Doctor of Nursing Practice (DNP): My Personal Pro's and Con's - pg.6 | allnurses

Doctor of Nursing Practice (DNP): My Personal Pro's and Con's - page 6

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... Read More

  1. Visit  juan de la cruz profile page
    3
    I think it's such a damaging proposition to speak of the DNP as a degree that focuses on "translation of existing evidence to improve patient outcomes" in the face of an APRN majority who do not hold this degree at the present time. I sure hope that the current crop of practicing NP's prepared at the Master's level all practice using current evidence. Saying that a DNP is needed for an NP to learn translational research in clinical practice provides further ammunition for physician lobbyists who have attacked our field citing "weak educational preparation".
    PatMac10,RN, PsychGuy, and elkpark like this.
  2. Visit  DNP_FNP profile page
    3
    Quote from juan de la cruz
    I think it's such a damaging proposition to speak of the DNP as a degree that focuses on "translation of existing evidence to improve patient outcomes" in the face of an APRN majority who do not hold this degree at the present time. I sure hope that the current crop of practicing NP's prepared at the Master's level all practice using current evidence. Saying that a DNP is needed for an NP to learn translational research in clinical practice provides further ammunition for physician lobbyists who have attacked our field citing "weak educational preparation".
    The DNP is not just about developing the skills to translate research into clinical practice. I apologize for failing to clarify this in my previous post. It was created for a variety of reasons, one of which is to better equip NPs for scientific inquiry and research (including data collection, analysis, and dissemination). It was additionally designed to add clinical time for residency (especially useful for the BSN-DNP tracks), improve global system assessment skills and communication, improve leadership skills, add knowledge of clinical informatics, improve healthcare policy and networking skills, and enhance collaborative interprofessionalism. The professional bodies created this degree in response to an Institute of Medicine report citing the aforementioned skills as lacking in health professions curriculum--including nursing. It made sense (to them) to move toward a doctorate if these skills were to be mandated in an already packed master's program. They also felt that it would provide increased parity with other fields.
    Rather than discredit the nursing governing bodies, I applaud them for trying to develop a degree that gives us parity with other professionals in our field--pharmacists have a doctorate, physical therapists have a doctorate, occupational therapist have a doctorate. Is having a doctorate in these fields as the level of entry any more ridiculous than requiring one for advanced nursing? Perhaps. I personally think that the entire nation suffers from "credential creep" in most regards, but the profession of nursing has to keep up with what other health professionals are doing or risk even further demerit.
    In my humble opinion, the field of nursing has caused most of its own problems in educational standards because we have a variety of different ways to attain one degree. For example: diploma nursing, associate degree nurse, bachelor degree nurse, master's NP, doctoral NP, PhD, DNSc. No other field does this. There should only be one, standardized route. Our political stance would surely be strengthened if there was only ONE way to be a nurse or advanced practice nurse--perhaps we could stop fighting amongst ourselves and put our positive energies into proving that we are excellent providers of health.
    In my opinion, that is one of the reasons why many lobbying physicians consider us to have "weak educational preparation". The other reason is obvious--physicians will always maintain that anything less than a "doctor of medicine" is weak educational preparation. Sadly, physicians should not be threatened and nurse practitioners should not try to be threatening. We all need to work together to provide good health outcomes. Nurse practitioners are certainly not physicians. We do have very different backgrounds and physicians do have the greatest knowledge base when it comes to science. That is just fact. Nurse practitioners do not, however, have weak educational preparation. Saying that something is "weak" suggests that you are comparing it to an accepted standard--but nurses aren't physicians. If we start adding physician curriculum into NP preparation, we might as well just go to medical school because the time to required to graduate as an NP would be just about as long. That being said, the DNP does not really change your scope of practice as a nurse practitioner but it will change the way you think about practice.
    Nurse_Diane, CraigB-RN, and db2xs like this.
  3. Visit  juan de la cruz profile page
    2
    Quote from DNP_FNP
    The DNP is not just about developing the skills to translate research into clinical practice. I apologize for failing to clarify this in my previous post. It was created for a variety of reasons, one of which is to better equip NPs for scientific inquiry and research (including data collection, analysis, and dissemination). It was additionally designed to add clinical time for residency (especially useful for the BSN-DNP tracks), improve global system assessment skills and communication, improve leadership skills, add knowledge of clinical informatics, improve healthcare policy and networking skills, and enhance collaborative interprofessionalism. The professional bodies created this degree in response to an Institute of Medicine report citing the aforementioned skills as lacking in health professions curriculum--including nursing. It made sense (to them) to move toward a doctorate if these skills were to be mandated in an already packed master's program. They also felt that it would provide increased parity with other fields.
    Rather than discredit the nursing governing bodies, I applaud them for trying to develop a degree that gives us parity with other professionals in our field--pharmacists have a doctorate, physical therapists have a doctorate, occupational therapist have a doctorate. Is having a doctorate in these fields as the level of entry any more ridiculous than requiring one for advanced nursing? Perhaps. I personally think that the entire nation suffers from "credential creep" in most regards, but the profession of nursing has to keep up with what other health professionals are doing or risk even further demerit.
    ...and the current manifestation of the NP Master's program do not offer these? I have 6 graduate credits in Research, 3 graduate credits in Health Care Policy, Business, and Professional Adjustment Issues, 3 graduate credits in Theories and Concepts of Stress and Coping in Acute Illness in my Master's degree ACNP program. I'm not in the camp that complains about these courses - they are helpful to a future provider but adding more to these in a BSN to DNP program is completely unnecessary.

    As far as I can tell from looking at current DNP programs, the additional clinical time that was intended initially never materialized. The bottomline for me is that nursing tried to achieve degree parity with other healthcare professions but wanted it all by adding equal parts of all the IOM recommendations without addressing the pressing need for more clinical content that many graduates of NP programs self-admit is true.

    Quote from DNP_FNP
    In my humble opinion, the field of nursing has caused most of its own problems in educational standards because we have a variety of different ways to attain one degree. For example: diploma nursing, associate degree nurse, bachelor degree nurse, master's NP, doctoral NP, PhD, DNSc. No other field does this. There should only be one, standardized route. Our political stance would surely be strengthened if there was only ONE way to be a nurse or advanced practice nurse--perhaps we could stop fighting amongst ourselves and put our positive energies into proving that we are excellent providers of health.
    ...and the DNP added a layer to that power struggle in the nursing profession to justify one camp over another as we are doing now. Was that a completely necessary consequence of our quest to achieve parity with other healthcare professionals? perhaps, but the planning and the fleshing out of an actual product (the DNP) could have been arrived at in much better ways than what we have done so that the choice between MSN and DNP is easier to make.

    Quote from DNP_FNP
    In my opinion, that is one of the reasons why many lobbying physicians consider us to have "weak educational preparation". The other reason is obvious--physicians will always maintain that anything less than a "doctor of medicine" is weak educational preparation. Sadly, physicians should not be threatened and nurse practitioners should not try to be threatening. We all need to work together to provide good health outcomes. Nurse practitioners are certainly not physicians. We do have very different backgrounds and physicians do have the greatest knowledge base when it comes to science. That is just fact. Nurse practitioners do not, however, have weak educational preparation. Saying that something is "weak" suggests that you are comparing it to an accepted standard--but nurses aren't physicians. If we start adding physician curriculum into NP preparation, we might as well just go to medical school because the time to required to graduate as an NP would be just about as long. That being said, the DNP does not really change your scope of practice as a nurse practitioner but it will change the way you think about practice.
    You are preaching to the choir here. Most of the readers of this thread are NP's or other types of APRN's or nurses interested in becoming any of the APRN specialists.
    Jules A and elkpark like this.
  4. Visit  PsychGuy profile page
    1
    The DNP does not add parity. Perhaps you have never examined the curricula of doctoral physician, pharmacist, dentist training, et al.

    Like it or not, physicians are at the pinnacle of healthcare. Their education does not include doctoral training in leadership, systems, or anything similar.

    To say you are as clinically prepared as someone with a degree in medical science with three plus years of residency training in a specialty is to get you laughed from a room. To be judged as equal, which won't happen, we must enter the race as well prepared clinicians, and although we manage somehow our raining is largely a disservice to our cause.
    Jules A likes this.
  5. Visit  RN-APNstudent profile page
    5
    Every time I try and find a good article/posting about DNP, all I seem to come across is MSN prepared NP's showing nothing but negativity towards the idea of NP's being doctorate prepared. It's very disappointing that I cannot read a good conversation on here, without the few NP's (or soon to be) explaining why the DNP is just so awful and unnecessary. There has been talk for years that the DNP will soon be entry level for those pursuing advanced practice nursing, and I understand that may be threatening to some who are already in the field or in the MSN program. What I do not understand though is why it has to be a competition- we are all in this field for the same reasons. The doctorate in nursing practice program may not be perfected at this point, and everybody understands that. But if people wishing to pursue advanced nursing feel that they will be better secured in their field by going ahead and obtaining a doctorate before its required (if and when) - and they wish to pursue higher education- then why are people being so hateful towards it!? If you don't agree with what a doctorate program for nurses has to offer- then simply don't do it!!!!
    DNP_FNP, PatMac10,RN, glamcakes, and 2 others like this.
  6. Visit  IsabelK profile page
    2
    I have a DNP. I do feel that it has provided me with a much greater depth of understanding about both my clinical practice and how to look at research and use it effectively. No academic program is perfect but I have few complaints about mine.

    Physicians are not the pinnacle of health care. They are members of a larger team of providers. They are one profession in a myriad number of players. Physicians must stop seeing themselves as the kings of the moutain and nurses must present a united front.

    I would also question why any nurse who is as negative about our profession as some participants are here became nurses.

    I worked hard for my credentials. And yes I am Dr. Nurse.
    Nurse_Diane and RobBSNRN like this.
  7. Visit  CraigB-RN profile page
    0
    I'd have to ask were you an NP already when you got your DNP or did you have a "generic" MSN?
  8. Visit  RN-APNstudent profile page
    1
    IsabelK I love everything about your post!!!
    IsabelK likes this.
  9. Visit  IsabelK profile page
    0
    Quote from CraigB-RN
    I'd have to ask were you an NP already when you got your DNP or did you have a "generic" MSN?
    I went from ASN/RN to BSN to MSN/ANP to DNP.

    I have been an ANP, and board certified, for 4 years. Worked for 2 years as a night hospitalist, then switched to days in consulting/primary care (we do either in my office) and went back to school. My ANP program was not as hard as my DNP program.
  10. Visit  IsabelK profile page
    0
    Quote from RN-APNstudent
    IsabelK I love everything about your post!!!
    Thank you.
  11. Visit  Jules A profile page
    1
    Quote from RN-APNstudent
    Every time I try and find a good article/posting about DNP, all I seem to come across is MSN prepared NP's showing nothing but negativity towards the idea of NP's being doctorate prepared. It's very disappointing that I cannot read a good conversation on here, without the few NP's (or soon to be) explaining why the DNP is just so awful and unnecessary. There has been talk for years that the DNP will soon be entry level for those pursuing advanced practice nursing, and I understand that may be threatening to some who are already in the field or in the MSN program. What I do not understand though is why it has to be a competition- we are all in this field for the same reasons. The doctorate in nursing practice program may not be perfected at this point, and everybody understands that. But if people wishing to pursue advanced nursing feel that they will be better secured in their field by going ahead and obtaining a doctorate before its required (if and when) - and they wish to pursue higher education- then why are people being so hateful towards it!? If you don't agree with what a doctorate program for nurses has to offer- then simply don't do it!!!!
    I'm not sure why you object to others adding their comments just because they don't support your opinion. No worries because until a DNP presents with more clinical and prescribing knowledge or increases my income I will not do it but that doesn't mean I can't add my opinion on an open forum. At present the "clinical hours"which to my understanding are spent on a "project" is not what I consider clinical hours.

    While it is apparent the schools are pushing the DNP, imagine that?, I personally remember the rumblings that LPNs were going to be obsolete as far back as the early 80s and yet they are still working and so are ADNs for that matter. I have absolutely no feeling of being threatened work wise from DNPs because I have a solid background, plenty of connections in my field and the physicians I work for think the DNP is unnecessary given there is no additional focus on pharm or clinical skills. Physicians are imo at the pinnacle of healthcare and they are the ones who hire and work with me.

    I do have concerns over the large number of inexperienced new grads both DNP and MS who will be practicing as NPs in upcoming years from the variety of schools that seem to be popping up out of the woodwork. There are great NPs and lousy ones just like physicians but for me I take it personally when it is a NP and think we need to strive to improve our clinical acumen and to me at this time the DNP does not do that in the NP arena. I am not anti-nurse. I loved being a RN and love being a NP. What I am is anti-inexperienced and incompetent NPs especially those who are calling themselves "Dr". Simply put I think our NP education should include more clinical time and more pharmacology hours or mandatory fellowships before we start patting ourselves on the back for elevating our profession.
    CocoaLoverFNP likes this.
  12. Visit  RN-APNstudent profile page
    0
    Your concerns seem to be aimed (and maybe should be voiced toward) the decision makers at the board level. As far as LPN and ADN nurses- in my state (Michigan) it's very rare to see LPN's anywhere but nursing homes, and they make considerably less money than RN's. BSN's are also becoming the majority in any acute care hospital, yes they still hire adn's but unless you know somebody or are working on your BSN- good luck. There will always be controversy and differing opinions regarding the different levels of nursing/advanced practice nursing..certain groups will always be bitter toward other groups and that won't ever change.
  13. Visit  RN-APNstudent profile page
    2
    And as far as your opinion on "incompetent nurses calling themselves doctor"... The schools you are worried about producing incompetent NP's may not be as well known as the one you went to, but we all have to pass the same boards and we all have to do close to the same amount of clinical hours. Aside from that- the board does not just give any school accreditation. I am going to a very well known, well recognized school and I also feel that these "degree mills" are becoming bigger than well known universities, but that's what education is coming to for nurses/APN's. To go as far as to call their students incompetent, I would never. I chose to apply at a top university (u of m) because I wanted to go to a well recognized school that I am proud of, but not everybody has the money for that. A doctorate degree is a very difficult degree to achieve, and I feel it's very offensive to call future or current dnp's incompetent. If you have the letters DNP following your name then I can assure you worked your butt off for that.
    Nurse_Diane and glamcakes like this.


Visit Our Sponsors
Top
close
close