Ph.D. 3 and 4 year options more common ): The is the highest academic degree available in nursing or any profession for that matter.

    • Many Ph.D. Nursing doctoral programs are transitioning to the 3-year BSN to Ph.D. program model to increase the number of nurse scientists.

    • DNSc (Doctor of Nursing Science/DSN Doctor of Science in Nursing). (4 years)P.

      • Less common credential than the Ph.D., but it is essentially structured the same way and is also focused on creating and producing new and original research, nursing theories, and preparation as an advanced educator.

      • This degree type used to be the standard for those desiring university faculty positions and tenure, however, that is changing slowly.

      • It should be noted that the time it takes to complete a Ph.D. can vary depending on the length of time it takes a student complete their dissertation research and writing.

    • Of note, there are also doctorate of education (Ed.D.) that offer specialization in Nursing Education. This degree was actually the first terminal/doctoral degree available for nurses, first being offered at Columbia University and New York University. Later, the first Ph.D. Programs would be established.

      • The Ed.D is a unique Degree in that, it is more of a true hybrid between a research and professional/practice degree. They receive training in researching various statistical methods.

  • Clinical/Practice-focused doctorate:

    • DNP: (3 years of full-time from BSN to DNP is most common; 15 months to 2 years Full-time to go from an MSN to DNP is most common)

      • This degree is designed for nurses seeking a terminal degree in nursing practice and offers an alternative to research-focused doctoral programs. DNP-prepared nurses are well-equipped to fully implement and translate science developed by nurse researchers prepared in Ph.D., DNS, and other research-focused nursing doctorates (AACN). 

      • DNAP: Essentially the equivalent of the traditional DNP, but with a focus on nurse anesthesia practice for CRNAs.

        • It’s interesting to note that not all schools of nursing with doctoral options for initial or post-certification CRNA education offer the DNAP, many offer the DNP to all APRN and advanced clinical role specialty students, regardless if they have CRNA certification or not. I don’t fully understand why this is the way it is. Here is a post that explains the difference in a DNAP and a regular DNP

        • Apparently, the difference is the fact that a DNP can only be conferred by a school of nursing. However, not all Nurse Anesthesia programs are found in and sponsored by schools of nursing, thus these programs cannot offer a DNP, but can offer the specialized DNAP.

        • Since Note: We have at least 1 Non-nursing school CRNA programs in NC, but formerly 2. One is offered by the Wake Forest University School of Medicine, but they advertise as offering a DNP and not a DNAP, despite the school not having a nursing program at all, so the previously mentioned rule doesn’t make sense.

      • Is now being accepted for tenured university faculty positions at SOME institutions.

      • Although the primary purpose of the DNP to take already established research and data and implement it into everyday practice, is it not impossible for DNP-prepared nurses to conduct their own original research. Just as it’s not impossible for a Ph.D. prepared nurses to work on implementing research into improving practice and quality improvement.

      • There are a number of Ph.D./DNP combination programs that allow students to obtain both doctoral degrees. These programs are often longer than your average DNP or Ph.D.

      • Specialty combo programs exist that offer a 2 different complementary doctorate degrees or Doctorate and Masters degrees.

      te and Masters degrees.

Finally! We made it!!! You now know the basics of most of the popular nursing education routes available today. There are so many to choose from. Which educational pathway have you taken? What educational options are you considering for the future?