Doctor of Nursing Practice (DNP): My Personal Proís and Conís - page 6

by juan de la cruz 32,727 Views | 56 Comments Guide

The Doctor of Nursing Practice or DNP degree has been one of the biggest buzzwords in Advanced Practice Nursing. The mere mention of it creates a stir of emotions and strong opposing opinions perhaps of the same magnitude as the... Read More


  1. 5
    Excellent summary of the pros and cons of the DNP degree, I agree on your astute observations. As a former clinical faculty member of a prestigious School of Nursing, I was told that the DNP degree would not be considered a "tenure" degree. So, if my purposes of pursuing an advanced degree were for teaching, why would I pursue a DNP vs. a PhD for academic advancement? Not only that, but I believe the nursing profession needs more PhD prepared nurses for the future.

    As for the DNP being the entry level for the nurse practitioner, this is the point of contention that has caused so much negative backlash against the DNP, in my opinion. I think it's fine to have the DNP as an educational option for nurses. There is absolutely no way that the individual states are going to require this for NP licensing. There is NO evidence to support that a DNP changes anything about the ability for the NP to perform at the highest level to practice within the current prescribed role. Hospitals will also not alter their pay structures for a "degree. Instead, they will alter their pay structure for a defined job. So, if you have a DNP and may be possibly better prepared to take on the job of say, an Advanced Practice Director, then it may well be beneficial. But if you're up for an NP position and someone has a master's degree and 10 more years experience than you, I don't think it will get you anywhere.

    Furthermore, until our profession can agree on the BSN as the ENTRY level for practice, we should stay away from meaningless mandates that were meant to increase enrollment in universities who could not attract enough PhD candidates, and therefore wanted the DNP to be the required level of entry for NPs!!!
  2. 1
    Quote from mmrb
    As for the DNP being the entry level for the nurse practitioner, this is the point of contention that has caused so much negative backlash against the DNP, in my opinion. I think it's fine to have the DNP as an educational option for nurses. There is absolutely no way that the individual states are going to require this for NP licensing. There is NO evidence to support that a DNP changes anything about the ability for the NP to perform at the highest level to practice within the current prescribed role. Hospitals will also not alter their pay structures for a "degree. Instead, they will alter their pay structure for a defined job. So, if you have a DNP and may be possibly better prepared to take on the job of say, an Advanced Practice Director, then it may well be beneficial. But if you're up for an NP position and someone has a master's degree and 10 more years experience than you, I don't think it will get you anywhere.
    Mmrb, I really like your point! I've heard too that nurse practitioners have been more than adequately prepared at the masters level. But it makes me wonder: How did other health professions end up starting as bachelor's or associate's-prepared field and move up the line to doctorates - like physical therapy and others? Were there other circumstances in those instances of degree inflation that aren't present in the case of the DNP?
    MandaRN94 likes this.
  3. 2
    Quote from OneDNP
    I have a few comments on the original thread and some of the replies.



    On PA doctorates and such: It is my understanding that the PAs were created as the MDs' answer to NPs, though certainly the role has changed over time. I think PAs have a huge semantic hurdle to overcome given that it contains "physician" and "assistant" in the title. I suppose the discussed replacement of "physician associate" is a little better, but that still sounds far more handmaiden-like than nurse practitioner. Then again, when I tell people I am a nurse practitioner, I still get some folks asking me if I plan to get my RN. I have enough trouble in my own profession without taking on their concerns, but one thing I will speak out on is the occasionally proposed (by MDs, usually) merging of PAs and NPs into a single MLP or physician-extender title. No thanks.
    Not quite right. PA's were one of the answers to primary care shortage in 60's. It had nothing to do with "the MD's answer to NP's". The PA model was never to indended to just be an "assistent" to the physician. The role was, and is, to extend healthcare while working with the supervision of a physician. Supervision is defined as "available for consult/advise"....not "under the thumb" as frequently suggested/implied on this site. Most States have done away with the archaic chart co-signature rules and the Physician doesn't have to be in the same building...just available. Sounds a lot like collaboration doesn't it? The "assistant" title has been the bane of the PA since it's onset...it is what it is.

    The first NP program (what we recognize as an NP today) was developed in 1965 at the University of Colorado. Dr. Eugene Stead tried to implement his PA model using nurses in 1964, but he was disillusioned by the by the push-back he was getting from the organized nursing organizations at the time. He went with military medics with his first PA class in 1965 instead. The value of nursing was recognized, but it was the decision of the NURSING organizations not to go with Steads model as opposed to Stead answering to the NP model tit for tat. Sources: Physician Assistant History Society and AANP - Historical Timeline

    NP's have it pretty good in regards to practice laws...and good on them. But it has little to do with being "better" or being more "competent", and everything to do with having a better lobby that is independent of the BOM. I know you didn't imply this and it is not an accusation, but it is "implied" quite a bit throughout the NP community.

    IMO, there will never be a merging of PA and NP. Most PA's were not nurses so it would make it difficult for them to practice "advanced nursing". NP's were not trained in the medical model and would have to build a stronger base in the core sciences to meet the curriculum of a PA program. Different approaches for the same goal...treat the patient.

    Just some thoughts from a guy who considered NP and PA and went with the PA model.
    RNJohnny23 and MandaRN94 like this.
  4. 2
    Quote from Will352nd
    But it has little to do with being "better" or being more "competent", and everything to do with having a better lobby that is independent of the BOM.
    I hear this quite a bit from people outside of nursing in a variety of contexts (not just related to NP practice), and I'm always amused. Where on earth did you get the idea that the "nursing lobby" is powerful or effective? If that were true, the entire face of US healthcare would be v. different from what it is now. Just as one example, TPTB in nursing have been pushing for close to 40 years to make the BSN the minimum eligibility for licensure, and they are no closer to getting that mandated than they were then. They've only convinced one state to try it, and that state rescinded the legislation several years later. The ANA has been advocating for some version of a single-payer system for healthcare in this country at least since the '90s, and they're no closer to getting that implemented than they are to flying to the moon. Any political/professional advances made by nursing happen not because of the power or know-how of the "nursing lobby," but because other, more powerful, stakeholders on a particular issue see it as a benefit for them and/or their constituents. And nursing is very rarely able to get anything passed/implemented/changed if the physician community isn't willing to go along with whatever it is.
    MandaRN94 and SycamoreGuy like this.
  5. 0
    Quote from elkpark
    I hear this quite a bit from people outside of nursing in a variety of contexts (not just related to NP practice), and I'm always amused. Where on earth did you get the idea that the "nursing lobby" is powerful or effective? If that were true, the entire face of US healthcare would be v. different from what it is now. Just as one example, TPTB in nursing have been pushing for close to 40 years to make the BSN the minimum eligibility for licensure, and they are no closer to getting that mandated than they were then. They've only convinced one state to try it, and that state rescinded the legislation several years later. The ANA has been advocating for some version of a single-payer system for healthcare in this country at least since the '90s, and they're no closer to getting that implemented than they are to flying to the moon. Any political/professional advances made by nursing happen not because of the power or know-how of the "nursing lobby," but because other, more powerful, stakeholders on a particular issue see it as a benefit for them and/or their constituents. And nursing is very rarely able to get anything passed/implemented/changed if the physician community isn't willing to go along with whatever it is.
    It's interesting to the hear that you don't think the AANP and the ANA as a whole, don't have clout. You described that change is difficult...yes, it is. You won't get it all and there will always be push-back from other organizations. But change happens....eventually.

    The AAPA is subset of the AMA that has little intrest in pushing the needs of the AAPA. The AANP has the backing and clout of the ANA, which is a beast. Power and numbers = money.

    The AANP has an organization within that is dedicated to State and Federal legislation...the AAPA can't even get their foot in the door. Again, it's power in numbers....money talks.

    AANP - Legislation/ Regulation Have a look, I cruised this for about 5 mins and saw more legislative initiatives being pushed now than the AAPA has been able to accomplish in ten years.

    Really, you guys should be proud of your organization. I'm sure it's not perfect, but there are tangables that you can see.
  6. 1
    Quote from Will352nd
    It's interesting to the hear that you don't think the AANP and the ANA as a whole, don't have clout. You described that change is difficult...yes, it is. You won't get it all and there will always be push-back from other organizations. But change happens....eventually.

    The AAPA is subset of the AMA that has little intrest in pushing the needs of the AAPA. The AANP has the backing and clout of the ANA, which is a beast. Power and numbers = money.

    The AANP has an organization within that is dedicated to State and Federal legislation...the AAPA can't even get their foot in the door. Again, it's power in numbers....money talks.

    AANP - Legislation/ Regulation Have a look, I cruised this for about 5 mins and saw more legislative initiatives being pushed now than the AAPA has been able to accomplish in ten years.

    Really, you guys should be proud of your organization. I'm sure it's not perfect, but there are tangables that you can see.
    Sure, all the national nursing organizations have divisions that are "pushing" state and federal initiatives -- but how many of those ever get passed?? I stick by my belief that, if the nursing "lobby" were as powerful as many non-nursing people seem to believe it is, the entire healthcare system in this country would look and function radically different than how it does now. I'm sorry you're unhappy with your own professional organization(s), but we (nurses) are not calling the shots or getting what we want. The very idea is laughable.
    MandaRN94 likes this.
  7. 1
    I am comparing and contrasting the AANP and the AAPA....this isn't a pi@#ing contest.
    RNJohnny23 likes this.


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