Nurses, physicians weigh in on new doctoral nurse degree

[Brian]

New Degree Creates Doctor Nurses-And Confusion

All Things Considered, February 22, 2009

No one wants to badmouth Florence Nightingale, but a new degree for nurses is causing bad blood between doctors and their longtime colleagues. The program confers the title of doctor on nurses, but some in the medical profession say only physicians should call themselves "doctor."

Dr. Steven Knope is a family practitioner in Tucson, Ariz. "If you're on an airline," he jokes, "and a poet with a Ph.D. is there and somebody has a heart attack, and they say 'Is there a doctor in the house?'-should the poet stand up?" Knope laughs. "Of course not."

Physicians such as Knope say the title of doctor implies a certain amount of training, hours in medical school that nurses just don't have. Dr. Ted Epperly, president of the American Association of Family Practitioners, says that while doctors place a high value on nurses, sharing the same title could confuse-and even harm-patients.

Full Story and listen to radio show here:

http://www.npr.org/templates/story/story.php?storyId=100921215

[Batman24]

If they earned the title of doctorate they earned the title of Doctor. This should hold true for all. A name badge with a clear identification and people introducing themselves appropriately will deal with this problem.

Half the people think anyone with scrubs on is a nurse or doctor anyway even if they are dietary and housekeeping. It's up to us to educate them on our proper titles and what we do.

[icyounurse, BSN, RN]

As a Nurse Practitioner student, I have no desire for patients to refer to me as "doctor" when I finish. I plan on introducing myself as a Nurse practitioner. However, I think after reading the MD thread, many are just plain uninformed as to just how hard we work to become advanced practitioners. I love how at the top it states that DNP's have less than 1000 clinical hours. And some poster stated that we can become masters nurses "completely online". First off, my program required a bachelors degree that required me to spend around 500+ hours in clinical nursing. Last time I checked, premed degrees have no clinical component whatsoever.I feel that my BSN was an academically challenging and competitive degree to obtain. Also, my nurse practitioner program required a minimum of 2-3 years NURSING experience in my area of specialization prior to admit to the program. Even if a nurse worked the minimum 2 years (not likely as most people I know in the program have 5 plus years, myself included) thats still 3,744 "clinical hours". And yeah, I do think they count since they are a prereq for admission and the MD thread counts residency hours that are salaried towards their number. I personally have put in about 8,000 clinical hours in nursing practice just from working. And then you add my 3 year advanced degree portion with its 1000 hours and I have:

around 9,500 hours clinical experience before I enter the field as an NP.

Sorry for the rant, I just wish there was more of an understanding of advanced practice nurses by these med students. Most seem to have no clue or respect about what advanced practice nursing is all about.

[GilaRRT]

I do understand the clinical hours argument; however, not every nurse entering an APN program has years of experience under their belt. For example, a mate of mine graduated nursing school before I. He had a few years of EMT experience, went to nursing school, then went directly into a MSN/FNP program. So, he had 900 or so clinical hours from nursing school, then 600 or so hours from FNP school. After 1500 hours and five years, he was a nurse practitioner.

I see some of the arguments. With all of this, nursing has yet to resolve fundamental nursing problems. Such as entry into practice educational requirements, dealing with poor working environments, nurse retention, and workplace safety. I am actually a little frustrated that nursing is fighting this whole DNP thing and pushing for more of the primary care pie, while still not addressing many of the problems that plague conventional nursing. Floor nursing is the backbone of our profession, yet it is often the most neglected.

[icyounurse, BSN, RN]

I do understand the clinical hours argument; however, not every nurse entering an APN program has years of experience under their belt. For example, a mate of mine graduated nursing school before I. He had a few years of EMT experience, went to nursing school, then went directly into a MSN/FNP program. So, he had 900 or so clinical hours from nursing school, then 600 or so hours from FNP school. After 1500 hours and five years, he was a nurse practitioner.

I see some of the arguments. With all of this, nursing has yet to resolve fundamental nursing problems. Such as entry into practice educational requirements, dealing with poor working environments, nurse retention, and workplace safety. I am actually a little frustrated that nursing is fighting this whole DNP thing and pushing for more of the primary care pie, while still not addressing many of the problems that plague conventional nursing. Floor nursing is the backbone of our profession, yet it is often the most neglected.

In my area there are no NP programs that will admit you with no nursing experience. I know many NP's who worked beside me in the ICU while attending school and do not know a single one with less than 3-4 years as a nurse before entering the program. Your friend would certainly be the exception rather than the rule here.

[GilaRRT]

Not at all, many programs only require a BSN. While I am not arguing against APN's, I really think we need to take a step back and look at this whole DNP concept. It almost seems like it is being pushed upon both the medical and nursing community.

[icyounurse, BSN, RN]

Not at all, many programs only require a BSN. While I am not arguing against APN's, I really think we need to take a step back and look at this whole DNP concept. It almost seems like it is being pushed upon both the medical and nursing community.

I agree with you there. In one of my classes I just had to write a paper on the cons of the DNP entry to advanced practice proposal (half the class did pros and half did cons) and I have to say there are many cons to it. I personally do not see the point of spending more money and time on your education just to be a "doctor" when it seems to me you are still doing the same job with the same scope of practice and most importantly the same salary as someone who is masters prepared. Maybe if you were going into education it would be worth it, but not to be a Nurse Practitioner. Its like you said, there are so many other more pertinent issues that need addressing in the field of nursing.

As far as the programs requiring only BSN, all the state universities down here are more competitive than that with limited entry, and require a good GRE score, experience and competitive GPA and resume and such. Its true that for twice as much tuition (often more) you could do one of those online programs like phoenix or whatever, but good luck finding a hospital around here to let you do your clinicals. Its a malpractice insurance thing-the local universities have a contract with the hospitals but not so with these "online universities". Also, around here there isnt really "independent practice" in the south as NP's practice with physician groups mainly and the physician groups only want to hire NP's with good RN experience from a reputable school. Jobs are scarce and I dont imagine theres much of a market for these NP's with no nursing experience where I live. Its just a geographical thing I guess, is there more of a shortage in your area maybe? No shortage here right now, thats for sure.

[Music in My Heart]

...the way hospitals try to confuse patients into thinking that CNAs or PCTs are all "part of the nursing team."

News flash: They are part of the "nursing team."

[Jerronious]

Geekgolightly

What is your point?

[chirodoc]

Glad to see the AMA is still doing its best to keep their collective heads up their own behinds. Just as they are trying to keep PT's and DC's from using the term Doctor, they have now taken on their closest allies in the workplace. This has never been about the patients being "confused" by the use of term Doctor. This has always been about the over-inflated egos and the overinflated sense of self importance that comes with those 2 little letters after their names. Oh, I'm sure we'll all hear how they went to med school for 4 years, and how hard their residencyt was and how much hard work went into their education and yada-yada-yada. Not once do they stop and consider how hard other people work for their doctorate degrees and how much time and effort is put into earning them. MD's even look down their noses at DO's. They may not admit it, but it irks them, that someone can do the SAME things as them and not have to go to medical school.

Patients aren't as dim as the opponents of the DNP want us to think. They can read nametags, they can understand the difference between an MD/DO and a Doctor of a different field of medicine. And if a DNP can provide care that is as good as, or even better than an MD/DO, then the ultimate goal of being a Doctor is reached. The patient benefitted from care that was given to them. Who gives a rat's behind what path you took to achieve your high level of medical competency that led to this patient getting better?

BTW, I'm a DC that is going to an accelerated BSN/FNP program. So yes, I will be referring to myself as Dr in a clinical setting. I do it now, and so do my patients and colleagues. (Not just DC's, but MD's and DO's too). And honestly, MD's can get uppity about it all they want, but the reality of it is that they better get used to it.

[sirI, MSN, APRN, NP]

BTW, I'm a DC that is going to an accelerated BSN/FNP program. So yes, I will be referring to myself as Dr in a clinical setting. I do it now, and so do my patients and colleagues. (Not just DC's, but MD's and DO's too). And honestly, MD's can get uppity about it all they want, but the reality of it is that they better get used to it.

If you are practicing as an RN and call yourself, "Doctor", you are misrepresenting yourself and could be setting yourself up for legal issues.

If you have a DNP (the degree vision for 2010) and are an APN, you still must be certain that you can call yourself, "Doctor", in the clinical setting. Some BON have already addressed this and is against the NPA.

If you wish to call yourself, "Doctor", because you are licensed as DC, you'll have to be practicing as a DC.

Be careful...

[chirodoc]

I don't plan on misleading patients as to what kind of a Doctor I am. And it won't be in a setting when the care provided is as an RN/NP. But when in a private practice setting, as a PCP, I am well within my right to refer to myself as Dr., as long as I am clear as to what kind of a Dr. I am.

[sirI, MSN, APRN, NP]

I'm sorry, but will have to respectfully disagree here.

If you are working as an RN, you will not be able to refer to yourself as, "Doctor", for that is not the role to which you were hired.

If, as an APN, you have a doctorate in nursing, you will be able to refer to yourself as, "Doctor", as it applies to your nursing degree. And, that is only if your BON and your facility allow this.

But, if you are practicing as a DC, you will be able to hold yourself out as, "Doctor".

Again, please check out your BON/NPA for any clarification about this.