Is there a CLINICAL DNP?

[PG2018]

I've been in conversation lately regarding the DNP, and I've read the position papers published by the AACN, et al. However, I do not believe they typical curricula are of merit. With the purpose of achieving "parity" amongst physicians (which will never happen), pharmacists, physical therapists, and others I don't understand how courses in research translation and application fit that purpose.

If we examine the curricula of any university's medical school, pharmacy school, and physical therapy (DPT) program we'll see that the years are filled with courses of a scientific nature and clinical training. I've never believed that RN prereqs and experience as a RN are a substitute for provider education, yet we accept that as such and take only a few "-ologies" while in NP academic preparation.

Having said that, is there such an animal as a CLINICAL doctorate for nurses? Not a PhD. Not a DNP focusing on research and policy. Not an EdD focusing on adult instruction. But rather a clinically-oriented doctorate.

I realize no NP's scope of practice or reimbursement will change due to an earned doctorate, but I think this encourages dialogue and fact sharing. I would likely enroll in a doctoral program if I could find one that offers instruction in something I want to know.

[anh06005, MSN, APRN, NP]

I am on this search as well. I want to further my education in patho, pharm, etc. so I can better understand diseases and their treatments. I am doing this on my own time but it'd be nice to actually get some recognition for it and end up with a terminal degree. I've also considered going for a post-master's so I can broaden my clinical knowledge.

[elkpark]

While everyone has her/his own opinion about DNP curricula, the whole point of the DNP is that it is the clinical doctorate in nursing.

[PG2018]

What's clinical about it?

[elkpark]

What's clinical about it?

Let me start by stating that I am not at all a fan of the whole DNP concept. However, having said that, what do you mean by your question? The existing post-MSN DNP curricula are designed to reflect the fact that advanced practice nurses have been prepared just fine for several generations now in MSN programs to practice safely and competently, and people applying to those (post-MSN DNP) programs have already learned the necessary clinical content in their MSN programs and just need to add the additional content to complete the DNP, just as BSN completion programs for people who are already RNs don't include much additional clinical content, but consist largely of content that many nurses (including large numbers of nurses who post here) consider "fluff" and "garbage" (terms I often see applied to the content of the post-MSN DNP curricula).

The growing number of DNP programs designed for people to enter from BSN programs include the clinical content currently considered necessary to enter advanced practice as well as the DNP-specific content.

It's clear from your various posts that you are unhappy with the nursing model of education for advanced practice (and, indeed, nursing in general). I'm not criticizing you for holding that opinion. However, I'm not sure the answer to that is to change nursing education. Do you have some evidence that advanced practice nurses educated in the existing model are, in general, deficient or unsafe in practice? Any evidence of systemic bad outcomes (apart from the occasional, individual "bad apple")?. AFAIK, the existing evidence suggests that outcomes for advanced practice nurses are similar or better to those of physicians. Did you have any of these concerns while you were going through your psych NP program? If so, why didn't you take steps at that point to change your course at that point, instead of finishing a program and starting on a path that you are (now) clearly unhappy with? And is there something keeping you from pursuing the additional education and knowledge you feel you need?

For better or worse, the DNP is the clinical doctorate in nursing (hence, the "P" for "practice"). You are welcome to start a movement to dramatically change graduate nursing education, but I think it will be hard to get anywhere without some solid evidence that the current model is deficient.

[PG2018]

Elk, I'm not unhappy with my career. Outpatient psychiatry is what I wanted, but I realize there are still gaps in my knowledge. Perhaps the things I don't know are the things I don't "need" to know. You're correct, however, nursing education (at all levels I have experienced) has been detail deficient.

I have not once suggested that APRNS do not provide safe, quality practice. Rather, I've stated APRNs are not, as a whole, scientifically educated, and that's what I want more of.

To reiterate, I'm not looking for a doctorate in practice but rather enhanced scientific and clinical education.

[elkpark]

To reiterate, I'm not looking for a doctorate in practice but rather enhanced scientific and clinical education.

And you're not going to find what you're looking for in a nursing doctorate. I say that as neither a criticism of you nor a criticism of nursing education. You will need to look elsewhere.

[sadiemae1123]

I'm not sure there is a clinically focused DNP for people who want to return for their DNP but not get certified in another area. I'm not really sure there's a need for it. Like some said above, it would be like someone with an ASN returning for their BSN. The focus would be less on repeating clinical content and more on what separates the DNP from the MSN, which is a greater focus on understanding and incorporating research into practice.

I did the BSN to DNP route. I really didn't think there was an excess of "fluff". Most was in the first term, which I found useful since I had been out of school for over a decade and it helped immerse me into the critical thinking and reading analysis I would need to have to get through the program. Most of the program was clinically focused and I graduated with over 1300 clinical hours, more than any MSN programs do in my area. There were other "fluff" classes, most of which tried to help us focus on the bigger picture of healthcare - i.e. healthcare policy and economics, creating a business plan for your own practice, contract negotiations, etc.

And there was the final project. For me that was a bit of a bust, but I think that had more to do with my lack of enthusiasm by the end of the program than actual class design. I think they have made some changes in the curriculum since I graduated; incorporating the final project into earlier semesters and combining some of the "fluff" classes.

[HOPEforRNs, ADN, BSN, MSN]

OP, I'm with you. The rigorous coursework is completely lacking. I'm enrolled in a MSN program right now at a well regarded university and it's a complete joke. It's nothing but useless fluff. Where's the real coursework? When I do actually get to finish a course and say "wow I really learned something valuable" ???

My ideal DNP program would have separate courses (with their associated pharmacology) in:

1. Cardiology (with teaching how to read a 12 lead)

2. Radiology (extensive teaching on reading xrays and CTs/MRIs)

3. Pulmonology

4. Renal

5. Surgery (optional--pick one: general, ortho, etc)

6. Elective (OB-GYn, peds, pain, primary care, etc.)

In addition, I would say add an advanced differential diagnosis course, a course dedicated to the prescribing of controlled substances (since some jurisdictions have a problem with this), a pain management course and an advanced psych course dealing with chemical dependency, and a specific course on when and how to make proper referrals.

I realize this starts to sound similar to medical school but unfortunately, those pushing the DNP are stating that "Dr. Nurse" is equivalent to "Dr. Doctor". So advanced practice nurses need to have some of that material if they are to fill the primary care void.

I feel like the bottom line with the DNP is that it is a back handed way to get more academics, not improve practice. It is an academic wolf in clinical sheep's clothing. That doesn't make it a bad degree, but certainly not what is needed. But, no one will listen because it makes sense. To the powers that be, sensibility and practicality are for fools. Ivory towers for the elite

[PG2018]

And I came, Elk, asking if anyone knew of such a beast.

[elkpark]

I realize this starts to sound similar to medical school but unfortunately, those pushing the DNP are stating that "Dr. Nurse" is equivalent to "Dr. Doctor". So advanced practice nurses need to have some of that material if they are to fill the primary care void.

I feel like the bottom line with the DNP is that it is a back handed way to get more academics, not improve practice. It is an academic wolf in clinical sheep's clothing. That doesn't make it a bad degree, but certainly not what is needed. But, no one will listen because it makes sense.

"Those pushing the DNP" are not "stating that 'Dr. Nurse' is equivalent to 'Dr. Doctor.'" Only a very few in nursing are proposing that, basically Mary Mundinger at Columbia and her acolytes.

And, again, nurse practitioners have been providing safe, competent primary care for generations now with "only" MSN degrees, without the "med school lite" curriculum you propose. Somebody must have been doing something right in nursing higher education all these years. You might have a stronger argument that the current model of advanced practice nursing education is "certainly not what is needed," and people might be more willing to listen, if there were some evidence that advanced practice nurses educated under the existing model were deficient, incompetent, or unsafe as clinicians.

[APRN., DNP, RN, APRN, NP]

Health Care Systems Leadership (BSN to DNP) - University of San Francisco (USF)

I am thinking about pursuing the DNP in Healhcare Systems Leadership. It is a CNL focused degree, which is what I (will soon) have my MSN in (CNL).

The role of the Clinical Nurse Leader is all about being a Microsystems expert clinician at the point of care.