2015 DNP - page 5

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... Read More

  1. Visit  shelly_BSN profile page
    5
    Credentialing agencies are beginning to provide insight into requirements for licensing in 2015 and beyond.

    The following question was submitted to Pediatric Nursing Certification Board, which certifies pediatric nurse practitioners.


    "Will the PNCB require an earned DNP as an exam eligibility requirement for CPNP certification in 2015?"

    This board's responses was as follows:

    "In the next ten to fifteen years as the DNP eventually becomes established as the majority framework for PNP education, the PNCB will continue to conduct its national role delineation on research to determine the influence of DNP education on the changing nature of PNP clinical practice. When our national PNP practice analysis research reveals that DNP education has influenced the knowledge and skills linked to PNP practice, then the PNCB will remodel its national elgibility requirements to require documentation of an earned DNP as an exam eligibility requirement. This would apply to new graduates taking the exam for the first time. "

    Source: http://www.pncb.org/ptistore/resourc.../forms/DNP.pdf

    In other words, the PNCB will not require a DNP in order for candidates to sit for the pediatric nurse practitioner certification exam in 2015. The board will make a decision after reviewing ten to fifteen years worth of data.

    Ultimately, the state boards and national credentialing agencies will determine how soon the DNP becomes a requirement for advanced practice. Educational institutions will have a significant role as well, as they will determine what degrees will be conferred 2015-DNP or MSN.

    I am reviewing the websites of various advanced practice credentialing agencies for this information, and I post the results.
    eagle78, tryingtohaveitall, NurseKJ, and 2 others like this.
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  3. Visit  shelly_BSN profile page
    3
    ANCC, or American Nurses Credential Center, which offers certification exams for various NP and CNS specialties, conducted a survey regarding the DNP and its implications on the certification process.

    After providing the survey results, which can be obtained by clicking on the link above, ANCC made the following statement: Ultimately ANCC believes that the movement from the master’s level graduate programs to doctoral level programs will evolve over several years with nurses educated at two different levels and credentialed at one for certification purposes. Differences if any between MS and DNP prepared grads will evolve over time.

    I have interpreted this to mean that MSN and DNP graduates will be credentialed using the same ANCC certification exam until differences in preparation necessitate separate exams. The ANCC could revise its position at any time and require advanced practice candidates to have a DNP in order to sit for the certification examination.

    The AANP, or American Academy of Nurse Practitioners, which certifies Family, Adult, and Geriatric Nurse practitioners, has not stated that a DNP is required to sit for its exams in 2015; however, this organization's position might change by 2015.

    The following is an excerpt of a letter that the AANP sent to the American Academy of Family Physicians in 2009: The DNP degree is just that – a doctoral degree; the DNP credential represents that an individual has completed this degree. It is not a clinical but an educational option available to nurse administrators, nurse midwives, nurse anesthetists, clinical nurse specialists ,NPs and others. It is confusing when the DNP is linked to primary care, as many practice in various other roles. In fact,completion of this degree is not now and is not anticipated to be necessary for NPs to continue to meet the needs of the millions of patients they serve now and will continue to serve as their numbers grow.
    eagle78, NurseKJ, and azhiker96 like this.
  4. Visit  BabyLady profile page
    0
    Quote from futuretravelnurse
    The issue is : Will you be able to sit for certification as a MSN grad come 2015.....That is the only thing that really matters. We could argue all day about whether or not DNP is better etc....but for those of us on the timeline crux that is what truly matters. If you can't sit for certification, then it's no different than getting your nursing degree and not passing your NCLEX.
    That said, I can't get a straight answer to that question. Both the certification board should be determining that NOW so we can make choices and the schools can organize their curriculum according.
    If I could give you 1,000 Kudos, I would!

  5. Visit  CraigB-RN profile page
    1
    To all those worried about being able to sit for a certification exam. Take a deep breath, and relax. From past exeperience, it's not going to be an over night thing. When they decide to make a change, they will post a timeline for transistion. Just ask people who were were are around when the change from certificate to MSN for NP's happend. It took years. Just focus on finishing your RN and getting a job and experience, If your not going to be graduating till 2012, then you've got a LONG time. Nothing happens in this field without lots of talk, discusion, and even some arguments.
    eagle78 likes this.
  6. Visit  prairienp profile page
    0
    Quote from CraigB-RN
    To all those worried about being able to sit for a certification exam. Take a deep breath, and relax. From past exeperience, it's not going to be an over night thing. When they decide to make a change, they will post a timeline for transistion. Just ask people who were were are around when the change from certificate to MSN for NP's happend. It took years. Just focus on finishing your RN and getting a job and experience, If your not going to be graduating till 2012, then you've got a LONG time. Nothing happens in this field without lots of talk, discusion, and even some arguments.
    Very True, yet having been around for the transition to the MS in 1992, I have found the transition to the DNP in 2015 happening at significantly faster rate than in 1992. My best guess is that the expectation will remain for the DNP for 2015, with full implementation for certification by 2020. The number of MS programs is decreasing for the NP and I think the MS will be a minority by 2015.
  7. Visit  juan de la cruz profile page
    1
    Regardless of what actions the AACN and the nursing educational institutions are doing to implement their DNP agenda, to me, the more unbiased and systematic way to deal with this proposed change if you ever find yourself on the cusp of a 2015 graduation date is to:

    (1) Check your state requirements for NP certification - some states do not require passing a national board examination for NP's. If this is your state, you only have to worry about whether your state is planning on changing educational preparation requirements for NP's. Ask the board members directly, most states I know of have a directory and contact emails of all the members of the BON.

    Just as a FYI, I lived in a state where the minimum educational requirement for an NP is a BSN until only recently. This has been their requirement long after all NP programs have transitioned to master's degress. Only goes to show how slow some states can get when it comes to changing language in regulatory legislation.

    (2) If your state requires passing a national board examination for NP's, then there are 5 entities that grant certification to NP's:

    ANCC (most NP tracks) - has not mentioned anything about a change to the DNP on their website. In fact, they seem to be more focused on the APRN Consensus Model for APRN Regulation, an issue few people talk about but is actually a more important issue and development for us NP's and NP wannabe's. The consenus model has a timeline of implementation by 2015 - go figure!

    AANP (ANP and FNP only) - no mention of DNP timeline issues on their website

    PNCB (PNP and PNP-AC) - no mention of DNP timeline issues on their website

    NCC (WHNP and NNP) - website still talking about the fact that non-master's prepared NP's are no longer eligible to take their exams. Only goes to show how far behind they are on the DNP issue.

    AACN (ACNP only) - nothing mentioned about DNP at all in their website.

    I feel that there's really no cause fo alarm. I know I am not affected by the issue apart from the fact that I am supposed to get grandfathered if changes do happen but I'm seriously not worried at all.
    Last edit by juan de la cruz on Mar 1, '11
    RavenAngel likes this.
  8. Visit  ccso962 profile page
    1
    Quote from Dr. Tammy, FNP/GNP-C
    Having a DNP does little, if anything, to aid in opening a practice. One thing (academic title) has nothing to do with the other thing (role and scope of practice). Regarding teaching, the DNP is not the appropriate terminal degree as the DNP is not research based--it is a practice-based degree.

    As far as "NPs/RNs don't even come close to what MDs have to do in clinical hours for med school and residency"you are absolutely correct. The third year medical student who is addressed as doctor has no where close to the 14 years of health care experience as the average NP had in my cohort, nor the average 20 years of health care experience, training and education as within my DNP cohort.

    In abandoning the profession of nursing for medical school, I think you are wise to consider as this path seems to be a much better fit for you. This way, you will never have to consider yourself a "fraud" by holding an earned doctoral degree within nursing.
    I am new to this forum, and should point out that I am not an RN, NP, PA, or MD (at least I'm not any of these yet) but I am interested in a future health career and the state of the health care system in the US.

    As others have pointed out medical students of ANY year should not be referred to as doctor and in fact have the responsibility to make sure that patient's they are dealing with understand they are not "doctors" yet but only students (I have several friends who went to medical school who have told me this is even brought up before they begin their clinical experiences). Even when I was in EMT school I had to make sure that during clinical rotations I identified my self as "EMT-Student" and not just EMT.

    The other thing I would like to comment on is that years of experience in one field does NOT equate to expertise in another field. While I am sure many RNs with substantial experience could diagnose many common illnesses differential diagnoses is not a part of their RN training thusly they would need to attend another program (an NP program perhaps?) to obtain the training and legal right to diagnose. If simply being a nurse for 14 years gave you all the experience you would need to diagnose and independently manage patient care I think we could all agree there would be no need to even have NP training programs. Simply have an examination to pass in order to practice as an NP. As it is there are NP programs because no amount of on the job experience as an RN will ever make someone spontaneously an NP. There again I think we are all in agreement on that.

    Another comment to make here is that NP (like PA) is a mid-level provider program. Don't get me wrong I do not disagree with mid-level providers and am in fact really interested in either becoming an NP or PA. That said the mid-level provider fills an important niche in the current state of the health care field in the US. Namely they offer more cost effective treatment for primary care areas, and in many cases extend the provision of medical care to those who otherwise might not have access (i.e. under served areas, etc.). What mid-level providers are NOT is medical doctors (they already have schools for medical doctors). With the decrease of graduating physicians choosing to take residency in primary care there will be a continued need for mid-level providers to staff these areas, and that is a good thing. The main reason, however, that more medical doctors do not pursue primary care and service in underserved areas is the increasing (add out of control?) costs of medical education. For example, a friend of mine and his wife have both graduated medical school (they got married shortly after graduation) and have a combined student loan amount of around $600,000!!! This means that it is unreasonable to assume that either one of them could take a job in a rural or inner city area making just $75,000 to 80,000 in a year (or less in some areas) and hope to ever be able to pay off their loans much less have a decent quality of life.

    This brings me to my third point which is how will the change from masters to doctoral level training for NPs affect their ability to continue to provide cost effective service in these areas? I think this is a real concern. Will a new NP who might have graduated with a masters and student loans of around $90,000 or less be able to provide care at the same rate and to the same population if say the student loan amount increases $150,000 or more because of the addition of requiring a doctoral degree?

    Finally, I agree with many that the change from MSN to DNP might be a good thing IF the basic medical science coverage was also increased. As it is from what I can tell most programs are, as others have said, increasing hours in classes like nursing theory, statistics, and research (there again there is already a degree for nurses who want to do research its called a PhD), but NOT increasing classwork in areas of medical sciences. The DNP may be considered a "practice" or "professional" doctorate, but if it is going to consider itself either then at the bare minimum they should add gross anatomy as a required course for the DNP. From what I can tell Advance Practice Nurses are the ONLY mid-level providers in the US whose training programs do not uniformly require a gross anatomy course. I say uniformly because there may be NP programs who do require this class, but all of the ones I have looked at do not. Keep in mind that PAs, Pathologists' Assistants, and Anesthesiologist Assistants all take gross anatomy, and yet none of these are allowed to practice independently. In many areas NPs can practice independently and even own their own practice, but they are not uniformly required to take gross anatomy which many specialists insist is one of the most, if not the most, important classes in the medical school classroom curriculum.

    In closing, if someone wants to be a medical doctor that is great, and they should pursue it with gusto. However, if someone really wants to be a mid-level provider they should be able to pursue that career goal also. If a person became an NP but they really want to be an MD then even the addition of the DNP to their name will not make them an MD. If they are happy with being an NP that is great, but if they are trying to drown out a desire to be a medical doctor by insisting that NPs also have a doctorate then I think they are not only being detrimental to themselves but the whole advanced nurse profession as a whole. Let's keep NP what it is which is a well respected mid-level member of the health care team, and not give mean spirited MDs (not saying they all are this way) a reason to accuse NPs of wanting to "play doctor" (have seen this on several MD/Medical Student forums) by insisting that a doctorate degree, without additional medical science coursework, will somehow make a better NP than an MSN program would.

    Just my two cents worth.
    eagle78 likes this.
  9. Visit  CuriousMe profile page
    2
    Quote from ccso962
    <snip>

    Another comment to make here is that NP (like PA) is a mid-level provider program. Don't get me wrong I do not disagree with mid-level providers and am in fact really interested in either becoming an NP or PA. That said the mid-level provider fills an important niche in the current state of the health care field in the US. Namely they offer more cost effective treatment for primary care areas, and in many cases extend the provision of medical care to those who otherwise might not have access (i.e. under served areas, etc.). What mid-level providers are NOT is medical doctors (they already have schools for medical doctors). With the decrease of graduating physicians choosing to take residency in primary care there will be a continued need for mid-level providers to staff these areas, and that is a good thing. The main reason, however, that more medical doctors do not pursue primary care and service in underserved areas is the increasing (add out of control?) costs of medical education. For example, a friend of mine and his wife have both graduated medical school (they got married shortly after graduation) and have a combined student loan amount of around $600,000!!! This means that it is unreasonable to assume that either one of them could take a job in a rural or inner city area making just $75,000 to 80,000 in a year (or less in some areas) and hope to ever be able to pay off their loans much less have a decent quality of life.

    <snip>
    This is pretty limited view of the Nurse Practitioner role. Primary care is one of the roles of an NP (and a very common one)...but there are many other NP roles. The first examples that come to mind are adult acute care NP's working in ICU's, or NP's who work in ED's around the country.
    Nccity2002 and LisaDNP like this.
  10. Visit  ccso962 profile page
    2
    Quote from CuriousMe
    This is pretty limited view of the Nurse Practitioner role. Primary care is one of the roles of an NP (and a very common one)...but there are many other NP roles. The first examples that come to mind are adult acute care NP's working in ICU's, or NP's who work in ED's around the country.
    This was not intended to be a limited view of the role of NPs in the health care arena. I chose to focus on primary care specifically because the number one reason that most medical students give for NOT pursuing a residency in primary care is the cost of student loans versus the expected income of a physician in primary care especially in a medically underserved area. This was chosen specifically to illustrate my concern that rising costs of attendance to NP programs (which will no doubt happen when all programs shift from MSN to DNP) could be a limiting factor for these NPs to practice primary care in an area that is already experiencing a shortage of medical providers. To be sure there are NPs in many other practice areas, but there are not a shortage of medical doctors in most of those areas like there are in primary care in medically underserved areas. This is not meant to imply that NPs are not needed in these areas (in fact I think NPs are probably needed in areas they don't practice in now also), but rather to say that if an NP does not choose to pursue a career in an ER, for instance, there will not be a hole left unfilled without a provider, since there are plenty of PAs and MDs willing to practice in an ER. In primary care that hole could be all too real if NPs that might otherwise pursue primary care in these areas are unable to do so because of an increase in student loans without an appreciable increase in compensation. There is only so much that people who live in poverty stricken areas can afford to pay for health care no matter what the provider might think they are, or even actually are, worth. That means the only alternative might be to abandon these patients as many physicians have been forced to do in order to keep afloat. For all the good in the world and debate on health care reform the cost of health care education does play a limiting factor on where practitioners choose to practice.

    I guess the primary point being that if you take mid-level providers and charge them as much for schooling as you do the medical doctor but pay them far less what is the incentive to enter the medical profession at this level. Sure feeling strongly about the nursing process or having a calling to work in this area are great, BUT these feelings don't pay the bills.

    As always just my two cents worth.
    NRSKarenRN and eagle78 like this.
  11. Visit  CuriousMe profile page
    1
    Quote from ccso962
    This was not intended to be a limited view of the role of NPs in the health care arena. I chose to focus on primary care specifically because the number one reason that most medical students give for NOT pursuing a residency in primary care is the cost of student loans versus the expected income of a physician in primary care especially in a medically underserved area. This was chosen specifically to illustrate my concern that rising costs of attendance to NP programs (which will no doubt happen when all programs shift from MSN to DNP) could be a limiting factor for these NPs to practice primary care in an area that is already experiencing a shortage of medical providers. To be sure there are NPs in many other practice areas, but there are not a shortage of medical doctors in most of those areas like there are in primary care in medically underserved areas. This is not meant to imply that NPs are not needed in these areas (in fact I think NPs are probably needed in areas they don't practice in now also), but rather to say that if an NP does not choose to pursue a career in an ER, for instance, there will not be a hole left unfilled without a provider, since there are plenty of PAs and MDs willing to practice in an ER. In primary care that hole could be all too real if NPs that might otherwise pursue primary care in these areas are unable to do so because of an increase in student loans without an appreciable increase in compensation. There is only so much that people who live in poverty stricken areas can afford to pay for health care no matter what the provider might think they are, or even actually are, worth. That means the only alternative might be to abandon these patients as many physicians have been forced to do in order to keep afloat. For all the good in the world and debate on health care reform the cost of health care education does play a limiting factor on where practitioners choose to practice.

    I guess the primary point being that if you take mid-level providers and charge them as much for schooling as you do the medical doctor but pay them far less what is the incentive to enter the medical profession at this level. Sure feeling strongly about the nursing process or having a calling to work in this area are great, BUT these feelings don't pay the bills.

    As always just my two cents worth.
    I guess I don't see it as anywhere near the expense of medical school. There are already BSN --DNP programs that are three years long as opposed to the BSN to MSN programs which are two years.
    LisaDNP likes this.
  12. Visit  ccso962 profile page
    0
    Quote from BabyLady
    Uh...this is where you are incorrect. If you read the position statement for the 2015 plan, this very issue is addressed. It is about an 85 page document, but well worth reading.

    Physicians ARE NOT SOLELY ENTITLED by any law, legal maneuver, or even hospital policy, to be the only healthcare professionals to use the title "doctor" and the national associations that certify NP's talk about this very issue and how DNP's will COMPLETELY earn the right to be called "Dr _____" in a clinical setting.

    That is one of the reasons for the change, believe it or not and they have ever intention of pushing DNP's to use the title.

    Your typical PharmD program is 3 years in most states past the Bachelor level...that is a Doctor of Pharmacy degree...all of the PharmD's at my facility are referred to "Dr so-and-so".
    This might be the case that the powers that be in nursing want to be called "doctor" if they have a DNP, and that is all well and good I guess. However, I have several friends who have their PharmD (my cousin is currently in pharmacy school now), but NONE of these call themselves "doctor". In fact in most states people who refer to themselves as "doctor" in a health care setting (yes psychologists too) who are not medical doctors have to wear identification clearly showing what degree and career path they are. In other words a Physician Assistant who has an earned doctorate in health science would still have to have the phrase "Physician Assistant" on their ID or lab coat even if they referred to themselves as doctor. I am sure this will be the same with NPs who have the DNP.

    One thing above that I KNOW is not truthful everywhere is the part about there being no hospital policies to limit who can be called doctor. The first hospital I worked at had EXACTLY such a policy. Even though DNPs would have been able to call themselves doctor under these policies those who did not have a specifically clinical doctorate (say for instance a PhD) were not allowed to refer to themselves as doctor unless they also had a clinically oriented doctorate (i.e. an MD/PhD or PharmD/PhD for example)when talking to a patient. Also at this facility ANY person who identified to a patient as "doctor" who was not an MD or DO had to follow their introduction to that patient by stating what they were. For example "Hi I'm Dr. Doe one of the Pharmacists here". For this reason NONE of the non-MD/DOs who practiced at this facility (and there were quite a few) that I am aware of referred to themselves as doctor to patients. Keep in mind also that in many states it is the responsibility of the non-medical doctor provider to make sure the patient understands they are not a medical doctor. This means that even if your ID tag says "John Doe, PhD Laboratory Science" and you identify yourself as Dr. Doe you have to make sure the patient knows you are not a medical doctor.

    That said even if I was a medical doctor I would prefer my patients to call me by my first name. That's just the kind of person I am and I know there are many who won't feel this way. Thats ok too though because we are all different.
  13. Visit  ccso962 profile page
    0
    Quote from CuriousMe
    I guess I don't see it as anywhere near the expense of medical school. There are already BSN --DNP programs that are three years long as opposed to the BSN to MSN programs which are two years.
    I understand and not saying that it WILL become that expensive, but I think one thing to consider on that front right now is that the three year BSN to DNP programs now still have to compete with BSN to MSN programs for students. If a BSN to DNP program shot the cost way up they would most likely loose some students to the BSN to MSN programs since they still exist. After the MSN programs go away (and I understand this might be significantly after 2015) then the only way to be an NP will be the DNP route meaning that all the schools can increase costs. Keep in mind that medical school tuition rises steadily every year. School One offering an MD of 4 years in length doesn't have to worry about competing with School Two whose MD program is 3 years in length and $50,000 cheaper since all MD programs (in the US at least) are 4 years in length. One thing that might help keep costs of DNP programs low is the shear number of NP programs versus MD programs. Meaning more competition between schools might help keep those costs lower, and lets really hope this is the case. If, however, some programs decide to close instead of offering the DNP (which might be the case for any number of reasons including not having accreditation to offer doctorate level programs) then that could increase the cost.

    That said I think that medical school costs are skyrocketing, and we may very well see more would be medical students attending nursing school and ultimately DNP programs. This might also help to keep costs down. At any rate my concern is more IF the costs increase substantially not that they WILL increase substantially.

    Hope that all makes sense, and being new to the forum I have really enjoyed the discussion on my post.
  14. Visit  CuriousMe profile page
    2
    I don't think that anyone is supporting that those with non-clinical doctorates use the title Doctor in a clinical setting, but any healthcare professional that has earned a clinical doctorate should be able to use the title they earned.

    Physician = MD....not Doctor as is evidenced by dentists, PharmD's, psychologists, etc all using the title Doctor. Of course a Physician Assistant won't call themselves Doctor....are there even any clinical doctoral programs for PA's?

    I find it amusing that it's only when DNP educated nurses use the term Doctor that folks get themselves into a tizzy.

    Quote from ccso962
    This might be the case that the powers that be in nursing want to be called "doctor" if they have a DNP, and that is all well and good I guess. However, I have several friends who have their PharmD (my cousin is currently in pharmacy school now), but NONE of these call themselves "doctor". In fact in most states people who refer to themselves as "doctor" in a health care setting (yes psychologists too) who are not medical doctors have to wear identification clearly showing what degree and career path they are. In other words a Physician Assistant who has an earned doctorate in health science would still have to have the phrase "Physician Assistant" on their ID or lab coat even if they referred to themselves as doctor. I am sure this will be the same with NPs who have the DNP.

    One thing above that I KNOW is not truthful everywhere is the part about there being no hospital policies to limit who can be called doctor. The first hospital I worked at had EXACTLY such a policy. Even though DNPs would have been able to call themselves doctor under these policies those who did not have a specifically clinical doctorate (say for instance a PhD) were not allowed to refer to themselves as doctor unless they also had a clinically oriented doctorate (i.e. an MD/PhD or PharmD/PhD for example)when talking to a patient. Also at this facility ANY person who identified to a patient as "doctor" who was not an MD or DO had to follow their introduction to that patient by stating what they were. For example "Hi I'm Dr. Doe one of the Pharmacists here". For this reason NONE of the non-MD/DOs who practiced at this facility (and there were quite a few) that I am aware of referred to themselves as doctor to patients. Keep in mind also that in many states it is the responsibility of the non-medical doctor provider to make sure the patient understands they are not a medical doctor. This means that even if your ID tag says "John Doe, PhD Laboratory Science" and you identify yourself as Dr. Doe you have to make sure the patient knows you are not a medical doctor.

    That said even if I was a medical doctor I would prefer my patients to call me by my first name. That's just the kind of person I am and I know there are many who won't feel this way. Thats ok too though because we are all different.
    jaluo2014 and elkpark like this.


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