NR 500 Discussion Topic WeNR 500 Discussion Topic Week 1, The Value of a Master’s – Prepared Nurse (Two Versions)ek 1, The Value of a Master’s – Prepared Nurse (Two Versions) - $7.49   Add to cart

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NR 500 Discussion Topic WeNR 500 Discussion Topic Week 1, The Value of a Master’s – Prepared Nurse (Two Versions)ek 1, The Value of a Master’s – Prepared Nurse (Two Versions)

Week 1: The Value of a Master's-Prepared Nurse Consider the current healthcare delivery models and practice settings. Reflect on how nursing practice is transforming in response to the current demands of the healthcare system and answer one of the following questions: 1. What differentiates the practice of a master's-prepared nurse compared to that of a baccalaureate-prepared nurse? 2. What is the value of a master's degree in nursing? 3. What do you consider to be the most essential professional competency for a master's-prepared nurse practicing in the 21st century? Refer to AACN Essentials, CCN Nursing Conceptual Framework and other scholarly sources. Use at least one outside scholarly article to support your position. Provide an example to illustrate an application to professional practice. Valerie Sayage Sep 2, 2018Local: Sep 2 at 3:42pm<br>Course: Sep 2 at 2:42pm Good evening Dr. Bucher and classmates, The baccalaureate program I completed held a great focus on nursing theory, and the program forced you to think differently and use critical thinking skills. We learned about Evidence Based Practices and new technologies and considered how to best integrate them into nursing care. Everything we discussed revolved around doing things better and with a focus on optimal patient outcomes. Along the way I also started to refine my leadership skills. The program provided me with a very strong base within the discipline of nursing. And, just like any discipline there are advancements that can change the practice and upset long held beliefs. That is the beauty of education. Nelson Mandela once said, “Education is the most powerful weapon which you can use to change the world” (Meah, 2015). I firmly believe this statement to be true. Graduate level nurses are taught to promote patient centered care and safety, ask why, and approach new evidence with a critical eye. The program allows the graduate “to engage in higher level of practice and leadership” (AACN, 2011, p. 4) which can influence change. Consider some of the nine Essentials set out by the AACN for a master’s program in nursing: science and humanities, leadership, quality improvement and safety, integrating scholarship into practice, informatics and technology, healthcare policy and advocacy, collaboration and patient outcomes (AACN, 2011). All of these Essentials build on the base of the baccalaureate program and takes it to the next level. The specifics involved with obtaining measurable differences between baccalaureate prepared nurses and master’s level nurses I found was difficult to find within a five year time span. I did find a dissertation comparing the two from an “impact of graduate education among nurse leaders (IGENL)” survey (Chari, 2017, p. 2) which demonstrated nurse leaders scored better in terms of “professional practice, communication/teamwork and problem solving subscales” (Chari, 2017, p. 46). The master’s prepared nurse is able to achieve positions within the healthcare system where they can guide and positively impact the discipline of nursing on the micro-level, the core of our practice, to benefit care and outcomes for the future. American Association of Colleges of Nursing. (2011). The Essentials of masters education in nursing. Retrieved from Chari, S. (2017). Comparing the effectiveness of masters-prepared and non-masters-prepared nurse leaders. Retrieved from ?article=4697&context=dissertations (Links to an external site.)Links to an external site. Meah, A. (2015). 50 Inspirational Nelson Mandela quotes that will change your life. Retrieved from Danielle Wiemann Sep 4, 2018Local: Sep 4 at 12:50pm<br>Course: Sep 4 at 11:50am Hi Valerie, I liked the Nelson Mandela quote you shared, and I too agree that education can change the world. Out of the few essentials by AACN you listed, is there one or two that stand out to you personally? I like community involvement, teaching about diseases, and the importance of preventative health. While I was in the BSN program here at Chamberlain, I participated in the Global Health Education Program for community health class and went to Kenya. It was one of the best and most rewarding things I have ever done! We did a symposium day that we got to teach community health workers about different subjects like CPR, sexually transmitted diseases and prevention, importance of clean water, and my group taught them how to perform self testicular and breast exams. The most touching thing from that was when one of the women we taught pulled me aside and told me that she has lumps in her breasts that she was concerned about, I was able to perform a breast exams on her, it was very concerning. I was able to get her a medical card and was able to go with her to a hospital so she could get a biopsy, that was definitely the highlight of my trip. I also agree with you that it was hard to find measurable information nurses who hold a bachelor’s degree versus a master’s degree. One thing that I keep coming across is that obtaining a master's degree increases personal satisfaction which in turn increases patient satisfaction. According to Cotterill-Walker (2012), “There are positive gains for nurses who undertake postgraduate nursing study at master's level related to professional and personal qualities which may provide direct benefit to patients”. This also supports your Mandela quote! Cotterill-Walker, S. M. (2012). Where is the evidence that master's level nursing education makes a difference to patient care? Nurse Education Today, 32(1), 57-64. Retrieved from  Valerie Sayage Sep 4, 2018Local: Sep 4 at 8:53pm<br>Course: Sep 4 at 7:53pm Hi Danielle, Sounds like you had an amazing and memorable experience in Kenya! The information and you and your team provided might seem to us to be common knowledge, but where you went to it could and was lifesaving and valuable. Imagine what could have happened to that woman if she had not learned what your team traveled so far to teach. I have never participated in such a trip. Not because it was unavailable to me to do so, but because when those opportunities arose I was not in a position to leave my home or work. What you have gained by participating will help you as a professional on many levels. From what I have read, these benefits include a broader exposure and scope of diseases, sensitivity to culture, and “exposure to alternative health delivery models with a broader emphasis on cost and resource allocation” (Bills & Ahn, 2015, para. 6). These are invaluable skills to bring forward in your career. Kudos to all of you. I hope she fairs well. If I were to choose which two Essentials speak to me the most I would have to say quality improvement and safety, and healthcare policy draw me in. I have seen firsthand the negative results of poor safety practices and weak policy. Both have resulted in sentinel events that were perfectly avoidable had someone taken a moment in time or had someone else check what they were doing prior to proceeding. It is frustrating for everyone as these events do not ultimately reflect everyones over-all practice, but none-the-less leave an indelible mark. I participated in the creation of several patient safety initiatives which have had major positive impacts on quality and patient safety – falls, specimen mislabelings, and patients presenting with truncal and or dental complaints (atypical MI presentations) to name a few. I have also participated in the development of policy where throughput is concerned which, in a very obtuse way, improves patient safety as “studies found that ED crowding is associated with higher rates of inpatient mortality among those admitted to hospital from the ED and discharged from the ED to home” (Carter, Pouch, & Larson, 2014, para 25.). The goal is that we get admitted patients to the inpatient units to which they are to be admitted in a more timely fashion which not only improves patient satisfaction, but clearly, improves patient outcomes. Bills, C., Ahn, J. (2015). Global health education as a translational science in graduate medical education. Journal of Graduate Medical Education. 7(2), 166-168. Retrieved from Doi 10.4300/JGME-D-14-00319.1 Carter, E., Pouch, S., & Larson, E. (2014). The relationship between emergency department crowding and patient outcomes: a systematic review. Retrieved from articles/PMC/ (Links to an external site.)Links to an external site.  Teresa Hogan Sep 7, 2018Local: Sep 7 at 11:36am<br>Course: Sep 7 at 10:36am Hello Danielle, I am so glad you had the opportunity to travel to Kenya and share your medical expertise with the people there. This summer, my husband also traveled to Kenya. It is amazing how much we take for granted in America. Clean water, for example, is something we rarely consider. Technology is another luxury that we in developed nations have come to expect. In the blink of an eye, we can be connected with a healthcare professional who is willing to virtually dialogue with us in our own homes, email our prescriptions to our favorite pharmacies, and infrastructures with cities that allow us to easily obtain medicine to make us feel well once again. Sometimes, we can become a bit blind in our own home country to those who are struggling. Even in such a rich nation, we have people without access to the resources to be able to live well. Sadly, life for some here in America does not include easy access to healthcare, money to afford needed medications, or the ability to get proper dental and eye care. When I think of how a masters prepared nurse can make an impact, I think of being able to serve the under-served here at home as well as in other very needy nations. Nurses are truly indispensable! Nicholas Whitaker Sep 9, 2018Local: Sep 9 at 9:50pm<br>Course: Sep 9 at 8:50pm Valerie, I think with most of us starting off as staff nurses and providing direct patient care, we are in a great position to implement better practices every day that are research-based. In other words, we are on the way to achieving our graduate degree so we can make our healthcare system better, and since we have first-hand knowledge of patient care, I think we are steps ahead of other healthcare professionals that haven’t had that opportunity. We can have a more realistic approach to solving problems that we know can be solved because we have seen those problems with our own eyes. Your thoughts on master’s-prepared nurses having a positive impact on nursing discipline is very true. The facility at which, I’m employed, all our clinical nursing educators have their master’s degrees. They are the ones always helping set up new policies after they do their own research on different practices our doctors are wanting to implement. We have “super-users,” I don’t know if this is a common term at other facilities, but super-users are staff nurses that also help implement those new policies on the more practical side of things and making sure the new practices won’t negatively impact our charting or workflow. I am a super-user myself and it has always been a fun experience helping take research-based procedures and tailoring them to our work-flow so we can keep our practices updated without hindering our productivity. Julia Bucher Sep 10, 2018Local: Sep 10 at 7:18am<br>Course: Sep 10 at 6:18am Nicholas and Class, Several of you mentioned you implementing evidence-based best practices. Commonly referred to as EBP, this approach is very important. Hospitals have EBP committees but even other work sites can implement EBP by 1) staying on top of EBP by attending conferences or 2) skimming the best journals and newsletters and replicating interventions or procedures with 3) evaluation attached of course. Dr. B. • Danielle Wiemann Sep 3, 2018Local: Sep 3 at 2:25pm<br>Course: Sep 3 at 1:25pm o What differentiates the practice of a master's-prepared nurse compared to that of a baccalaureate-prepared nurse?  Master’s-prepared nurses should have knowledge in specialty area’s such as administration, education, leadership, informatics, and healthcare policy. Bachelor’s-prepared nurses have broad knowledge of nursing across the lifespan and use evidence-based practice and critical thinking in their everyday practice (Chamberlain College of Nursing, 2016). What is the value of a master's degree in nursing? 0. According to Nurse Journal (2017), with a master’s degree in nursing there are jobs such as education, primary care, management, and leadership options available. With some master’s degree jobs there is more flexibility, autonomy, and increased salary. 2. What do you consider to be the most essential professional competency for a master's-prepared nurse practicing in the 21st century? 0. I believe all of the essential professional competencies listed in the American Association of Colleges of Nursing (AACN) Essentials of Master's Education in Nursing are important to the advancements of healthcare, however the one that stands out most to me is Clinical Prevention and Population Health for Improving Health. This stands out most to me because enjoy community outreach and teaching people about preventative care, disease processes, and interventions. I also believe if there was more focus on community health and preventative care, especially in low income areas we may be able to reduce the amount of unnecessary ER/Urgent Care visits and reduce health care costs. According to American Association of Colleges of Nursing (AACN) Essentials of Master's Education in Nursing (2011), 50 percent of preventable deaths in the United States are due to unhealthy lifestyle behaviors. American Association of Colleges of Nursing (AACN). (2011). The essentials of master's education in nursing. Washington, DC: Author Chamberlain College of Nursing (2016). Chamberlain college of nursing masters of science in nursing conceptual framework. Retrieved from Nurse Journal. (2017). About the Added Value of a MSN Degree. Retrieved from 3. Emily Kelly Sep 4, 2018Local: Sep 4 at 6:14pm<br>Course: Sep 4 at 5:14pm Danielle, I like what you were saying for the last question about how you believe that Clinical Prevention and Population Health for Improving Health is the most important professional competency for a master's prepared nurse. I agree that if more people focused on community health then the health of the general population as well as the health of the impoverished community would improve and therefore healthcare costs would lower. I also believe that if there were more of a focus on primary prevention as opposed to secondary and tertiary prevention then healthcare costs would lower dramatically. I wrote in my post about the value of a master's degree in nursing. In your response to that question you mentioned that nurses flexibility, autonomy, career options and higher salaries. However, I think one thing that should definitely be mentioned is how master's prepared nursing benefits the patients as well as the nurses. A master's prepared nurse directly benefits patients by having increased critical thinking skills, better decision making abilities, and the ability to develop advanced skills to put into practice(Cotterill-Walker, 2012). Cotterill-Walker, S. M. (2012). Where is the evidence that master's level nursing education makes a difference to patient care? A literature review. Nurse Education Today, 32(1), 57–64. doi:10.1016/.2011.02.001 o Zachary Nolan Sep 5, 2018Local: Sep 5 at 1:14pm<br>Course: Sep 5 at 12:14pm Hi Danielle, I agree that the master prepared nurse has knowledge in leadership. At the facility that I work at, a master degree in nursing is a requirement in order to become a unit director. According to the American Association of Colleges of Nursing, essential two includes organizational and systems leadership. The master prepared nurse has leadership skills that allows them to promote improved patient outcomes (AACN, 2011). As a bachelor prepared nurse, I do not have the confidence to organize and lead a nursing unit. With a master degree, nurses are educated on organization systems, leadership, and healthcare policy. Having this additional training not only would give a master prepared nurse the confidence to lead but it would also give the nurse leader the knowledge to support their leadership decisions and more importantly, it will help promote improved patient outcomes. I do agree that the essential regarding clinical prevention and population health is crucial also. In my original posting, I discussed how important it is for the master prepared nurse to critique scholarly writing in order to ensure nurses are using evidenced practice. Through the master prepared nurse using their education to implement essentials four and eight, we are able to improve patient outcomes and implement the most up to date evidence for patient care. After all, the patient is the focus of nursing practice. References American Association of Colleges of Nursing. (2011). The essentials of master's education in nursing. Washington, DC: Author. 0. Julia Bucher Sep 5, 2018Local: Sep 5 at 3:33pm<br>Course: Sep 5 at 2:33pm Class, For Week 1 it is evident that you are committed to the profession of nursing and advancing your own learning. 1. What do you consider to be the most essential professional competency for a master's-prepared nurse practicing in the 21st century? This question above makes me wonder if you think that the answer about competency differs depending on employment setting? For example, would a home health MSN CNS need the same priority competency as an inhospital CNS? What about a NP employed in primary care versus a NP in an acute care hospital setting? I am interested in your thoughts. Dr. B. 2. Valerie Sayage Sep 5, 2018Local: Sep 5 at 8:24pm<br>Course: Sep 5 at 7:24pm Good evening Dr. Bucher and classmates, I believe that the Essentials are relevant in all the settings you describe. The level to which each essential will be employed may differ, but it is without doubt that all the essentials are pertinent in each care setting. Each essential comes into play in one way, shape, or form when caring for patients in general. Essential I involves integrating sound, proven findings into all aspects of nursing: “biopsychosocial fields, genetics, public health, quality improvement, and organizational sciences” (AACN, 2011, p. 4). Clearly this essential crosses boundaries between acute care settings and private. Essential II talks about the importance of leadership and its impact on quality and safety of patient care, along with importance of critical thinking and a global view for effectiveness. Essential III high-lights the systematic and structured methods that are to be adopted to measure quality and performance for optimal patient outcomes and organizational structure. Essential IV is about applying research to current issues and assessing its benefit or lack thereof. Once a successful intervention is identified, it is expected that the findings are disseminated to other professionals to positively impact practice across the continuum. This means impacting private and acute care settings. Essential V has to do with incorporating healthcare technology which is inescapable in all healthcare settings. Essential VI is about advocacy and having a professional responsibility to “intervene at the system level through the policy development process” (AACN, 2011, p. 5) to improve care and outcomes. Essential VII emphasizes teamwork/collaboration, and communication with all pertinent members of the care team. VIII accentuates the need for cultural sensitivity and patient centered care which does not leave out family and/or significant others. Essential IX covers the broad spectrum of knowledge and influence a master’s prepared nurse must possess in order to positively impact care both overtly and collaterally patient care and outcomes. A well rounded, professional will/should incorporate each essential to some degree in each care setting. One may focus more or less on a particular essential, but they are just what they are called – essential and integral to the forward thinking progress of the nursing discipline. American Association of Colleges of Nursing. (2011). The Essentials of masters education in nursing. Retrieved from 3. Emily Kelly Sep 6, 2018Local: Sep 6 at 1:26am<br>Course: Sep 6 at 12:26am Dr. Bucher, I believe that all the essential professional competencies for master's prepared nurses are applicable to all settings of nursing. However, there may be some essentials that are more relevant in one setting as opposed to another. For example, the Essential VIII: Clinical Prevention and Population Health for Improving Health states that master's prepared nurses "apply and integrate broad, organizational, client centered, and culturally appropriate concepts in the planning, delivery, management, and evolution of evidence-based clinical prevention and population care and services to individuals, families, and aggregates /identified populations." (AACN, 2011, p. 5) This essential competency in particular may be more relevant to a public health nurse who's work focuses on the population at large as opposed to a nurse working in an acute care setting. Yet, despite the fact that I believe one policy may be more relevant in one setting versus another, I do believe that they all are essential in all settings. Essential number three focuses on quality improvement and safety. This essential competency of master's prepared nurse states that each nurse must continuously focus on improving patient safety and the quality of the care they deliver (AACN, 2011, p. 4). If any nurse did not uphold this essential competency then they are not doing their job as a nurse, no matter what setting they are working in. Each of these essential competencies is specifically chosen as a basis for all master's prepared nurses to base their care off of. They were not chosen for one setting or another and therefore are applicable to all nurses in all settings. American Associations of Colleges of Nursing. (2011). The essentials of master's education in nursing. Retrieved from 4. Danielle Wiemann Sep 6, 2018Local: Sep 6 at 2:01am<br>Course: Sep 6 at 1:01am Dr. Bucher, When I originally started to answer this question I without a doubt was going to say there is a major difference between home health MSN CNS and a hospital CNS. However, after doing some research, I came across a study published in BioMed Central called, Nurses competencies in home health care: an interview study (Andersson, Lindholm, Pettersson, Jonasson, 2017). This study allowed me to see the similarities and slight differences. "Home is a place where the patients have their family and where e.g. certain values, preferences, culture and habits prevail" (Andersson et al., 2017). This is obviously a difference between HHC MSN CNS and hospital CNS. A priority competency of a HHC CNS would be taking care of the patient and their family as a whole, while understanding and following values, preferences, cultures, and habits of others even though it may not be the same as the nurses. Although this is important to a hospital CNS, I think sometimes they get wrapped up in the tasky part of the job they aren't able to take the time to focus on and appreciate their patients beliefs, cultures, and values. Although there are a lot of differences there are a lot of similarities as well. HHC is not the same as it use to be with the advancement of healthcare. HHC nurses are responsible for managing central lines, dialysis, IVF pumps, pain pumps, and more. Nurses are able to manage chronic and acute illness from the patients home. Because of this, priority competencies are the similar. With constant advancements nurses have to continually increase their knowledge whether HHC or in a hospital. "Knowledge can be described e.g. as knowing facts, being able to handle different situations or understanding the consequences of actions" (Andersson et al., 2017). Both HHC and hospital CNS have to be able to think quickly and critically while maintaining a safe environment for themselves and their patients. Based off of the information I got in the previous article and an article in Nurse Journal, I believe there are similarities and differences in priority competencies, again. Both primary care versus acute care NP always have safety and knowledge advancement in their heads. However, primary care NP's generally work in primary care or outpatient settings with patients who have chronic or non emergent acute illnesses (Nurse Journal, 2018). NP's in acute care generally work on hospital units such as ER and ICU and treat patients with acute and potentially life threatening illnesses (Nurse Journal 2018). Acute care NP's will have a more focused assessment and idea of treatment where primary care NP's will focus on the big overall picture and treat all illnesses. Andersson, H., Lindholm, M., Pettersson, M., & Jonasson, L. (2017). Nurses' competencies in home healthcare: An interview study. BioMed Central, 16. doi:10.1186/s12912-017-0264-9 FNP vs ACNP Core Differences. (2018). Nurse Journal. Retrieved from  Julia Bucher Sep 6, 2018Local: Sep 6 at 1:49pm<br>Course: Sep 6 at 12:49pm Danielle. You wrote a very thoughtful post and backed up your writing with intext citations and matching references. The setting indeed makes a difference too. In home helth we anticipate problems and try to prevent them just like RNs in hospitals. But we do not have others to confirm findings onsite when it comes to physical assessment whereas inpatient CNSs have the support and advice of others. Because of this difference I'd argue that home health CNss are even more autonomous. The roel incldues many more referrals too and operating sometimes justa s much like a social worker if they are not available to assist or only can visit once. Just some additional thoughts. I am devoted to helping the whole family and I prefer home health. Dr. B. 5. Claudia Felder Sep 7, 2018Local: Sep 7 at 6:14pm<br>Course: Sep 7 at 5:14pm Dr. Bucher, I believe that all registered nurses regardless of their degree have obtained the basic nursing skills and knowledge that is required by the National Council State Board of Nursing. There are several things that set us apart. One is the level of education that has been obtained. The other is in the field or specialty in which they have chosen to practice. Last but not least, is the amount of experience one has in their field of practice. This three things has an effect on the competencies of any nurse. So, Yes. I believe that nurses that have received their Master's degree within the same professional track but have chosen different areas to focus and practice will acquire a different set of essential professional competencies. 6. Veronica O'Neil Sep 8, 2018Local: Sep 8 at 10:46am<br>Course: Sep 8 at 9:46am Dr. Bucher, I do believe that some competencies have a higher priority than others depending on employment settings. In my initial post, I discussed that Essential III. Quality Improvement and Safety was the most important for an RN practicing in the OR (AACN, 2011). The Association of perioperative Registered Nurses (AORN) is the professional organization for OR nurses. Their goal is to provide evidence-based guidelines which provide standardized practice in order to promote their mission of providing safe patient care (AORN, 2018). OR nurses must then keep their skills and knowledge up to date by belonging to their professional organization, AORN, and reading their journals. There is a nurse educator in our OR, but she is not involved in one to one, hands on education. That job falls to the preceptor, who is usually also the circulating RN. I have been precepting many new nurses over the years. The baccalaureate level courses in nursing leadership and management have increased my teaching and precepting skills and style. Becoming a master’s prepared nurse will add to and strengthen my knowledge, skills and style in order to help new OR nurses successfully achieve their education in the OR. It then follows that Essential II. Organizational and Systems Leadership is a competency required of a service coordinator and preceptor to ensure that the OR team is delivering the highest quality of care (AACN, 2011). The Master’s prepared OR nurse will be competent in Essential VII. Interprofessional Collaboration for Improving Patient and Population Health Outcomes (AACN, 2011). The OR nurse must not only be an assertive leader, but a skilled collaborator. There are many different levels of care providers in the OR. The OR nurse must be able to effectively and efficiently collaborate, coordinate , trouble shoot and communicate with housekeeping, materials handlers, SPD instrument techs, Surgical technologists, RNs, medical students, surgical residents, fellows, surgeons and anesthesiologists. It is without a doubt, that the OR nurse must be competent in Essential V. Informatics and Health Technologies (AACN, 2011). When I first started working in the OR, the patient’s intraop record was on paper. Paper is only used for downtime of the EHR system EPIC, now being used (epic, 2018). The OR nurses are now facing issues with the not so smooth interfacing of Beaker into EPIC. Technology has changed the way surgery is performed, causing perioperative nursing to be constantly evolving (PNEC perspective, 2011). The future of the operating room will continue be driven by technology (PNEC perspective, 2011). This affects how the OR nurse remains the patient’s advocate and keeps them safe. American Associations of Colleges of Nursing. (2011). The essentials of master's education in nursing. Retrieved from About AORN. (2018). Retrieved from Gramling, A. (2016). What is Epic Beaker? Healthcare IT Leaders. Retrieved from PNEC perspective. (2011). Canadian Operating Room Nursing Journal, 29(2), 16-19. Retrieved from 7. Kindel Keener Sep 8, 2018Local: Sep 8 at 12:05pm<br>Course: Sep 8 at 11:05am Dr. Bucher and class, I do believe that depending on setting of employment for a master's prepared nurse, the most important of the essential core competencies would differ. The American Association of Colleges of Nursing states that there are nine essentials that all master's prepared nurses will need regardless of the roles they will practice (AACN, 2011). The essential core competencies are the outcomes expected of master's prepared nurses (AACN, 2011). While all of the nine competencies will be taught in master's degree programs, the importance of them will change based on the background, experiences, and primary role of the individual nurse. For example a nurse educator my have stronger ties to Essential IX having a higher level of comprehension of nursing and sciences giving them the ability to apply this to teaching nurses and students using developed teaching curriculum, teaching methodologies, and learning needs assessments (AACN, 2011). Another example is nurses in director roles may require a stronger focus on Essential II which encompasses organizational and system leadership. This essential will allow nurse directors to manage and organize nursing units with the knowledge to back up their decisions (AACN, 2011). CNS nurses may use a combination of the essentials to provide patient centered care. They will use Essential I to provide best practices for the patients and ensure the nursing staff are up to date with the most important treatments for improved patient outcomes. CNS nurses also use Essential VII to create collaboration with multidisciplinary teams to achieve best practice for patient care (AACN, 2011). In the hospital setting, I work with many master's prepared nurses in the roles of : nurse practitioners, nurse directors, nurse educators, and CNS nurses. I have seen these core nine Essentials in use with these nurses. One example that really stands out to me is our neuroscience CNS. She follows our neuroscience patients from their admission to the ICU to discharge. She is often at the bedside teaching families about their loved ones massive ruptured brain aneurysm pathophysiology, treatment plan, medications and providing emotional support to the patients and their families. She also spends a great deal of time with each nurse in the ICU making sure that he or she is update with understanding the care of the patient and able to explain that plan of care to patients and families. She does monthly competencies with the nursing staff and spends one to one time teaching new nurses about our neuro patient population. None of our new staff will be assigned a neuro patient until they have been checked off by the CNS on their comprehension of the neuroscience patient population. My hospital is our regions only comprehensive stroke center and we have a significant neuro population in our 24 bed mixed ICU. The hospital is currently adding on a 12 bed neuro ICU. Our CNS is also the middle man between nursing staff and neurosurgeons. She helps to coordinate patient care and collaborate with other multidisciplinary team members to ensure the patients are getting the right cares at the right time. My ICU nurse manager also works diligently on finding research based best practices to coordinate with our infection control nurses to improve infection rates such as VAP, CAUTI and CLABSI in the ICU. I am currently working on a research project for the CAUTI team collecting data on a weekly basis to improve our CAUTI rates in the ICU. This is how I believe the Essentials of the master's prepared nurse are actually utilized in differing roles. Kindel Keener Sep 8, 2018Local: Sep 8 at 12:07pm<br>Course: Sep 8 at 11:07am Dr. Bucher, here is my APA reference. I sent too soon. I apologize. American Association of Colleges of Nursing (AACN). (2011). The essentials of master's prepared education in nursing. Washington. DC: Author. Julia Bucher Sep 9, 2018Local: Sep 9 at 8:32am<br>Course: Sep 9 at 7:32am Dear Class, I am noticing posts that use what CCN provides as references and this is fine. However at least one scholarly citation and matching reference is required from research or literature outside of what CCN provides you in the Module Lesson and reading. If you only used AACN and an article in the required reading, for example, you did not search for and use a peer-reviewed article from "outside" of what CCN provides. I look for any outside reference in all of the posts so one is fine "somewhere" but it is preferred to have it used in the initial post. Just an FYI. Thanks, Prof JB Mia Peters Sep 8, 2018Local: Sep 8 at 5:49pm<br>Course: Sep 8 at 4:49pm Kindel, Wow! I was very intrigued reading this post. I find it very interesting to hear about other pathways to take with a masters degree. The options are truly endless. I agree with you. I found it hard to find one main point for the "most important" thing a nurse with a masters needs to be successful. Each job requires such specific guidelines on how to practice. Most of them can revolve around just making sure you do everything you can to keep your patient safe. On the other hand, there are jobs you can find with a masters that are so specific on patient care. Like your example with the neuro team. I find it so amazing they are using nurse practitioners in so many dynamics. It makes it hard narrow things down to accurate importance. Nice job on using examples in your post. I really appreciate reading things like that. It makes you start pondering job opportunities. -Mia  Kindel Keener Sep 8, 2018Local: Sep 8 at 8:26pm<br>Course: Sep 8 at 7:26pm Thank you, Mia I’m glad it interested you. 8. Teresa Hogan Sep 8, 2018Local: Sep 8 at 8:03pm<br>Course: Sep 8 at 7:03pm Dear Dr. B., I do think that there needs to be primary standard competencies for nurses across all settings,, which of course we have. However, beyond the minimum NCLEX standards, I feel nurses needs are widely varied based on where they work. The nurse practicing in a physician's office needs very different skills than the one working in the Emergency Department. And the home health care nurse needs to be supported and educated on hugely different skills than the radiology nurse. I work in the quality department at my hospital. As a result, I no longer need to maintain my ACLS and PALS certificates. It took me a long time to make my peace with not being a bedside nurse. However, I now really enjoy using my nursing skills in this capacity. I see how my role helps to make sure we are delivering best practice care in a collaborative way. But regardless of where we each choose to practice, I think improving ones skills and competences and working to become an expert in our own chosen areas of nursing equates to better patient care and higher degrees of patient satisfaction. 9. Carletta Casto Sep 9, 2018Local: Sep 9 at 9am<br>Course: Sep 9 at 8am I do feel that there can be competency differences, over the long-term, when it pertains to a nurse practitioner in primary care, a nurse practitioner in an acute-care hospital, or a nurse practitioner in long-term care. Each specialty requires expertise in different categories. Acute-care hospital nurse practitioners may be monitoring more daily labs and IV antibiotics or critical drips. Long-term care may be trying to decrease daily medication intake to help improve quality of life, and primary care may be adding new medications for newly diagnosed conditions like hypertension or diabetes. However, the role of the nurse practitioner does have the same principle regardless of the department. The nurse practitioner will develop the role of educator, leader, investigator, and caregiver (Anderson, 2018). All of these, regardless of the department, will help the nurse practitioner to gain the knowledge and expertise for his/her specialty. References Anderson, C. (2018). Exploring the Role of Advanced Nurse Practitioners in Leadership. Nursing Standard, 33(2), 29-33. 10. Mia Peters Sep 9, 2018Local: Sep 9 at 11:16am<br>Course: Sep 9 at 10:16am Dr. Bucher, When I first started this assignment, I searched and searched for information in articles that could pin point the most important priority competency with a masters degree. I found that there really isn't one. Once you obtain your masters, that is just the start of a journey in which direction would want to go. Each professional setting whether in hospital or acute care can be so job specific. I started to ask my friends who were nurse practitioners if they knew of any other NP's that had a much different scope of practice. The results were pretty interesting. I have a friend who works with a NP in surgery. She assists the doctors during surgery and will suture and help close the patient up. I find this so intriguing! Yet my other friend knows NP's who work in a level one trauma center with their FNP who can intubate and do a lot that a doctor can do. I read a few articles to try to differentiate from an acute setting versus hospital setting. Mark Anthony Dalton (2013) wrote an article of the different perceptions of the advanced nurse practitioner role in a hospital setting. They were conducting a study to show different job descriptions for day time versus night time. They found that even though the NP's were well educated, there was room for improvement on understanding what their role truly consisted of. Kelly Kilpatrick (2013), wrote an article on the understanding of acute NP communication along with roles. Depending on their confidence level of training, some NP's communicated more with the nurses taking care of the patients. If their confidence level was compromised, the study showed that NP's communicated more with the doctors on appropriate patient care. I concluded that knowledge still is power. Understanding your job role with whatever job you obtain is a critical factor in how successful you become. Kilpatrick, K. (2013). Understanding acute care nurse practitioner communication and decision-making in healthcare teams. Journal of Clinical Nursing, 22(1-2), 168-179. Dalton, M. (2013). Perceptions of the advanced nurse practitioner role in a hospital setting. British Journal of Nursing (mark Allen Publishing), 22(1), 48-53. 11. Catrice Proctor Sep 9, 2018Local: Sep 9 at 3:50pm<br>Course: Sep 9 at 2:50pm Dr. B., I believe Essential VII: Interprofessional Collaboration for Improving Patient and Population Health Outcomes to be the most essential competency for the master's-prepared nurse that's practicing in the 21st century. It is of great importance, that the care team as a whole collaborate to create a POC that will allow for patients to achieve the best possible outcomes for current health status, both inpatient and outpatient. Through further education being able to prevent, improve, and/or decrease the rate at which the disease progresses. "Interprofessional practice is critical for improving patient care outcomes and, therefore, a key component of health professional education and life long learning (American Association of Colleges of Nursing & Association of American Medical Colleges, 2010). I do not believe that this particular competency differs for setting to setting, as positive outcomes should be the focus of all care regardless to setting. Catrice Reference American Association of College of Nursing. (2011). The Essentials of Master’s Education in Nursing. Retrieved from  Julia Bucher Sep 10, 2018Local: Sep 10 at 7:15am<br>Course: Sep 10 at 6:15am Mia, It sounds like you put in much effort to find your information. Good work! I may take some time in Week Two to assist with library search tips too so everyone saves some time by becoming more efficient searchers. Thanks again, Dr. B. • Zachary Nolan Sep 4, 2018Local: Sep 4 at 11:59am<br>Course: Sep 4 at 10:59am Chronic health conditions such as congestive heart failure, chronic obstructive pulmonary disease, diabetes mellitus, and obesity are increasingly effecting the current practices of nurses worldwide. These chronic diseases often exacerbate and complicate acute medical issues. There is a constant need for nursing practice to adapt to the complications these chronic medical conditions include. A master prepared nurse possesses the skills and abilities to include the best evidence for practice into everyday nursing of these chronic conditions. With a master degree in the nursing, registered nurses are more educated to incorporate evidence based nursing practice into everyday use to a compared to bachelor prepared nurses (“The Essentials of Master’s Education in Nursing, 2011). A master prepared nurse is trained to incorporate a higher level of decision making and the use of leadership skills to analyze and ensure safe and effective nursing care (“The Essentials of Master’s Education in Nursing, 2011). The master’s prepared nurse is trained to practice in both leadership and educator roles. According to Kim and Hyat (2015), a master prepared nursing is valued for their ability to critically read, analyze, appraise, and apply healthcare literature to improve patient care. A master’s degree in nursing trains registered nurses to understand and analyze statistics in literature, which is a vital skill used in appraising literature for best practice. There is evidence that supports nurses who pursue a master degree are related to the ability to improve patient outcomes (Cotterill-Walker, 2012). On a personal level, critically appraising scholarly articles has always been one of the less appealing aspects of nursing but at the same time essential to our practice. However, having the ability to do so is needed in order to deliver evidence based practice, which is very important to the constantly changing and improving world of nursing. In a master degree program, this skill of critically appraising literature is emphasized, focused on, and strengthened. Strengthening the ability to appraise literature is essential to nursing practice because without the ability to effectively pull the evidence from literature, nursing practice could remain stagnant or even have a negative effect on patient outcomes. Unfortunately, the methods of treatment that were used in the past for medical conditions were not always the most effective and beneficial to patient’s overall health. However, if nurses are able to pull the new evidence out of literature and adapt our practice according to the evidence, the field of nursing will continue to grow and provide the most current, effective treatment. The master prepared nurse is trained to ensure that this standard and improvement in practice is able to be implemented. References American Association of Colleges of Nursing. (2011). The essentials of master's education in nursing. Washington, DC: Author. Cotterill-Walker, S. M. (2012). Where is the evidence that master's level nursing education makes a difference to patient care? A literature review. Nurse Education Today, 32(1), 57-64. doi:10.1016/.2011.02.001 Kim, M. J., & Hayat, M. J., (2015). Statistical preparedness of master's degree-prepared nurses in the workplace. Nurse Educator, 40, 144-147. doi: 10.1097/NNE. o Julia Bucher Sep 4, 2018Local: Sep 4 at 6:12pm<br>Course: Sep 4 at 5:12pm Zachary, As you gain experience in reading research you will find ways to read the most important parts and then decide if you need to read the enitre article. I am happy to read that you value this part of graduate preparation. It is indeed a major benefit of the Master's. You all will be better consumers of research when you finish your MSN program. Dr. B. o Mia Peters Sep 6, 2018Local: Sep 6 at 9:12pm<br>Course: Sep 6 at 8:12pm Zachary, I completely agree with your outlook on the importance of change from a bachelors degree to your masters degree. Pending what healthcare setting we are currently working in now, we start to pay attention more to how our nurse practitioners are practicing. Currently employed in the ER and hoping to continue my heath care journey in an acute setting, I often find myself paying close attention to the differences on how our nurse practitioners treat patients. We must hold a much higher understanding of responsibilities when we step into this role. Once again, pending what area we decide to practice in, some of our patients could be pretty critical and it takes a lot more judgment, critical thinking skills, knowledge, confidence and understanding to take care of these patients. This means we must stay up to date on all aspects of healthcare with current journals and readings. We are all aware on how much and often healthcare changes and staying up to date on those things could be life saving. -Mia o Emily Kelly Sep 9, 2018Local: Sep 9 at 3:16am<br>Course: Sep 9 at 2:16am Zachary, Your post goes into detail describing the importance of a master's prepared nurse being able to extract helpful information from scholarly articles and evidence based literature to improve care provided to patients. I believe this is a good point to focus on because healthcare is always changing. There is always new evidence that points to changes that should be implemented in patient care in order to improve patient outcomes and without the ability to find and analyze this data correctly, our care for our patients will become stagnant and therefore outdated. However, there are many other barriers to implementing the most current evidence based practice. Some barriers that nurses have identified as their facility having are a lack of a research "friendly" environment, no regularly scheduled events for nurses to share current research findings and a lack of funding for new practices to be implemented (Cline & Burger & Amankwah & Goldenburg & Ghazarian, 2017, pg. 115). Once we can overcome all barriers to the implementation of the newest evidence based practice it will be infinitely mor ehelpful to have nurses who can identify and analyze this evidence based practice. References Cline, G., Burger, K., Amankwah, E., Goldenburg, N., & Ghazarian, S. (2017). Promoting the Utilization of Science in Healthcare (PUSH) Project: A Description of the Perceived Barriers and Facilitators to Research Utilization Among Pediatric Nurses. Journal for Nurses in Professional Development,33(3), 113-119. doi:10.1097/nnd.  Julia Bucher Sep 9, 2018Local: Sep 9 at 8:42am<br>Course: Sep 9 at 7:42am Emily and Class, Research 'unfriendly' settings can be driven by accreditation bodies or state licensing programs, for example. When they require certain approaches then the changes roll out and happen. So even if the front lines or their supervisors are not implementing best practices then we can expect the driving forces "outside" demand and require best practices. Sanctions are imposed now for certain diagnoses among Medicare patients who repeat hospital admissions within 30 days. Look at the positive changes in hospitals, home care agencies, and nursing homes generated by the 'carrot and stick' approach! Trust the powers outside of these institutions that are less research 'friendly' and employ fewer MSNs. Dr. B. • Emily Kelly Sep 4, 2018Local: Sep 4 at 3:43pm<br>Course: Sep 4 at 2:43pm What is the value of a master's degree in nursing? There are many reasons to pursue a master's degree in nursing. Having a master's degree in nursing can enable a nurse to have a more comprehensive understanding of nursing as a whole as well as educates the nurse on different aspects of nursing that can improve the nurse's ability to care for patients in the best way possible. Some of these aspects include: leadership, informatics, interprofessional teamwork, knowledge and application of theory to practice (American Association of Colleges of Nursing, 2011). Due to the master's prepared nurse's increased knowledge in these areas, as well as others, a nurse with a master's degree is able to engage in higher levels of practice in multiple different settings and thus improve the quality of care given at these different settings. This is the value of having a master's degree in nursing (American Association of Colleges of Nursing, 2011). Anything a healthcare professional can do to improve patient care is of high value in this profession. Recent research shows that there are five areas of nursing that having a master's degree specifically improves: personal and professional growth, increased confidence and self esteem of the nurse, enhanced communication, analytical thinking and decision making and lastly, knowledge and the ability to apply theory to professional practice. The improvement of these five areas of nursing directly impact patient care in a positive way, showing that there is high value in getting a master's in nursing (Cotterill-Walker, 2012). Another research study done in England in 2015 looks at evidence suggesting that not only does having a master's degree n nursing improve the five areas mentioned earlier, it also improves a nurse's critical thinking abilities as well as his or her decision making skills. In addition, there is also evidence that a master's in nursing empowers nurses to attempt to change poor nursing practice and develop skills to advance in clinical practice roles (Clark & Casey & Morris, 2015). American Associations of Colleges of Nursing. (2011). The essentials of master's education in nursing. Retrieved from Clark, L., Casey, D., & Morris, S. (2015). The value of Masters degrees for registered nurses. British Journal of Nursing,24(6), 328-334. doi:10.12968/bjon.2015.24.6.328 Cotterill-Walker, S. M. (2012). Where is the evidence that master's level nursing education makes a difference to patient care? A literature review. Nurse Education Today, 32(1), 57–64. doi:10.1016/.2011.02.001 o Carletta Casto Sep 9, 2018Local: Sep 9 at 10:41am<br>Course: Sep 9 at 9:41am I agree, Emily, that there are many reasons to pursue a master’s degree in nursing. Whether it be to gain the knowledge to teach the next class of undergraduates, to advance the patient care module, to perform and prescribe treatments that can be life changing, or just taking the next step needed to meet a goal, master’s degree nursing is on a much higher level. Master’s degree nurses will possess better critical thinking and decision-making skills, therefore, the patient care will have a better approach both clinically and economically (Casey, Clark, & Morris, 2015). The master’s degree nurse will not only think more holistically about the patient, but economically, he or she will be more desirable. Reference Casey, D., Clark, L., & Morris, S. (2015). The Value of Master’s Degree for Registered Nurses. British Journal of Nursing, 24(6), 328-334. doi:10.12968/bjon.2015.24.6.328 • Kimberly Sagun Sep 4, 2018Local: Sep 4 at 4:42pm<br>Course: Sep 4 at 3:42pm Nursing has been rapidly transforming over the past years. Revisions of new nursing guidelines, in response to the current demands of the healthcare system, contribute to the evolution of the healthcare system and influence nursing practice. Nurses play an important role in the healthcare system regardless of a nurse’s educational preparation, such as a baccalaureate-prepared nurse or a master’s-prepared nurse. However, there are certain qualities that differentiate a master’s-prepared nurse to that of a baccalaureate-prepared nurse: duration and specialization. A Bachelor of Science in Nursing (BSN) degree commonly takes four years to complete. With this, there are accelerated programs that are available for other degree holders to concurrently continue their education and work. A nursing candidate that completes a BSN degree is usually an entry-level nurse when employed. A baccalaureate-prepared nurse’s role is to provide direct patient care and collaborate with interdisciplinary teams. They are strong critical thinkers, communicators, and skilled problem-solvers (American Association of College in Nursing, 2017). To complete a Master of Science in Nursing (MSN) degree, an additional two years of education, following a BSN degree, is required. A key difference between master’s- prepared nurses and baccalaureate-prepared nurses is that a nurse with an MSN is able to specialize in different areas, such as administration, education, nurse practitioner, informatics, and so on. They have a greater understanding of higher-level nursing practice compared to a nurse with a BSN. With the healthcare system continuing to grow and evolve, nursing education needs to be transformed, allowing for nurse graduates to be able to collaborate and work effectively with other health care professionals. The advancement in education will strengthen nurses. Nurses who choose to continue a master’s education will be able to provide efficient quality patient care, improve health outcomes, and be compassionate within their lifespan of practice (Institute of Medicine, 2011). References: American Association of College of Nursing. (2017). The Impact of Education in Nursing Practice. Retrieved from Institute of Medicine (US) Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine. (2011). The Future of Nursing: Leading Change, Advancing Health. Washington, DC: National Academies Press. Retrieved from o Julia Bucher Sep 4, 2018Local: Sep 4 at 6:51pm<br>Course: Sep 4 at 5:51pm Kimberly, Second degree students also join BSN programs and often only have to complete the nursing courses if they have a science bachelors already. This eeductional path can take just two years. What is becoming mroe common now are programs that offer the BSN and the MSN as one long track. Thoughts? Anyone? Dr. B.  Brittany Kalupski Sep 6, 2018Local: Sep 6 at 7:54am<br>Course: Sep 6 at 6:54am Dr. B, I know a few nurses that I work with that have their ADN and are going to a school with a nurse bridge program combining BSN and MSN. They both seem to like it but have different lifestyles. One nurse is a single mom and is working full time while the other nurse lives on her own and works part-time. This type of program is not for everyone but may work out for others. Everyone is at a different point in their life where they may or may not be able to go to school. For nurses that are trying to advance their career in a short amount of time, this program would work well. By doing the RN to MSN program, you would cover information that is important from the BSN track and combine it with the MSN material. Most schedules are flexible, and nurses would be able to work while getting this degree. I think that if a nurse would like to advance their career and has a particular goal in mind, they should consider looking into this type of program. 1. Julia Bucher Sep 6, 2018Local: Sep 6 at 1:52pm<br>Course: Sep 6 at 12:52pm Thanks Brittany for weighing in on this newer option of prelicensure to the MSN in one full path without a "stop". Do your freidns get to apply for their license as a RN at the bachelors completion? I'd think this would be needed to continue in clinicals that require the BS in Nursing or BSN for them to be MSN clinical students. Am I correct? Thanks, Dr. B.  Brittany Kalupski Sep 6, 2018Local: Sep 6 at 5:14pm<br>Course: Sep 6 at 4:14pm The nurses that have their RN license are able to become MSN students but after they completed the required bachelor's courses first. From my understanding, there are a few BSN classes that need to be completed first but not clinical hours. It is just the evidence-based research classes that you would take if you were getting your BSN that are combined with the MSN courses.  Julia Bucher Sep 7, 2018Local: Sep 7 at 8:24pm<br>Course: Sep 7 at 7:24pm Thanks for clarifying this two step MSN program Brittany. Dr. B. 2. Abigail Zacharias Sep 7, 2018Local: Sep 7 at 4:10pm<br>Course: Sep 7 at 3:10pm Hi Brittany, As I was reading your post I started thinking about the different degrees nurses can have to practice. I work with many AD nurses and BSN nurses which I don't feel they are any less competent to do their jobs correctly. We all know that with advanced education we can become more valuable and can expand practice to become educators, managers or practitioners, which is why we are all here. I was trying to do a little research more on the BSN to MSN program which I have been seeing a few more of those options arise in nursing schools for students. I have also seen BSN to DNP program which is defiantly a wonderful option. While doing that I came across an article I found to be very interesting it stated "there is no clinical evidence that ADs and DIPs are so different from BSNs". So it makes me wonder why even offer AD programs? Everywhere I have worked they have pushed BSN but this article gives another view. I even found data to be very interesting, on how many nurses completed AD and BSN programs from 1959 - 1979. AD started low and numbers increased over the years and vs. for BSN degree, it seems odd to me because I feel AD programs seems to be more common where I live. Thanks for your thoughts, good read!  Abigail Zacharias Sep 7, 2018Local: Sep 7 at 4:11pm<br>Course: Sep 7 at 3:11pm Mennemeyer, S. T., & Gaumer, G. (1983). NURSING WAGES AND THE VALUE OF EDUCATIONAL CREDENTIALS. Journal Of Human Resources, 18(1), 32-48. my reference from above information  Julia Bucher Sep 7, 2018Local: Sep 7 at 8:27pm<br>Course: Sep 7 at 7:27pm Abagail, Next week I will coach the class in correct APA format for references. However starting in week one, I will advise everyone not to use ALL capital letters! The rest of this reference is very correct. Compare it to your format in your previous references. Thanks, Dr. B.  Brittany Kalupski Sep 7, 2018Local: Sep 7 at 4:58pm<br>Course: Sep 7 at 3:58pm Hi Abigail, Thanks for the response! Where I work now it is not required to have your BSN, some of the nurses do and some don't. It seems to me that depending on where you live depends on the requirement. I do however know that AD nursing and BSN nurses make the same amount of money based on how much experience. So why would someone want to spend more money on their BSN if they are going to make the same amount and now have debt? I have heard however that some hospitals say that you can work there but it will be required after so many years that they will need to get their BSN. It is very interesting to think about and what exactly is the benefit of it if you don't need it at your current job.  Kimberly Sagun Sep 6, 2018Local: Sep 6 at 11:50am<br>Course: Sep 6 at 10:50am To be honest, I think that it is an awesome idea that they offer the BSN and MSN program as one long track. I wish they had this when I started nursing school. I probably would of continued going to school full-time and worked part-time. After completing my BSN degree and started to work as a nurse for 5 years and deciding to return back to school was a difficult transition for me. I was nervous and excited at the same time because it has been so long since I went back to school, but I knew it was time for me to advance my career. What I would have done differently is that I would have continued my education straight after I completed my BSN degree and went into my MSN degree to complete the FNP track. I remember after graduating from my BSN degree I didn’t plan on going back to graduate school because I was scared to be in so much debt. Also, I wanted to get some experience because becoming a nurse was my first job in my entire life. After having my daughter two years ago I thought about it and decided that advancing my career would benefit me in the long run. So here I am today!  Julie Klonowski Sep 8, 2018Local: Sep 8 at 3:01pm<br>Course: Sep 8 at 2:01pm Professor Bucher, I have never looked into a program that offers BSN and MSN in one long track, however; I do recall someone I work with who is enrolled in a program like this. I believe she goes to Chamberlain? Is that an option? I was looking on Chamberlain’s website and could not locate details on this, maybe I’m wrong. I do believe that the option of the extended track could be very beneficial for some nurses. For example, if one was looking to complete their education in a shorter period of time, this option may work best. If one had several children to take care of, this option may work best because the degree(s) would be completed in less time than they would if one obtained their BSN, took a break, and went back for MSN. On the flip side, I do think that there are benefits to obtaining the degrees separately. The biggest point that comes to my head when I think of this fact is experience. A nurse can never have too much experience, and each patient, and clinical setting can teach us a lot about the profession of nursing as a whole, which would ultimately help out in a graduate program such as this. Taking time to work at the bedside, and gain clinical experience between degrees would be very beneficial. I actually read a statistic while researching this myself, and that is, that the Bureau of Labor Statistics is predicting the need for more than 580,000 registered nurses by the year 2018 (2013). This is forcing nursing schools to become more creative with their programs, in hopes to appeal to more new students. Wow, talk about a nursing shortage! Julie Reference Accelerated programs: The fast track to careers in nursing. (2013, January). Retrieved September 08, 2018, from 1. Julia Bucher Sep 9, 2018Local: Sep 9 at 8:34am<br>Course: Sep 9 at 7:34am Hi Julie, I am not aware of CCN offering the two step program. You may want to search for this at the larger inperson schools and this path probably is hybrid. Hybrid means some time inperson face to face and some time online. Dr. B.  Nicholas Whitaker Sep 8, 2018Local: Sep 8 at 8:49pm<br>Course: Sep 8 at 7:49pm Hi Dr. Bucher and classmates, My wife is currently in a different program where she can complete her MSN while starting with her ADN. That type

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