APRNs should only be DNPs! APRNs should only be DNPs! - pg.3 | allnurses

APRNs should only be DNPs! - page 3

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... Read More

  1. Visit  Bluebolt profile page
    1
    I start my CRNA DNP program in August. Here is my perspective as a nurse with about 5 years in the field and observation of the changes I've seen in just the last 5 years alone.

    A DNP or Doctorate of Nursing Practice (notice it says practice and not theory) is quite literally titled for a clinician who should be seeking their terminal degree in clinical practice. With CRNA's already transitioning to DNP's by the year 2025 you'll see more APRN's with DNP or DNAP.

    I think as the field progresses and changes there should be a clear delineation between the two doctorate level nurses, the clinicians and non clinicians. A medical research scientist and a family practice physician may both be "Doctors" but they are clearly different careers.
    LadyFree28 likes this.
  2. Visit  PsychGuy profile page
    3
    I googled DNAP and went to the Texas Wesleyan website to view the "CRNA to DNAP" curriculum. For the mere fact that the DNAP incorporates Pathophysiology, Biochemistry and Pharmacology I and II, this doctorate is replete with practicality. This is in addition to administrative coursework that is clearly administrative in nature. After looking at the course descriptions, the coursework seems realistic and devoid of content plummeting nurse crap. I stamp this with the Psych Guy seal of approval.

    Missouri State, Midwestern, Duke, Baylor, and Mayo all have scut that mirrors the typical DNP. I was quite disheartened. I thought maybe the CRNAs were onto something. I'd enroll in the Wesleyan program if I were in anesthesia.
    cayenne06, twozer0, and synaptic like this.
  3. Visit  Bluebolt profile page
    0
    Quote from PsychGuy
    I googled DNAP and went to the Texas Wesleyan website to view the "CRNA to DNAP" curriculum. For the mere fact that the DNAP incorporates Pathophysiology, Biochemistry and Pharmacology I and II, this doctorate is replete with practicality. This is in addition to administrative coursework that is clearly administrative in nature. After looking at the course descriptions, the coursework seems realistic and devoid of content plummeting nurse crap. I stamp this with the Psych Guy seal of approval.

    Missouri State, Midwestern, Duke, Baylor, and Mayo all have scut that mirrors the typical DNP. I was quite disheartened. I thought maybe the CRNAs were onto something. I'd enroll in the Wesleyan program if I were in anesthesia.
    That's great you found a university whose online site displayed curriculum that represents a program you feel holds up to DNP ideal standards.

    It's rare to find a CRNA program that isn't long and intensive with heavy clinical and advanced science focus. Even my friends who have done or are currently doing the masters program as CRNA seem to be getting a very intense and advanced education. In the very least the DNP at a CRNA program should augment the 2 to 2.5 years of masters type heavy clinical/science education with an extra year of medical and anesthesia research theory.

    I don't know every program out there but I would caution you against drawing conclusions based off website browsing. You mention The Mayo Clinics DNP CRNA program, which I interviewed/toured the program and hospital. They even took us into the OR's and we looked over equipment. The interview was an 8 hour process where they tell you everything about the entire 3.5 years of the CRNA DNP program. It is a heavy clinical focus with rotations in pretty much every specialty and sub specialty.

    I actually ended up going into a different CRNA DNP program that better suits where I'd like to live but I'd highly recommend Mayo to anyone interested in it.
  4. Visit  PsychGuy profile page
    5
    Quote from Bluebolt
    That's great you found a university whose online site displayed curriculum that represents a program you feel holds up to DNP ideal standards.

    It's rare to find a CRNA program that isn't long and intensive with heavy clinical and advanced science focus. Even my friends who have done or are currently doing the masters program as CRNA seem to be getting a very intense and advanced education. In the very least the DNP at a CRNA program should augment the 2 to 2.5 years of masters type heavy clinical/science education with an extra year of medical and anesthesia research theory.

    I don't know every program out there but I would caution you against drawing conclusions based off website browsing. You mention The Mayo Clinics DNP CRNA program, which I interviewed/toured the program and hospital. They even took us into the OR's and we looked over equipment. The interview was an 8 hour process where they tell you everything about the entire 3.5 years of the CRNA DNP program. It is a heavy clinical focus with rotations in pretty much every specialty and sub specialty.

    I actually ended up going into a different CRNA DNP program that better suits where I'd like to live but I'd highly recommend Mayo to anyone interested in it.
    I'm a psychiatry NP. I couldn't give a rip about the OR or actual practice of anesthesia. You clearly didn't understand my post. The programs I referred to were DNAPs for people who were already CRNAs. These DNAPs were post-masters.

    I'm impressed that CRNAs actually study science. A scientific profession that requires scientific coursework. Do you hear that fellow NPs? We should emulate these guys.
    cayenne06, JustKeepDriving, twozer0, and 2 others like this.
  5. Visit  synaptic profile page
    0
    We seem to only talk about what is in the programs. What about the order the curriculum is taken in. I mean, intellectually it would be beneficial to take another biochem, patho, pharm course, but a CRNA to DNP program providing all of those basic-er science classes to someone who has been in practice a while seems to be backpedaling in a way. I am not saying its not good, I just wonder how the mind would react to that information since it seems to be providing backward-ly in comparison to for say medical schools. I suppose they probably are great for those researching new anesthesia-ish type drugs and protocols and such but I wonder if students actually would put those into practice after being in the field for a while.

    Are there any increase in privileges offered to those who get a DNP? I suppose that would be institution specific. For say at some big medical center place that usually doesn't let CRNAs do heads and hearts would a DNP give them an opening to that. Im sure there are places that already let them do heads and hearts which is fine but I wonder if it would open more doors or is just another pretty expensive framed sheet of parchment to place a nail through on the wall.

    BTW im all for chemistry and biology, all APRNS should have to have some base in it before practice. I read the stuff just for interest regularly and it does help me in practice. Understanding physiology can help you figure out diseases that you haven't even read about yet. I probably just answered my own question above at least in part lol.

    If somebody understands organic chem decently then you can easily understand biochem. If you understand biochem you can sit there and ask yourself (even with no exposure to the PATHOphysiology) "Well if this thing doesnt work right here, I wonder what happens (like an enzyme error or deficiency) and then when you look up the disease after you ask yourself what you think would go wrong the treatment (and hopefully the name of the disease) will make sense. Of course thats not true on the name part if its named after somebody lol.
    Last edit by synaptic on Mar 27
  6. Visit  PsychGuy profile page
    1
    I think a substantial portion of these PA-DO programs includes the science courses that most MS-I kids get that PA kids don't get. Of course, NPs don't really get any science coursework.

    Regarding your initial question, I don't really care if we'd put it into practice. I think that type of content needs to be in our marrow. As professionals, we need better awareness. Of course, I'm preaching to the choir with you. In depression, for example, I don't sit around and think about the different receptor affinity among the SSRIs. I've read this material and various opinions on why Lexapro might be better than Zoloft (is it?), but with a disorder we don't know the cause of and meds we don't understand (sure, we know the mechanism) why ponder it? Heck, try this Celexa, let me know what you think in a month.

    There are of course subtle nuances between the meds that it takes a trained clinician to be aware of, i.e. bleeding risk, seizure threshold, QTc prolongation, etc.

    Nonetheless, I feel that I and my profession were slighted when we didn't have a professional stand up and lecture ad nauseum about the science of human bodies. Yeah, we had some poorly taught pathophysiology crap, but why study pathophys when you haven't had phys and why study phys when you havent had biochem, why study biochem when you haven't a clue what methyl groups are, etc. As an English speaking, blatantly obvious Anglo, I can learn Spanish, but it's a heck of a lot easier when I know the alphabet. But those darn verbs can be trouble. Imagine the trouble if I didn't know the letters first.
    cayenne06 likes this.
  7. Visit  sauce profile page
    2
    But it wouldn't be nursing if it had a lot of science lol
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  8. Visit  sauce profile page
    0
    At least the good nursing schools require people to take the teas before they enter in. So at least some nurses know what mitochondria are. I'd say most probably think it's a bone disease though. But all the sucky ones don't require anything really. Of course everybody but the worst end up with similar jobs though since nurses are in short supply everywhere. That will change though since for some god awful reason everybody wants to go back to be a nurse. I guess so they can feed their kids which isn't really an unnoble cause but it doesn't mean they have any what of a scientific mind. More than likely it means they are super unscientific.


    Eh it's a good thing most regular nursing jobs don't require any brain power. But when somebody steps into an aprn role that changes and most people try to retain the unscientific mind. Doesn't work out too well
    Last edit by sauce on Mar 27
  9. Visit  twozer0 profile page
    1
    Quote from PsychGuy
    I'm a psychiatry NP. I couldn't give a rip about the OR or actual practice of anesthesia. You clearly didn't understand my post. The programs I referred to were DNAPs for people who were already CRNAs. These DNAPs were post-masters.

    I'm impressed that CRNAs actually study science. A scientific profession that requires scientific coursework. Do you hear that fellow NPs? We should emulate these guys.
    Been saying this since the inception of the DNAP. NP could take a lesson from the ol anesthesia chaps.
    PsychGuy likes this.
  10. Visit  PsychGuy profile page
    0
    Quote from sauce
    But it wouldn't be nursing if it had a lot of science lol
    So true, lol.
  11. Visit  PsychGuy profile page
    1
    Quote from sauce
    At least the good nursing schools require people to take the teas before they enter in. So at least some nurses know what mitochondria are. I'd say most probably think it's a bone disease though. But all the sucky ones don't require anything really. Of course everybody but the worst end up with similar jobs though since nurses are in short supply everywhere. That will change though since for some god awful reason everybody wants to go back to be a nurse. I guess so they can feed their kids which isn't really an unnoble cause but it doesn't mean they have any what of a scientific mind. More than likely it means they are super unscientific.
    I'm honestly with you on the non-sciencey nursing. How much science does a butt wipe need? When I was in RN, particularly the traumatizing experience I spent in a medical-surgical unit, I was completely thoughtless. I was so over run with trying to juggle tasks that I didn't give a ****** **** about science, pharm, or anything. My only thought was "***, have I done!" I detested being a RN in all settings, but med-surg was the absolute epitomy of hell for me. In fact, have now have a visceral stress response to people coughing or puking. I become infuriated and do everything I can to exit the situation.

    That being said, maybe the critical care folks, which I did for a short-time, or the ER folks, which I did for a year or so, need a little science. However, I can attest that most of the nurses in my ER were not remotely interested in any -ology.

    The sad part is that most NPs I've been around are this way. I was at a lecture recently and a pharmacist was presenting. A question was asked to the audience when I just happened to be looking toward the door at the back of the room. It looked like a herd of deer standing on a highway about to get run over. And then I went to a break out session with other PMHNPs. I don't think any of them had any clue about anything other than mental illness being a "chemical imbalance." Just what the heck is this imbalance? What chemicals are out of balance? No one has quantified how much serotonin one should have so how do you know an imbalance exists? It's the stupidest thing I've ever been taught. Hypoglycemia is a chemical imbalance.
    sauce likes this.
  12. Visit  sauce profile page
    1
    I suppose a butt wipe ologist could throw in the coefficient of kinetic friction when wiping to determine the maximal butt wipe force able to be applied without causing a skin tear. Of course this would require calculus since most forms of stool could be considered s lubricant and usually stool isn't distributed in s perfect shape thus again requiring calculus. and also the friction coefficient of the style of wipe would also have to be considered. Lol

    but anyway like you said nursing isn't all about science at the rn level which is fine, but ego-ology many nurses having thinking they know everything is what causes the annoyance. Then this is carried over to the aprn role which actually should have more science and the sh*t his the bedpan.

    Aprn practice seems to be based off of symptom matching and cookbook medicine, again which isn't all bad and some docs do it too. But again, when APRNS try to tout they are just as good as docs in all aspects it just sounds ridiculous and all these research studies pop up saying we can handle disease as well as docs. Sure, we can, at least the ones that can be algorithmitized. And those are the only ones present in these studies. Sort of you know providing the lay people with false hope and lies.
    Many diseases cannot be cookbooked and there is where the difference lies peeps.

    htn and and dm outcomes just as good for APRNS compared to docs. Great. All that says is we can read a flow chart lol. Not to mention how do you control for specialist care. You can't.
    PsychGuy likes this.
  13. Visit  AndersRN profile page
    0
    Quote from sauce
    I suppose a butt wipe ologist could throw in the coefficient of kinetic friction when wiping to determine the maximal butt wipe force able to be applied without causing a skin tear. Of course this would require calculus since most forms of stool could be considered s lubricant and usually stool isn't distributed in s perfect shape thus again requiring calculus. and also the friction coefficient of the style of wipe would also have to be considered. Lol

    but anyway like you said nursing isn't all about science at the rn level which is fine, but ego-ology many nurses having thinking they know everything is what causes the annoyance. Then this is carried over to the aprn role which actually should have more science and the sh*t his the bedpan.

    Aprn practice seems to be based off of symptom matching and cookbook medicine, again which isn't all bad and some docs do it too. But again, when APRNS try to tout they are just as good as docs in all aspects it just sounds ridiculous and all these research studies pop up saying we can handle disease as well as docs. Sure, we can, at least the ones that can be algorithmitized. And those are the only ones present in these studies. Sort of you know providing the lay people with false hope and lies.
    Many diseases cannot be cookbooked and there is where the difference lies peeps.

    htn and and dm outcomes just as good for APRNS compared to docs. Great. All that says is we can read a flow chart lol. Not to mention how do you control for specialist care. You can't.
    Are you a NP?

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