Doctoral degree to become an NP???

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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

Specializes in CT ICU, OR, Orthopedic.

OK, the thing is (as I've said over and over), the DNP was NEVER intended to make a "mini doc". Or to make NPs equal to physicians etc. The DNP was meant to create excellence in NURSING. The DNP graduate will be prepared to provide the LEADERSHIP necessary to promote excellence based on EBP, system leadership, HEALTH POLICY, & interdisciplinary collaboration (ANA 2004, 2010). This is the purpose of the DNP. So this is why these classes are required. It is a "practice doctorate". Any how, Yes, I'd love more clinical hours and classes...

The reason I chose to pursue my DNP had nothing to do with wanting to be referred to as, "Doctor" or wanting some sort of gratification. It was a personal decision. I am happy with it.

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i agree, the dnp will not be a requirement for awhile. i do know that the ancc and aanp are considering the impact of the dnp on certification exams. i know that nonpf and ccne are recommending the dnp as the minimum degree by 2015. all of these organizations have been reviewing the impact. strong possibility that the np students starting a np program in 2015 will be required to have the dnp to be eligible for a certification exam form ancc or aanp.

and if states don't buy into the idea that the dnp (as opposed to the current msn educational model) is really necessary, they can simply change the bon rules so that ancc or aanp certification is not required to practice in the state ... there are a whole lot of organizations (including the state legislatures!) who would have to climb on this bandwagon for the dnp to really become mandatory.

keep in mind that the academic nursing organizations (and others) have been pushing the bsn-as-entry-level idea for over 30 years now, and that's no closer to happening now than it was 30 years ago ...

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and if states don't buy into the idea that the dnp (as opposed to the current msn educational model) is really necessary, they can simply change the bon rules so that ancc or aanp certification is not required to practice in the state ... there are a whole lot of organizations (including the state legislatures!) who would have to climb on this bandwagon for the dnp to really become mandatory.

keep in mind that the academic nursing organizations (and others) have been pushing the bsn-as-entry-level idea for over 30 years now, and that's no closer to happening now than it was 30 years ago ...

i agree, the bsn as entry into practice has been pursued for a long time, more like 40/50 years. in fact, one state had the bs as entry into practice from the mid eighties until the early 2000s.

my point is, np is quite different from the rn in how states and bon view. the transition to a masters entry for np went much faster than anybody expected. as you may recall we had very few msn np programs in the mid 80s, yet by 1992 the masters was required for the fnp and the rest soon followed.

i disagree with the premise that states will opt to not require ancc or aanp certification in the future in order to hang on to the msn entry. history often repeats itself, increased education is considered a benefit for the public.

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Specializes in FNP.

I agree with DNPstudent on many points. I too am a BSN to DNP student, and the primary reason is that I have the time and opportunity and I like being a trendsetter; in fact, I wore crocs before anyone else did. ;) So I will wear ugly shoes and pursue unpopular degrees just because they suit me!

I cannot speak to the fluff issue, except to say that the DNP students ahead of me are working their tails off. I know two who are, in fact, doing a dissertation as an adjunct to their capstone project for which they will not be awarded a PhD alongside their DNP. They aren't doing it for "props" or glory. They are doing it b/c the research is a natural extension of their investigative capstone project, they think it is significant to their fields and may be of value, and because they are intensely interested and engaged in their own education and evolution. I really respect and hope to emulate these two. I don't think they are less than their PhD peers, and I genuinely doubt any serious nurse scholar who appreciates the depth of their work would either. And frankly, who the he11 cares about the people that don't? It one does not understand the meaning and scope of such a contribution, their opinion is irrelevant.

So I am pursuing the DNP because I want to, and I don't care if other people do not understand the importance of what I will do to earn it (I know what my topic is and generally how I will pursue it, but I'm not going to discuss it on the internet for obvious reasons) so long as my doctoral committee and chair understand it! In 30 years, the DNP either will or won't be an established and relevant part of advanced nursing practice. I don't pretend to know. Either way, my education and experience are relevant to my practice. I will be better for it. I don't even pretend to know for certain that patients will be better for it, and you know what, it doesn't matter (they certainly won't be worse). This life, this education, this is my journey, and my outcome is the one I'm concerned with right now.

However, that being said, just b/c it is an important part of my existential journey, I don't think it needs to be part of everyone's. So while I generally believe that more education is always preferable to less, I think 2015 is too soon to mandate the DNP. I think before it is required as entry into practice, there should be firm data that it equates with improved patient outcomes, and that is going to take time.

The only part of the whole debate that troubles me is that nurses (I do not care in the least that physicians or PAs are unimpressed by the DNP, it isn't for them) continue to fail to support one another and the evolution of our profession. There should be a heck of a lot more "You go girls" (and guys) and a lot less sniping.

I will further add that I am in favor of standardization of the DNP, I am in favor of a more rigorous program in general, and I do think all programs (MSN and DNPs) would benefit from an increase in minimum clinical hours. Constructive criticism of the flaws in nursing education is very important. I just wish it could be done effectively w/o tearing down the aspirations and achievements of colleagues.

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Specializes in ED, Cardiac-step down, tele, med surg.

Do you think adding more advanced medical science classes might be a possibility for this degree? Maybe instead of fighting the degree itself, trying to modify it to make it more appealing may be a possibility. I don't know how one would do that though. Who decides these types of things?

I'd love to do a DNP later on, but it would be much more exciting for me to do more medical science or advanced assessment, etc.

j

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Do you think adding more advanced medical science classes might be a possibility for this degree? Maybe instead of fighting the degree itself, trying to modify it to make it more appealing may be a possibility. I don't know how one would do that though. Who decides these types of things?

I'd love to do a DNP later on, but it would be much more exciting for me to do more medical science or advanced assessment, etc.

j

But at that point, you are going to school 4-5 years post BSN so why not just go to medical school?

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Here's a concern I've had for a while- Let's say the DNP curriculum is updated to include much, much more in depth clinical coursework. While, I like the idea of this, I have a feeling that the medical community will say that the DNP is too much like MD/DO training, and that DNPs really are trying to take over. (this is hypothetical, and by no means my opinion).

However, IMHO, I do think that often independent practice is becoming confused with the DNP. I really wish the powers that be would keep these two separate issues.

Thoughts?

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Specializes in ED, Cardiac-step down, tele, med surg.
But at that point, you are going to school 4-5 years post BSN so why not just go to medical school?

I'd consider it. But there are things about medical school that I don't like. One is the philosophy of how people are viewed. Physician's diagnose and treat disease. Patients are reduced to symptoms of disease and this is encouraged in medicine. Something is missed when that is done and I would not want to spend 4 intense years with that basic framework.

I don't think people can be broken down into symptoms or that the whole is just a sum of it's parts. There's too much rigidity in traditional medical school for me.

j

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Here's a concern I've had for a while- Let's say the DNP curriculum is updated to include much, much more in depth clinical coursework. While, I like the idea of this, I have a feeling that the medical community will say that the DNP is too much like MD/DO training, and that DNPs really are trying to take over. (this is hypothetical, and by no means my opinion).

However, IMHO, I do think that often independent practice is becoming confused with the DNP. I really wish the powers that be would keep these are two separate issues.

Thoughts?

I think the DNP is a great way to become a more advanced nurse. It would be great for anyone who wants to go into administration, especially at a larger scale. Anyone who wants to go into academia. Anyone who wants to branch out into public health. Yet it still keeps the roots in nursing practice for those who aren't interested in nursing. I just don't think it should be REQUIRED for those who just want to do nursing and don't have an interest in education or administration or public health.

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I'd consider it. But there are things about medical school that I don't like. One is the philosophy of how people are viewed. Physician's diagnose and treat disease. Patients are reduced to symptoms of disease and this is encouraged in medicine. Something is missed when that is done and I would not want to spend 4 intense years with that basic framework.

I don't think people can be broken down into symptoms or that the whole is just a sum of it's parts. There's too much rigidity in traditional medical school for me.

j

Why not DO? They are much more into the view of the "whole body" view. An old roommate of mine went to DO school because she also had similar views on treating the person, not the disease/symptoms.

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Specializes in FNP.
Here's a concern I've had for a while- Let's say the DNP curriculum is updated to include much, much more in depth clinical coursework. While, I like the idea of this, I have a feeling that the medical community will say that the DNP is too much like MD/DO training, and that DNPs really are trying to take over. (this is hypothetical, and by no means my opinion).

However, IMHO, I do think that often independent practice is becoming confused with the DNP. I really wish the powers that be would keep these are two separate issues.

Thoughts?

Ah, yes, I agree they are best kept two separate issues. I think they get thrown together sometimes due to the 'nurses calling themselves doctor' issue, which is completely inane IMO.

I do not know what the MD students and PAs that visit this forum would say, but physicians I know personally are all for NPs having more and better education. I am not personally acquainted with any physician who feels threatened by NPs or DNPs, but I suspect that is b/c I don't know very many young docs and only one student. The criticism I hear from them is just what the more plaintive voices here have been saying for 90+ pages: there should be more hard science, and more clinical hours, and some standardization across the board. Other than that, I have never met a medical or nursing professional who didn't think that the DNP in general is a positive step for nursing and ultimately for patients.

I know quite a few physicians who are indeed wary of independent practice for NPs b/c, let us be honest, we are all acquainted with a NP or two that is not well suited to it for one reason or another. I don't know anyone who would generalize and say "No NP should ever practice independently." I think they are all appropriately concerned about the details. How are these independent NPs going to be educated, credentialed and assured to be competent on a continual basis? So far there are inconsistent and poorly defined answers to these reasonable questions in many states. Some boards of nursing have not done a stellar job of policing our own, and this is worrisome. Of course, other professional boards have also made errors of judgment along the same lines historically, but I don't think this point lessens the responsibility of the Boards of Nsg to adequately ensure public safety. There are going to be NPs who are extremely well suited to it and who will provide excellent care. Separating the wheat from the chaff is going to be difficult and controversial but I do think independent practice is going to be the new reality. I don't think anything is going to impede that at this point, but the transition will be contentious. I do not see any way around that. I suspect that in two generations the primary care physician will be a thing of the past.

We have passed a tipping point IMO, and there is no going back. The dynamics of health care delivery in this country are changing dramatically and I think will continue to change until some equilibrium is achieved. Physicians have traditionally led the health care team, and I think that too is going to change because while individually they have given their all to their patients, collectively their organizations have been more selfserving. Like unions have sometimes been more about the leadership than the membership, so has the AMA, to it's long term detriment. Out in the professional world, I do not see the hostility toward nursing in general and NPs that I see on the internet. I do understand the confusion and ire of medical students/residents and very young or new physicians. I appreciate that they work incredibly hard and make tremendous sacrafice. I'd be frustrated too, and NPs are easy target. I think it is misplaced, and that they will find it so when they get out there and start collaborating with excellent NPs in professional practice. In the meantime, I don't blame them for being disturbed by changes that are taking place very quickly, long after they have made plans, commitments and sacrifices based on the previous model. I just think if there is a body they should be frustrated with, it is their physician leaders who have sold them out to the insurance companies, big pharma and health care corporations.

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Specializes in FNP.
But at that point, you are going to school 4-5 years post BSN so why not just go to medical school?

Speaking only for myself, the primary reason is that I do not want to practice medicine. I am interested in health promotion and disease prevention for communities as a whole. Nursing research and practice is uniquely suited to my area of interest. I cannot speak for others.

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