2015 DNP

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shelly_BSN

3 Posts

At this point, the DNP is a recommendation, not a requirement. Member institutions ultimately have to decide whether or not to comply with the recommendation. Many institutions are offering post-MSN entry options, while continuing advanced practice MSN programs. The post-MSN options will likely be phased out as the post-BSN entry options are conceptualized. Eventually, the DNP will be required for entry level advanced practice, but until this occurs, institutions have to decide what is best for their students.

UNC Charlotte, a premier institution that is a part of the UNC system, will accept its last cohort of MSN students in 2016.

This document provides additional insight into the DNP implementation in North Carolina. Currently, there are two post MSN-DNP programs in NC- one is at Duke and the other one is at Gardner Webb University. In 2016, UNC Charlotte and Western North Carolina will offer a Post-BSN DNP program.

http://provost.uncc.edu/planning/degrees/RTP/NursingPractice.pdf

PMFB-RN, RN

5,351 Posts

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
This thread isn't about nurses entering in to RN practice. It's about becoming an advanced practitioner (nurse practitioner, nurse midwife, certified registered nurse anesthetist, etc) which requires (now) a masters degree....but the ANA is proposing to require a doctorate (DNP) to become an advanced practitioner.

*** Lucky for me the nurse haters at ANA have absolutely NOTHING to say about CRNA practice or qualifications.

PMFB-RN, RN

5,351 Posts

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Oh..keep in mind...that we refer to all medical residents as "Dr ____" at the facility, even though not a single one of them are authorized to practice medicine, by law, independently...they are under the supervision of an attending at all times.

There is no difference, between that level of practice and a DNP, who also, functions under the supervision of an attending physician.

*** In every place I have ever worked residents are lisenced physicians. Interns, those in their first post graduation year are not lisenced.

I guess it depends on your state but in my state an NP, reguardless of their degree, does NOT have to work under the supervison of any physician. Most do though.

"At this point, the DNP is a recommendation, not a requirement. Member institutions ultimately have to decide whether or not to comply with the recommendation. Many institutions are offering post-MSN entry options, while continuing advanced practice MSN programs. The post-MSN options will likely be phased out as the post-BSN entry options are conceptualized. Eventually, the DNP will be required for entry level advanced practice, but until this occurs, institutions have to decide what is best for their students"

Shelly BSN..... that is interesting. While it may not be a requirement.....the key does seem to be whether or not you can literally sit for the licensing test.......When is that going to be determined ? Ugh. I plan on graduating ASN dec 2012 and heading straight into a MSN program, but that hinges on being able to take the test.

shelly_BSN

3 Posts

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/resource/content/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.

shelly_BSN

3 Posts

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.

BabyLady, BSN, RN

2,300 Posts

Specializes in NICU, Post-partum.
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!

:yeah::yeah::yeah::yeah:

CraigB-RN, MSN, RN

1,224 Posts

Specializes in Critical Care, Emergency, Education, Informatics.

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.

prairienp

315 Posts

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.

Advanced Practice Columnist / Guide

Corey Narry, MSN, RN, NP

8 Articles; 4,362 Posts

Specializes in ACNP-BC, Adult Critical Care, Cardiology.

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.

ccso962

68 Posts

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.

CuriousMe

2,642 Posts

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 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.

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