Getting your MSN degree in nursing is a significant step in mapping out the next part of a nursing career. But making this decision and choosing the right program for your personal and professional goals takes a lot of research and thought.
An MSN degree offers more profound knowledge and experience, leading to more significant career opportunities. However, with many specialized degree options, you must reflect and research to find the best program.
MSN programs are diverse and focused on specific career paths, including nurse practitioner, so choosing the right program for you will pay off.
“It’s important to look at your career goals and your interests,” says Dr. Latina Brooks, Ph.D., CNP, FAANP, and assistant professor and director of the Master of Science in Nursing Program and the Doctor of Nursing Practice Program at the Frances Payne Bolton School of Nursing at Case Western University. For example, she says if you’re seeking more knowledge or something different from your current career path, you’d naturally look to an MSN degree as one way to move forward.
If you want to become an advanced practice nurse practitioner (APRN), look for schools that offer clinical programs aligned with what you see yourself doing. Many nurses can narrow down their preferences while in their pre-licensure programs and through required clinical rotations and nonclinical courses, says Brooks.
“It starts in the RN programs, and then while they are working as an RN or in different areas, they will understand their strengths and interests,” she says. With that clarity, you can start to think about what you need to do to meet your career goals.
Changing Advanced Practice Qualifications
While the MSN is the fundamental path to advanced practice and licensure as a nurse practitioner, there are changes toward making the DNP a benchmark requirement for NP work. The difference seeks to ensure consistency of experience upon graduation with an MSN. Still, only some nurses want to pursue a DNP path, says Anne Derouin, DNP, APRN, CPNP, PMHS, FAANP, assistant dean and director of the MSN program at Duke University School of Nursing.
“A very dynamic change is happening,” she says, “and not all nurses are prepared in the same way.” Unlike a BSN program, where the end goal is to graduate and become a working registered nurse, the master’s degree in nursing offers vastly different outcomes.
Anne Derouin, DNP, APRN, CPNP, PMHS, FAANP, is the assistant dean and director of the MSN program at Duke University School of Nursing
As a prospective MSN student, you’ll quickly notice curriculums vary widely. To find the program that matches the degree you need for the job you want, check all program guidelines and options to see all the courses and what the curriculum requires based on your credentials. While some programs are shorter, they aren’t necessarily going to give you the clinical hours you need for a particular role or that an organization requires.
Accelerated programs for those with a bachelor’s degree in a field other than nursing may require students to complete prerequisites to advance into an MSN program. Other schools have MSN programs that are accelerated MSN/DNP programs, so you’ll graduate with both degrees.
Pay Attention to Your Interests
“When I counsel students considering a master’s degree, I ask what they are passionate about and what patients or populations they love to care for,” says Derouin. The answers should guide prospective MSN students because they will show the result that will help them become the nurse they want to be.
MSN programs can be clinical for an advanced nurse practitioner specialization or nonclinical for nurses who want to work in management, with data or technology in informatics, or who plan to become an educator.
Within the APRN clinical routes, there are additional choices.
A family nurse practitioner path offers the greatest flexibility and job potential, but Derouin says it’s not the best option for every nurse. For a student to make that decision, she says, you’ll need to be comfortable caring for patients across the lifespan.
A pediatric specialization will give greater you depth and breadth of experience and knowledge if you prefer to work with infants and children. And if you enjoy working with older or cardiac patients, the degree path geared toward those populations will offer a better career and skill match, she says. “Then you are no longer a generalist but an expert,” Derouin says. “Think of what you love to do and hone your skills in that area.”
Brooks agrees, noting that nurses should keep their minds open when considering different paths. For example, nurses who enjoy technology or business might find careers in nursing informatics or management that blends their interests and goals.
Look into Every Aspect of MSN Programs
When assessing programs, Derouin advises students to look at certain factors. For example, ensure each program is accredited and that the faculty are practicing nurse practitioners or nurse educators, as those faculty will have the most current industry knowledge.
Ask about clinical placement, she says, as it’s an extraordinarily competitive part of many programs. Find out what kind of clinical access is available, if the school places students, or if the students have to research and secure their placements.
And use your time out of school to find out more. Ask people in your chosen field if you can shadow them or talk with them to see their daily work. “Most NPs are willing to share their journey into their role,” Derouin says.
“If you go on to graduate-level education, it opens up a whole other world of all that you can do,” says Brooks.
If researching an MSN path, you still aren’t sure what area of nursing you want to pursue, or if you have the resources to devote to an advanced degree, she recommends taking more time to make a decision. “You don’t want to waste your time or money if you’re not sure it’s something you want to jump into,” says Brooks. Then, investigate all the possibilities to reap the full benefits of an advanced degree.
“With graduate programs, there are so many avenues you can take, and that’s the beauty of our profession,” says Brooks. “There are so many aspects to nursing.”
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The current health care crisis is multifaceted, ongoing, and incredibly significant to those within the profession. The reform the country is currently experiencing came as a result of several factors: high cost of treatment, ineffective payment methods, and millions of uninsured Americans in need. Though these problems have begun to enter the national conversation, there are still many issues that need to be addressed and fixed.
Nurses are often referred to as the front line of the health care system—meaning that the changes occurring on a national level will affect them directly, perhaps even first. With the coming reform, health care facilities and their nursing staff must account for slashed budgets, reduced personnel, and political pressure. Moreover, President Obama recently set aside more than $36 billion to create a nationwide network of electronic health records—a massive undertaking that will require a combination of proven communication skills and strategic management to implement, use, and manage.
In addition to these changes, the population is aging, Medicare funding is in jeopardy, and the nursing shortage is projected to grow to one million by 2020. As the public gains access to health care, the lack of nurses will be felt even more acutely.
Nurses must equip themselves with the skills necessary to manage and help solve these crises.
The next generation of nursing leaders will be charged with placing an emphasis on interpersonal and interdepartmental communication—translating and acting as a diplomat between the clinical and business sides of health care institutions. Nursing leaders must have a strong working knowledge of clinical practice and the business of health care, all within an everchanging political arena. Nurses holding both a Master of Science in Nursing (M.S.N.) and a Master of Business Administration (M.B.A.) will be better equipped to understand both sides of the equation.
This may be unfamiliar territory for the nursing profession. Executives must be able to identify key health care trends, watch regulatory rules and legislation—and be able to implement changes within their own organization based on these findings.
Dual degrees in nursing and business help nurses manage these responsibilities in more ways than one could count. Registered nurses are not generally educated in the business side of health care, and while a Bachelor of Science in Nursing is excellent preparation for nursing clinical practice, patient care is far removed from the fiscal responsibility of bringing consumption and cost to sustainable levels. A business-trained leader, such as an M.B.A.-prepared executive, may be able to provide financial analysis of factors associated with treatment, providing the cost in real dollars and highlighting areas of strength or problematic gaps. Yet, while that training may prove invaluable in discovering economic stopgaps, understanding financial problems is not effective in providing a cost benefit unless a clinical solution can be found as well. Therein lies the primary benefits of obtaining dual M.S.N./M.B.A. degrees—understanding and linking both sides of health care.
M.S.N./M.B.A. programs aim to prepare students for mid- to upper-level management roles in health care organizations, including chief nursing executives, nursing managers, nursing supervisors, nursing educators, nursing informaticists, nurse practitioners, clinical nurse specialists, and more. According to the Centers for Medicare and Medicaid Services, by 2015 health care costs will hit $4 trillion and account for 20% of the U.S. economy. By 2012, the number of nursing executives is expected to increase faster than most health care professions. Still, in today’s diffi cult economic environment, being as educationally competitive as possible is key to securing a position as a nursing executive.
Employers will be looking for nursing executive candidates skilled in communication and conflict resolution, leaders who have the ability to cultivate an ongoing conversation between patients, staff, and administration. M.S.N./ M.B.A. degree programs also generally provide more targeted business preparation, training students in areas such as relationship management, organizational leadership, business relations, and change management—skills which are more crucial now than ever.
Where to Obtain a Dual M.S.N./M.B.A.
Just a few options of many… Anderson University
Barry University
Canyon College
Chamberlain College of Nursing
DeSales University
Duke University
Johns Hopkins University
Lamar University
Lewis University
Loyola University Chicago
Lynchburg College
Madonna University
Sacred Heart University
Saint Joseph’s College of Maine
Saint Xavier University
Seton Hall University
Thomas University
University of Indiana
University of Iowa
University of Pennsylvania
University of Texas, Arlington
University of the Incarnate Word
University of Virginia School of Nursing
Valparaiso University
Waynesburg University
Xavier University
Class work, prerequisites, clinical requirements, and other details of these dual degree programs vary widely. Students may obtain their dual degree at one school or through articulation agreements between two distinct schools of nursing and business. Accelerated programs often combine these studies even further, saving students both time and money. At Chamberlain College of Nursing, courses such as Leadership Role Development, Health Policy, and Informatics prepare graduates to serve as effective nursing leaders, able to understand the politics and decisions inherent in health care leadership. Business studies, including Managerial Accounting, Marketing Management, and Business Economics help students develop strong analytical abilities, understand health care economics, learn to resolve organization and business issues, execute health care strategies, and foster communication and interpersonal skills.
In order for the health care field to flourish in the face of a continuing recession and monumental policy changes, the profession must seek out and support individuals prepared for both the monetary and clinical challenges. The time for aspiring health care leaders to gather the knowledge and credentials they need is now. The industry’s success depends just as much on cost savings as on the finite resources vital to maintaining crucial care—namely, the people and practices that allow health care to function. Future nursing leaders must further prepare themselves to manage every facet of the coming changes to the industry, including attaining knowledge of both the business and the science of health care.
A labor and delivery nurse in Springfield, Missouri, Rosario Kowalski, M.S.N., R.N., was working towards her master’s degree in nursing when she experienced an unexpected trauma of her own: she tore a ligament in her knee while walking up the stairs. “It was completely out of the blue,” she says, a nurse for nearly 30 years.
Knee surgery and a difficult, lengthy recovery followed the accident. “When you’re in pain, all you can think about is getting out of pain,” Kowalski says. “I couldn’t work at the job I loved. I couldn’t even walk. I felt like I’d lost everything.”
Despite having to take a break from her job, she was able to continue working toward her M.S.N. because she was enrolled in a distance-learning program with Regis University in Denver, Colorado. “During my difficult recovery, it was wonderful to have education. I looked at my curriculum and felt better. I realized that I was probably only two semesters from graduating,” she says. Kowalski opted for an online approach to her master’s degree because it fit with her lifestyle. Like many nurses, her work schedule varied, and she juggled working full time with family life. Distance-learning offered her the flexibility she needed to pursue her degree.
“I loved working alone and at my own pace within given time frames and guidelines, so independent studying worked well for me,” she says. “The convenience was important to me since I live in a rural area and didn’t want to drive. For years, I drove 55 miles each way to work and I didn’t want more drive time.”
Making the most of a difficult situation, she threw herself into her studies, completing four courses in seven months. “I was able to study, and it really saved me. I had a schedule, something to do, and a sense of the future,” Kowalski says. “I learned so much and had a lot of insights into things that I wouldn’t have had the time to learn otherwise. The courses provided a distraction from my tumultuous circumstances.”
In addition to the convenience, she discovered that Regis was a good fit for her personally. “I really felt in harmony with their approach. Their leadership style is a servant-leader style, and that matches my goals. It opened up a brand-new world for me,” Kowalski says. “In my work setting, I see things differently and I’m a better nurse now.”
The married mother of three grown children, Kowalski had to overcome another major obstacle before she started studying for her M.S.N. and the injury to her knee. “I was acutely aware of being an older student. I hadn’t been in school for 25 years, and I was intimidated by the technology,” she says. “I was a nurse and loved what I did, but I hadn’t fully integrated technology into my practice, and every job now requires computer skills.” Kowalski took several basic computer courses before starting her nursing course work and found that she greatly enjoyed the challenge. “I was really, really excited!” she says. “By the time I took my first online exam, I was back into studying and felt comfortable with computers and the online aspect.
“For me, there is something about wanting more knowledge,” Kowalski says. “I always loved school. I saw that no GRE was required by Regis University for an M.S.N. if you took a statistics course in college. I had statistics in college, so that got my interest. I didn’t want to take the GRE after being out of college for so many years. I signed up—and thought I was crazy for signing up for an online program when I was not efficient with technology!” Though she had initial reservations, Kowalski graduated in May of 2007 with her M.S.N. from Regis.
Achievement as a family tradition
Born and raised in Belize City, Belize, Kowalski came to the United States in 1972 to go to college. She first attended the University of New Orleans for her prerequisites for the nursing program at Louisiana State University Medical Center. LSU’s nursing program was the only B.S.N. program in the state at that time, and admission was very competitive. “At that point, the school was very progressive in their thinking and very much trying to push nursing into the academic arena. They encouraged research and nursing theory and were offering a B.S.N. when most schools in the area were only offered diploma certificates in nursing,” she says. “It was very visionary at the time. Now, almost all schools have shifted to some type of B.S.N. program.”
Distance Learning: What to Look For Nurses considering distance learning programs to earn their associate, bachelor’s, or master’s degrees should look at many factors, including: School Accreditation Regional accreditation is the most widely accepted form of accreditation. There are six regional accrediting agencies recognized by both the United States Department of Education and the Council for Higher Education Accreditation: New England Association of Schools and Colleges, North Central Association Commission on Accreditation and School Improvement, Middle States Association of Schools and Colleges, Southern Association of Schools and Colleges, Western Association of Schools and Colleges, and the Northwest Association of Schools and Colleges. These six also grant brick-and-mortar schools their accreditation. To find out if an online school is regionally accredited, check the U.S. Department of Education website, www.ed.gov, and search the database of accredited programs and institutions. Course Requirements Find out what time and technology requirements are involved. Students are often required to log on and interact with instructors and other students via e-mail, chat programs, discussion boards, and other interactive avenues. Students should be realistic about the time involved and the technology. Off-campus support services should be available to online students, just as they are to traditional students. Clinicals and Preceptorships After the course work is completed, nurses should be required to complete clinicals and/or preceptorships. Find out how these are handled with each program and if they can be completed locally. Costs and Fees Do thorough research to avoid surprises when it comes to program costs. Usually, online programs are more cost effective than traditional programs, especially since travel and childcare costs are less, but the cheapest program may not be the best. Ask about any additional fees, including test fees.
Kowalski earned her bachelor’s in nursing from LSU and started working as a nurse in med-surg. “My husband’s role as a minister required us to relocate about every three years. I had always wanted to be a labor and delivery nurse but the frequent relocations would have made it difficult. Relocating did remind me, though, of the variety and job security you have in nursing. I was able to work wherever we went.”
After they moved to rural Missouri in the 1980s, Kowalski was finally able to pursue cross-training as a labor and delivery nurse. “Labor and delivery was my passion,” Kowalski says. “Every day was a wonderful experience. I couldn’t believe they were paying me to do this. When you love what you do, nothing is hard. I had found something I just loved.”
Education is an important part of Kowalski’s family. Both of her daughters graduated from college, her son is currently earning his degree, and her husband is an adjunct professor at a local bible college. She also comes from a big family, with five sisters and two brothers, all of whom attended pursued higher education.
She is, however, the only one of her siblings to earn a master’s degree. “When I got my master’s degree, no one was more delighted than my mother,” she says. She credits her mother for always being very supportive of education. “We all understood that we would be going to college.”
Her entire family has since immigrated to the United States. She credits their Mayan ancestry for their passion for education. “The Yucatan people are of Mayan descent, and the Mayans were a brilliant people,” Kowalski says. “My mother’s family is from that area, and that genetic pool helped us.”
Growing acceptance of online education
While distance education has existed for centuries, the development of the home computer and the Internet has made it possible for working nurses like Kowalski to take whatever classes they like, whenever they like, and complete them as fast as they like.
Of course, the convenience of an online course does not mean it’s simple to complete successfully. “I think people used to think that an online course is easy, like a correspondence course. But you really have to earn your grades. You have to be disciplined, but I loved the freedom and the online culture. And there’s plenty of individual attention and more online support,” Kowalski says. “You do have to be able to sacrifice time to accomplish the work because it is no cake walk.”
With changing and unconventional work schedules, nurses often find attending a traditional classroom-based program impossible. Distance learning offers flexible class schedules and immediate start dates often with no waiting lists like traditional nursing programs.
In addition to saving money compared to traditional two- or four-year colleges, the ability to continue earning a steady paycheck and supporting their families while taking courses is typically a key factor for nurses like Kowalski who decide to pursue online education.
She even hopes to teach nursing after she fully recovers from two knee replacement surgeries.
Kowalski credits her family, education, and opportunity for her success in nursing. “The United States really is a land of opportunity,” she says. “You can accomplish anything if you are willing to work hard. People will give you opportunities, and if you hold onto them, you can become anything you want to be.”
Hispanics are the fastest-growing segment of the United States’ population—they currently comprise 16% and are expected to grow to 30% by the year 2050, according to the U.S. Census Bureau. However, Hispanic nurses make up only 3.6% of all registered nurses in this country, as reported by the 2008 National Sample Survey of Registered Nurses (NSSRN).
While other minority populations experience problematic underrepresentation in nursing, it is especially apparent in the Hispanic community, and the gap widens every day. In 2008, only 5.1% of all RNs spoke Spanish, according to the NSSRN. There are not enough Hispanic nurses to deal with the health care issues facing this growing population, and the language barriers and lack of cultural understanding created by the void lead to substandard health care for the entire community. In fact, a July 2006 article published by USA Today pointed out that the lack of English language proficiency in patients directly contributed to diminished health care for those individuals.
A 2008 workforce survey showed that Hispanics were 28 years old on average when obtaining their initial licensure compared to an average age of 25 for whites. The most common type of initial R.N. education among Hispanics was the associate degree in nursing (55.1%) followed by the bachelor’s (39.4%), and then a hospital diploma (5.5%). Why does the associate degree come out ahead? The reason may be financial. The A.S.N. provides earning power earlier than a four-year bachelor’s program in nursing. Hispanics were also more likely to pursue a bachelor’s degree after obtaining the initial R.N. (41%), but were less likely to pursue graduate degrees (11%) than white, non-Hispanic RNs (39% and 14.5%, respectively). Hispanic nurses comprise only 3.5% of all nurses in advanced practice fields.
The vast majority of Hispanic nurses (68.8%) work in hospitals and then in ambulatory care (6.9%). Hispanic nurses also hold only 10.9% of all nursing management jobs, possibly due to the low number of Hispanic nurses with graduate degrees. Finally, there are fewer Hispanic mentors in higher education and nursing leadership positions who can guide other Hispanics. Attracting and retaining nursing students from racial and ethnic minority groups can’t be accomplished without strong faculty role models. According to 2009 data from American Association of Colleges of Nursing member schools, only 11.6% of full-time nursing school faculties come from minority backgrounds, and only 5.1% are male.
As the U.S. population becomes more diverse, leaders in multicultural segments, including Hispanic communities, must encourage minorities—and minority nurses—to become leaders themselves, so when they continue to build upon their skills and advance their careers, they will help themselves and their communities. Health care for this underserved population should ultimately improve if it helps members of the Hispanic nursing community become leaders in health care, experts in the growing field of nursing informatics, and trained nurse educators.
Taking advantage of the online learning environment
Many factors promote successful career development and mobility among Hispanic nurses, and one of the most important is the opportunity for educational advancement. Online higher education programs in the field of nursing help students develop critical leadership skills that, in turn, lead to improvements in their overall community. The online format provides flexibility, providing students the opportunity to take courses while meeting their professional and personal obligations, contributing to multiple other benefits of studying nursing online.
Minority students at all educational levels can see graduates from these programs as role models and examples of how they, too, can achieve success. In cases where students may be struggling, it’s especially important when they can point to a nurse in a leadership position—someone who looks and sounds like they do—as an inspiration to keep going, whether it’s toward getting a Bachelor of Science in Nursing (B.S.N.), a Master of Science in Nursing (M.S.N.), getting a promotion, or taking on an important social change initiative to help a group in need.
Many of these minority students seek out mentors in school, possibly other minority nurses, and often go on to become mentors for the next generation of nurse leaders. For example, many of Walden University’s graduates work and teach in associate degree nursing programs, which have a large representation of Hispanic nursing students, and they help in retain these students through mentoring.
In some ways, online education “levels the playing field” for minority students, fostering increased participation and confidence that may lead to their greater success in the classroom and workplace. Many Hispanic students speak English as a second language and may write better than they speak. Since writing is integral to online learning, it adds a level of confidence that Hispanic students may not feel when sitting in a traditional, bricks-and-mortar classroom. There is no sitting in the back of the room or far from the action and dialogue up front. Consequently, minority students who may struggle in a traditional setting often thrive in online classes, which provide a unique venue for students to have a new voice, speak up, and become leaders in the classroom and beyond.
Increased participation in the online classroom has additional benefits for Hispanic and other minority nursing students. These students not only have the opportunity to hone their personal and professional skills and talents, but they can also develop relationships and network with other nurses across the country. A nurse working in the Cuban American community in South Florida may share best practices with a nurse working with the Mexican American population in Southern California. Or perhaps non-Hispanic nurses working with Hispanic patients may consult with their Latino classmates online for advice regarding how to provide the best care for these patients. Online higher education gives students a special way to connect so they can enhance their education and make a difference in the lives of many.
Making strides toward improving access
As a minority fellow of the American Nurses Association and a current board member of Ethnic Minority Programs for the organization, I work with my colleagues to develop proactive strategies to train, recruit, and retain more minority nurses, especially Hispanics. As Associate Dean of Walden University’s School of Nursing, I lead an experienced, dedicated, and talented team of faculty and staff focused on creating the next generation of leaders in the minority nursing community. Through programs like our Master of Science in Nursing and Bachelor of Science in Nursing Completion Programs, we can make great strides toward increasing the number of Hispanic nurses who serve as role models for the larger minority community.
Online Education in Nursing Informatics By Dr. Kathleen Hunter and Dr. Toni Hebda, Online Master of Science in Nursing Program Faculty, Chamberlain College of Nursing It’s hard to believe, but online education has been around for some time now. Many early online classes were largely text-based, inconsistent in quality, and less than dynamic. Today, the quality of instruction continues to improve, as schools integrate audio and video to meet different learning styles and provide robust student support structures and resources. With nursing informatics, it makes sense to use information technology to teach nurses about how that same technology can support them in a clinical, administration, or educational setting. Nurses must develop their informatics capabilities to understand how to use automated record systems to document care and to retrieve information on individuals as well as patient populations in order to track quality and identify potential problems. As patient advocates, nurses need to be involved in the design of this technology to ensure it promotes patient safety, is easy to use, and supports the caregiver. Increasingly, nurses will be involved in the delivery of care at sites heavily reliant on such technology, including home monitoring and virtual intensive care units. Many online education programs offer informatics, exploring core concepts of data, information, and knowledge in depth. Students gain experience in data management, health care information systems, and project management. The courses prepare nurses to combine their knowledge of information technology, health information exchange, and legal and regulatory issues with their clinical background. Nurses trained in informatics can:
Make the transition to a technology-rich health care delivery system smoother, more efficient, and safer for nurses and patients.
Help design information systems to optimize practitioner decision making.
Design, develop, and test tools for consumer health care, such as health-related websites, home care management systems, remote monitoring, wearable monitoring devices (smart technology), and telenursing (remote nursing via telephone, computer, and/or television).
Promote health literacy through the design and development of information tools that bring health information to diverse populations.
Teach patients using mobile technology (cell phones, notepads, etc).
For many M.S.N. and B.S.N. students, the training they receive in their online courses is put to work directly in their own communities. During their practicum or capstone course, M.S.N. students can choose projects that are inclusive of the needs of their workplace or neighborhoods. Often, these projects involve working with underserved populations to solve problems in community health care. B.S.N. students undertake similar projects in their community health practicum. They can all tap into their nationwide network of fellow students to come up with the best solutions for problems they encounter.
I especially recognize the importance of recruiting faculty members at the doctorate level from minority groups. Since there already is a shortage in the number of Hispanic nurses, you can only imagine how few in this population have earned their doctorates. Yet, they do exist, and when they teach, they make a difference.
One example is Patti Urso, Ph.D., A.P.R.N., C.N.E., Specialization Coordinator of Nursing Education, who currently teaches nursing education courses at Walden. Dr. Urso, a Cuban American originally from Miami, is a nurse practitioner who now lives in Hawaii and works with other underserved populations from Polynesian and Micronesian communities. In Hawaii, she engages with Hispanic patients through community churches and is involved in forming a new chapter for the National Hispanic Nurses Association. She hopes to inspire her students to reach out to underserved communities, and she mentors Hispanic students in the capstone course of the nursing education program.
One of the ways Dr. Urso works to connect with Hispanic nurses is through contact with alumni such as Lydia Lopez, one of the first graduates from Walden’s M.S.N. program in 2007. As a nurse and mentor, Ms. Lopez is committed to being a role model who recruits and retains minority nurses, keeping them interested in their course work and giving them the necessary tools and strategies to facilitate academic success. “True role models are those who possess the qualities that we would like to have and those who have affected us in a way that makes us want to be better people,” she says.
The nursing profession needs both men and women from all ethnicities to meet the needs of society. Minority nurses—especially Hispanics—with bachelor’s degrees and, eventually, master’s and doctoral degrees—who are prepared to educate and lead a new generation of minority nurses—will help improve this critical situation and provide essential health care for all.
There’s no sugarcoating it: pursuing a doctoral degree is tough. Balancing a clinical job with classes and homework—not to mention family time and your social life—takes determination and sacrifice. But if you’re prepared for the challenge, that hard-won degree may be the best investment of your life.
That intimidating introduction aside, keep in mind that hundreds of nurses proudly graduate with a Doctor of Nursing Practice (D.N.P.) or another doctoral degree every year. So what does a D.N.P. program really entail? We asked two experts some common questions surrounding doctoral study, from the admission process to program requirements. Both doctoral-prepared nurses, they can speak to their personal experiences as they now guide other nurses as university administrators.
Q. D.N.P. or Ph.D.: How should nurses choose between them?
TORRES: Ph.D. and D.N.P. programs differ both in their goals and in the competencies of their graduates. The decision to pursue a D.N.P. or Ph.D. depends on your career goals. While a Ph.D. student generates and develops new knowledge, a D.N.P. student translates research already done, evaluates it to see if it works for a specific problem or project, and then puts it into practice.
Ph.D. programs focus heavily on scientific content and research methodology, so if you want to be a nurse scientist/scholar with a research-centric career, you should pursue a Ph.D. The D.N.P. is designed for nurses seeking a terminal degree in nursing practice and offers an alternative to research-focused doctoral programs.
Generally, a D.N.P. is the choice for Advanced Practice Registered Nurses (Certified Registered Nurse Anesthetists, Nurse Practitioners, Clinical Nurse Specialists, or Nurse Midwives) or nurses in other areas of specialized nursing practice (nursing administration, informatics, public health) who want to continue practicing in their area of expertise and are interested in gaining advanced knowledge and skills.
In recent years, there has been a growing demand for D.N.P. programs and degrees. According to the American Association of Colleges of Nursing (AACN), currently there are 153 D.N.P. programs, and between 2009 and 2010, the number of students enrolled in these programs increased from 5,165 to 7,034. In the same period, the number of nurses graduating with a D.N.P. doubled.
RODRIGUES FISHER: The increasing need for practitioners with D.N.P.s stems, in part, from hospitals and health systems looking for skilled nurses who can provide primary care to many people and, in particular, to those in low-income communities. There is also a move to increase the number of Latino and African American nurses who have advanced practice degrees because patients want primary care providers who have the same understanding of cultural beliefs and health care issues.
In order to determine which advanced degree is best for you, it’s important to decide if you want to continue practicing or if you wish to pursue research and teaching.
TORRES: Rather than concentrating on dissertations or research, D.N.P. programs help nurses build upon their current practice, learn new skills, and conduct applied research. Many doctoral students also find great value in completing a project that they can readily apply in practice.
Q. How should nurses prepare for the doctoral program application process?
RODRIGUES FISHER: Start by brushing up on your writing, language, and math skills. They will serve you well. In my personal experience, because English is not my first language, it was important for me to study and brush up on my writing and math skills. I struggled until a professor in my master’s program recommended I take an English course; it was truly the best decision I could have made. After bolstering my language and writing abilities, I felt prepared to take the GRE for my doctoral program.
You should also generate a list of organizations you support, either as a member or otherwise. For example, if you participated in a fundraiser for the American Heart Association or did something to engage members of your community to encourage minority students to continue their education, be certain to list those activities in your application. If you are out in your community doing good deeds, institutions will recognize you as someone who would represent them well.
Make sure someone else reviews your application before you send it in! It’s important to submit a polished application. It should shine a light on you and your achievements, but any mistakes will be blinding.
TORRES: Some schools require Ph.D. and D.N.P. applicants to write an essay about why they want to earn a doctoral degree, what their career goals are, and what they hope to accomplish with the degree. The essay needs to be well-written, with no spelling errors and good grammatical structure.
Many doctoral programs also request written references. Be especially careful who you ask to provide a reference—preferably it should be someone in your area of practice or a faculty member who teaches in that area—and make sure they know you well. Check with the institution if you have any questions about the application or the process.
Q. What are admission counselors looking for in nurses’ applications?
TORRES: Counselors evaluate applications based on a variety of factors, including academic record, essays, and prior experience. Requirements may include a master’s degree or its equivalent, a 3.0 minimum GPA in that master’s program, an active R.N. license, two or more professional references, and official transcripts of highest course work completed, plus the completed application and fee.
RODRIGUES FISHER: Yet, it’s not just about the applicant’s individual grades. Admission counselors look at the whole person, and they want people with broad, varied experiences.
Some questions admission counselors will be asking themselves as they review applications are “What have they done?” “What committees have they served on either in their community or in their health care facility?” and “Have they demonstrated they will be successful in the program?” It’s important to list all activities and committees you are involved in and specifically what your role was on those committees.
TORRES: Doctoral programs may also prefer (or require) a number of years of professional nursing experience. International students may need to demonstrate equivalency via an additional evaluation from the Commission on Graduates of Foreign Nursing Schools (CGFNS).
The D.N.P. requires 1,000 post-bachelor’s clinical hours, of which 500 must be at the D.N.P. level. Admission counselors will obtain information on how many clinical hours the entering students had in their master’s program.
Q. What does the typical doctoral program entail?
TORRES: A typical D.N.P. program is developed based on AACN’s The Essentials of Doctoral Education for Advanced Nursing Practice and covers both course work and clinical hours. The publication outlines the curricular elements and competencies that must be present in programs conferring the Doctor of Nursing Practice.
Doctoral course work is very rigorous. Time management is important, and you will need to closely examine how you are going to complete the course work and use your time to your advantage.
An integral part of the D.N.P. program is the final D.N.P. project, which is usually based on an issue or problem at the student’s institution or facility. It’s important for students to work closely with their schools to ensure the institution supports the project’s implementation. During this project, the student will typically accrue the practicum hours needed. In some ways, the D.N.P. project is similar to a dissertation since it requires approval of the Institutional Review Board (IRB) and includes a committee to guide the project.
RODRIGUES FISHER: All doctoral programs require a lot of reading and library research. Once you get through your core course work, it will be important to identify your research area and possible mentors. One additional piece of advice: focus your course work in the direction of your research.
Q. How might doctoral course work impact a working nurse’s personal life?
RODRIGUES FISHER: Going back to school to pursue your doctorate will definitely impact your personal life. I worked full time, went to school, and had a family to take care of, but the great support from my family made it all possible. My husband made sure the children were taken care of and the housework was done. The house wasn’t always as clean as it could be, and I missed some of my children’s games, but because of the partnership with my husband, we made it work.
TORRES: Before you start a doctoral program, talk with your family so they understand what’s involved, how it may impact them, and how they can help you succeed. You will soon discover how many courses you can manage at a time and whether you can handle a full- or part-time commitment, based on your family, work, and other commitments.
Online programs typically offer nurses more flexibility to work their classes around individual schedules. But even if the delivery method is online, course work still takes time, and doctoral students quickly realize they won’t be able to continue to do all they were doing before deciding to pursue a doctorate. On average, each course is a minimum of 15 hours of work per week.
RODRIGUES FISHER: They say if you educate a woman, you educate a family, and I believe this to be true. Yes, going back to pursue my doctorate took away from some of the other things in my life, but my children benefited as they saw me working hard to achieve what I wanted, both for myself and our family. I was proud to be that kind of role model for them. Work hard and you will be rewarded.
Q. How will a nurse’s duties change after obtaining his or her D.N.P.?
TORRES: Most nurses pursue their D.N.P. because they want to advance in their careers and increase their income. According to the 2009 salary survey conducted by ADVANCE for Nurse Practitioners magazine, D.N.P.-prepared NPs earned $7,688 more than master’s-prepared NPs.
Many graduates move into a new job or position where they can use the skills they learned while acquiring their D.N.P. Others decide to take on additional responsibilities in their current jobs or go into teaching.
RODRIGUES FISHER: The biggest change is more responsibility. As a nurse with a D.N.P., you will be put into leadership positions supervising other nurses. You will also have a more familiar relationship with physicians at your facility. In short, a D.N.P. means increased opportunity.
Q. What do you think about the AACN’s push to have nurses earn a D.N.P.?
TORRES: I support the movement toward the D.N.P. In the transition to the D.N.P., nursing is moving in the direction of other health professions such as medicine (M.D.), dentistry (D.D.S.), pharmacy (Pharm.D.), psychology (Psy.D.), physical therapy (D.P.T.), and audiology (Aud.D.) to provide their professionals with a practice-oriented degree. Nursing is advocating having more nurses obtain their D.N.P., so we are headed in the right direction. In fact, the AACN membership approved a target goal for transition of Advanced Practice Registered Nurse programs to the D.N.P. by 2015.
RODRIGUES FISHER: It’s not just a push from the AACN, but also from the Institute of Medicine to have more educated nurses out there to deliver needed health care to the nation. We are an aging population that is living longer and needs more care. However, with a shortage of health care providers, we need to have nurses who are prepared to practice, are well educated, and can work in a colloquial role with physicians.
Many nurses who choose Walden University do so to advance their careers and become better practitioners. Colleges and universities are looking to develop lifelong learning programs, such as associate to master’s programs and B.S.N. to D.N.P. programs, in order to quickly meet the increased and growing demand for more educated nurses.
Q. What advice do you have for nurses debating whether or not they should pursue a doctorate?
RODRIGUES FISHER: My number one piece of advice is to think about what you are willing to give up for a short period of time in order to pursue your doctorate. I had to give up some of my personal and family time to advance my education and career. For me, the end results—making contributions in the quality and delivery of care and giving patients the best health services they can receive—are truly worth it.
TORRES: Know your career goals, assess your personal life, and identify your passion. Where are you in your career, and what do you want to do? Do you want to concentrate on research and academia, or do you wish to advance your practice?
Timing is everything, so ask yourself: Is this the right time in my life to do this? If not now, when?
