2015 DNP - page 9

by BabyLady 83,459 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


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    She must be trying to convey that the school has decided to no longer convey the MSN after that date because there is nothing on the world weird interwebs that says the measure has become law. Neither the AANP nor AANC website are saying that they are firmly requiring a DNP to sit for exams beginning in 2015 and I know of no state that has said it will not license MSN grads who pass the boards. So I don't think she lied, I think she's just confuzzled. A lot fo people are. It's going to take a few years to sort it all out. Go ahead and get started and tackle hurdles as they come up. No worries.
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    Quote from TeleMeMore
    WTH is going on? Did I just get lied to? How does someone in her position make such a bold statement without it being true? Or is it true? I'm in illinois and now, super confused.

    I'm trying to research it but my head is hurting from it all!!
    I second linearthinker. We've had lots of students post here asking about this (or advising others), stating that it is a fact that the DNP is going to be mandatory/required as of 2015, because a faculty member at their school told them this. I don't know if these faculty people are that misinformed, the student misunderstood what the instructor was saying (having taught nursing myself, I know that happens plenty ), or the instructor is pushing some agenda of her/his (or the school's) own.

    But, so far, this is still a proposal, not a requirement. Lots of schools are switching over, as you are experiencing, from MSN programs to DNP programs for their advanced practice concentrations, and this may become a moot point for a lot of people because it will become difficult to find an MSN program, depending on where you live and what your interests are -- but there's a big difference between schools offering a degree and states and certifying organizations requiring it.

    As far as I know so far, the only advanced practice group in the real world (as opposed to the "groves of academe" )that has embraced this idea is the CRNAs; their target date for requiring the doctorate is 2025, not 2015; and it still remains to be seen whether that will actually happen.
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    Thank you so much!
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    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.
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    Reasons why I choose not to drink the Kool-Aid offered by the AACN and the Universities who are sponsoring the DNP degree:

    1. There have been studies conducted showing that MSN prepared nurse practitioners perform as well as, if not better than, physicians in diagnosing and managing medical illness and diseases in patients. Where is the empirical or statistical data showing that a DNP will improve the care rendered by NP's? I have read the AACN's white paper on the DNP degree, and foundit to contain mainly conjecture and opinion as to why the degree is necessary.

    2. Yes, it will cost quite a bit more to become an NP via the DNP route. The current MSN/FNP programs are between 47 to 50 credits. The average DNP program is between 73 and 85 credits. At Arizona State University, the cost is $847 per credit hour. At 48 credits under the old MSN/FNP program at ASU, the cost for the degree was $40,656, not including books and other fees. The current DNP/FNP program is 85 credits, making the total program $71,995. That's a mere difference of $31,339.

    3. Let's look at the University of Minnesota. The current rate for their MSN program is only $614 per credit hour. Under their old MSN/FNP program at 48 credits, the total cost was $29,472. The current DNP/FNP program is 82 credits with a per credit hour cost of $877.89 (and that's in-state tuition), the total cost is $71,986.98. That's a difference of $42,514.98. (Yes, the university does charge the full rate of $877.89 per credit for all 82 credits of the BSN-DNP program, because the credits are now DOCTORAL level, remember?)

    4. Student loans need to be payed back. These horrible harbingers of indentured servitude take years to escape from and eat away quite a bit of your post tax income. So if you are a nurse practitioner and want to work in an underserved area, and you have $72,000 of loans hanging over your head (not including possible undergraduate loans), a meager income of say $75,000 - $80,000 a year to start will not exactly inspire an NP to work in an underserved area. (Perhaps if those loans are forgiven to work in a medically underserved area, then yes it would, but not every NP will get this deal.)

    5. It takes an average of 2.5 years to complete an MSN/FNP program at 48 credits. The universities are telling us it only takes about a year to a year and a half longer to complete a DNP beyond the MSN level. So if it takes 2.5 years to complete 48 hours, do they really expect us to believe we can complete 37 credit hours in only 1 to 1.5 years? I don't see it happening. Try 4 - 5 years total, unless the student doesn't have to work.

    In closing, it is my opinion that the DNP is nothing more than a way for the universities to take in huge amounts of revenue. I have found no evidence to support the DNP as being necessary to provide increased quality of patient care. It does not increase scope of practice. It does not dramatically increase salary offers. What does it do to help the profession? In my humble opinion, not much. Just my opinion...
    ccso962, WhirlingPopTarts, Lannister, and 1 other like this.
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    I am all for education. I am all for anyone who gets the DNP. In my own investigation and consideration, it is not worth it for me. In looking at the additional requirements, there seems to be little clinical value in the additional education above a MSN (yes, all education has value). I have made the personal decision to apply to MSN programs and only one DNP (just because I do like some of their ideas). The bottom line is that it is not, nor has it ever been a law or requirement. MSN's will not be grandfathered in...they don't need to be as MSN is the standard. DNP has been suggested, not mandated. Yes, many universities are dropping their MSN programs, but many are not. The DNP, like the BSN will become the standard..... one day. It will happen the same way, not largely through legislation, but through the market. Many hospitals are only hiring BSN's and of the ones I know of that are still considering ADN's, the BSN's get first choice and only BSN new grads are being put in specialty units....ADN's are put in med/surg or peds only. Most schools will eventually shift to the DNP option, and as their numbers grow (like BSN's), they will become the preferred....but not for a while. Let's be real here. If all schools could offer the BSN, ADN programs would disappear. MSN programs that remain will do so only because the schools do not have the resources in place to offer doctorates. Besides the economic interest of academia, the usual degree creep, and the bloated self-view/self-interest of academics, the DNP movement will cut down on the number of Advance Practice Nurses which will drive up salaries and keep the market from being flooded. I am all for access, but some of these schools do seem to make it too easy to get a MSN. The bottom line is that people like to have the latest and the greatest. More will eventually opt for the DNP so they can feel that they have gotten the best available. Again, they won't be in the majority for a while.
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    I question whether or not requiring the DNP movement will cut down the number of advanced practice nurses and drive up salaries. Why? There are quite a few P.A. programs out there, and they have no intention of going to a doctorate degree. When we see positions posted, they usually ask for an NP or a PA. There are still some bachelor degree PA programs and even some associate degree programs. Because all PA programs are standardized in their curriculum regardless of the degree conferred, the medical community understands these programs are academically rigorous and have trained the graduates in what they need to know. Nursing has become so focused on degrees that they fail to understand what the P.A. community already knows... standardize the curriculum regardless of the degree and you will have quality providers. Furthermore, if you can pay a P.A. less than a "doctorally" prepared nurse practitioner, you will choose the P.A. I have so many NP friends, and they all say the same thing, MOST physician groups and hospitals are notoriously cheap. If NP's overprice themselves due to having a "doctoral" degree, the P.A.'s will be more than happy to fill those positions. Many physicians also like PA's because they are trained in the same allopathic model that they were trained in, but the NP model can vary significantly from school to school. Even the DNP can vary (i.e. DrNP versus DNP). The DNP is overpriced, overinflated, and unnecessary. The MSN nurse practitioner model isn't broken and clearly works, so why is nursing trying to "fix" it? PA's are here to stay and will remain in competition with the NP's. Remember, most physicians and hospitals are more concerned with scope of practice than they are with the degree the provider holds. (i.e. Case in point, I work with PA's that hold associate and bachelor's degrees in physician assisting, and they make as much as, if not more than, the master's level prepared NP's in the group.) Just my two cents...
    ccso962 and LiLoRN like this.
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    Quote from nursemark29
    1. There have been studies conducted showing that MSN prepared nurse practitioners perform as well as, if not better than, physicians in diagnosing and managing medical illness and diseases in patients.
    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.
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    Quote from nursemark29
    reasons why i choose not to drink the kool-aid offered by the aacn and the universities who are sponsoring the dnp degree:

    1. there have been studies conducted showing that msn prepared nurse practitioners perform as well as, if not better than, physicians in diagnosing and managing medical illness and diseases in patients. where is the empirical or statistical data showing that a dnp will improve the care rendered by np's? i have read the aacn's white paper on the dnp degree, and foundit to contain mainly conjecture and opinion as to why the degree is necessary.

    none exist due to the recent entry of the dnp.

    2. yes, it will cost quite a bit more to become an np via the dnp route. the current msn/fnp programs are between 47 to 50 credits. the average dnp program is between 73 and 85 credits. at arizona state university, the cost is $847 per credit hour. at 48 credits under the old msn/fnp program at asu, the cost for the degree was $40,656, not including books and other fees. the current dnp/fnp program is 85 credits, making the total program $71,995. that's a mere difference of $31,339.

    at $847 a credit--that's highway robbery! shop around. many schools offering under $300 unit. isu and usi are two.

    3. let's look at the university of minnesota. the current rate for their msn program is only $614 per credit hour. under their old msn/fnp program at 48 credits, the total cost was $29,472. the current dnp/fnp program is 82 credits with a per credit hour cost of $877.89 (and that's in-state tuition), the total cost is $71,986.98. that's a difference of $42,514.98. (yes, the university does charge the full rate of $877.89 per credit for all 82 credits of the bsn-dnp program, because the credits are now doctoral level, remember?)

    $614 a credit? see above.

    4. student loans need to be payed back. these horrible harbingers of indentured servitude take years to escape from and eat away quite a bit of your post tax income. so if you are a nurse practitioner and want to work in an underserved area, and you have $72,000 of loans hanging over your head (not including possible undergraduate loans), a meager income of say $75,000 - $80,000 a year to start will not exactly inspire an np to work in an underserved area. (perhaps if those loans are forgiven to work in a medically underserved area, then yes it would, but not every np will get this deal.)

    get into a cheap program. pay as you go. i spent less than $20k over 2.5 years. no bills to pay afterward. if you really want big bills to pay back, goto medical school.

    5. it takes an average of 2.5 years to complete an msn/fnp program at 48 credits. the universities are telling us it only takes about a year to a year and a half longer to complete a dnp beyond the msn level. so if it takes 2.5 years to complete 48 hours, do they really expect us to believe we can complete 37 credit hours in only 1 to 1.5 years? i don't see it happening. try 4 - 5 years total, unless the student doesn't have to work.

    in closing, it is my opinion that the dnp is nothing more than a way for the universities to take in huge amounts of revenue. i have found no evidence to support the dnp as being necessary to provide increased quality of patient care. it does not increase scope of practice. it does not dramatically increase salary offers. what does it do to help the profession? in my humble opinion, not much. just my opinion...
    not sure about this. i kicked it in the ass to complete dnp in 16 months. there are many in my cohort extending beyond two years--post msn.
    questioningRN likes this.
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    Guinea, Wow! There were quite a few words in your post that put words in my mouth. First, I respect physicians and what they've gone through to get where they are. Second, the study I was talking about was published in JAMA, not just nursing journals. Where did I say anywhere that physicians were fools? Implying that I lack common sense is a personal attack. You don't even know me, or my educational background. I am well aware that the study has flaws, and in my opinion, most studies do. But I felt this study made a very valid point about master's prepared NP's. I don't believe a DNP should be a degree that is forced upon the nursing community as a whole, especially when there are studies showing the effectiveness of master's level education for nurse practitioner preparation. For the record, I work with physicians all the time. I am unimpressed with many of them. I've caught many of their mistakes as a registered nurse, including some that could have been deadly for the patient. I've been talked down to by them when it was not warranted. I've seen them throw temper tantrums like little children when they don't get their way. I've seen them demean people that are beneath them in the medical hierarchy, or should I say caste system? I've seen them try to blame nurses for their mistakes instead of owning the mistakes like they should have. To be honest, your post is reminiscent of how a physician would reply to the study I cited. For being the most educated "professionals" in the medical food chain, I've seen many examples of them being less than a professional. Again, I never called physicians "fools". I never demeaned their education. One more thought... what do they call the medical student who graduated last in his class... that's right..."Doctor".
    MandaRN94 likes this.


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