You Asked, We Listened: The Return of the MSN

Posted: September 9, 2019

Since becoming a nurse, Stephanie Durbin had always planned to pursue her master’s degree. Last year, after 10 years in the workforce at UK HealthCare®, she finally decided on a path: health care leadership.

This year she was thrilled to learn the University  of Kentucky College of Nursing (UKCON) is bringing back its MSN program of study; this time with a focus on Healthcare Systems Leadership.

“It took longer than I expected to decide what path I wanted to take,” says Durbin, RN, BSN,CPN, a manager and clinical quality specialist in Quality Monitoring and Reporting. “I started looking at schools last year and then heard a rumor they were bringing the program back and waited to see if it came to fruition, which it did.”

The Healthcare Systems Leadership MSN program is being “reinvigorated” and offered online, according to Janie Heath, PhD, APRN-BC, FAAN, FNAP, FAANP, dean and Warwick Professor of Nursing, to better prepare nurses as mid-level managers and provide a stepping stone to a doctorate-level degree.

“In today’s constantly changing health care environment, that additional education, knowledge and expertise are what’s going to be  a game changer in the success of that individual and that organization,” says Dr. Heath.

Mid-level nurse managers are now being asked  to not only oversee a unit or a floor, but they also are being charged with financial, technological and strategic responsibilities.

“Health care is much more challenging and complex than it used to be,” says Debra Hampton, PhD, MSN, RN, FACHE, NEA-BC, CENP, assistant professor and academic coordinator for the MSN Leadership, BSN-DNP Executive Leadership and MSN-DNP Leadership programs. “The expectations in a leadership role are really high.”

Nearly a decade ago, the College discontinued its master’s degree program and instead offered a doctorate in nursing practice (DNP)—the first of its kind in the nation. A DNP, says Sheila Melander, PhD, APRN, ACNP-BC, FCCM, FAANP, FAAN, professor and associate dean of MSN and DNP Faculty Affairs and Practice, better prepares students to meet the growing demands being asked of nurses, especially in higher-level leadership roles. The change was endorsed nationally by the American Association of Colleges of Nursing, which had spent four years researching the issue.

But as UKCON eagerly embraced the shift and encouraged more BSN-prepared nurses and students to pursue their DNP in lieu of an MSN, the College began to hear from hospitals around the state. Many chief nursing officers (CNOs) were asking the College to reinstate its MSN in Healthcare Systems Leadership.

“We’ve been told by CNOs in Kentucky that we really need that master’s program because we have a lot of nurses who want to be nurse managers, and the DNP program doesn’t best meet their needs,” says Dr. Hampton.

Dr. Hampton says the DNP program is a longer commitment and is more of an executive leadership program. Whereas, an MSN can be completed within two to  three years and provides basic leadership-level preparation.

For many BSN-prepared nurses who want to become nurse leaders or have been promoted because of their excellent bedside nursing, the additional necessary management skills can fall into a less familiar realm. 

“You’re often put in a leadership role because you are a good bedside nurse,” says Dr. Melander. “You did your job well, but it doesn’t mean you have, for example, the finance background to understand budgeting or the professional development to get your nurses to the next level.

“Our goal is to have our leaders prepared just as high as we can get them,” she continues. “We had to fill that gap.”

As an example, Dr. Hampton cited the need for mid-level nurse leaders to learn about maintaining quality outcomes and meeting federally issued expectations, all while managing productivity and staying within financial goals and guidelines.

It’s tough to balance, especially when you don’t have a lot of resources. The MSN program is going to give leaders competencies that will help them balance those expectations,” says Dr. Hampton. 

Going back to school gives nurses a chance to not only learn about these changes, many of them data and outcome driven, but to also understand the rationale and principles behind them, says Gwen Moreland, DNP, RN, NE-BC, interim chief nurse executive for UK HealthCare.

“At work you are asked to decrease the cost of care,” she says.  “But new managers do not always understand how expensive health care is in this country compared to other countries with better outcomes.” 

And the bottom line of all this, says Dr. Moreland, is excellence in nursing care. 

“That’s our focus.  If nurses have not received the preparatory work, they may not understand the different quality metrics or cost data,” she says.  “The focus is on the outcomes for the patients, which is why we evaluate the work.”

Dr. Moreland says she received her MSN before she went on to earn her DNP.

“I worked for three years before moving to my DNP work,” she says. “The MSN set me up to function well at the executive level with my DNP.”

Durbin says the MSN program is the better fit for now. “The MSN met me where I was professionally,” she says. “Being out of school for the past 11 years, I am little nervous about going back. So, the MSN seems like the step I am ready to take in my professional life and my personal life.”

To better reach potential students like Durbin and appeal to a broader audience, the MSN program also needed to be online, says Dr. Heath.

“Brick-and-mortar days are really over for nurses who are seeking post-licensure education,” she says. “When you look at the state of Kentucky, we’ve got 15 higher education institutions, and every one of us offers some degree or program of study online because the learners of today have changed from what they were years ago.”

For many adult learners it can be overwhelming and daunting to think about physically going back to school and seeking higher education when they are trying to balance their work, family and being in class all day or for half a day.

“That can be like mission impossible for a lot of our nurses,” says Dr. Heath. “Online learning is very viable and desirable. They can do their day jobs and what they need to do at home, and then they can carve out that time to meet the objectives of their program of study online.”

It makes all the difference for Durbin. “I have a full-time job; I am the manager of the quality department and having the program available online definitely makes it more feasible,” she says.

Dr. Heath says UK will discontinue its tuition reimbursement in 2021 for its employees who seek further education at outside institutions, making reinstating the MSN program even more practical. She says they are also looking at the possibility of adding other subsets of MSN education, such as clinical instruction or informatics.

“Every nursing program’s job is to always be listening to our partners to see how we can

do better in both our learning and working environments,” says Dr. Heath. “As nursing educators, we’ve got to be sure when designing our nursing curriculum that it is focused on how we can, directly or indirectly, impact quality of care in patients, families, communities and systems. It’s critical for our curricula to always be relevant.”

That relevancy played a part in Durbin’s decision to seek her MSN at the College.