Career Advice: How Do BSN-PhD or BSN-DNP Programs Work?

This month’s question about BSN-PhD/DNP programs comes from a hospital clinical educator who commented on my YouTube video on the choice between getting a PhD or a DNP in nursing.

Finger pressing expert advice key

Credit: Tashatuvango, shutterstock.com

Nursing education has changed over the years in response to changes in social trends and healthcare mandates and to improve the transition from one nursing degree to another.

There are a variety of different pathways to becoming a nurse. You can start out as an LPN with a certificate or an RN with a two-year or four-year college degree. You might work for a few years and then decide you want to improve your opportunities in nursing by continuing your education. But for many, jumping through the hoops to make that advanced education possible is difficult.

For many years, to meet the demand for well-qualified nurses, nursing leaders have encouraged the development of innovative career pathways for nurses seeking their first degree or for nurses going back to school to advance their nursing career (AACN, 1997). These programs are also known as articulation pathways or models or educational mobility programs.

Educational mobility is described as a nursing education curricular design that allows the student to progress as smoothly as possible (i.e., with as little repetition of previous learning or bureaucratic obstacles) from one degree to a higher degree (AACN, 1997).

Educational Mobility in Nursing Education

The BSN-PhD or BSN-DNP pathways are fairly new curricular designs for nursing schools. The purpose is to encourage highly motivated registered nurses (RNs) to continue their education in an accelerated manner.  Credit for prior learning from previous course work and the creation of experience portfolios are mechanisms that allow these models to be affordable and offer an accelerated path to the terminal degree (Scheckel, 2009). The current nursing faculty shortage and growth of distance education (Thompson, 2016) are some of the drivers of innovative BSN-PhD/DNP pathways.

Benefits of educational mobility programs include flexible degree plans, affordability, accessibility (especially with online programs), and accelerated learning (Scheckel, 2009). LPN to RN, RN (Diploma, ASN/ADN) to BSN, RN to MSN, and BSN-PhD/DNP programs are all examples of educational mobility programs.

Characteristics of BSN-PhD/DNP Programs 

Most BSN-PhD/DNP programs are directed toward post-baccalaureate students. That is, they require the students to have completed their BSN and to be licensed as an RN for admission to the program.  A few programs will allow you to be enrolled as a BSN-PhD/DNP student upon admission to the BSN program — but you will have to complete your BSN degree and get licensed as an RN to continue in the program. 

Though there will be individual differences in the programs depending on the college you attend, the following are common policies in these type of programs:

  • BSN from an accredited university
  • An unencumbered RN license
  • A set number of master’s level courses must be successfully completed before any doctoral-level course work can be initiated
  • Students may be required to attend 1-2 intensive sessions per year, lasting 1-2 weeks (commonly during the summer and/or fall), even if the program is advertised as “fully online.” (Expenses are the sole responsibility of the student.)
  • For BSN-DNP students, you’ll choose an advanced practice role (CNS, NP, CRNA, CNM) and will usually need to complete that master’s curriculum first (or most of it) before you are allowed to start doctoral level courses. You’ll need to sit for national certification, also. The APN roles and population-foci available will depend on your school of choice. 
  • Depending on the program, you may be awarded a master’s degree and your doctorate or the awarding of a master’s degree may be bypassed. (You still take master’s level courses, but don’t get a master’s degree when you finish those courses – you only get the PhD or DNP degree at the completion of your program.)
  • For some programs, a set number of hours of clinical nursing experience may be required before enrolling in master’s or doctoral courses
  • Accelerated study: Depending on the program, the doctoral degree may be completed in three- (DNP) to four-years (PhD) of full-time study, including completion of the terminal project or dissertation research.

This is an estimate. Realize that the complexity of the research or project, plus the number of clinical hours that may be needed will determine the length of time it will take to complete the degree. You typically will have 5-7 years, from the date of your first course, to complete your degree. Check your school’s policy.

General Characteristics of Graduate Programs

Though there will be individual differences in the programs depending on the college you attend, the following are common policies in graduate programs:

  • Coursework may be face-to-face or online
  • A minimum grade is required to progress in course work (usually no less than a B average)
  • A passing grade on comprehensive exams (AKA Comps), plus successful defense of your research or project proposal is mandatory to progress to doctoral candidacy (the research phase or project implementation phase of your program). 
  • Clinical hours are required for a DNP degree
  • Teaching hours may be required for either degree
  • Successful completion of a scholarly product (e.g., dissertation of an original research study or theory development) or a terminal project (e.g., capstone project) in order to graduate
  • All graduate schools will have a maximum length of time to complete your degree, typically 5-7 years depending on your specific program

Nurses who are interested in pursuing original research and research-based activities should look into BSN-PhD programs. Nurses interested in advanced clinical practice (CNS, NP, CNM, CRNA) should look into BSN-DNP programs.  For more information on the difference between PhD and DNP preparation see my posts on: How to choose between the degrees, the Benefits of doctoral education, or watch my video on Why you should get a doctorate in nursing.

My Advice …

My thoughts about going straight from a BSN to a doctoral degree are mixed.  Many nursing programs are now offering this pathway.  We need more nurses with doctoral degrees, so flexible pathways are good! But at the same time, I know how different the expectations are from undergraduate to graduate education. It’s a hard shift from thinking like a nurse with a baccalaureate degree to thinking like a nurse with a doctoral degree.

The number one thing I’d tell you is to be sure that whichever program you choose – that the institution you are getting the degree from is accredited!  Look up their ratings in US News and World Report, for example.  Read any reviews about the institution and seek information about how successful their graduates are and where they are getting jobs. 

Second, the more clinical nursing experience you have before you go back to school, the better, in my opinion.  As a former master’s degree option coordinator, I can tell you that even the smartest BSN students struggled in graduate classes when they didn’t have a lot of experience “to hang the theory on.” Of course, I have worked with students who were successful with only a minimal amount of post-BSN clinical practice experience, too — but it wasn’t easy for them!

It’s hard to pick a “magic number” of years to suggest to you.  But I would argue that 2 years of full-time clinical practice experience is a good start – figuring it takes about 1 year after school to learn what being “a nurse” really means and then another year to feel fairly comfortable in your specialty area. I had 5 years of experience when I went back to school and that served me well, plus I continued to work as a staff nurse and unit teacher throughout my BSN and MSN degrees. 

Remember that a graduate degree signifies expertise!  It’s hard to be accepted as an expert when you don’t have a lot of experience.  So if you don’t have much clinical experience and you do go the BSN-doctorate route, as hard as it will be, you should continue working to build your experience.

The bottom line with these programs is that you will be expected to meet the BSN-PhD/DNP terminal outcomes, regardless of your age or the amount of clinical or nursing experience you have going into the program.

Congratulations to those of you considering this path! The work is hard, but the reward will be sweet. 

What questions do you have about BSN-PhD or BSN-DNP programs? Let me know in the comments!

 

References

American Association of Colleges of Nursing. (1997). Educational mobility. Journal of Professional Nursing, 13(4), 271.

Scheckel, M. (2009). Nursing education: Past, present, future. In G. Roux & J. A. Halstead (Eds.), Issues and trends in nursing: Essential knowledge for today and tomorrow (pp. 27-61). Sudbury, MA: Jones and Bartlett. 

Thompson, C. J. (2016). Disruptive innovation: The rise of distance education. Clinical Nurse Specialist,30(4), 238-241. doi: 10.1097/NUR.0000000000000213