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Proctored Essay Nursing Examples Of Autonomy

Q: Are you sure nurses are autonomous? Based on what I've seen, it sure looks like physicians are calling the shots.

A: Nursing is an autonomous, self-governing profession, a distinct scientific discipline with many autonomous practice features. Despite what the media may portray, nursing is not directed by physicians, even though nurses have less practical power than physicians do. In addition to extensive medical expertise, nurses have a unique, holistic patient advocacy focus, a unique scope of practice, and a unique body of knowledge, including special expertise in areas such as patient education, wound care and pain management.

Nursing is clearly an autonomous and distinct scientific discipline. For entry into practice, nurses are educated by nursing scholars typically in nursing degree programs lasting two or four years at universities and colleges, using textbooks authored by those scholars, many of whom are at the forefront of health care research. About 10,000 U.S. nurses have PhD's in nursing (another 10,000 nurses have Ph.D.'s in other health-related fields and work in nursing), and close to 380,000 U.S. nurses have master's degrees in nursing. These nurses--not physicians--are the theoretical and practical leaders of the nursing profession.

The profession also has many of the hallmarks of autonomous practice, though that issue is more complex because of the social, legal and economic limits under which nurses have traditionally operated. Current state laws typically define nursing practice in broad terms that do not depend on physicians, nurse-controlled state boards administer rigorous licensing examinations, and nurses have independent malpractice liability and codes of ethics. Though there is clearly a significant overlap with medicine, nursing is not a subset of or dependent on medicine.

Even in the managed care era, nurses have significant autonomy in clinical settings. Nurses typically are hired, fired and managed by other nurses. In hospitals, where most U.S. nurses work, registered nurses are managed by other nurses in a chain of command reaching up to a chief of nursing (or sometimes, patient care services). Contrary to the great majority of popular media depictions, nurses do not report to physicians in hospital care settings. Indeed, physicians do not have expertise in many areas of nursing practice, and even where they do, nurses' patient advocacy duties require that they actively resist any care plan that they believe is not in the patient's best interest. This is also the basic structure in nursing homes and other assistive care facilities, where many other nurses work. And in public schools and other public health positions, nurses are effectively autonomous within the scope of their professional duties. Even the nurses who work in what are commonly called "physicians' offices" are operating autonomously within the scope of their nursing practice, though they may be employees of the practice. Since today such offices often include Advanced Practice Registered Nurses (APRNs), it would be more accurate to call them "advanced practitioners' offices," or even better, "outpatient health offices," which would not ignore the contributions of registered nurses and other health workers in such outpatient settings.

There are a number of reasons for the common misperception that nurses report to physicians. Of course, nurses and physicians collaborate as members of the health care team. But historically, nurses have deferred to physicians, for reasons including the imbalance of power among the genders. Today, physicians' combination of economic power and social status is unmatched. Physicians still have more years of formal education than most (but not all) nurses. And over 90% of nurses are still female, at a time when women have a much wider range of career choices. Most physicians are not well-informed about nursing, and many refer to anyone working in the health care setting who is not a physician as a "nurse." Many physicians regard themselves as being essentially in charge of patient care. Consistent with this authoritarian vision, physician disrespect and disruptive behavior, including verbal and even physical abuse, remain issues in many care settings. (See Suzanne Gordon, Nursing Against the Odds, 2005.) As a result of these and other factors, many nurses remain reluctant to challenge physicians or assert themselves generally. (See Buresh and Gordon, From Silence to Voice, 2nd ed. 2006.) In addition, recent developments in health care have led to some confusion as to professional identity among patients and others. In many care settings, registered nurses are now visually indistinguishable from a range of other caregivers who may not be highly trained members of autonomous professions. Not even all nurses agree that they are members of an autonomous profession, in our view mistaking a lower level of practical power for a conceptually subordinate practice role, and maintaining that physicians have final authority over all patient care decisions. And some scholars and nursing advocates who are sympathetic to nursing and aware of its importance are susceptible to this way of thinking. (See, e.g., Dana Beth Weinberg, Code Green: Money-Driven Hospitals and the Dismantling of Nursing (2003), at 16, 80, 112, 115, 133, 177-78; Gordon, Nursing Against the Odds.) In reaching such flawed conclusions, these nursing supporters often seem to rely on the views of workplace sociologists, rather than nursing leaders and scholars, who are presumably too close to their own subordination to see it clearly.

Despite these obstacles, nurses' unique scope of practice is finally gaining recognition from some influential government institutions. Many state nurse practice acts now define nursing in broad and independent terms that do not depend on physicians or any other practitioners. For instance, California's Nursing Practice Act defines nursing practice as care that promotes health and requires significant scientific knowledge or skill, including patient care, disease prevention, the administration of medications and other procedures "ordered" by physicians or other advanced practitioners, testing procedures, health assessment and intervention. Cal. Bus. & Prof. Code § 2725. The comparable Massachusetts law defines nursing as services to "assist individuals or groups to maintain or attain optimal health," and contains details similar to the California law, including the administration of procedures "prescribed" by advanced practitioners, "clinical decision making" based on nursing theory to develop and implement care strategies, evaluating responses to care and treatment, coordinating care delivery, collaborating with other members of the health care team, and "management, direction and supervision of the practice of nursing." Mass. Gen. Laws Ann. ch. 112 § 80B. The Massachusetts law further provides that "[e]ach individual licensed to practice nursing in the commonwealth shall be directly accountable for [the] safety of nursing care he delivers." Id. The Texas Nursing Practice Act defines professional (registered) nursing practice to include assessing, intervening, and teaching to help the ill, working to maintain health and prevent illness, supervising nursing practice and education, administering medications or treatments "ordered" by physicians or other advanced practitioners, and performing acts "delegated by a physician" under the Medical Practice Act. Texas Occ. Code Ann. § 301.002.

All of these state laws make clear that nursing is responsible for managing itself, and broadly define nursing practice to include a wide range of critical prevention and care functions that do not depend on physicians or anyone else. Obviously, all the statutes are also careful to note that one--ONE--aspect of nursing is to administer certain treatments prescribed by advanced practitioners, and certain language in the California and Texas laws ("ordered," "delegated") does suggest a subordinate relationship with regard to those tasks. However, even in administering treatment prescribed by these other practitioners, nurses have a professional and legal obligation in their patient advocacy role to assess the care prescribed, and if necessary to work for better options, even in the face of advanced practitioner opposition. Indeed, nurses are not relieved of malpractice liability simply because they are administering treatment prescribed by a advanced practitioner, even if they are doing so precisely as the advanced practitioner wished; nurses are subject to independent legal requirements. Nurses' patient advocacy may include persistent negotiation with advanced practitioners, obtaining interdisciplinary ethical consults, refusing to participate in care plans or practices nurses deem unsafe, removing inebriated surgeons from the OR, and if necessary going to the appropriate administrative or other authorities to stop such actions. Do nurses find any of that easy to do, given current power structures? No. But that does not make them subordinate to physicians.

Moreover, recently some courts have begun to recognize that nursing is in fact a distinct scientific profession with its own standards and scope of care. For decades U.S. courts have tended more or less unthinkingly to regard nursing as a subset of medicine, and accordingly permitted physicians to testify as to the standard of nursing care in malpractice actions. (See Ellen K. Murphy, Nov. 2004, "Judicial recognition of nursing as a unique profession,"Association of periOperative Registered Nurses Journal.) However, the Illinois Supreme Court recently reviewed the evolving recognition of nurses' unique practice, and concluded that a physician was not qualified to testify as to a nursing standard of care because he was not a nurse. (See Sullivan v. Edward Hospital, 806 N.E.2d 645, 653-61 (Ill. 2004).) Although this decision was specific to the Illinois statutory and judicial context, it is fairly characterized as "judicial recognition [of] nurses' long-time assertion that nursing is an independent profession with a unique body of knowledge and not simply a subcategory of medicine." (Murphy.)

Indeed, one powerful argument that nurses are autonomous appears in a recent position paper by The American Association of Nurse Attorneys (TAANA) demonstrating that only nurses (not physicians) should be permitted to provide expert testimony as to the nursing standard of care in malpractice actions. (See TAANA Position Paper on Expert Testimony in Nursing Malpractice Actions, TAANA, September 23, 2004.) The TAANA piece cites many of the factors discussed above, including the distinct, self-directed nature of nursing theory and practice, the state nursing practice acts, and cases reflecting the growing judicial recognition of nursing as a distinct profession in the malpractice context. The paper concludes:

Based on the foregoing it is clear that nursing is a profession, unique, identifiable and autonomous. As a profession, nursing has the authority and responsibility to define its standards of practice. ... It is clear that the profession of nursing, though closely related to the practice of medicine, is, indeed, distinct with its own licensing scheme, educational requirements, areas of specialization, Code of Ethics, models, theories and contract with society. The standard of care for nurses arises from the very nature and scope of nursing and is derived from the nursing process. The nurse is not a "junior doctor" nor is the nurse a mere "underling" of the physician. To so hold would negate the existence of nursing as a profession and would render the Nurse Practice Acts of every state, commonwealth and territory meaningless. It is unlikely that any physician, unless he/she has completed a nursing program and has practiced as a nurse, can offer competent, reliable expert opinion on these nursing standards. ... The nursing profession and only the nursing profession has the right, duty and responsibility to determine the scope and nature of nursing practice including the standard of care for nurses.

Perhaps the most visible apparent examples of nursing autonomy are APRNs, who now number over 200,000 in the United States. Most APRNs are nurses with masters degrees or doctorates in nursing who perform "practitioner" tasks that have traditionally been associated with physicians. APRNs include Nurse Practitioners, Certified Registered Nurse Midwives, Certified Registered Nurse Anesthetists, Nurse Psychotherapists and Clinical Nurse Specialists, who work in a variety of fields including emergency care. (See The Registered Nurse Population: Findings from the National Sample Survey of Registered Nurses.) However, because many states have responded to physician pressure with statutes requiring that physicians "supervise" APRNs in some way in their expanded scope of practice, practitioner APRNs may not be the best example of nursing autonomy--they are moving into areas that have traditionally been the province of physicians, and physicians have responded in unsurprising ways. Of course, many of these restrictions are little more than a legal fiction, and numerous studies have shown APRN care to be at least as good as that of physicians. Unfortunately, it would be easy to conclude--as a major recent health report in U.S. News & World Report appeared to--that APRNs represent a kind of liberation of nurses from their former position as subordinate physician assistants. That fits with traditional beliefs, but as demonstrated above, it is incorrect.

What's that you say? Nurses have no real autonomy because the reality is that oppressive, greedy, patriarchal physicians, hospitals and other powerful health care system actors exercise so much practical control over nursing, to the detriment of public health and the future of the world? We know that the state of nursing can be immensely frustrating. There is no doubt that nurses generally have less practical power than physicians, and that social constructs tend to reflect that, and of course formal autonomy means less if it is not fully reflected in reality. To some extent this may depend on how you define autonomy--if it means having just as much power as physicians, or the legal and practical rights to do everything physicians do, such as prescribe narcotics, then nurses obviously do not have autonomy. However, in our view that would be an unduly narrow and physician-centric way to define autonomy, one that reflects the assumption that what physicians do is the most important part of health care. Nurses can't practice medicine, but neither can physicians practice nursing. If you're snickering, we suggest you examine your own understanding of and respect for what nurses do.

We believe there is a difference between a relative lack of power, on the one hand, and subordination, which suggests that one party reports to another in a formal sense, i.e., a master-servant relationship. Physicians are no more the conceptual "masters" of nurses than the United States is of India. Code Green gave the impression that, while nurses at the peak of their potential power may have real influence on patient care decisions, the ultimate authority for all care rests with physicians; in bad times, nursing consists of blindly following physician orders. In other words, the book suggests that the physician role varies between benevolent monarch and ruthless authoritarian. But as explained above, we believe that nursing has many powerful hallmarks of autonomy despite its relative lack of power, and that it is in nurses' interests to push the idea that they are part of an autonomous profession as strongly as possible. Just as human rights do not cease to exist simply because they are not fully observed, nursing autonomy does not cease to exist simply because it is subject to daunting practical constraints. If nurses' influence on patient care is seen as merely a matter of physicians' grace and as confined to the boundaries of physicians' practice, then nurses' ability to protect themselves and their patients is accordingly limited. But if nurses are seen as autonomous professionals with a unique practice model and scope of care--if they are not a class of "physician subordinates"--then they have a far stronger base on which to build and advocate.

Career seekers who have the qualities skilled nursing requires--including intellect, courage, passion, interpersonal ability, and a strong work ethic--value autonomy greatly. It is not hard to see why they would find little to interest them in the mute, servile "nurses" they encounter in many mass media products, particularly on television. They must understand that no matter how weak nursing may at times appear to be, especially in the managed care era, it has been and remains a distinct, self-regulating profession like medicine and law. Nursing has its own scope of practice, its own knowledge base, its own leaders and scholars, and its own legal and ethical duties. Nurses' unique, autonomous practice has saved countless lives, despite the prevailing belief that it does not exist. In this respect, nursing has been a kind of shadowy superhero: the Dark Knight Nurse, perhaps. But that must change if the profession is to gain the strength it needs to meet the global health challenges ahead.

 

Q: But how are nurses autonomous? We do not prescribe. We have to work under the "guidance" of physicians or some healtcare facility.

Even though nurses collaborate with physicians and nurse practitioners who write prescriptions, that does not mean nurses are not autonomous! Every time nurses make an assessment of a patient, they are engaging in autonomous nursing work. Every time nurses make a decision about what to do with the findings of their assessments, they make autonomous professional decisions. Every time they educate a patient or advocate for a patient they are engaging in autonomous professional acts.

For instance, a nurse's patient is struggling to breathe a little bit, so the nurse listens to his lungs and finds them 3/4 full of rales. The nurse lays out the options for action in her head: apply oxygen, consider COPD status, evaluate medications, straighten him up in the bed, check the cardiovascular medications to make sure the heart is pumping adequately and a whole bunch of other things. Finding the patient in slight distress was one autonomous assessment a non-nurse would probably not have noticed. Listening to lungs in response to her initial assessment was something the nurse knew to do and nurses are empowered to do because of their nursing education and status as a nurse. Considering the myriad options about how to respond to the rales are more autonomous acts. The nurse educates the patient about his heart disease, fluid buildup, salt intake, positioning, exercise—autonomous acts built on nursing knowledge base. Maybe the patient is on 20 mg./day of furosemide, the nurse advocates for the patient by negotiating with the prescribing health partner for 40 mg./day. All autonomous acts. This autonomy, these thought processes, this decision-making--this is how nurses save lives all over each and every day. Just because nurses do not prescribe does not mean their assessments and interventions do not matter. Oh no, they matter a great deal. This power, this knowledge, these actions--they come from nurses as individuals and the profession of nursing. Nurses save lives and they should embrace the power they have and stand behind it with pride.

last updated: March 4, 2015

For more information on nursing autonomy see:

Lynda Carey and Mark Jones, "Autonomy in Practice Is it A Reality?" in Practice Nursing,
Elsevier Health Sciences, October 2000.

 

 

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With new healthcare legislation, increased emphasis on preventative medicine, and aging baby-boomers, demand for healthcare services for MSN graduates is expected to grow 31% between 2012 and 2022.

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Are you ready to take your nursing career to the next level with a master’s degree? An online master of science in nursing (MSN) degree will help distinguish you from your bachelor’s-holding colleagues and allow you to advance in your career more quickly. An online master’s in nursing will also prepare you for higher-level nursing roles that normally require a graduate degree, such as nurse anesthetists, nurse midwives, and nurse practitioners.

Master’s in nursing online programs are geared toward nurses who plan to take on managerial or administrative roles at hospitals, clinics, and other healthcare facilities. The curriculum combines classroom-based studies with practicum training at the hands of certified nurses. Most MSN programs require a two-year commitment, and allow you to earn a degree specialization in areas like clinical leadership or healthcare administration. You may also choose to complete an accelerated RN to BSN program; these programs are aimed at students with a non-nursing bachelor’s degree, and generally take three years to complete.

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Choosing a Program

WILL AN ONLINE MSN PROGRAM PROVIDE ME WITH THE SKILLS I NEED TO ADVANCE MY NURSING CAREER?

In most cases, students who are accepted into an MSN program have a bachelor’s degree in nursing. The MSN builds on undergraduate studies by allowing you to develop expertise in particular areas of nursing. Generally, you can expect to take classes like statistics and data analysis, nursing research, nursing theory, medial information technology, health promotion, and clinical decision-making. Throughout the course of your MSN program, you will contribute to healthcare research, grow your professional network, and gain skills in management and leadership. You also get plenty of hands-on training from clinical practicum sessions.

WILL AN ONLINE MSN WORK WITH MY SCHEDULE?

MSN online programs are designed for convenience and flexibility; you can access course lectures and readings, submit written assignments, take exams, and communicate with your professors any time of day from the comfort of your home computer. Current technology also enables you to study on the go using a laptop, tablet, smartphone, and other devices with Wi-Fi. When it comes to completing the practicum component, many programs will help you get set up at a site that’s close to your residence.

WHAT CAN I DO WITH AN MSN?

MSN graduates will qualify for dozens of jobs after graduation. Depending on your specialization, you may pursue work as a nurse practitioner, nurse midwife, nurse anesthetist, or other specialized roles. You will also be well-positioned to pursue employment as a registered nurse, licensed practical nurse, medical and health service manager, and other titles that require a bachelor’s degree. Please note that most nursing roles that deal with patient care require state-issued licensure; more information about licensing requirements and procedures can be found in the ‘Careers’ section below.

WHAT ARE THE BEST ONLINE MSN PROGRAMS?

Choosing a program is an incredibly personal decision, and only you can properly evaluate whether a target school’s strengths match your educational needs. The following ranked list of schools should serve as a helpful starting point in your search for the best online MSN programs in the United States. If you are considering an online master’s in education, be sure to contact admissions specialists at different colleges and universities to learn more their about specific MSN requirements and offerings.

Accredited Online MSN Programs

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RankSchool NameRanking ScoreRelative Cost% Enrolled OnlineLocationDescription
1 Duke University82.6010%Durham, NC

Duke's School of Nursing boasts scholars and clinicians dedicated to innovative healthcare. The North Carolina school's strategic areas of focus include research, clinical practice, global health, and nurse preparation. Nurses seeking to become advanced practice registered nurses (APRNs) can enroll in the school's 42-49 credit master of science in nursing, a comprehensive program with several APRN majors, three non-clinical majors, and a speciality option.

APRN majors can earn a degree in one of these focus areas: adult-gerontology nurse practitioner-acute care, adult-gerontology nurse practitioner-primary care, family nurse practitioner, neonatal nurse practitioner, pediatric nurse practitioner-acute care, pediatric nurse practitioner-primary care, psychiatric mental health NP, and women’s health nurse practitioner. The curriculum of each APRN major involves an 11-credit clinical core, major courses, and a supervised clinical residency. Nurses in this program can select specialties in cardiology, endocrinology, HIV/AIDS, oncology, orthopedics, or a veterans healthcare concentration.

All APRN students must make on-campus visits to Duke for some courses. During these two- to five-day intensives, nurses engage in face-to-face practice simulations with experts and faculty. Programs offer nurses experiential curriculum in rural or high-tech environments, extensive resources, and a comprehensive financial aid program. Admission requirements include a bachelor of science in nursing, a minimum cumulative 3.0 GPA at the baccalaureate level, the GRE, at least one year of nursing experience, and licensure or eligibility for licensure in North Carolina or a compact state.


Program Overview
Program name: Master of Science in Nursing
Available concentrations: Adult-gerontology - acute care, adult-gerontology - nurse practitioner, family nurse practitioner, neonatal nurse practitioner, pediatric nurse practitioner - acute care, pediatric nurse practitioner - primary care, psychiatric mental health nurse practitioner, women's health nurse practitioner
Tuition: $20,721/semester
Credit requirements: 42-49 credits depending on concentration
Program length: 2 years

Delivery
Format: Hybrid
Instruction style: Synchronous

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2 Georgetown University82.3915%Washington, DC

Georgetown offers four accredited online master's in nursing programs in the following areas: adult gerontology acute care nurse practitioner, family nurse practitioner, nurse-midwifery/women's health nurse practitioner, and women's health nurse practitioner program. All online master’s in nursing programs have the same rigorous admissions requirements: all students must be citizens or permanent residents, hold a BSN or similar certification, have a RN license, and have taken a statistics course to be considered. Georgetown is accredited by the Middle States Commission on Higher Education.

The adult gerontology acute care nurse practitioner master’s program is a 40-credit, 23-month program that requires 600 clinical hours and three on-campus intensives. The program is designed for RNs with some acute care experience who are looking to pursue a more in-depth career. Students learn ethical decision-making and acute care strategies and will sit for the ACNP exam at the end of the program. In fact, 100% of Georgetown grads have passed since the program's inception.

The family nurse practitioner track prepares students for a primary care setting, where they will provide care for the wide range of family needs as a nurse practitioner. Georgetown notes this program emphasizes the “cure and care” culture of holistic healthcare. This 44-credit program can be completed in 19 months. The program includes 650 clinical hours and two on-campus intensives. There is also a part-time option for this program, which can be completed in 27 months.

The two women’s health tracks focus on primary care, prenatal, postnatal, lifespan care, reproductive care, and general medicine for women. The 44-credit women’s health practitioner track can be completed in 27 months with 768 clinical hours and two on-campus intensives. This program prepares students to shift from RN to nurse practitioner in a variety of healthcare settings. The midwife/women’s health practitioner track is 49 credits and can be completed in 27 months or seven terms, including more than 1,000 clinical hours and three on-campus intensives.


Program Overview
Department: School of Nursing & Health Studies
Program name: Master's of Science in Nursing
Available concentrations: Adult gerontology acute care nurse practitioner – board certified (AGACNP-BC), family nurse practitioner – board certified (FNP-BC), nurse practitioner – certified (NP-C), nurse-midwifery/women's health nurse practitioner (NM/WHNP), women's health nurse practitioner (WHNP)
Accrediting body: ACME, CAHME, CCNE
Tuition: $1,995/credit

Delivery
Format: Online
Instruction style: Asynchronous & synchronous

Program Requirements
Prerequisites: BSN, Registered Nurse license
Credit requirements: AGACNP-BC - 40 credits; FNP-BC - 49 credits; NM/WHNP - 49 credits; WHNP - 44 credits
Field education requirements: Clinical hours, intensives

Program Length
Program options: Full-time or part-time
Program length: AGACNP-BC - 23 months; FNP-BC - 27 months; NM/WHNP - 27 months; WHNP - 27 months
Program start dates: Fall, winter

Admission Requirements
Application deadline: Fall - June 19; winter - October 30
GPA: 3.0 minimum

Contact
Department phone: (877) 910-4692
Admissions email: onlinenursingadmissions@georgetown.edu
Social media accounts: Facebook; Twitter

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3 Texas Tech University Health Sciences Center82.0237%Lubbock, TX

The Texas Tech University Health Sciences Center offers a master's in nursing online that is ideal for students with a BSN who want to transition into a career in nursing education. All coursework can be completed online, with the exception of the practicum experience which must be completed in-person at a healthcare facility. Graduates are prepared to pursue educational positions in academic and practice settings.

The 42-credit MSN education degree consists of nine, three-credit courses on topics such as health informatics, health policy, pharmacotherapeutics for nurses, research, and more. Students must also complete 15 credits of speciality courses including four education classes and one practicum. Education classes cover a variety of topics, including leadership in nursing and comprehensive clinical care. Transfer credits are accepted as long as they were earned at a "B" grade or above.

Applicants to TTUHSC's MSN program must have a valid RN license and a BSN from an accredited institution with a minimum GPA of 3.0 to be considered. They must also submit transcripts, three letters of recommendation, a personal essay, a resume or CV, and proof that they have completed an undergraduate statistics course with a "C" grade or better. The admission process also includes an additional essay question and an interview with faculty. The school notes that GPA is one of the most important factors for admission. This program offers two application deadlines throughout the year, in the late winter and late summer.

TTUHSC also offers online post-certificate programs for current MSN holders who want to earn a new credential. Distance learners at Texas Tech can take advantage of a variety of resources, such as online access to library books, journals, and databases. The TTUHSC School of Nursing MSN program is accredited by the Commission on Collegiate Nursing Education.


Program Overview
Department: School of Nursing
Program name: Master's of Science in Nursing
Available concentrations: Education
Accrediting body: CCNE
Tuition: $14,403/semester in-state; $18,075/semester out-of-state

Delivery
Format: Online
Instruction style: Asynchronous & synchronous

Program Requirements
Prerequisites: BSN, Registered Nurse license
Credit requirements: 42 credits
Field education requirements: Practicum

Program Length
Program options: Full-time or part-time
Program length: 2+ years
Program start dates: Fall, spring, summer

Admission Requirements
Application deadline: Rolling
GPA: 3.0 minimum
Work experience: Professional nursing experience

Contact
Department phone: (806) 743-2730
Department email: songrad@ttuhsc.edu
Social media accounts: Facebook; Twitter

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4 Vanderbilt University81.995%Nashville, TN

Vanderbilt University is located in Nashville, Tennessee, and offers one of the best online master's of nursing programs in the country. The MSN in healthcare leadership program is designed for nurses who want to advance their career and become a leader in their healthcare institution. The program emphasizes business and management courses that are applicable to the healthcare field. Past graduates have gained leadership roles in community clinics, hospitals, corporate businesses, practice management organizations, and more. The program can be completed entirely online and can be completed in one year of full-time study or two years of part-time study. The 39-credit MSN in healthcare leadership consists of 13 separate courses on a variety of topics, including organizational behavior, health informatics, leadership, APN role with the U.S. healthcare delivery system, and quality improvement. Students must also enroll in two management practicum classes, which require 210 to 280 hours of field work and a project.

Applicants must have nursing credentials and a BSN with a minimum GPA of 3.0 to be considered, although there are other acceptable option such as an ASN, or BA or BS with additional credentials. They must also provide three letters of professional reference, GRE scores, and a statement of purpose. The program is offered on a full-time basis with classes beginning in the fall semester each year. Vanderbilt’s online nursing master's program is accredited by the National League for Nursing Accreditation Commission and the school is accredited by the Commission on Colleges of the Southern Association of Colleges and Schools. Vanderbilt has temporarily suspended admissions into their MSN program.


Program Overview
Department: School of Nursing
Program name: Master's of Science in Nursing - Healthcare Leadership
Accrediting body: NLN, SACSCOC
Tuition: $1,454/credit

Delivery
Format: Online
Instruction style: Asynchronous & synchronous

Program Requirements
Prerequisites: BSN & 3 credits of statistics; or ASN or diploma in nursing & 78 credits in natural science, social science, humanities, English, statistics, nutrition, developmental psychology; or BA/BS in non-nursing field & 11 credits of natural science; Registered Nurse license (or eligibility for such licensure)
Credit requirements: 38 credits
Field education requirements: Clinical practica and/or preceptorship

Program Length
Program options: Full-time or part-time
Program length: 1-3 years
Program start dates: Fall (full-time); fall, spring (part-time)

Admission Requirements
Application deadline: Rolling
GPA: 3.0 minimum
Standardized tests: GRE or GMAT

Contact
Department phone: (888) 333-9192
Admissions email: VUSN-Admissions@vanderbilt.edu
Social media accounts: Facebook; Twitter

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5 Johns Hopkins University78.8047%Baltimore, MD

JHU offers an online master’s of nursing program in health systems management that prepares students to pursue careers in leadership at hospitals, private practices, clinics, and educational institutions. This program teaches RNs how to use evidence-based decision making to make difficult, ethical, and informed decisions. Students who complete the program can sit for the American Nurses Credentialing Center and American Organization of Nurse Executives exams. This RN to MSN online program includes additional coursework on healthcare policy, information technology, case management, and fiscal management.

Students enroll in 12 credits of core requirements on topics like ethics, applied research, healthcare in advanced practice nursing, and statistical literacy. Then they enroll in 24 credits of business, leadership, healthcare management, and health systems courses. Students must also complete four credits of management electives and a financial management seminar. Several courses include clinical components, which currently cannot be conducted in Massachusetts. The program can be completed in one year of full-time studies, with part-time options also available. Transfer credit is considered on an case-by-case basis and students should with their state of residence to ensure that the clinical requirement meets state standards. JHU offers a variety of resources to help students find funding through financial aid, scholarships, grants, or employment.

Applicants must have a BSN with a minimum GPA of 3.0 and a current nursing license, as well as submit three letters of recommendation, a personal statement, and a resume to be considered. Graduates are eligible to apply for certification with the American Nurses Credentialing Center and the American Organization of Nurse Executives. JHU is accredited by the Middle States Commission on Higher Education.


Program Overview
Department: School of Nursing
Program name: Master's of Science in Nursing - Health Systems Management
Available concentrations: Management & administration, information technology, health policy, case management/population management
Accrediting body: CCNE
Tuition: $1,591/credit

Delivery
Format: Online
Instruction style: Asynchronous & synchronous

Program Requirements
Prerequisites: BSN, Registered Nurse license, undergraduate statistics
Credit requirements: 41 credits

Program Length
Program options: Full-time or part-time
Program length: 2+ years
Program start dates: Fall, spring

Admission Requirements
Application deadline: Rolling
GPA: 3.0 minimum

Contact
Department phone: (410) 955-4766
Department email: jhuson@jhu.edu
Social media accounts: Facebook; Twitter

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6 George Washington University75.0630%Washington, DC

George Washington University is a large, private university is headquartered just blocks from the White House in Washington, D.C. The school offers an online nursing master's program that allows students to a pursue one of six separate tracks: adult-gerontology acute care nurse practitioner, adult-gerontology primary care nurse practitioner, family nurse practitioner, nursing leadership and management, nurse-midwifery, and RN-MSN.

The adult-gerontology primary care nurse practitioner track prepares nurses to become advanced practical nurses. The program teaches students how to care for teens, adults, elderly adults, and frail elderly patients. Graduates from this track are prepared to practice primary care medicine for a wide range of adult populations. The family nurse practitioner track also covers a wide range of populations, but also includes a focus on every member of the family and the family unit as a whole. The master's of nursing leadership and management program is designed for nurses who want to become administrators and leaders in hospitals, healthcare networks, large practices, and insurers. This program features a heavy business focus on topics like clinical practice management, human resources, marketing, finance, and economics.

The RN to MSN track allows students who have an RN and associate degree or unrelated bachelor's degree to earn a BSN or a MSN. The track allows students to earn a bachelor's of science in nursing in four semesters or an MSN degree in three years. All nursing programs at GWU are accredited by the Commission on Collegiate Nursing Education. The master's in nursing programs are also approved by the Washington, D.C., Board of Nursing.


Program Overview
Department: School of Nursing
Program name: Registered Nurse to Master's of Science in Nursing
Available concentrations: Adult gerontology primary care nurse practitioner (AGPCNP), family nurse practitioner (FNP), nurse-midwifery (NM)
Accrediting body: CCNE
Tuition: $1,295/credit

Delivery
Format: Online
Instruction style: Asynchronous & synchronous

Program Requirements
Prerequisites: Associate degree in nursing, Registered Nurse license, CPR certification
Credit requirements: AGPCNP - 48 credits; FNP - 48 credits; NM - 47 credits
Field education requirements: Clinical practicum rotations

Program Length
Program options: Full-time or part-time
Program length: 2-3 years
Program start dates: Fall, spring

Admission Requirements
Application deadline: Rolling
GPA: 3.0 minimum
Work experience: Professional nursing experience

Contact
Department phone: (202) 994-7901
Department email: nursing@gwu.edu
Social media accounts: Facebook; Twitter

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7 Samuel Merritt University74.7920%Oakland, CA

Founded in 1909, SMU prepares healthcare professionals through its campuses in California and through distance learning. SMU offers nurses a 49-credit master of science in nursing-family nurse practitioner (FNP) that immerses learners in the clinical expertise needed for family nurse practitioner licensure. FNPs sustain the healthcare system by providing patients with information about diseases and self-care, prescribing medications, and disseminating information about ways to stay healthy.

Full-time students complete the program in 20 months and three semesters of clinical practicum. Courses include research methods, advanced practice nursing, advanced pathophysiology, family-centered advanced nursing, advanced pharmacology, and advanced physical assessment and lab. Nurses in the program also learn how to address the medical needs of multicultural and underserved populations. SMU emphasizes personalized instruction delivered by clinically experienced and distinguished faculty. FNP candidates develop a final thesis or project demonstrating mastery of program competencies. The program's flexibility allows nurses to work full-time while earning their degree.

This FNP program aligns with the standards established by the the American Association of Colleges of Nursing and National Organization of Nurse Practitioner Faculties. Admission requires RN licensure and at least one statistics course. Nurses must demonstrate an interests in working with people in underserved populations and provide proof of previous work experience. Nurses entering the master of science in nursing online live and work in Arizona, California, Colorado, Illinois, Nevada, Ohio, and Virginia. Classes start in May, September, and July, and students pay the same tuition rates regardless of in-state or out-of-state residency. Ninety-eight percent of students at SMU receive financial aid.


Program Overview
Program name: Master of Science in Nursing - Family Nurse Practitioner
Tuition: $1,353/credit
Credit requirements: 49 credits
Program length: Under 2 years

Delivery
Format: Online
Instruction style: Asynchronous

Admission Requirements
Standardized tests: GRE
Work experience: Required

Contact
Phone: (855) 971-1213
Email: admission@samuelmerritt.edu

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8 Rush University74.2663%Chicago, IL

Rush University prepares future leaders in healthcare through access to research, community services, and diversity initiatives. With a national reputation for clinical excellence, the Illinois College's School of Nursing offers an online, 37-credit master of science in nursing – clinical nurse leader program for RNs on a part-time basis. It prepares nurses in leadership who develop, implement, and evaluate research-based plans of care.

The two-year program incorporates online didactic courses, community clinical experiences, and two short campus visits. Courses in the program include studies in applied epidemiology and biostatistics; advanced pharmacology; evidenced-based practice; and healthcare economics, policy, and finance. A course in organizational and systems leadership focuses on organizational and leadership theories, ethical leadership principles, and clinical informatics. During the sixth term, nurses take a course to demonstrate clinical competency and use their clinical experience during a capstone project.

Nurses receive Clinical Nurse Leader certification by the American Association of Colleges of Nursing upon program completion. Some of the program's core courses transfer into Rush's Doctor of Nursing Practice (DNP) programs. RNs with baccalaureate degrees and RNs with an associate degree in nursing and a bachelor’s degree in a non-nursing field may apply to the master of science in nursing online. All applicants need a minimum 3.0 GPA and RN licensure in the U.S.

Students in this program receive the same tuition rates regardless of in-state or out-of-state residency, though the residents of Louisiana and Tennessee may not apply. The school is accredited by the Commission on Collegiate Nursing Education.


Program Overview
Program name: Master of Science in Nursing - Clinical Nurse Leader Program for Registered Nurses
Tuition: $1,066/credit
Credit requirements: 37 credits
Program length: 2 years

Delivery
Format: Online
Instruction style: Synchronous

Admission Requirements
GPA: 3.0
Standardized tests: GRE required if undergraduate GPA is below 3.25

Contact
Phone: (312) 942-7117
Email: Monica_Degenhardt@rush.edu
Social media accounts: Twitter

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9 The University of Texas Medical Branch73.2830%Galveston, TX

UTMB is located in Galveston, Texas, and is a component of the University of Texas system. The school has become a global leader in the academic health sciences and offers an online master’s in nursing in one of seven tracks: adult/gerontology acute care nurse practitioner, acute/gerontology primary care nurse practitioner, clinical nurse leader, executive nurse leader, family nurse practitioner, neonatal nurse practitioner, and nurse educator. Graduates are prepared to pursue advanced nursing positions and make improvements to the healthcare policy.

Most online MSN tracks share a common core curriculum. UTMB MSN students take seven core courses on topics such as foundations of research, pharmacology, informatics, pathophysiology, and public policy. However, the ENL track has slightly different cores requirements. All students have access to specific nursing career services, including resume help, internship and career placement, and more. Students can transfer up to 12 credits into the program. UTMB helps local students find clinical placements for practicums in the Galveston area. Distance learners must find a facility in their area that meet some restrictions.

Applicants must have a bachelor's of science in nursing degree from a program accredited by either the NLNAC, CCNE, or another nationally-recognized nursing education accrediting body to be considered. There are also healthcare work experience requirements that vary from program to program. Applications are typically reviewed and answered within two months. UTMB is accredited by the Commission on Colleges of the Southern Association of Colleges and Schools and this program is accredited by the Commission on Collegiate Nursing Education.


Program Overview
Department: School of Nursing
Program name: Master's of Science in Nursing
Available concentrations: Family nurse practitioner (FNP), adult gerontology acute care nurse practitioner (AGACNP), adult gerontology primary care nurse practitioner (AGPCNP), neonatal nurse practitioner (NNP), clinical nurse leader (CNL), executive nurse leader (ENL), nurse educator (NE)
Accrediting body: CCNE
Tuition: Varies

Delivery
Format: Online
Instruction style: Asynchronous & synchronous

Program Requirements
Prerequisites: BSN, Registered Nurse license
Credit requirements: FNP - 49 credits; AGACNP or AGPCNP - 49 credits; NNP - 46 credits; CNL - 43 credits; ENL - 39 credits; NE - 40 credits
Field education requirements: Clinical hours or preceptorship

Program Length
Program options: Part-time only
Program length: 3 years
Program start dates: Fall

Admission Requirements
Application deadline: January 15; CNL or ENL - March 15
GPA: 3.0 minimum
Work experience: 1-2 years of professional nursing experience in relevant concentration area

Contact
Department phone: (409) 772-8271
Admissions email: espucek@utmb.edu (Ned Pucek, Admissions

Contact)
Social media accounts: Facebook; Twitter

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10 University of Central Florida72.9140%Orlando, FL

UCF was founded in 1963 in Orlando, Florida. Today, the school serves more than 64,000 students annually and offers accredited online MSN program. UCF offers three tracks as part of the online MSN program: nursing leadership and management, nurse educator, and nursing and healthcare simulation. This online MSN program is perfect for working nurses and BSN degree-holders who want to earn more credentials to advance their career.

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