2015 DNP - page 10

by BabyLady

80,430 Views | 235 Comments

I am wondering if anyone has heard any updates. Everything I keep seeing online from the AACN is "recommendation", "strongly encouraged", "highly suggested". I have yet to see anything, that says, "Look, either you... Read More


  1. 1
    Dr. Tammy,

    I was looking at your educational accomplishments, and I am quite impressed. I am an Excelsior College graduate also. I'll be in University of Phoenix's MSN/FNP program as of November 11th of this year.

    Just some thoughts. My problem with the DNP is that even though it is a new degree, there were no surveys given to current advanced practice nurses asking for their opinions on the DNP degree. There could have been some type of research done to help back the AACN's position of why this degree is needed. The complete and utter lack of hard data dumbfounded me when I read the white paper.

    I agree that there are cheaper schools, especially with distance education; however, the point I was making is that universities are seriously jacking up their prices due to the degree being called "doctoral" instead of "master's". I have nothing against anyone who wants to get the DNP. I just don't like the idea of students being forced into it and the universities overcharging for it.

    I have friends who are currently completing the post-masters DNP program. My post was based on what they said... basically, there is no way they were able to complete it in 1 year. I have to commend you for getting it done in 16 months... that's almost unheard of. The issue I take is the universities telling the students that it's "only one more year" as a way to push the DNP degree to increase their revenue stream.

    I only want to know one thing if you will oblige me. Was what you learned in the DNP degree program useful to you as a practicing nurse practitioner? More specifically, did it help you be a better nurse practitioner?

    I look forward to your response.

    Mark
    oldiebutgoodie likes this.
  2. 0
    Quote from nursemark29
    So here's the deal. I don't see our profession as being so malicious as to tell someone who has graduated an MSN level nurse practitioner program that they started before the year 2015, "Oh well. It's 2015 now. You need to get a DNP degree, or else we won't let you get licensed as a nurse practitioner." I'm absolutely certain that they will grandfather those people who were accepted into an MSN level N.P. program before the year 2015 so they can take their boards and practice for what they were trained to do. I will be done with my program in late 2013 or early 2014. Even if I were done in 2015, I would not worry, as I am certain I could easily present my case to the certifying body and would be granted an exception. As others have also stated, I do not know of even one certifying body that states a DNP will be required to be certified as a nurse practitioner. So for those of you that are worried, just concentrate on school and getting through it... that will be challenging enough. You will be a nurse practitioner when you are done.
    This wouldn't happen anyway, nor is it even mentioned in the PROPOSAL. I have no idea why people think that "grandfathering" is even part of the equation...it never has been and never will be.

    Even back before you had to have an MSN to be an NP, when the MSN-NP became the standard, that only applied to NEW applicants applying for credentials, it had no impact at all on the ones that were already licensed to practice.

    Same thing with the DNP..that will only apply to NEW graduates IF the measure comes into fruition.
  3. 1
    Quote from Guinea
    This is mostly false. It's only true in very specific cases and diseases investigated by the studies.

    You are essentially saying that primary care physicians are fools for going through so much more education and training (something like a minimum of 15,000 clinical hours versus a minimum of 1,500-3,000). This kind of BS is not going to help your relations with physicians, whom you will be working with on a frequent basis.

    Anyone with a modicum of common sense will realize that those extra years of education and training that a physician has will have a positive impact to care that may not be captured by the limited and flawed studies you cite. Even if you personally are the best and most competent nurse practitioner in the world, others studying to be NPs may severely fall through the cracks at a higher rate than that of physicians, given the shorter duration of training and fewer repetitive drilling especially in the direct entry NP programs. See for instance the anxiety in this thread of not passing the DNP certification exams on the first try, something that 95% of US medical students pass with harder exams.
    I would have to disagree with you on that.

    The major difference between nurses and physicians is that physicians come and review the chart, talk to the patient for 5 minutes, write an order and leave.

    It is nurses, who stay with the patient for 12 hours a day and see, first-hand, how the subtle early signs of a disease process/condition begin to show.

    The vast majority of NP's have that nursing experience before they go to NP school. Virtually all physicians only have their experience in classroom settings, doing rounds where they spend no extended time with the patients and reviewing charts and writing orders.

    MASSIVE DIFFERENCE in training, you are correct, but hours doesn't necessarily equal expertise.

    Ever watch the show mystery diagnosis? Ever noticed how a person can visit 10 to 20 physicians and NONE of them can accurately diagnose the patient and then this patient that has zero medical training is able to diagnosis themselves, finds the right specialist, who confirmed what 10 to 20 other physicians couldn't do?

    It is because NP's are ultimately Advanced Practice NURSES. They are taught to critically think, they are taught to listen, they are taught to watch, they are taught that you have to remain open minded and not get arrogant about your own abilities.

    I wouldn't go to an NP for everything, but the good ones, would be able to catch so much that a slacking MD would miss.
    missvictoriat likes this.
  4. 6
    Quote from ccso962
    Oh no I agree 100% that if you have earned a doctorate (clinical or otherwise) and you want to refer to yourself as doctor then that is great. I am simply saying that not everyone agrees with that. In fact if you look around on most of the other medically relevant forums there are plenty of people discussing the problem of confusion to patients by multiple people being called doctor in a health care setting not just NPs. I happen to know of more than one hospital where pharmacists are NOT allowed to refer to themselves as doctor period.

    As for the PA calling themselves doctor I worked with two PAs (both working in the ER) who had earned doctorates (one in Health Science (DHSc) and the other a PhD in Health Related Studies). Neither of these PAs saw any reason to refer to themselves as doctor so I don't know how the hospital would have reacted if they had.

    I am not aware of ANY entry level PA programs at the doctorate level...YET. There seems to be quite a bit of discussion out there on the internet about some PAs wanting to have a clinical doctorate option especially in light of the move to DNP. I don't know that the AMA would back this move, or the AAPA for that matter either. Keep in mind there are still PA programs that award the Bachelor's and a couple in California that still award Associate's degrees although the curriculum is all standardized for the most part and it all depends on pre-reqs etc. at the various schools.

    As far as people getting in a tizzy when DNPs want to be known as a doctor and not other providers I think this, again, may depend on the region of the country you are in. There is still plenty of discussion on the forums out there about whether a pharmacist should be called doctor for instance, and even within the pharmacy profession there is division on this issue. I think maybe it seems more like its all DNPs on this site, because this site is geared toward nurses. I can assure you though that on sites geared toward medical students, residents, etc. there is plenty of dissent for anyone other than an MD or DO to be called doctor.
    There is a finite difference between confusing the patient and EDUCATING THE PUBLIC.

    It is time to educate the public.

    The last time I had surgery, I had no less than 4 MD's enter my room and here is how the conversation went:

    MD: "Hello, My name is Dr. Smith....I am here to take a look at your incision."

    ME: "...and you are?"

    MD: "I'm Dr. Smith"

    ME: "Are you a psychiatrist, surgeon, endocrinologist, cardiologist...what?"

    MD: "I'm a medical doctor".

    ME: "So you are a resident?"

    MD: "No, I am the general surgeon".

    Granted, I will ADMIT I was being sarcastic, but my point was made: I should know which disciplines are coming into my room and who is looking at me.

    NOBODY, should be introducing themselves as Dr. without an explanation of who they are...for example


    I'm Dr. Smith, I am your Cardiology resident.

    I'm Dr. Jones, I am your Anesthesiologist.

    I'm Dr. Doe, I am your General Surgeon

    I'm Dr. Patel, I am a Nurse Practitioner

    There are several pharmacists in my hospital and in surrounding pharmacies, ALL of them are referred to as "Dr. ____".

    When in the hospital, they refer themselves as a Dr. ____, I am the Pediatric Pharmacist.

    You know why I should support the title, because after the public is educated, it will show the level of expertise of the person who is treating you.

    If you are treated by Ms. Smith the NP, you know she has an MSN, If you are treated by Dr. Smith, the NP, then you know she has a DNP.

    It is only as confusing as we make it out to be and I personally, don't believe the majority of people are that stupid.
    ktliz, Lovanurse, missvictoriat, and 3 others like this.
  5. 7
    Quote from BabyLady
    You know why I should support the title, because after the public is educated, it will show the level of expertise of the person who is treating you.

    *** The idea that the degree a nurse holds is an indicator of the nurses expertise is absurd. I am the Rapid Response Nurse for my hospital. I have years of high acuity critical care, level I trauma, transport, and ER experience. CCRN, CEN and CRNI certifications. I am an ACLS instructor and have years of paramedic experience as well. That anyone would assume that the new grad with a direct entry MSN has more expertise than I do cause I do not have a masters is ridiculous.
    ccso962, Szasz_is_Right, CCRNDiva, and 4 others like this.
  6. 2
    Quote from BabyLady
    It is because NP's are ultimately Advanced Practice NURSES. They are taught to critically think, they are taught to listen, they are taught to watch, they are taught that you have to remain open minded and not get arrogant about your own abilities.

    I wouldn't go to an NP for everything, but the good ones, would be able to catch so much that a slacking MD would miss.
    Yeah, you're just so open-minded and not arrogant about your abilities that you think NPs are better than MDs.

    And what do you think residency is? A classroom setting? Why do you think residents work 30 hour shifts? How many patients do you think medical students on clerkships follow at a time?

    Are there great NPs with decades of experience who are wonderful assets to the team? Absolutely. But you're kidding yourself if you think the plethora of recent online NP programs and direct entry NP programs are even remotely equivalent to the MD-residency combination, let alone superior. NP graduates from these newer programs today are nowhere in the same league as the previous generation of critical care nurses who went to NP programs after a decade of experience. Yet they have the audacity to feel superior to those MSNs because they took a couple fluff classes in elementary statistics and have a degree with the word Doctorate in it.

    And BTW, I think Illinois just made it illegal for DNPs to call themselves Doctors in the clinical setting.
    Last edit by Guinea on Jul 21, '11
  7. 0
    Quote from PMFB-RN
    *** The idea that the degree a nurse holds is an indicator of the nurses expertise is absurd. I am the Rapid Response Nurse for my hospital. I have years of high acuity critical care, level I trauma, transport, and ER experience. CCRN, CEN and CRNI certifications. I am an ACLS instructor and have years of paramedic experience as well. That anyone would assume that the new grad with a direct entry MSN has more expertise than I do cause I do not have a masters is ridiculous.
    Someone with a new grad MSN from a direct-entry program, I am assuming, wouldn't be on a transport them, etc..unless properly trained, correct?
  8. 0
    Quote from Guinea
    Yeah, you're just so open-minded and not arrogant about your abilities that you think NPs are better than MDs.

    Please post where I stated that....and by the way, thanks for the nasty comment.

    And what do you think residency is? A classroom setting? Why do you think residents work 30 hour shifts? How many patients do you think medical students on clerkships follow at a time?

    Oh, do you even WORK in a hospital setting? I know what a residency is...and they may be following 20 patients, but they also may not even see a patient directly for a couple of days and I have NEVER seen one spend more than 10 minutes in the room. They never read what the nurses write and they walk around with their little ipod Touches expecting that device to give them all the answers.

    Are there great NPs with decades of experience who are wonderful assets to the team? Absolutely. But you're kidding yourself if you think the plethora of recent online NP programs and direct entry NP programs are even remotely equivalent to the MD-residency combination, let alone superior.

    Again, please post where I said that they ALL were. Are you denying there are bad MD's?


    NP graduates from these newer programs today are nowhere in the same league as the previous generation of critical care nurses who went to NP programs after a decade of experience.

    No NP program EVER required a decade of experience...please copy and post evidence that any of them did prior to applying.


    Yet they have the audacity to feel superior to those MSNs because they took a couple fluff classes in elementary statistics and have a degree with the word Doctorate in it.

    I am not even going to address this because obviously, by this post you have CLEARLY shown that you have no idea of what any of these degrees entails or have viewed the curriculum of any program. Otherwise, you would know how ridiculous this statement is.


    And BTW, I think Illinois just made it illegal for DNPs to call themselves Doctors in the clinical setting.
    Alcohol used to be illegal during the prohibition also....this is physicians making this call, thus, confusing the public even more instead of educating them. AMA forks out big $$$ for lobbyists...or didn't you know that?
  9. 0
    Quote from BabyLady
    Someone with a new grad MSN from a direct-entry program, I am assuming, wouldn't be on a transport them, etc..unless properly trained, correct?
    *** Unlikely in transport. At my hospital you will see them in the ICUs and ER. Well that's not really true as my hospital has stopped hiring direct entry master grads into speciality areas and the experience we have had with them.
    They used to be hired into the critical care nurse residency program and they would be working along side much more experienced nures in any of the critical care units plus ER & PACU.
  10. 10
    Quote from nursemark29
    I only want to know one thing if you will oblige me. Was what you learned in the DNP degree program useful to you as a practicing nurse practitioner? More specifically, did it help you be a better nurse practitioner?

    I look forward to your response.

    Mark
    The DNP added a new dimension to my practice for sure. Duke taught me how to access, interpret and translate evidence. Simple enough concepts, but here is what I was able to do with what many describe as "DNP Fluff courses":

    1. I created the first police nurse practitioner program in the United States. Through Duke, I used my capstone experience to formulate an IRB approved study to evaluate the effectiveness of one component of the outreach program, which is being published August 3 in The Journal of Community Health Nursing. Once, where there was nothing--now there is a tangible program in place that is helping thousands in the community--all through direct implementation of what I learned through the DNP program. To date, the police nurse practitioner program has now provided screening and direct health care services for over 10,000 individuals within my community--all at no cost to the agency or the taxpayer.

    2. I created a special health chair position with the NAACP where I developed a free out patient clinic program for those vulnerable populations who have absolutely no access to health care services. Even though not one physician I contacted was willing to help or provide any assistance whatosever, I used my DNP training to craft, design and implement a program that has provided more than 100 patient care primary care visits over the last few months. Now, the local chapter has procured its own clinic site to expand the services provided by my project developed within my DNP training.

    3. Even though the DNP is not the research arm of nursing, there is a heavy emphasis on the research process. I now feel I have the tools to conduct research in the context of evaluating and translating evidence. As with the study I did at Duke, this will translate into improving outcomes across my practice.

    So, to answer your question, I would say that through my DNP training, I was not trained how to diagnose cystitis any better than within my MSN program. I wasn't provided with any additional training on how to manage diabetes or lipidemia or provide better birth control counseling, but I would say that the impact I have had on the lives of those in my community was pretty good.
    cniro7PMHNP-BC, eagle78, szeles23, and 7 others like this.


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