2015 DNP

[BabyLady]

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 graduate and pass your boards by January 1, 2015 or you can put the MSN you have in back of the closet and start working on your DNP, because the MSN isn't good enough anymore to sit for national certification."

There are many of us, including myself, that will be finishing probably in 2013 or 2014...now, we would all like to think that we would pass our certification the first go-round, but we all know that may or may not happen for some of us.

Example: You graduate in June 2014 with your MSN and it is January, 2015, you still cannot pass your certification exam...does that mean you have to go back to school or you cannot practice?

I have seen some colleges that have completely phased out MSN programs but I have seen MANY that have not...that makes me wonder if it is not going to be a "go" like they are claiming that it is.

I would love to hear from those that keep up with this sort of thing...that may have more insight.

[prairienp]

The onlyway to make this argument is to compare students who have a degree (BS or MS)in another field who are in a BSN program. My hypothesis would be the studentswith a degree in another field in a BSN program would outperform the studentsin the AD program.

My understanding is that DNP fnp programs require 1000 hours of clinical, a MS fnp program requires 500

Adding a residency wouldbe great, who pays? If the same residency as MDs were available we would havevalid option supported by our tax dollars

[wtbcrna, MSN, DNP, CRNA]

Of course they are saying the existing APNs will be "grandfathered" in, because there is no way they would even be able to get a conversation going about the proposal if they weren't. However, no one knows how this would work out in "real life." What we do know is how it worked when nurse practitioners went from the certificate programs to MSN as a minimum requirement. The existing certificate-prepared NPs were "grandfathered" in -- however, those individuals found that they could continue to practice in their current state of licensure but could not get licensed in another state because the minimum requirement for licensure was now an MSN, which they did not have. So those individuals were basically stuck in their current state for the rest of their careers, without any ability to relocate if they chose or needed to and continue practicing at the advanced practice level.

That is true for any state BON that adopted the Masters as a requirement for APN, but that state requirement does not have to do with the AACN, AANA, or NP accrediting organizations. It also didn't just get decided overnight in these states that a Masters would be required for entry level practice. Those APNs had years in most cases before this became an issue, and they still have the option of going back and getting their MSN. This isn't even an issue for NPs right now and probably won't be for at least another decade and maybe not even then. There is plenty of time for APNs to decide where they want to go with their practice in the next 10-20 years and make an educational and career decision based on that decision. As long as someone is an APN you will have to continue your education in one way or another that is given whether it is a formal education ending with a clinical doctorate or CEU/CMEs our continuing education is not done until we retire our APN licenses.

[Ellen NP, MSN, NP]

The 1000 hours include the MSN hours (at least 500, many are more, mine was 600) and the remainder are 'practice hours'. The Practice may occur in an educational rather than clinical setting and the subject may be related to management, leadership, policy, education, or a clinical practice issue. The confusion lies in the fact that people assume that practice hours are clinical hours. Nurse educators who are not NPs do not have to do one single hour seeing patients. In fact NPs do not have to do any further clinical work. They can focus on education, leadership, etc. in their DNP program.

[Ellen NP, MSN, NP]

Our ADN students are actually outperforming the BSN students who have degrees in other fields. Our students have significantly more clinical hours than do the BSN programs.

[PMFB-RN, RN]

Nursing organizations have been stating for years that a BSN should be the entry level degree for RNs, but nothing has changed.

*** Of course nothing has changed. If they were serious about it they would simply grandfather in all the diploma and ADN nurses. The "BSN as entry to practice" crowd refuse to do that so naturally they face stiff opposition.

The studies are out there that BSN prepared nurses provide better patient outcomes,

o

*** What studies? The studies I have seen, like the Akin study, are highly flawed and biased.

Here is what hospitals are facing: Armed With Bigger Fines, Medicare To Punish 2,225 Hospitals For Excess Readmissions - Kaiser Health News

Hospitals are under pressure to cut down HAI and readmission rates as much as possible, and nursing as the largest workforce in the hospital we will always be looked at critically.

*** Ya, I know.

It is easy to go from ADN to BSN.

*** Yes, it's ridiculously easy. I got dumber getting a BSN at a well respected state university. The level of discourse and critical thinking expected where embarrassing.

There isn't a reason that all nurses could not get their BSNs.

*** That is a good position to take if you want to make sure BSN as entry to practice takes as many years as possible to implement. In that case then _IF_ DNP ever becomes the only entry point to APRN then ALL APRNs should be forced to go back for their DNPs if they want to keep their license. Same for all the non doctoral prepared pharm and PT's out there.

Now back to the original topic...There isn't any professional organization that has suggested non doctoral prepared APNs would not be grandfathered in.

*** No of course not. That would be silly.

[wtbcrna, MSN, DNP, CRNA]

*** What studies? The studies I have seen, like the Akin study, are highly flawed and biased.

Did you miss the link with all those studies I posted?

[PMFB-RN, RN]

Did you miss the link with all those studies I posted?

Hmmm, people with a product to sell have found better outcomes if more nurses purchase their product.

For a study to be evidence in this argument it would have to compare nurses who entered nursing with diplomas or ADNs REGARDLESS OF THEIR OTHER EDUCATIONAL ACHIEVMENTS with those who entered nursing with BSNs regardless of their other educational achievements. None of the studies you posted do that.

[wtbcrna, MSN, DNP, CRNA]

Hmmm, people with a product to sell have found better outcomes if more nurses purchase their product.

For a study to be evidence in this argument it would have to compare nurses who entered nursing with diplomas or ADNs REGARDLESS OF THEIR OTHER EDUCATIONAL ACHIEVMENTS with those who entered nursing with BSNs regardless of their other educational achievements. None of the studies you posted do that.

So what you are saying is that you have evaluated the methodologies and came to the conclusion that all these authors just overlooked the fact that some of these nurses used to have their ADNs. Now since you have reviewed each and everyone of these articles methodologies from the articles not the abstracts why don't you paste those methodologies so we can all come to that exact same conclusion that has escaped pretty much every nurse scholar in North America.

[PMFB-RN, RN]

So what you are saying is that you have evaluated the methodologies and came to the conclusion that all these authors just overlooked the fact that some of these nurses used to have their ADNs.

*** No of course not. Why would I when others have done such a good job if it for me? What I am saying is that no study that does not compare out comes of nurses who entered practice as a diploma or ADN to nurses who entered practice as BSNs it's not useful in the BSN as entry to practice debate. They MAY be useful as an argument to require all nurses to earn a BSN (something I might well go for) but that is a different debate than the BSN as entry to practice debate.

Now since you have reviewed each and everyone of these articles methodologies from the articles not the abstracts why don't you paste those methodologies so we can all come to that exact same conclusion that has escaped pretty much every nurse scholar in North America.

*** (chuckle, chuckle) You are much too smart and have too many perfectly reasonable and valid arguments to resort putting words in my mouth.

[wtbcrna, MSN, DNP, CRNA]

*** No of course not. Why would I when others have done such a good job if it for me? What I am saying is that no study that does not compare out comes of nurses who entered practice as a diploma or ADN to nurses who entered practice as BSNs it's not useful in the BSN as entry to practice debate. They MAY be useful as an argument to require all nurses to earn a BSN (something I might well go for) but that is a different debate than the BSN as entry to practice debate.

*** (chuckle, chuckle) You are much too smart and have too many perfectly reasonable and valid arguments to resort putting words in my mouth.

I am glad you admit to not evaluating any of these articles and have based your statements on ignorance of the research.

[PMFB-RN, RN]

I am glad you admit to not evaluating any of these articles and have based your statements on ignorance of the research.

*** What a shame. Rather than hold a discussion you resort to again putting words into my mouth. OK, I see how you want to behave. I expected better. You have disappointed me.

"In a study released in the May 2008 issue of the [COLOR=#003366]Journal of Nursing Administration, Dr. Linda Aiken and her colleagues confirmed the findings from her landmark 2003 study (see below) which show a strong link between RN education level and patient outcomes. Titled “Effects of Hospital Care Environment on Patient Mortality and Nurse Outcomes,” these leading nurse researchers found that every 10% increase in the proportion of BSN nurses on the hospital staff was associated with a 4% decrease in the risk of death. "

For the purposes of this discussion we can ignore the evaluations of this study that shows the flaws in Dr.Aiken 's methods and take it at face value. It isn't evidence that can be used to support the BSN as entry to practice argument. Dr.Aiken failed to differentiate between nurses who entered nursing practice with a diploma or ADN (and possibly went on to earn BSNs or MSNs or doctorates) and nurses who entered practice with a BSN. Thus is has nothing to tell us about BSN as entry to practice. Assuming we ignore the flaws in the study it may be evidence for something else, like requiring all nurses to earn BSNs. But that is a different topic than BSN as entry to practice.

[wtbcrna, MSN, DNP, CRNA]

*** What a shame. Rather than hold a discussion you resort to again putting words into my mouth. OK, I see how you want to behave. I expected better. You have disappointed me.

No, you try to make points about articles you haven't evaluated and you continue to bring in opinions with no proof. I on the other hand posted peer reviewed articles, expert opinions, and statements from professional organizations. You disappoint from the lack of use of research and then try to make claims that more education does not do anything to improve patient care and more education is nothing but a business/universities trying to make money.