Doctoral degree to become an NP???

Specialties Doctoral

Published

The American Association of Colleges of Nursing (AACN) is calling for the requirement of doctorate in nursing for advanced practice nurses, such as nurse practitioners, nurse midwives, clinical nurse specialists, and nurse anesthetists. This new degree will be called a Doctor of Nursing Practice and, if the AACN has its way, will become the entry level for advanced nursing practice.

AACN Position Statement on the Practice Doctorate in Nursing

I agree with you, for the most part... but, what concerns me is that most NP programs are going to DNP by 2015--- so all new NPs after 2015 will be DNPs. (Some have told me this isn't true; however, if you read the position statements of major universities and some minor (mine included), you will see that their goal is to have all new NPs have a DNP degree.

So, in that respect, experience before the DNP degree is not always a pre-req, depending on the school/program.

I'm not sure its worth the 40 K, either...

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Specializes in GI/GU surg,Pacu, ct surg, home care, NH.

There is still debate about the standard education for NPs to be the DNP starting in 2015. There are many within the nursing community that are unsure about the benefits of the DNP program. So it is not a definite that by 2015 it will be a requirement. They have not yet reached a consensus on that.

You are right that some schools will start phasing out the MSN NP programs.

I know that ANCC for sure will require a DNP starting in 2015 to even sit and take their certification test.

So its all up to you. By 2015 all current NPs will just be grandfathered in. So you would be OK. But I would say atleast start working and making some NP money before shelling out for the expense of a DNP.

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There is still debate about the standard education for NPs to be the DNP starting in 2015. There are many within the nursing community that are unsure about the benefits of the DNP program. So it is not a definite that by 2015 it will be a requirement. They have not yet reached a consensus on that.

You are right that some schools will start phasing out the MSN NP programs.

I know that ANCC for sure will require a DNP starting in 2015 to even sit and take their certification test.

So its all up to you. By 2015 all current NPs will just be grandfathered in. So you would be OK. But I would say atleast start working and making some NP money before shelling out for the expense of a DNP.

There are still those in the nursing community who think we should have stayed with the diploma as the entrance level for the RN. In reality, most schools have started the process of phasing out the MS NP programs, many have already phased out the MS NP programs and now only offer the BSN to the DNP. I was around when we transitioned to the MS requirement for the NP in 1992, there is far more consensus for the DNP in 2015.

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I just don't see the point in the DNP degree. It is supposed to add to our knowledge base but how? I see lots of fluff classes about research, nursing theory, and management, as well as clinical time to do your capstone but no advanced patient management courses.

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Specializes in GI/GU surg,Pacu, ct surg, home care, NH.

I live in the NYC area and most major institutions like Columbia, NYU, Pace, Hunter, & Stony Brook have not begun phasing out their Masters program. And of these schools that have DNP programs they require advanced practice nursing experience.

The State Board of Nursing varies from state to state about the current requirements in order to practice as a Nurse Practitoner. So now the question is will the State Board of Nursing now require a DNP in order to practice as a NP?

Another issue has been whether or not a DNP should or will affect insurance reimbursement rates. Medicare reimbursement rates for NP services currently vary from state to state. So the question is will medicare recognize the DNP and if so will it affect reimbursement rates for DNP services? I currently work in a hospital so this does not affect me. But for NPs working in outpatients settings this is very important.

The nursing community still has not even been able to agree on the entry requirements for the RN. There is still debate about whether all ASN programs should be phased out. There are many who feel that basic nursing education should be standardized to be a BSN.

My point is, that the DNP entry requirements for the NP is controversial. And I doubt that it will be resolved as soon as 2015. There is too much inconsistency right now.

I do feel that nursing education requirements should be standardized across the board for all Nurse Practitioners. However there should be consistency in state requirements as well as consistency in program curriculum. There are some DNP programs that are jokes.

For right now I am still skeptical.

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There is still debate about the standard education for NPs to be the DNP starting in 2015. There are many within the nursing community that are unsure about the benefits of the DNP program. So it is not a definite that by 2015 it will be a requirement. They have not yet reached a consensus on that.

You are right that some schools will start phasing out the MSN NP programs.

I know that ANCC for sure will require a DNP starting in 2015 to even sit and take their certification test.

So its all up to you. By 2015 all current NPs will just be grandfathered in. So you would be OK. But I would say atleast start working and making some NP money before shelling out for the expense of a DNP.

Just out of curiosity do you have a source for this?

The only statement I can find from the ANCC is this:

http://198.65.134.123/Headlines/DNPSurveyResults.aspx

David Carpenter, PA-C

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I too, have heard this, but do not have a written source. I questioned the director of my nursing program (an NP) and she said that they will either have to institute a DNP program soon, or stop offering the track option at all, because students will not be allowed to sit for certification after 2015.

I agree with Brooklynbaby that there is alot of inconsistencies, and no one person or establishment has a standardized response or plan. I'm all for more education-- when it will be beneficial- not for the sake of saying we are on the same educational track as PharmDs, and PTs...

I am currently looking into Pharm D programs and PTs just out of curiosity... It seems that they get more clinical education with their doctoral degree... thoughts?

-KJ

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Specializes in GI/GU surg,Pacu, ct surg, home care, NH.

I dont have a source other than what I have heard from several of my NP professors who stated that ANCC will require this in 2015. So I guess thats not a definite either.

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So, how does this really change the course for becoming an NP? As I understood it, one could start off with their ASN, then go to their BSN, then go to their MSN, and become an NP, all while during this process holding down a decent to good steady job while continuously advancing. From what I could tell, to get your MSN after a BSN, took about 2 to 3 years yes? Now, what will the year requirements be, 4, 5, 6 years? If this is the case, what will the point of an NP be? If it requires just as much education and time investment as an MD/DO, why bother with NPs? Won't this also mean NPs have to be paid more, thus removing the economic advantage utilizing NPs for primary care and other such fields could yield? I don't really understand this decision, but I'm very new to the nursing world. I was thinking of going into nursing, starting out with a two year degree possibly, and advancing overtime to an NP route, but this seems no longer a viable option.

Could anyone explain all this to me?

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Hi Everyone,

Has anyone looked into applying for a DNP program post-masters without experience as an advanced practice nurse.

Ideally, I would like to keep up my momentum when I am done my Masters in the spring of '11 and continue on to my DNP degree. I have noticed that alot of schools in NY and NYC require a year or two experience as an advanced practice nurse. Any thoughts or comments?

Thanks!

The University of Michigan no longer offers an MSN at all, and their DNP does not require any experience.

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From what I could tell, to get your MSN after a BSN, took about 2 to 3 years yes? Now, what will the year requirements be, 4, 5, 6 years? If this is the case, what will the point of an NP be? If it requires just as much education and time investment as an MD/DO, why bother with NPs?

Yes, I understand what you mean. But for someone who is already a nurse, at least they don't have to start over. This DNP option gives them the alternative without having to start over like MD/DO options. At least, it encourages those who "already" RNs to advance their education and knowledge. Not many people are lucky enough to have family support or know themselves enough to go for MD route when they were younger. Not everyone can realistically go back invest another 8 years in school after already being RN with BSN in mid 30s. They have family to feed and other financial obligation.

In some countries, they waived a few year of med school if you're already a nurse. Here, there's no option besides going for DNP route.

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Specializes in Emergency, Cardiac, PAT/SPU, Urgent Care.
If you want to see a REAL mid-level education...

Anatomy

The course in anatomy is a central focus of basic science education in the Physician Assistant Program. During this course the student is introduced to gross anatomy presented by the regional approach. The student becomes familiar with the chest, upper extremity, abdomen, pelvis, lower extremity, neck, head, and the central nervous system. Whenever appropriate, clinical and especially surgical correlation's are made both from a diagnostic as well as operative point of view. Instruction is primarily in lecture and lab format, however, atlases and other visual aides are available.

Physiology

The principal objective of the physiology course is to provide physician assistant students with a basic understanding of both cellular physiology and integrative physiology. The course introduces students to the normal vital processes of the human body. Students will be taught the characteristics of cellular structure and the cellular mechanisms, which promote the maintenance of homeostasis. In addition, the specific characteristics of the nervous system, the respiratory system, the endocrine system, the cardiovascular system, gastrointestinal system and the kidney will be discussed in detail to provide a basis with which to compare and characterize clinical disorders.

Microbiology

The course in microbiology and immunology familiarizes the student with the basic information needed to understand the role of these disciplines in clinical medicine. Lectures are supplemented with demonstration materials from the Laboratory of Microbiology whenever feasible. The core course includes Bacteriology, Mycology, Virology, Parasitology, and Immunology. Emphasis is placed on the presentation of practical and useful infectious disease topics relevant to clinical practice.

Biochemistry

Medical biochemistry emphasizes the biomedical principles of carbohydrate, protein, and lipid chemistry fundamental to clinical medicine. Basic biochemical information is presented and integrated with selected nutritional and health problems by means of lectures and clinical discussions. Specific topics include vitamins, minerals, the chemistry of respiration, pH balance, blood coagulation, and hormonal effects on the metabolism of proteins, carbohydrates and lipids. Clinical biochemistry correlates concepts of medical biochemistry with clinical problems such as maintenance of good health, aging, wound healing and growth. Specific topics include hormonal dysfunction, pancreatic/ gastric function, iron/heme metabolism, and mineral/water balance.

Pharmacology

The course in pharmacology introduces the student to therapeutic drugs, their chemistries, actions and uses. Instruction is presented in lecture format. Emphasis is placed on the practical application and evaluation of drug actions on the functions of various organ systems of the human body including but not limited to the autonomic nervous system and cardiovascular system. Studies of antibiotics as well as other important topics are also covered.

Pathology

This course in pathology introduces the student to the natural history, etiology, pathogenesis (gross and microscopic) and clinical findings associated with disease states. Instruction is presented mainly in lecture format with the use of visual aids. Emphasis is placed on disorders commonly encountered in surgical patients.

The Medical Interview

This course will introduce the student to the skills necessary for successful medical interviewing. Course materials and readings will explore the relationship between normal conversation and medical interviewing. The student will learn and practice various techniques for eliciting an accurate medical history from a variety of patient types. Each section of the medical interview will be studied and practiced in detail in preparation for the patient encounters scheduled for the subsequent semester.

Physical Diagnosis I & II

This course, offered in a two-semester sequence, introduces the student to the fundamental techniques of interview and examination. The student will use this basic knowledge throughout his or her career in medicine. Emphasis is on performance of mastered techniques, medical chart recording and oral presentation format in preparation for the clinical phase of education.

Surgical Aspects of Primary Care/General Surgery/Surgical Specialties

The surgery courses are divided into three semesters. The student is introduced to clinical problems common to the discipline of surgical practice including clinical presentation and the correlation between anatomy, pathology, and stage of disease and treatment. Indications and contraindication for surgery are presented along with a pertinent discussion of surgical techniques. The student is introduced to operating room protocol, asepsis and scrubbing, gowning and gloving, instrumentation, suturing and knot tying. The disciplines of orthopedics, radiology, and anesthesiology are also introduced.

The entire Surgery curriculum includes laboratory sessions which are designed to introduce the student to the practical care of patients including bedside procedures such as intravenous catheterization, blood drawing, techniques of hemostasis, suturing methods, use of drains, catheterization techniques, nasogastric intubations, wound care management, and preoperative, postoperative and daily note writing. At this time the student is introduced to the hospital setting and is assigned to attend morning rounds on various clinical rotations in preparation for clinical rotation.

Fundamentals of Primary Care and Clinical Medicine I & II

The medicine course is divided into two semesters. Each semester's course is divided into smaller modules, which introduce the student to the various medical sub-specialties. The student is introduced to recognition and management of common medical problems encountered inpatients and outpatient medical facilities. These include topics such as hypertension, cardiovascular and pulmonary diseases, diabetes, hematologic disorders, hematology, oncology, endocrinology, and otolaryngology and multiple system abnormalities of the elderly.

Obstetrics and Gynecology

This course introduces the student to the fundamentals of prenatal care and childbirth as well as common obstetrical and gynecologic problems and other issues related to women's health that are encountered in clinical practice.

Pediatrics

This course introduces the student to the fundamentals of growth and development, well-baby care, principles of immunization, commonly encountered childhood diseases and their treatments as seen in clinical practice.

Psychiatry

This course introduces the student to the fundamentals of common behavioral abnormalities and their treatment as encountered in clinical practice. Topics include the professional-patient relationship, reactions to history taking and physical examination, stress and coping mechanisms, detection and treatment of psychiatric complications, and management of death and dying.

Physician Assistant Seminar

This course prepares the student to understand the role of the physician assistant in the 21st century healthcare in the United States. Topics are addressed such as professionalism, legal aspects of health care, use of medical literature, familial and cultural components of health care, medical ethics, health promotion/disease prevention, and patient education.

Emergency Medicine

This course further explores concepts introduced in Fundamentals and in Surgery lectures, with an emphasis on emergent care and life-threatening illness and injury. Common presenting complaints seen in emergency medicine settings, their diagnosis and treatment are addressed. Explores emergency medicine both as a field of study and as a medical specialty.

Research I

This course explores the basic concepts of research in the health sciences and the communication of new information to peers. Standard style and content for research proposals, publications and presentations are utilized. Topics such as problem finding, formulation of a research questions, methodology, design, instrumentation, literature review, ethics and funding are explored. Published research articles will be critically analyzed.

Research II

This course applies the theoretical foundation of Research I in the formulation and satisfactory completion of a written final project, working individually with a project advisor. The research process will conclude in an oral presentation to peers and submission of a clinical review article suitable for publication in a peer-reviewed journal.

Epidemiology

This course applies the scientific method to the study of disease in populations. The epidemiological method for studying a problem involves description of the frequency and determinants of a disease in a defined population , evaluation of factors that may cause a disease, and experimental studies of the effects of modifying risk factors on the subsequent frequency of a disease.

Biostatistics

This course provides an introduction to statistical methods as applied to health care research. Topics include population sampling, hypotheses testing, probability, and chi-square, linear regression and correlation, analysis of variance and non-parametric statistics.

This includes a full cadaver dissection lab and patient contact.

Then clinicals...

Internal Medicine - 8 weeks

Surgery - 8 weeks

Pediatrics - 4 weeks

Primary Care - 4 weeks

OB/Gyn - 4 weeks

Emergency Medicine - 4 weeks

Family Medicine - 4 weeks

Psychiatry - 2 weeks

Geriatrics - 2 weeks

Electives (to allow specialization) - 20 weeks

If we assume 40 hours per week, that is 2,400 clinical hours. 800 of those hours are elective and allow you to specialize, which is more hours than a NP gets in their "specialty" area. And we all know a lot of those clinicals won't let you get away with just 40 hours per week!

OK, so substract 320 hours for 8 weeks of surgery (FNPs don't need that for they don't do surgery), 160 hours of emergency medicine (FNPs don't need that specifically to practice in the office setting, plus I've been an ED nurse for over 10 years), 80 hours psych (that was incorporated into each of my adult health, geriatric, peds, and even ob/gyn clinicals), and 800 hours of electives to specialize (FNPs who go into family practice don't need this, either, since family practice is their specialty) from 2400 hours - that leaves you with 1040 hours. Really, that's only about 40 more hours than the typical DNP program clinical hour requirement, so I don't see what the big difference is. Plus, almost all of those courses you listed above (A&P, micro, biochem, pathophys, pharmacology), NPs have taken at least once at the undergrad level (many times twice in the case of patho, pharm, and some aspects of A&P since those are also taken at the graduate level), except for emergency medicine, the surgery, and the PA-specific course.

I just don't think that anti-NP people realize that we have already taken all of those "hard" sciences that they vehemently insist we need to take at the undergraduate level. They just seem to anally focus on what is included in the NP (be it MSN or DNP) program. They really need to look at the bigger picture of our entire education.

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