What kind of nursing school to go to?
November 12, 2009 7:49 AM   Subscribe

Career change filter. I'm interested in becoming a nurse. How do I pick what degree to go for?

I find the number of options confusing - ASN, BSN, LPN/LVN, masters programs, etc, and I have no idea what path would work best for me.

About me: I graduated with a BA from a liberal arts college a few years ago and have spent the past 2-3 years doing scientific research. I have taken a number of the courses commonly listed as pre-requisites for nursing school, although not all of them. I have a good (around 3.5) gpa and 1500+ GREs. I currently work full-time and take 1-2 courses per semester through the university I work at, although none so far have been targeted to nursing school. I plan on volunteering at a local hospital starting in January, to get a better sense of what a nursing career would be like (and would love suggestions of other ways to get more of that kind of experience).

I'd like to move through nursing school as quickly as possible. The end goal is to become a traveling nurse. I enjoy research and teaching a great deal, and have a background/interest in psychology/psychiatry, so those are avenues to pursue as well, but my most immediate hope is to gain the stability and flexibility of a working nurse as soon as possible, and I'm happy to bust my ass for a year or two to get there.

It seems that accelerated BSNs exist but are very hard to get into. It also seems like an associates, or becoming an LPN would be fast and probably less expensive as well, but perhaps there are fewer job opportunities?

What *are* the functional differences between these options?

Throwaway email is paging.anonymous@gmail.com if you need it. Feel free to ask follow up questions and I'll find a way to reply.
posted by anonymous to Education (16 answers total) 13 users marked this as a favorite
I've heard good things about Mass General's Accelerated BSN Program. It's specifically geared for those with a degree but no nursing background. Good luck to you!
posted by handabear at 7:59 AM on November 12, 2009

As a follow up, based on the qualifications you've stated, I really think that you might be a more competitive candidate to a BSN program than you realize!

I have a couple of friends working in the field and from what they've explained to me, the scope of practice for a LPN can be limited compared to the scope of practice of a RN. Of course I believe this varies depending on where you will be practicing.
posted by handabear at 8:13 AM on November 12, 2009

You definitely want to be an RN. Much better money, higher status, broader range of duties. I'd recommend getting the full BSN degree because every nurse I know who hasn't done that has ended up going back for it later.
posted by something something at 8:38 AM on November 12, 2009 [1 favorite]

Like handabear, I think you would be a competitive applicant for an accelerated BSN program, and getting a BSN is going to be the most marketable credential for becoming a traveling nurse. Also, if there is a Master's program that allows you to be a registered nurse when you are finished, that would probably qualify you to teach and research some day as well.

I think that an associate degree nursing program is an option, but at least around here, the schools have pretty long wait lists. LPN is probably not going to give you the flexibility you are looking for.

One thing you could do to improve your marketability to some of the accelerated programs is to get a Certified Nursing Assistant credential. Usually the course is pretty short, maybe a month, and then you can work part-time as a CNA or do more intensive volunteer work....Even just the course will give you a good grasp of some of the day-to-day aspects of nursing.
posted by mjcon at 8:40 AM on November 12, 2009

LVN/LPN vs RN are licenses. Forget about LVN. Be a Registered Nurse.
AD vs BS/BSN are educational programs that will qualify you for a license.

Master's in Nursing or a related field will require that you are already an RN.

So you need to decide between an AD program and a BS. (or BSN, depending or the school. Tomato/ToMAHto)

If you already have a BA, I am not sure that a BSN will offer you a lot more than an associate's Degree. You have a wide-ranging educational background that will serve you well in advancement. Look at what programs you can get into and complete quickly. An AD will get you licensed and working just as well as a BS, and possibly more quickly. But an accelerated BSN program may be just as quick, I am not familiar with those. If you have an AD and want to go further, you can take RN to BS programs. Or maybe go directly to a Master's program, since you already have a BA.

Feel free to me-mail me.

posted by SLC Mom at 8:56 AM on November 12, 2009

Not sure how much this will help, but here goes...

My step daughter went into a 3 year MSN program straight out of college. Her college degree was a BA, not in anything related to nursing. After the first intense year of the MSN program, she qualified to take the state RN exam to get her RN license. During the last 2 years of her program, while she was working toward her MSN, she worked parttime as an RN. Once she graduated, she qualified to take the state APRN exam to get her APRN license. As an APRN, she can do things like write prescriptions and open her own practice, which I don't think RNs can do (but I could be wrong).
posted by Maisie at 10:29 AM on November 12, 2009

I used to be the graduate coordinator for a major US university school of nursing. I counseled people just like you, and I would probably advise you to go into a direct-entry MSN program. They are designed exactly for adults changing careers, and I think they take much better advantage of your previous education and skills.

There are around 30 or so programs like this in the US, and they vary a bit by specifics. The program I worked with was a 3-year program starting in the summer. The first year you took accelerated coursework to complete the RN requirements, and sat for the NCLEX exam at the end of that year to get your RN license. That means you could be a working nurse in 1 year. Then the next two were spent on advanced practice coursework towards the MSN.

In that program, we did not award a BSN, so there was the stipulation that you could not work out-of-state until you finished the MSN. Some programs do offer the BSN en-route to the MSN, it just varies. Our program was also designed such that you took your RN coursework only with fellow direct-entry students, you were not in the regular BSM program. That means that you could work at a higher level b/c all the students already had at least one bachelor's degree (and we sometimes also had people with non-nursing graduate degrees).

These programs are competitive, but based on the information you posted here, I would say you would be very highly qualified and exactly the type of student we would heavily recruit. Your research background makes you especially attractive.

I'd be happy to share more specifics via MeMail if you want.
posted by DiscourseMarker at 10:31 AM on November 12, 2009 [2 favorites]

RN, BSN, Traveller, here.

An Associate Degree will indeed make you eligible to take the RN license exams. The AD will limit your opportunity for advancement, and in some places, an AD or diploma means you will be considered to be trained for work in extended care or similar facilities.

Traveling requires at least three year's experience after graduation, and isn't all that lucrative these days unless you have a specialty or two to peddle.

I challenged my way into the BSN programme, and cut out a lot of the prerequisite arts, humanities and sciences. That still left me with 2+ years of nursing school.
posted by reflecked at 10:35 AM on November 12, 2009

Mrs. imjustsaying is a 55 year old RN and would be the first to tell you to go for the BSN. She does not have this degree because she doesn't want to jump through the necessary hoops at her age.
posted by imjustsaying at 3:10 PM on November 12, 2009

Let me start with a side note, because this alphabet soup confused me like crazy when I started researching changing careers into nursing:

- credentials = what degree you got = AN (associates in nursing), BSN (bachelor of science in nursing), MN (master of nursing), MSN (master of science in nursing), DNP (doctor of nursing practice)

- licensure = what nationally standardized test you passed = LPN (licensed practical nurse), RN (registered nurse), NP (nurse practitioner), CNS (clinical nurse specialist), etc.
People with a short community-college course can become LPNs. ANs, BSNs, and MNs can take the RN exam. To take the NP or CNS exam, you must have completed an MSN or DNP degree.

- certification = what extra education and experience and testing you've done to be certified in a specialty = oncology certified nurse (OCN), certified wound care nurse (CWCN), and a ton of others for RNs and advanced practice nurses

OK, with that out of the way...

I just started a MN (Master of Nursing) program this fall. It's aimed at people who have their undergraduate degree in something not-nursing, and it's only 18 months long. When we graduate we will have Masters degrees and take the NCLEX exam to earn our Registered Nurse (RN) licensure.

This is somewhat different from the alternate-entry MSN (Master of Science in Nursing) programs offered at some schools, in which students with a non-nursing bachelor's degree can earn their MSN over (about) 3 years to become advanced practice nurses (a category which includes nurse practitioners, nurse anesthetists, nurse midwives, and clinical nurse specialists, and typically involves more independent practice and the legal ability to prescribe medicines).

My program is shorter than the MSN, and basically provides the same basic knowledge that a BSN (bachelor of science in nursing) student would get, but our courses involve much more critical thinking and leadership work than a bachelor's degree. When we graduate we will apply for the same jobs that BSNs apply for, but with the MN degree we are expected to move up in the clinical setting much more quickly. That is why I chose to go for the MN instead of an accelerated second bachelors. It would definitely be a great qualification for a travel nurse, and several people in my program are planning to go that direction when we graduate.

I should also point out that our classes are all with MN students instead of BSN students, and the tenor of the coursework and the quality of my classmates is definitely above what I remember from undergrad. Everyone in our group has proven their academic mettle by completing an undergrad degree. Many of them have worked in some field (from medical research to peace studies to computer science to psychology to theater) and have serious maturity and insight from those experiences that you wouldn't see with undergrads. And because we're all making career changes into nursing, we all really want to be there -- none of my classmates wish they were studying a different major but their parents said this would help them earn lots of money, or whatever. These people are passionate about becoming nurses. That sets the experience in this program above what you would get in a bachelor's program, and waaay above what you would get in an associate's degree program. (And incidentally, your description of your educational and work background sounds like a perfect fit for the program I'm in.)

That said, I've met plenty of working nurses who say you should get into the field any way you can, even if it's an associate's degree. If that's all you can afford, or that's the only school you can get into, you can always go back to school later and work your way up, as many of them have done. Still, in 5 years of hospital volunteering I think almost every nurse I've talked to has said they hope to go back to school to either complete their bachelors, or get their masters degree, so if you have the opportunity you might as well do it now.

One thing I wouldn't really recommend doing is the LPN. The "practical" in "licensed practical nurse" means they only do technical skills, such as taking blood pressures, doing bed baths, etc. An RN has much more autonomy and decision-making authority, which is likely something that someone with your educational background is going to want. RNs also get paid better.

My school also offers the DNP (doctor of nursing practice), which will be the required degree for anyone who wants to become a new advanced practice nurse starting in 2015. It's basically like the final 2 years of the MSN programs others have described above, and those schools will eventually have to change their programs to be DNP instead of MSN for people who want to be advanced practice nurses. Luckily for me, many of the courses I'm taking in the MN program will carry over to meet the early requirements for the DNP because they're at the graduate level. BSN courses would not qualify.

The MN program is definitely less specialized than the MSN, and qualifies me for lesser licensure (RN instead of NP or CNS), but it is much shorter. As a new nurse, I felt that the MN was a better option for me because:
* It's a shorter time commitment before I can get my degree and work as an RN, which means I'll be out less time and money if I get into the field and somehow find that I don't like nursing (though I don't expect that to happen).
* Many alternate-entry MSN programs require you to apply to a specialty right off the bat, and I would rather do my MN, get some experience working and seeing what options are available to a nurse, and THEN pick a specialty to become an advanced practice nurse.
* These programs are intense and fast-paced, which makes it very hard to work during them. I'm racking up a lot of loans in my 18 months, and I'm looking forward to paying some of them off with a job before going back to study a specialty. Heck, I'm hoping I can keep working while I do my DNP, and get some tuition reimbursement from my employer. That's not always possible if you go directly into a 3-year MSN program.

The American Association of Colleges of Nursing has an info sheet on accelerated nursing programs for people who already have a bachelor's degree, and I referred to it often while I was researching and applying to schools. In particular, the top of the page has lists of accelerated bachelor's and master's programs by state. This will save you a lot of time compared to visiting the website of every school you can think of to see if they offer an accelerated program.

I would be happy to answer any other questions you have about this; feel free to add on here or send me a message.
posted by vytae at 4:38 PM on November 12, 2009 [5 favorites]

I'm currently in a one-year 2nd career BSN program. My BA is in theatre & drama (undergrad GPA of 2.997), and I have a masters in information and library studies as well. I volunteered every Saturday morning for two years at our university's hospital, and took all my science and nursing prereqs at community college while working full-time. We have just finished the first 10 weeks of this program and I have never worked so hard in my life. I love it.

I agree that you sound like an excellent candidate for this type of program. At my school they LOVE the students with a research background. Let me know if I can answer any questions about my experiences.
posted by shiny blue object at 5:40 PM on November 12, 2009

I apologize if this is too far off of your question, but have you considered PA school? It sounds a little more up your alley.
posted by LittleMissCranky at 7:20 PM on November 12, 2009

OP here. Thank you all for your very informative replies! Please keep them coming, if anyone has more to add.

Also, if people wouldn't mind me-mailing me with the specific accelerated BSN/MN/MSN programs that they're referencing, that would be great. I'm compiling a list of programs but I've just started looking.

A nearby school offers a 16 month "Clinical Nurse Leader" program, with an MSN at the end. Has anyone had experience with this type of program?

Finally - does anyone have a feel for how abundant financial aid is in these programs?

Thanks again, everyone!

Oh, and LittleMissCranky - I did not know anything about PA school. What do you think makes it more suited to me? I think it looks more challenging in certain respects, but does it have options like part-time, per diem work or travel jobs like nursing?
posted by shaun uh at 9:08 PM on November 12, 2009

One problem I ran into with financial aid is that some of the programs didn't make those decisions until well AFTER I had to send in my decision about where I was going.

From one MSN program at a large state school, I was offered a $10k per semester grant along with my acceptance letter. My first-choice school wasn't even looking at financial aid apps until 2 months after our decisions were due, but I hoped they would give me something comparable because they're also a large state school. I signed on for my 1st choice program, and found out 2 months before the program began that they didn't have ANY free money for me. All they could offer was guaranteed federal loans to cover the cost of the program and living expenses.

My overall impressions are (a) don't expect full funding the way people seem to in liberal arts and science graduate programs, and (b) find out from any schools you're looking at what kind of scholarships they offer, how much money is available, and when the decisions are made, because this varies highly.
posted by vytae at 10:21 AM on November 13, 2009

Well, a few things that made me think of that:
- It's a two year program, sometimes with an internship semester if you would like to specialize, with no expectation of prior coursework beyond basic science prerequisites
- There are a lot of opportunities to be involved in the interesting parts (i.e. not just administrative or grunt work) of research
- The opportunity to specialize, including in psychiatry
- A lot of geographic flexibility
- You sound rather academic, and PAs tend to be a little more academically inclined than most nurses -- not that there aren't very academic nurses, but fewer in my experience. Note that I am NOT using "academic" as a euphemism for "smart." There are truly a lot of very smart people in both fields.
- Excellent job security and flexibility
- Generally much better pay than for most nurses
- More autonomy than most nurses
- PAs continue to be in greater demand as healthcare costs continue to rise. This is likely to continue -- and perhaps accelerate -- even if some kind of government healthcare is passed.

Negatives or caveats that I can think of off the top of my head:
- It is a tougher science program and generally a more rigorous load. You don't really discuss how you are at science or how much you enjoy it. You'll have to get through quite a bit of science for either program, but you should probably enjoy it pretty well to go the PA route.
- It is a different job in many ways, and you would have to evaluate which path is right for you. Generally, PAs fall on the physician side of things, and there jobs are more similar to doctors than to nurses. The physician side tends (broadly) to make medical decisions, while nurses tend to implement those decisions and serve as the "front line" in patient care. You will spend more time with each individual patient as a nurse.
- Programs can be quite competitive. Your current grades and numbers sound like you would be in very good shape to get in to a good program, but it would also be highly dependent on your science grades and scores.

Good luck!
posted by LittleMissCranky at 4:34 PM on November 13, 2009

Oh, and I forgot -- there are a LOT of PAs who work part time and as locum tenens.
posted by LittleMissCranky at 4:38 PM on November 13, 2009

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