Fast Track to Success
Accelerated MSN programs offer students with non-nursing degrees an opportunity to make swift progress on the road to practice

By John Leighty
February 28, 2003

When Michelle Hampton, MSN, RN, earned her psychology degree from the University of Southern California more than a decade ago, she couldn't find a job. In fact, she went to work at JC Penney before deciding to investigate a career in nursing.

Her timing couldn't have been better, as the University of California, San Francisco School of Nursing the year before started an accelerated program for non-nurses with bachelor's degrees who wanted to earn a master's degree in the healing profession.

She was accepted into a class of 30 in 1993 and spent the first year in clinical training and course work. Two years later, she entered the mental health field with her master's in the specialty of psychiatric mental health nursing.

"It was very intense, but I didn't have any apprehensions once I got into the program," said Hampton, who is now director of staff development at Garfield Neurobehavioral Center in Oakland.

Many others in her class had some health care background, she said, whereas she had "a little catching up" to do in understanding medical terms and performing simple procedures, such as blood pressure readings.

UCSF is one of four Northern California nursing schools to initiate an entry-level-to-master's program for people with various degrees; 60 students now are accepted annually into the three-year curriculum. Four hundred candidates applied for the latest class and the demand is growing, according to Scott Ziehm, ND, RN, assistant dean and director of the master's entry program in nursing.

Ziehm, who is also an associate clinical professor, said the program attracts bright, motivated people who have strong liberal arts and science backgrounds. Those enrolled take the RN licensure test (NCLEX) after the first year of clinical studies and boast a 98 percent to 99 percent pass rate. They then go on to advanced practice studies.

"Nearly 400 people have been through the program, gone out and gotten jobs in a range of advanced practice specialties and have been successful," Ziehm said.

In demand

Hampton, who lives in nearby Richmond and has a 4-year-old daughter, is working part time at her mental health job and taking courses toward a doctorate at UCSF, with an eye toward becoming a nurse educator. The inspiration for the higher degree came during research study in the master's program.

"I was definitely impressed and the class was the brightest group of people I've ever been associated with," Hampton said.

In addition to UCSF, similar programs also are offered at Samuel Merritt College/St. Mary's College, San Francisco State University and the University of San Francisco in Northern California and at the Hahn School of Nursing and Health Science at the University of San Diego.

Nationwide, 33 nursing schools have launched entry-level-to-master's programs and the trend pioneered by Yale University is gaining momentum, according to a survey by the American Association of Colleges of Nursing.

K. Sue Hoyt, Ph.D.(c), RN, is the MEPN coordinator at San Diego, which started the program last year in response to an obvious need. "The community was asking for a program like this," Hoyt said, adding that about 1,300 inquiries poured in from people with degrees.

The 28 people accepted into the program will finish their first year in May. They'll return in September in one of three tracks-nurse practitioner, health and care systems administration or clinical nurse specialist.

"We did a feasibility study that showed there truly was a need for this program in the community," Hoyt said. "Also, if someone wants to enter nursing who already has a degree, this program offers the best way to achieve their goals as quickly as possible."

Yale pioneered the concept of accepting non-nursing students in 1974 with an initial enrollment of a dozen students, a number that has steadily increased. The latest class of 66 students started in August and is undergoing an intensive first 11 months of preparations in basic nursing skills and background sciences designed to prepare the students for advanced practice roles. They then will be able to take the NCLEX exams and work part time to gain experience while finishing the three-year program.

"It was a really heretical idea and the major nursing groups were quite threatened by the idea that people with no background in institutional nursing could get an education and go straight into advanced practice, but the program was successful and really took off," said Margaret Beal, Ph.D., MSN, a certified nurse-midwife and Yale's program director for the graduate entry prespecialty in nursing option.

While most GEPN candidates have been students with other degrees who decide to pursue nursing, people from other professions also have joined the program, such as a banker who became a family nurse practitioner and carries a heavy caseload of HIV-positive patients, and an anthropology professor who decided to become a professional midwife and now runs a private practice in the Pacific Northwest.

"What distinguishes Yale is that we really tailor the curriculum to dovetail well with student goals and to thoroughly prepare them for actual advanced practice nursing roles," Beal said.

Taking off

With the successes at Yale, UCSF and other schools that have had programs for some time, other nursing departments are considering offering some form of MSN for people with non-nursing degrees. Many nursing schools recently started programs and at least 17 have such plans on their agendas, according to the AACN.

At DePaul University in Chicago, the nursing program received approval in April 2001 to start a master of science in generalist nursing for students who already have BA/BS degrees in other fields. While starting with just a few students who were already interested in such a program, the last class enrollment was 24 and interest is high.

"The program has grown dramatically in popularity since the word got out," said Susan Poslusny, Ph.D., RN, chair of the nursing department at DePaul. "The students are wonderful. They're very bright and accomplished learners who have a broad background in other areas that enriches the educational experience for all of the students as well as the faculty."

The two-year program has some prerequisites such as organic chemistry, a year of biology and some allied field requirements such as psychology, basic statistics and economics. The curriculum contains 830 clinical hours and prepares students to become licensed RNs with a master's degree. If they then want to specialize to become a nurse practitioner, nurse anesthesiologist, midwife or health administrator, they can return and complete a post-master's in the field.

"These are students who made a career plan transition," Poslusny said. "They really are coming to nursing with a well-thought-out decision that this is what they want to do."

One of the first graduates of the DePaul program was Susan Kinsley, MS, RN, who had a BS degree in therapeutic recreation from the University of Iowa and was looking for a way to enter the nursing field when she heard about the entry-level-to-master's degree. She was accepted in the initial class of four in September 2000 and earned her generic master's last June, passing the nursing exam in August.

"My childhood dream was to be a doctor, but I decided if I wanted a family, I couldn't go to medical school," said Kinsley, who was working as a recreational therapist at a residential treatment facility before entering the master's program. Today, she's a busy full-time nurse in the burn intensive care unit at the University of Chicago Hospitals.

Kinsley was able to graduate with the master's in two years instead of the usual three because she had many of the course prerequisites as an undergrad premed major. She may decide to return to DePaul to prepare for the specialty of nurse practitioner, but it won't be for awhile. "I really love what I'm doing too much to return to school right now."

Innovative approach

At the University of Iowa College of Nursing, a professional master's degree in nursing and health care practice was offered for the first time last year and attracted an initial class of 16 students with non-nursing baccalaureates.

"The nursing shortage has given us some real opportunities to do some innovative programs and really change the culture of nursing," said Melanie Dreher, Ph.D., RN, FAAN, dean of the school's College of Nursing. "I think the timing is perfect for this program and the first class size is just right to get the kinks out."

Dreher said that even without advertising the program, the school received 90 inquiries. Those accepted included students with undergraduate degrees ranging from English to accounting, and included one Chinese physician. The school plans to increase enrollment for the next classes to 32, then 48 and, eventually, 64 students.

The professional master's may be completed in four semesters, including a semester-long clinical internship that occurs five days a week for three months. Students then are eligible to take the national licensing exam. At this point, they can enter the workforce or return to school to pursue advanced nursing practice specialties, Dreher said.

Seattle University admitted its first class of 20 students in June and 20 more will enter this summer in an advanced practice nursing immersion master's program for people holding bachelor's degrees in non-nursing fields. The curriculum consists of four consecutive quarters of pre-licensure clinical study and coursework followed by five additional quarters of specialty focus.

"It's very intense, but the first class is doing very well," said Graduate Program Director Kathryn Anderson, Ph.D., RN. "We put them right into a nursing home setting, which was a little hard, but after overcoming their initial anxiety, they got into it and really enjoy the clinical component."

Kathleen Dracup, DNSc, FNP, RN, FAAN, dean of the UCSF School of Nursing, said that even though many of the fast-track MSN candidates don't have clinical experience or even health care backgrounds, they've been attracted to nursing after careful consideration and few students have dropped out of the program. For this reason, she encourages staff nurses to be patient and encouraging when non-nursing MSN students show up for clinical rotation training.

"It's been a long-held belief that before a nurse gets a master's, they need several years of nursing experience, but with this program we encourage students to go straight through," Dracup said. "This is an amazing group of students who will be leaders in nursing. We've found them to be extraordinarily motivated, mature and successful."

Contact John Leighty at johnsan@aol.com