2015 DNP - page 9

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  BabyLady profile page
    0
    Quote from elkpark
    I'm not trying to be argumentative, I'm just curious -- do you have a source that documents that it is (still) the case that the "vast majority" (or even a small majority -- any majority at all ) of individuals going into NP programs are experienced RNs? Even with the incredible boom in direct-entry programs for non-nurses and the growing number of schools that take new grads with no experience? Sure, it used to be the case that nearly everyone who pursued NP (or any advanced practice specialty) education was an RN with years of experience -- but, with the number of people going into nursing nowadays who are only interested in being APNs, I doubt that that's still true.

    I hear lots of people on this site (and other places) defend the idea of NPs, or independent practice for NPs, with the ol' "but they have years of clinical experience before they even go to grad school" line, but it is often coming from people who have no idea how much nursing education has changed in the last 10-15 years (please note that I'm not saying you're necessarily one of those people -- I have no idea), and I have no idea whether there are actual numbers anywhere to support that.
    I understand what you are asking, but think about it.

    Very rarely do I see, even on Allnurses, post that they "just" graduated from nursing school and are going to immediately apply to an NP program. Some only work for a few years, but most of them do work first.

    I personally, have only met ONE and I know a ton of NP's.

    We have 8 in our unit currently going to NP school and every one of them had a minimum of 2 years of experience before going to NP school.

    No, I do not have documentation, but think about the common sense level of what you are suggesting, which would be the opposite...that the MAJORITY of NP's never worked as a floor nurse before getting their NP.

    There are thousands of NP's in this country...I would bet a year's salary the MAJORITY had experience before getting their MSN...I never said vast experience, I was simply suggesting SOME.

    I am currently in an RN-BSN program...out of 38 students, I had been out of school for one year before I started and I am the ONLY one in the class that had that small amount of experience.
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  3. Visit  healthstar profile page
    0
    So many years and steps to go through to become a DNP, I would choose medical school instead, seriously what's the point of becoming DNP!?
  4. Visit  linearthinker profile page
    1
    To obtain the terminal degree in my field, not another one. Good luck to you Healthstar, I think you should choose medical school if that is where your heart lies. My heart has led me differently.
    ktliz likes this.
  5. Visit  linearthinker profile page
    1
    Quote from Boatswain2PA
    Nurse Tammy - your DNP from Duke has given you the skills to create a program and a chaired position, and has taught you how to do research.

    If this is what you wanted to do with your career, I'm curious why you chose a DNP degree versus a degree in health care administration?
    I'm not Dr. Tammy, and my career goals are somewhat different. However, if I may hazard a guess, it could be that Tammy does not want to limit herself, and enjoys the NP role in a variety of domains.

    That is part of the beauty of this career path, the opportunity to really evolve and actualize as you really want to! Tammy has set such a great example for us all. I am so proud of her, and her outstanding contributions to Nursing.
    jaluo2014 likes this.
  6. Visit  elkpark profile page
    0
    Quote from BabyLady
    I understand what you are asking, but think about it.

    Very rarely do I see, even on Allnurses, post that they "just" graduated from nursing school and are going to immediately apply to an NP program. Some only work for a few years, but most of them do work first.

    I personally, have only met ONE and I know a ton of NP's.

    We have 8 in our unit currently going to NP school and every one of them had a minimum of 2 years of experience before going to NP school.

    No, I do not have documentation, but think about the common sense level of what you are suggesting, which would be the opposite...that the MAJORITY of NP's never worked as a floor nurse before getting their NP.

    There are thousands of NP's in this country...I would bet a year's salary the MAJORITY had experience before getting their MSN...I never said vast experience, I was simply suggesting SOME.

    I am currently in an RN-BSN program...out of 38 students, I had been out of school for one year before I started and I am the ONLY one in the class that had that small amount of experience.
    I hear what you're saying, and I am aware that many traditional advanced practice programs require some minimum amount of clinical experience to apply (although plenty don't), but are you considering the plethora of direct-entry MSN programs? When you talk about how few people post on AN about entering an NP program fresh out of nursing school, are you also considering the large number of posts by people who are in or looking to enter a direct entry program? I went to grad school (as an experienced RN) at a program that included a direct-entry program, and a large majority of my classmates were direct-entry students who were not nurses and had no prior healthcare experience. They went directly into advanced practice without ever having practiced a single day as a "regular" RN. That school turns out large numbers of direct-entry graduates every year (and v. few traditional, experienced RN graduates, although the administration spends a lot of time wondering why they have such trouble attracting traditional-student applicants). These programs are all over the country now. That's why I'm asking about any actual documentation. I don't know if it's the case that new NPs without previous nursing experience are the majority (of new NPs, that is, not the entire population of NPs) now, but I don't think it's safe to assume that's not the case.
  7. Visit  linearthinker profile page
    0
    I have to say, while Elkpark and I (respectfully, I believe) disagree about the value and purpose of the DNP, I agree with her here Babylady. Anecdotal references and summaries are insufficient support for sweeping generalizations. You are going to need to cite firm statistics please.
  8. Visit  Dr. Tammy, FNP/GNP-C profile page
    0
    Quote from Boatswain2PA
    Nurse Tammy - your DNP from Duke has given you the skills to create a program and a chaired position, and has taught you how to do research.

    If this is what you wanted to do with your career, I'm curious why you chose a DNP degree versus a degree in health care administration?
    Two different animals. One is clinical-based and the other is not. One is within the field of nursing, uses nursing science, nursing philosophy, nursing paradigms and the nursing process (the same that many here scoff at yet without these to inform and direct practice, they would be technicians) and the other is not.
  9. Visit  Dr. Tammy, FNP/GNP-C profile page
    0
    Quote from psychonaut
    "One of these things is not like the others, one of these things just doesn't belong."
    You forgot to list the dentist, psychologist, pharmacist, chiropractor and optometrist.

    Don't mean to be rude, but you clearly have a problem with nurses who hold clinical-based doctorate degrees. Wouldn't your anti-nursing, anti-professional advancement and growth for nurses rhetoric be better served on a number of other forums designed for medical student wannabes that primarily focus on the advancement of these ideas?

    Perhaps you could even reach out and help Dr. Kieth Assblow (Sp?) construct a few more articles on this subject, focusing primarily on how nurses are intellectually inferior to physicians and are not worthy of the doctoral title:

    http://www.foxnews.com/health/2010/0...ading-doctors/
  10. Visit  PMFB-RN profile page
    2
    Quote from Dr. Tammy, FNP/GNP-C
    Don't mean to be rude, but you clearly have a problem with nurses who hold clinical-based doctorate degrees. Wouldn't your anti-nursing, anti-professional advancement and growth for nurses rhetoric
    *** Nothing in what you quoted would lead any reasonable person to the above conclusion.
    ccso962 and Szasz_is_Right like this.
  11. Visit  Boatswain2PA profile page
    1
    Quote from Dr. Tammy, FNP/GNP-C
    Two different animals. One is clinical-based and the other is not. One is within the field of nursing, uses nursing science, nursing philosophy, nursing paradigms and the nursing process (the same that many here scoff at yet without these to inform and direct practice, they would be technicians) and the other is not.
    So, I'm curious....do you think your DNP was more "clinical-based" than MS level NP programs? Did it teach you to practice medicine (nursing) better than a MS level NP program? If so, I would like to hear how it did that. And, if it was more "clinical-based", how did it prepare you for the admin/management aspects of creating positions, chairs, and programs.

    As to the management/administrative stuff that you have achieved and advertised here, I would propose that my MPH helped give me the tools to accomplish those same things (if I wanted to enter management/admin instead of practicing medicine (nursing)). Also, if what you wanted in your career was accomplishments such as successfully chairs, positions, and programs....why didn't you pursue a degree such as an MPH, or Health Care Admin, instead of a DNP?
    oldiebutgoodie likes this.
  12. Visit  Dr. Tammy, FNP/GNP-C profile page
    0
    Quote from PMFB-RN
    *** Nothing in what you quoted would lead any reasonable person to the above conclusion.
    You are absolutely correct and my sincere apologies. I had three screens opened at once and ripped into an individual who, from another post, was bashing nurses on a different thread. That's the last time I try and multitask at 2 in the am.
  13. Visit  Dr. Tammy, FNP/GNP-C profile page
    0
    Quote from Boatswain2PA
    So, I'm curious....do you think your DNP was more "clinical-based" than MS level NP programs? Did it teach you to practice medicine (nursing) better than a MS level NP program? If so, I would like to hear how it did that. And, if it was more "clinical-based", how did it prepare you for the admin/management aspects of creating positions, chairs, and programs.

    As to the management/administrative stuff that you have achieved and advertised here, I would propose that my MPH helped give me the tools to accomplish those same things (if I wanted to enter management/admin instead of practicing medicine (nursing)). Also, if what you wanted in your career was accomplishments such as successfully chairs, positions, and programs....why didn't you pursue a degree such as an MPH, or Health Care Admin, instead of a DNP?
    First, I have never practiced medicine (nor have I been educated or licensed to practice medicine) any more than I have practiced optometry, dentistry, psychology, optometry or podiatry--even though there are functions within those fields that do overlap with the advanced practice of nursing such as prescribing, counseling, performing minor foot surgery, treating dental abscess and doing ophthalmic exams.

    Second, It's important to remember that the DNP program that I, and the vast majority of others have completed thus far, is different than what the DNP program is today and will become in the very short future. The DNP program I went through only admitted those who were already clinical experts in their fields (NP, CRNA, CNM). All had MSN's were board certified and had many years of nursing experience. This will transition very shortly to the DNP program where the MSN content is within the DNP program and students will go straight through from BSN to DNP. So it goes, there will be no part 1 and part 2, but just one part, as it should be.

    The MSN portion of the NP program gave me the tools, theory and practice-based skill to work with clients as a FNP. The programmatic information I received in my DNP program gave me the direction, information and guidance for developing the context with which to provide that care. Collectively, both programs made me a beginning doctorate prepared NP. Again, in the future, this will not be an issue as there will be no part 1 and part 2. As time passes, the question of whether the DNP program makes better NP's will be equivalent to asking whether or not a NP program makes better NP's.

    Third, the MPH and health care administrator are not nursing-based, and are not clinician-based professions. Nursing is a clinical-based profession where both client and the systems that provide for health care are central to the profession. My accomplishments, thus far, are guided by effecting positive outcomes for my clients through nursing systems and structure. To state that my goals were as you stated, really misrepresents what I am about. The "management-administrative stuff" was just a component in the larger picture of developing programs, where there was once nothing, to provide a vehicle for me to take my clients to a greater degree of health.

    Lastly, it is important to remember that my particular accomplishments are not unique in there application to facilitate positive outcomes in the lives of others. I was far from head of the class. There was one student who used his knowledge and training to bust through barriers in Nebraska and established independent practice for CRNA's, thereby reducing barriers to access to care. Another developed a special diabetic registry program that decreased people from slipping through the cracks which is now implemented at Kaiser. Another developed a program that greatly reduced morbidity and mortality regarding falls with Alheimer's patients by implementing a form of line dancing. Another bridged a gap between nursing and dental health practices for the underserved. Another developed a program for mobile colorectal cancer screenings. The list goes on.

    In the mid 1850's, many were critical and adamantly opposed to the idea that nursing could have a place in reducing mortality and morbidity for those wounded in the Crimea. Many high power physicians, leaders and others scoffed at the idea that nursing could have a greater impact on health care outcomes than the present medical-model driven system of the time. It is sure curious how nursing has transformed the health care industry since then, rising to the most trusted profession in the US--year after year after year.

    It will certainly be curious to see how the health care industry transforms over the next century with the advent of the DNP compared to how we view those who served as barriers to the advancement of the DNP.
  14. Visit  Boatswain2PA profile page
    0
    I understand the argument about practicing nursing vs practicing medicine....although I do not agree that if a (real) medical doctor or PA places a central line it is considered practicing medicine, but if an AP nurse places a central line it is considered practicing nursing. In my opinion, AP nurses practice medicine in addition to nursing, and it is what makes them so effective clinically.

    And I understand your 2nd point - that the future DNP programs will likely be much different from the early ones. They may actually turn into the entry level for Nurse Practitioners, they may continue in their current state, or they may just die away if people do not think they offer what is needed.

    Your 3rd point - you first inferred that your DNP was clinical based, but then you say that your Masters gave you your clinical base but your DNP gave you your knowledge/skills to "develop programs" from nothing & such....hardly clinical (clinical = 1 patient, 1 provider) applications there.

    I still don't see why you would choose a DNP. You had the clinical education necessary to practice medicine/advanced nursing, but you apparently wanted something more to break into the administrative/management/political world of creating new programs & chairs. So why not a MPH?

    And please, do not compare medicine of today with the 1850s. We both know that today's medicine was barely beginning at that time in Europe and didn't make it to the US until Johns Hopkins opened decades later. Nobody will refute the enormous impacts nursing has had in both the history of national or global health care, or or the impacts on an individual patient.


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