Has the 2010 DNP alledged requirement for NP's already fizzled?

Editorial Team / Admin · Aug 5, 2008

I doubt it has fizzled. I'm sure it's still slated for 2015, not 2010

There are many entities who have already changed to the DNP terminal degree.

Here's a list of current DNP programs (last update April '08):

http://www.aacn.nche.edu/DNP/DNPProgramList.htm

CardioTrans, BSN, RN · Aug 8, 2008

Also add Univeristy of Alabama at Birmingham to that list. They took their first class Summer 08.

Selke · Aug 8, 2008

But states require the MSN for licensure, NOT a DNP. They may not even accept a DNP for licensure without an MSN. So I do not understand how some nursing organization can mandate a DNP for entry into practice, unless I am missing something here. Who is going to help people pay for these DNPs? Some of us can barely afford to get our MSN as it is. Forget a DNP, that 's completely off the table for me. Might as well go to medical school -- med students seem to have access to much larger amounts of loan money than nursing students, and it might take as long to get a DNP as an MD, so go for the gold if you can.

I think this whole thing is as bogus as the attempt to mandate all RNs have BSNs. Nice idea, but practically speaking, will never get off the ground given real world conditions (nursing shortage, shortage of faculty, shortage of dollars to fund nursing education, shortage of financial aid for nursing students, &c.) Unless, MSN programs can give us the option of an actual residency for a few months in addition to the usual required clinical hours, a few extra months of intensive clinical experience, then give us the DNP. That might be worth something, and make it easier to get a job after graduation.

Just my 2 cents.

elkpark · Aug 8, 2008

The DNP "requirement" is still simply a proposal -- it has a long way to go before it becomes a actual mandate. The idea is being pushed v. hard by some pockets of nursing academia, but the larger nursing community doesn't seem to be rushing to jump on this particular bandwagon.

I predict this will play out much the same as the "BSN-as-entry-to-practice" debate -- we'll still be discussing it many years from now, and it will be no closer to becoming official.

(Hey there, Selke -- how are you?)

justme1972 · Aug 8, 2008

But states require the MSN for licensure, NOT a DNP. They may not even accept a DNP for licensure without an MSN. So I do not understand how some nursing organization can mandate a DNP for entry into practice, unless I am missing something here. Who is going to help people pay for these DNPs? Some of us can barely afford to get our MSN as it is. Forget a DNP, that 's completely off the table for me. Might as well go to medical school -- med students seem to have access to much larger amounts of loan money than nursing students, and it might take as long to get a DNP as an MD, so go for the gold if you can.
I think this whole thing is as bogus as the attempt to mandate all RNs have BSNs. Nice idea, but practically speaking, will never get off the ground given real world conditions (nursing shortage, shortage of faculty, shortage of dollars to fund nursing education, shortage of financial aid for nursing students, &c.) Unless, MSN programs can give us the option of an actual residency for a few months in addition to the usual required clinical hours, a few extra months of intensive clinical experience, then give us the DNP. That might be worth something, and make it easier to get a job after graduation.
Just my 2 cents.

DNP programs do have a HUGE clinical requirement. Remember, they are differnet from a PhD program. PhD programs are based on theory and DNP is practice focused.

That much I do know....but the following is not what I am sure about...

Someone on the board correct me if I am wrong, but isn't the NP exams national in nature? In other words, you can practice in your home state once you have passed a national exam?

Advanced Practice Columnist / Guide · Aug 11, 2008

Someone on the board correct me if I am wrong, but isn't the NP exams national in nature? In other words, you can practice in your home state once you have passed a national exam?

Examinations offered by certification boards such as ANCC, AANP, NCBPN/N, etc. are meant to be national in scope and are widely recognized in majority of states. However, the authority to practice as a nurse practitioner in one's home state is granted by the BON in many states and jointly by the BON and BOM in some states. Each state has a list of requirements to be met prior to being granted the authority to practice as a NP. Many require passing a national certification examination from the specialty boards I mentioned but not all states do. Some require additional post-MSN courses in Pharmacology to gain prescriptive authority. Authority to practice as a NP in individual states is granted via a license, or a certification as a NP. In majority, if not all states, the NP license or certification is only valid if the RN license is kept active.

In the RN realm, some state BON's have signed an agreement to participate in the NCSBN compact. This means that the RN license from one's home state is recognized in a participating compact state if one's home state is part of the compact agreement. The NCSBN have not yet rolled this program over to NP's and other APN's. So if a NP moves out of state, the NP needs to apply for a license or certification to practice in the new state. This is where national certification (from ANCC, AANP, NCBPN/N, etc.) can be valuable since many states require national certification as a requirement to be granted authority to practice as a nurse practititoner.

Refer to http://www.webnp.net/ajnp.html for an up-to-date list of state-to-state requirements for NP practice.

Advanced Practice Columnist / Guide · Aug 11, 2008

...and just to add to the above. Some states (mine included) are strict enough to prohibit someone from using the state designated NP title (it is different for each state, my home state's is simply NP, some states use ARNP, CRNP, APRN, CNP, etc.) even if you've passed the national certification if the state has not granted the state license or certification as a nurse practitioner. These states provide strict title protection to the NP role.

llg, PhD, RN · Aug 11, 2008

I do not pretend to know how this will all play out. When I first heard of it a few years ago, I had pretty strong doubts that significant changes would be made very quickly. However, I have been surprised by the changes that have occurred in the past 2 or 3 years and it gives me reason to think that maybe this proposal has "more legs" than might at first be apparent.

The people who proposed the switch from MSN to DNP are/were the educators. They control the types of programs that are available to new people seeking education as an NP. I see a lot of DNP programs starting up and MSN, NP programs being closed. If the educators form a concensus and switch their programs from MSN to DNP, then those will be the only programs available. The other nursing groups (existing NP's, Boards of Nursing, etc.) don't need to be involved in that decision. If the predominant type of program available is the DNP, then that's what the majority of new NP's will get. (Though I suspect there will be MSN, NP programs that will exist for some time. Not every school will convert.)

So ... the key thing to watch in this process is the number of MSN, NP schools that convert to DNP ... and the number who don't.

prairienp · Aug 11, 2008

i have been around long enough to be part of the bsn ups and downs. the major difference between the bsn push for all and the dnp programs is total # of programs. with the bsn push the community colleges and diploma programs fought hard against the bsn mandate. look at the number of bsn/ad/diploma in the 70s as compared to the current ratio. the diploma programs are virtually gone. community colleges have the ad and the universities have the bsn. the total number of np programs isn't comparable to rn programs and the np programs are already in the university systems. the transition from ms to dnp has been very significant, by 2010 the number of ms np programs will be in the minority. those that continue to offer the ms np will be dominated by the smaller schools who are unable to offer a doctorate degree. most of the larger schools (doctorate degree granting) will convert to the dnp by 2010 and the rest by 2015

n_g · Aug 11, 2008

i have been around long enough to be part of the bsn ups and downs. the major difference between the bsn push for all and the dnp programs is total # of programs. with the bsn push the community colleges and diploma programs fought hard against the bsn mandate. look at the number of bsn/ad/diploma in the 70s as compared to the current ratio. the diploma programs are virtually gone. community colleges have the ad and the universities have the bsn. the total number of np programs isn't comparable to rn programs and the np programs are already in the university systems. the transition from ms to dnp has been very significant, by 2010 the number of ms np programs will be in the minority. those that continue to offer the ms np will be dominated by the smaller schools who are unable to offer a doctorate degree. most of the larger schools (doctorate degree granting) will convert to the dnp by 2010 and the rest by 2015

but for who's benefit? for the universities who will collect more tuition money from me? if i don't see an increase in pay or scope, how do i benefit? i'll be forced to compete with pa's for the same salary but i have to spend twice as long and much on my education.

Selke · Aug 12, 2008

n_g, I agree with your point. Many nurses have enough trouble funding graduate education and finding time to do it. Lengthening the program and making it more costly will not necessarily benefit them, improve the NP professions, or increase the # of NPs on the market or increase # of jobs.

Look at the requirements for a DNP. It's not all clinical, like an MD!! I think you would be better off getting a PhD in Public Health (DrPH?), it is a recognizable degree, you acquire more higher level job skills, and you would have more job options.

Meanwhile, the AMA continues to whittle away at the right of APRNs and CNMs to practice, malpractice insurance becomes more difficult to obtain and rising costs drive CNMs and others out of a job altogether and back into the ranks of staff RNs, hospitals and MDs continue to drop CNM and maybe NP privileges, and the reimbursement fight with insurers goes on and on without resolution ... we can't even get a federal law passed in Congress mandating equal reimbursement for CNMs for care.

Given the big picture, this DNP seems pure vanity to me, sucking energy and time away from these other much more critical fronts.

Just my 2 cents.