Doctoral Preparation of Nurse Anesthetists

Specialties CRNA

Published

  • Home Health Columnist / Guide
    Specializes in Vents, Telemetry, Home Care, Home infusion.

silentRN

559 Posts

If it's not broke why change it? I don't understand why nursing is requiring more and more, and yet our pay stays the same. I don't know.

allnurses Guide

wtbcrna, MSN, DNP, CRNA

5,125 Posts

Specializes in Anesthesia.
If it's not broke why change it? I don't understand why nursing is requiring more and more, and yet our pay stays the same. I don't know.

It isn't just nursing it is most/all of previously master prepared health professions (pharmacists, OT/PT/ST etc.) that are going to doctoral degrees. I would say a system that can't even decide on the minimum entry level requirement for nurses and has over 100K hospital related deaths a year is a broken system.

It is not that I agree with the DNP curriculum, but advanced education never hurt a profession.

ImThatGuy, BSN, RN

2,139 Posts

It isn't just nursing it is most/all of previously master prepared health professions (pharmacists, OT/PT/ST etc.) that are going to doctoral degrees. I would say a system that can't even decide on the minimum entry level requirement for nurses and has over 100K hospital related deaths a year is a broken system.

It is not that I agree with the DNP curriculum, but advanced education never hurt a profession.

Pharmacists were previously trained with a bachelor's degree, FYI.

So if nursing needs advanced education then advanced practice nurses need doctorates? Does that mean that the current BSN programs will become master's programs? Perhaps all LPNs will now not become LPNs until an associate's degree has been granted?

It's a stupid a cycle, and I feel like the DNP was POORLY thought out.

mariahas4kids

86 Posts

Specializes in hospice, corrections.

I am applying for an RN-MSN, FNP program. This is the last year they are having this program because of the FNP program going from a Master's level to a doctorate level. When my husband and I had the discussion whether I go back to school or not, master's vs doctorate was a big part of the discussion. Especially when it came down to the "do it now or do it later" portion. I told him that if I did not do this program now, I would probably finish my bachelor's at some time, but not go on for Nurse Practitioner because of time and costs.

Why doesn't anyone suggest that doctors have more clinical practice and patient time before they become doctors? Nurses have tons of clinical practice, now they (who-ever "they" are) want us to have more time and money invested before we can become mid-level practitioners? PA programs aren't that long, but they have to practice under a doctor preceptor.

Is this an extension of the centuries-long prejudice of medical doctors against nurses/midwives/wise-women?

Sorry for the rant, this dichotomy has always fascinated me.

allnurses Guide

wtbcrna, MSN, DNP, CRNA

5,125 Posts

Specializes in Anesthesia.
Pharmacists were previously trained with a bachelor's degree, FYI.

So if nursing needs advanced education then advanced practice nurses need doctorates? Does that mean that the current BSN programs will become master's programs? Perhaps all LPNs will now not become LPNs until an associate's degree has been granted?

It's a stupid a cycle, and I feel like the DNP was POORLY thought out.

I don't like the DNP curriculum, but what is that makes having your doctorate a bad decision. First of all this has absolutely nothing to do with undergraduate nursing degrees. So, what you are saying is it is okay for all these other health professions to go ahead require a doctorate but nurses should stay stagnate be the same as they always have been.

This seems the logical progression for CRNAs. CRNAs started out as certificate programs, then Bachelor programs, now Master level programs are the norm, and finally we will require a Doctoral degree for CRNAs in the future.

ImThatGuy, BSN, RN

2,139 Posts

Why shoot for a doctorate though? The other allied health professions have not become autonomous as a whole as a result of their progression. Why isn't a master's degree enough to be a midlevel provider which is what advanced practice nurses are? What's wrong with being a midlevel? Part of the reason for creating midlevels was to churn people out to fill a need. Why increase the education? Unless the DNP changes drastically in nature with significant courework in biomedical science and clinical exposure it's not going to do anything for the image or efficacy of the profession. More coursework in nursing theory and healthcare policy isn't something patients care about.

I agree it has nothing to do with undergraduate degrees, but why hasn't someone begged that question? I think it's logical to make all RNs have a bachelor's degree. Why relegate them to associate's degrees and diploma programs? I simply asked another question here that no one else seems to care about.

allnurses Guide

wtbcrna, MSN, DNP, CRNA

5,125 Posts

Specializes in Anesthesia.
Why shoot for a doctorate though? The other allied health professions have not become autonomous as a whole as a result of their progression. Why isn't a master's degree enough to be a midlevel provider which is what advanced practice nurses are? What's wrong with being a midlevel? Part of the reason for creating midlevels was to churn people out to fill a need. Why increase the education? Unless the DNP changes drastically in nature with significant courework in biomedical science and clinical exposure it's not going to do anything for the image or efficacy of the profession. More coursework in nursing theory and healthcare policy isn't something patients care about.

I agree it has nothing to do with undergraduate degrees, but why hasn't someone begged that question? I think it's logical to make all RNs have a bachelor's degree. Why relegate them to associate's degrees and diploma programs? I simply asked another question here that no one else seems to care about.

1. First of all CRNAs aren't midlevel providers. CRNAs have been around for over a hundred years. CRNAs can and have provided independent practice during that whole time. Being a midlevel provider implies that you are an extender of care and that you provide something in between what a physician/anesthesiologist does and what CRNAs do. CRNAs can and do provide the exact same anesthetic care as anesthesiologists.

2. Like I have stated a couple of times already I don't agree with the DNP curriculum. I will be pursuing a DNAP which from TWU is more science based and skips all the nursing fluff classes.

3. Trying to get all RNs to get their Bachelor degrees is a fight decades long with no resolution in sight.

subee, MSN, CRNA

1 Article; 5,416 Posts

Specializes in CRNA, Finally retired.
1. First of all CRNAs aren't midlevel providers. CRNAs have been around for over a hundred years. CRNAs can and have provided independent practice during that whole time. Being a midlevel provider implies that you are an extender of care and that you provide something in between what a physician/anesthesiologist does and what CRNAs do. CRNAs can and do provide the exact same anesthetic care as anesthesiologists.

2. Like I have stated a couple of times already I don't agree with the DNP curriculum. I will be pursuing a DNAP which from TWU is more science based and skips all the nursing fluff classes.

3. Trying to get all RNs to get their Bachelor degrees is a fight decades long with no resolution in sight.[/QUOT

Gee, I never took mid-level practitioner designation as an insult. I don't even have prescriptive privileges. And even though I'm sick of the ACT "team" concept that infantalizes me (almost 30 years of experience), I think there are differences between CRNA's and MDA's. CRNA's can clearly do 90% of cases without medical supervision, but I still have my doubts about the other 10% of the work, much of which is research or cases that we never do as CRNA students. They are the exceptional cases for sure, but its pure hubris to think that CRNA's can be all things to ALL patients.

BCRNA

255 Posts

I don't agree completely with the DNP requirement. It is mainly political reasons that it is being pushed. It puts us on a more equal footing since many other providers are going to a doctorate. The public automatically assumes a person with a doctorate is very knowledgeable. The public will often automatically give credence to the opinions of a doctorate prepared person. In administrative settings it is the same thing. Nurses have to fight against the constant stigma of "what do they know they are just nurses." Pharmacist went directly from bachelor to doctorate with just one or two years added on. What every other profession would make a masters degree. It is even possible to get a PharmD with having never had a previous degree and only six years of education; granted most actually have a bachelors with a total of 8 or more years. Most master's programs in nursing are much longer than other disciplines. My masters education is just 18 semester hours from what most programs give a PhD. On administrative boards in hospitals, if nurses are the only ones at the table with less than a doctorate then they aren't given as much credit for there opinion. My personal opinion is that most np and crna programs could be made doctorates with very few extra classes added, if pharmicists can do it in 6 to 8 years then we should be able too. They went from bachelors straight to doctorate with about just one more year added. I was pre-pharmacy before going to anesthesia, it was my back up plan. Thats why I know the requirements in their program.

I am starting a DNP program now, and I can see how it can help with policy and administration. Clinically it might be able to help, but the current set up is more focused on policy or administration. I have heard from the people who recruit for the graduate school that part of this is because they are focusing on people who already have clinical training and years of experience to start with. There programs are for the post masters, not the new practitioners. They are focusing on the people who are going to train the upcoming DNP students, and that it is difficult to start up a DNP program with a lack of DNP prepared nurses. Also, they are going to teach us to interpret research to apply it to practice, I can't speak for everyone else but I know that my master's preparation did not prepare me to critically review research. I had a great teacher in my research class, but it was on a 3 semster hour class and couldn't possibly teach me to interpret most nursing research.

Hopefully this won't backlash the nursing profession by decreasing the number of future students. Most NP's I know are part time female students with family obligations, I hope future students aren't discouraged from joining because of the longer time in school. My worry is that the programs will be so long that it can't be done part time within seven years (the time most schools mandate as the amount of time the program has to be finished). And if it does take 5 to 7 years, will people even try to do it?

ImThatGuy, BSN, RN

2,139 Posts

Yeah, being called a midlevel isn't anything bad. The person who thinks it is derogatory is probably the same person pushing for a DNP. I'd think most healthcare professionals would view a CRNA as a midlevel provider. Sorry. Don't mean to step on your toes! You're higher on the clinician ladder than I am.

allnurses Guide

wtbcrna, MSN, DNP, CRNA

5,125 Posts

Specializes in Anesthesia.
1. First of all CRNAs aren't midlevel providers. CRNAs have been around for over a hundred years. CRNAs can and have provided independent practice during that whole time. Being a midlevel provider implies that you are an extender of care and that you provide something in between what a physician/anesthesiologist does and what CRNAs do. CRNAs can and do provide the exact same anesthetic care as anesthesiologists.

2. Like I have stated a couple of times already I don't agree with the DNP curriculum. I will be pursuing a DNAP which from TWU is more science based and skips all the nursing fluff classes.

3. Trying to get all RNs to get their Bachelor degrees is a fight decades long with no resolution in sight.[/QUOT

Gee, I never took mid-level practitioner designation as an insult. I don't even have prescriptive privileges. And even though I'm sick of the ACT "team" concept that infantalizes me (almost 30 years of experience), I think there are differences between CRNA's and MDA's. CRNA's can clearly do 90% of cases without medical supervision, but I still have my doubts about the other 10% of the work, much of which is research or cases that we never do as CRNA students. They are the exceptional cases for sure, but its pure hubris to think that CRNA's can be all things to ALL patients.

The simple fact is CRNAs aren't midlevel providers. We never have been and we will never be.

There isn't a type of anesthesia case that a MDA does that CRNA can't or doesn't do somewhere. I realize that MDAs take the majority of bigger more complex cases especially at larger teaching hospitals, but there are still CRNAs that do hearts, TEEs, Neuro, complex peds, trauma etc. independently. As a military CRNA I have only worked independently since graduation so I think it is kind of funny when CRNAs think they need to work in an ACT practice or that only MDAs can do certain types of surgeries. If a CRNA wants to confine themselves to dependence on MDAs and work only in ACT practices more power to them. I personally will stick with independent practice.

+ Add a Comment