APRNs should only be DNPs! - page 2
by Lovanurse 7,918 Views | 22 Comments
Hi all! First, I want to say that I am NOT starting this thread to start a war. I am working on my very last assignment for my DNP/FNP (graduating 5/4). 1300 clinical hours were required for graduation and was completed in Peds,... Read More
- 5Apr 7, '12 by zenman GuideQuote from PsychcnsWe've also had (and maybe others) DNSc (Doctor of Nursing Science), ND (Nursing Doctorate), DSN (Doctor of Science in Nursing)...and you wonder why we are lost and confused...I think it is confusing how these degrees come along...There used to be a phD in Nursing and another doctoral level degree called something like Doctor of Nursing Science. Why were these not adequate?
- 1Apr 7, '12 by llg GuideAs a nurse with a PhD (in nursing) who specializes in Nursing Professional Development, I see a strong need for a doctoral alternative that is not a PhD for people like me. And I don't think we should add a 3rd type of degree. The PhD and the DNP should be able to sufficiently cover everyone -- with the PhD emphasizing philosophy, theory, and research ... and the DNP focusing on practice -- ALL types of nursing practice and NOT just NP's, CNS's, CNM's, and CRNA's. Other types of nursing practice (e.g. administration, staff development, case management, informatics, etc. etc.etc.) also require leaders prepared at the doctoral level.
The actual patient care skills of the APRN's can be taught at the Master's level. It's the bigger picture and broader view that the DNP degree brings to the APRN. The other types of nurses need those courses, too.
Nursing practice is more than just direct patient care. Even Florence Nightingale said that. Those other functions of the nurse must also be respected and included in discussions of nursing practice.
The problem/confusion was made worse when some people started limiting the use of the word "advanced" to describe ONLY the practice of those 4 roles -- ignoring the fact that knowledge beyond the basic level is needed for other types of nursing at the highest levels. By claiming the exclusive use of the word "advanced," the leaders of those 4 roles have shut out all the other nurses in other specialties who also practice at an advanced level -- but who are now left with no reasonable phrase to use refer to the higher level of their practice.
And yes, I am fully aware of DNS, DSN, DNSc, etc. They just make matters worse, too.
- 0Apr 7, '12 by juan de la cruz GuideActually, the DNP paved the way for institutions offering DNS and DNSc to transition them to PhD. There are still many professors with this degree but I doubt if one can still find a DNS or DNSc program now. ND's were the precursor to the DNP. The decision was made to not stick with ND so as not to confuse it with the other ND (Doctor of Naturopathy).
Historically, (at least the institution I work for) DNSc was begun because some institutions would not recognize a terminal (doctoral) degree for nurses at the PhD level. The degree was one way to circumvent the opposition from the institution's graduate school from granting PhD's in Nursing. It is a sore issue in some institutions for years until wide acceptance of a PhD in Nursing ocurred.
- 0Apr 8, '12 by studentdrtobeQuote from pro-studentSorry, but none of that produces a better clinician (unless, by informatics, you're talking about learning how to better evaluate the clinical literature). They don't improve your ability to diagnose and manage patients. They help you run a business better, which is a completely separate issue. A better business acumen =/= an improved clinical acumen.I agree with the above poster in that the DNP is a practice-based degree though not necessarily limited to clinical practice. I have closely followed the DNP development from inception and, while some specific programs will describe their DNP as a clinical degree, the standards for the degree across the board do not strictly limit it to clinical practice. I would also contend that the DNP curriculums unanimously do not add any real clinical content. I'm sure that comment will have someone up in arms and I don't mean it to diminish the content or rigor of the degree. Notwithstanding, the content is focused exclusively on practice-related issues which could potentially have clinical significance (hopefully so). The majority of programs offer curriculums weighted heavily towards EBP with informatics, systems, and leadership content included. My point being, while all of that, in theory, could produce better clinicians, it could also produce better administrators, educators, and other areas of nursing practice. Therefore, I don't think it would make any sense to limit the degree to clinicians who, for decades before the DNP came around have been shown to be competent and successful without it.
Other than that, I agree with the rest of your post. Since it doesn't appear that the DNP is a clinical doctorate, I don't think it should be restricted to only clinician-NPs. In fact, I'd argue that it's more geared toward those that are in administration, education, etc, rather than actual clinicians.
- 0Apr 8, '12 by elkparkQuote from juan de la cruzThe version of this that I've heard over the years is not that schools (at least the ones with which I've had experience) wouldn't allow a PhD in nursing, but that the nursing programs couldn't (or didn't want to) meet the academic standards and requirements for a PhD program (the standards and requirements that all the other departments that do offer PhDs meet). PhDs are granted by the university as a whole and the requirements/expectations are standardized across academia; the "other" nursing doctorates (DNsc, DNS, ND, etc., and now DNP) are granted specifically by the SON, and the requirements for that aren't as rigorous or stringent. (That's how it's been explained to me when I've asked about this at different schools in the past, at least.)Historically, (at least the institution I work for) DNSc was begun because some institutions would not recognize a terminal (doctoral) degree for nurses at the PhD level. The degree was one way to circumvent the opposition from the institution's graduate school from granting PhD's in Nursing. It is a sore issue in some institutions for years until wide acceptance of a PhD in Nursing ocurred.
- 0Apr 8, '12 by juan de la cruz GuideQuote from elkparkI think you're right too. I was just going by what I heard locally and from reading an article published in opposition of the early development of the DNP by two prominent faculty from UCSF and UPenn that stated:The version of this that I've heard over the years is not that schools (at least the ones with which I've had experience) wouldn't allow a PhD in nursing, but that the nursing programs couldn't (or didn't want to) meet the academic standards and requirements for a PhD program (the standards and requirements that all the other departments that do offer PhDs meet). PhDs are granted by the university as a whole and the requirements/expectations are standardized across academia; the "other" nursing doctorates (DNsc, DNS, ND, etc., and now DNP) are granted specifically by the SON, and the requirements for that aren't as rigorous or stringent. (That's how it's been explained to me when I've asked about this at different schools in the past, at least.)
"In many schools, such as the University of Pennsylvania and the University of California San Francisco, the rationale for offering the DNS was the lack of supported and sustainable faculty research programs, the limited number of faculty holding PhDs, and, most importantly, the resistance of those in power in university administration to grant nurses the privilege to study for and receive a PhD. It was a relief for leaders of university graduate programs, who controlled the development and implementation of doctoral degrees in the university, to be able to propose instead a professional degree other than the PhD. In most cases, that degree (such as DNS) was offered and administered by the school rather than by the university. When the school was able to prove that they had developed the critical mass of doctorally prepared faculty, and demonstrate that the faculty members had an appropriate research program trajectory, these schools submitted a new application to change their program and, therefore, grant a PhD degree (see entire NLN issues of 1986-87& 1989; Downs, 1989; Grace, 1983)."
Full article at: The Case Against the DNP: History, Timing, Substance, and Marginalization
- 2Apr 8, '12 by BlueDevil,DNPI agree with llg. I think that the DNP can encompass Nurses from a variety of backgrounds and need not be restricted to those of us that are advanced practice providers. It isn't simply about clinical performance, and that misunderstanding has probably been the biggest obstacle to date.
I do think the DNP is here to stay. I don't think it should be the minimum for entry to practice. I used to, but I have changed my mind. I believe that in one generation, DNP prepared nurses will evolve into the leadership of their respective disciplines and the profession as a whole.
- 0Apr 11, '12 by FNPdude74I say enough with this battle and just join 'em! It's inevitable anyway. I'm gonna do it just to also tell my friends "hey you got a law doctorate, I also got a nursing doctorate! Hey wait a minute, you have a medical doctorate, me too! but it's a nursing doctorate so a little different". Sorry Just needed a laugh and thought I'd bring out my immaturity out here and keep my professionalism in the clinic.