Spin off: how do you deal with DNP haters.

Specialties Doctoral

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I didn't want to derail PurpleScrub's thread, but I am in a similar position. Please let's not debate this. I am speaking to other DNP students in particular. I have recently been very disappointed by highly negative remarks about DNP I hear from nurse colleagues. I understand that some are not interested in pursuing it, and I think that is fine. I understand that many of those people are not happy with the nursing leaders that are advocating it, and I think that is appropriate too. I think they deserve to be heard and should be publishing their reasoned arguments and talking with their representatives at the BON, etc. What I don't understand is why these people feel the need to insult me, my goals and denigrate my chosen path? I went to an International nursing conference recently and many MSN and PhD prepared nurses there were downright insulting about my degree plans. Why can't we all just support one another?

I want to do the additional clinical and didactic work because it interests me. I am thinking of making my capstone project something to do with diet/exercise interventions with regard to diabetes and cardiac disease. I lost almost 100 pounds w/o surgery or drugs (weight watchers), and normalized my blood sugars, blood pressures, cholesterol, etc. After struggling w/ obesity for 25 years, I finally did it. I envision formulating an intervention aimed at helping the people like me. I can tell you that achieving a normal weight has literally changed my life, my whole perspective. I want to offer that to other people in some kind of group out patient setting. I have a wealthy benefactor willing to put up some money to subsidize YMCA memberships as part of my intervention. I think that is worth something. I strongly believe that my DNP classes and project will make me better at the kind of AP nursing I want to do. Why p!ss on it/me? It is so disheartening.

I don't want to make 100K, treat inpatients (puh-lease, I've had more than enough of that ;) ) trick people into thinking I'm a medical doctor or operate independently of one. I think I probably could, given the scope I have in mind because I don't want to treat acute patients. I have seen more than enough DKA and I'm tired of treating it (as a nurse), I want to help try to prevent it. I picture it run a lot like a coumadin clinic. Managing diabetes meds would certainly be part of it, but I don't want it to be the main focus. My state requires physician collaboration, and I don't mind a MD reading over my charts; if they want to be more integrally involved, I welcome their input and expertise. How the he!! to get reimbursement for any of this is another question, but I'll figure out something, I hope. I just wish my nurse friends and colleagues didn't feel the need to tell me I'll have a 2nd rate degree, that my degree and aspirations are/will be a "joke."

How do other DNP students deal with negative remarks?

Please, I'm looking for dialog and/or support, not debate. If you cannot offer either, I respectfully request you direct your remarks to a forum more suited to your purpose. Thanks in advance. :)

Specializes in FNP.

I'm the OP. Hate is a bit hyperbolic, I agree. I still do not, and probably will never, understand the petty anti-DNP attitude, but frankly, I don't care anymore. It's an old thread, and I'm over it. ;-)

Specializes in Med Surg,.

I too am in a doctorate program, I was confronted with the same attitude. Doctors we are, physician we are not.

Advanced degree(s) conferred upon anyone, doesn't/don't make them superior to anyone, unless they utilize them thoughtfully and contribute something more than those without them. By more, I mean simply something that isn't done by everyone, that separates the mundane from the special.

I'd hate to think that having a DNP degree meant that a person has finished all the education they may need, that they're "done" with school. Nursing and medicine can never be studied too much, as these fields are constantly changing. Our contributions to the world are a result of all we've done, experienced, and learned. Formal education doesn't make one wiser, as it isn't until theories are utilized, that their real meaning and value become evident. Teaching can be one component in a DNP's career, but nurses just aren't themselves usually, without patient contact.

Unfortunately the history of the careers medical doctors have, is somewhat like a work of fiction. It has a beginning (medical school), an impending crisis (internship and residency), and an end (practising medicine) that can result in premature cessation . Happily ever after, for doctors is a myth. Unless we and they mutually search for more and better answers to our problems, life becomes and stays deadly dull. What I've seen happen most in the past 50 years in which I've been a nurse, that doctors' "beginnings" and "crisis" experiences have been so stringent, that they think they should be able to rest back and make their lives easier, afterward (unless they owe tons of money to a money lender for the education that can become obsolete all too soon).

The difference for nurses, is that practising nursing is not the end, it's the beginning. Our role is one that depends on others, those with whom we work and those who benefit from what we do, as well as great research that keeps our tasks varied. Satisfaction in our work depends on how well we do it, and general agreement that we do it well. Along the way we interface with doctors as members of the healthcare provision team; and we and their patients' outcomes depend on working in synchrony. Orders need to be mutually agreed upon and be effective, otherwise other directions would need to be taken rather than hand wringing and blame games.

The preparation of a physician has been weighed down by much personal abuse, which is then passed down to the next generations, and frustrations taken out on those in the lower echelons. That is just dysfunctional "dog kicking", and impedes professional development while many "life scripts" become intertwined in an adversarial time consuming manner. In some doctors' need for ultimate power, the PA role developed according to their tendency to boss underlings around, who would respect them all the more for their abusive ways, as nurses resisted that role.

Fortunately for us, but unfortunately for the PA, the varied educational backgrounds they started with, if they're not nurses, doesn't provide for a specific school of higher learning, other than perhaps a short trip to health administration. The ultimate goal of the game of oneup(person)/manship, is to win. Nurses checkmated PAs because they attended schools of nursing that set standards for them all along their way; and their opportunities for professional and personal growth within it, flowered. Those outside that network do become resentful unless they accept that infrastructure.

The physician has been off on the tangent of thinking that money spells success in life, as in "he/she with the most and largest toys, wins". What is sadly lacking, if they aren't surgeons is that sense that they accomplished what they set out to do, attained with the patient being involved in the planning of the effort. I believe there was derailment in their sense of accomplishment, when the competition for doing the most successful coronary bypasses at one surgery, was in its heyday. When the death rate for their patients accelerated, skids were put on those endeavors, they had to cut (no pun intended) back on multiples and possibly admit that they were wrong.

Pediatricians and Obstetricians used to proudly declare how many patients they saw in one day, or how many deliveries of babies were attended by them in a month. When the evidence of their own declining health, with accompanying shorter lifespans due to sleep deprivation and anxiety, their aims turned to how much they could play in life and their golf games became more frantic. Now I find more and more physicians referring their patients to ER/EDs if their shorter schedules are filled, with the last patient being seen mid afternoon. They have 2 hour lunches (no patients in the hospitals reaching out to them then), and no hospital rounds to make at the beginning and end of each day (unless they work in teaching hospitals, and actually teach).

Hospitalists have taken over their work with inpatients. They also see the ER/ED patients and have become much like overworked interns and residents, today. They've assumed total responsibility for the most critically ill inpatients, and no staffing plan by them has undergone an "acuity of care study". Please don't get me wrong, as I'm no proponent of that quickly fading development in health care. I believe it isn't working, as patients spend half or whole days waiting to be seen in ER/EDs and not occasionally dying in that process. It did get the personal physicians off the hook for malpractice cases, handily.....

You're probably wondering what my point is, here. The responses in this thread have been fabulous, in that they paint a picture of what needs to be planned for a nurse to become a DNP. That is no easy route, and certainly not an inexpensive one. DNPs will be on the "front lines" in the provision of preventive and frugal care, as well as thoughtfully planned treatment while doctors (please pardon my oversimplification), will continue cutting and dicing, complaining and badgering.

Unless physicians strike out in a different direction from their forebears, they'll continue to find themselves dependent on insurance company direction of specific patient care, the money allowed them; and have many more patients who don't think they're daddy, mommy, and God/Allah, all rolled into one. Certainly the bloom has come off that "rose" greatly.

DNPs haven't the same needs, other than becoming the best provider of their kind of healthcare that they can be, with more and more education and especially experience. With greater skills communicating with people of all ages; and less, to no "handmaiden" ways, nursing has and will be the most versatile and challenging profession of all. There are some things that are greater than monetary rewards.

(Eat your hearts out, docs, PAs, other nurses satisfied with their status quo, and others not willing to go with the flow.....)

Could you please explain what a DNP will bring to the frontlines that a master's prepared APN will not?

line,

I'm a bit late to this thread and am not yet a nurse (will be in an ABSN program shortly), but I plan to earn a DNP within the next decade. All I can say is, good for you! I think you plan sounds great and your goals completely admirable. I see no reason for people to chastise others for wanting to pursue higher education. In my opinion, no one is at a loss for having taken the time to improve his or her mind. So do what you want and ignore the idiots telling you otherwise. My mom's a PhD nursing instructor and thinks the DNP is a great idea. She also thinks it's stupid that many in nursing are already saying that the DNP is not as respectable as the DNP. So do it and enjoy! Best wishes to you and congratulations on losing the weight and changing your life!

Specializes in Anesthesia, Pain, Emergency Medicine.

No offense intended but I DO practice independently.

Ron

I don't want to make 100K, treat inpatients (puh-lease, I've had more than enough of that ;) ) trick people into thinking I'm a medical doctor or operate independently of one.

How do other DNP students deal with negative remarks?

Please, I'm looking for dialog and/or support, not debate. If you cannot offer either, I respectfully request you direct your remarks to a forum more suited to your purpose. Thanks in advance. :)

Specializes in Anesthesia, Pain, Emergency Medicine.

Thank god someone can finally put into words how I feel. We need one advanced degree. I have said this before. Make the FNP the base to the DNP, then specialize at the end of the DNP.

The DNP is useless clinically, period.

Ron

First let me say I am all for the advancement of the nursing profession. I might not always agree with it's direction, but I always want it going up.

Second...Wow... That was the most pompous, pious, and self aggrandizing thing I've ever heard come out of a nurse. I'm so sick of people painting professions with a broad brush. You are no better than the physicians who do the same to nurses. Not all physicians are as you described. As a matter of fact, I know more of the opposite than not. DNPs are also not immune to being money grubbers, weak advocates, uncompassionate, or lazy. When will people understand that work ethic and aptitude are more individual characteristics than those of a particular profession/title?

Oh, and your thoughts on PA creation couldn't be further from the truth. Nursing was offered a midlevel degree and it rudely declined because the ivory tower thought it would be traitorous to learn medicine, until they taught medics to be PAs. Then all of the sudden we snap to and accept becoming NPs. Read the history of Dr. Still, Pediatric NPs, and PAs before you make such ignorant statements.

what physicians do should have no bearing on anything nursing. I find that opposition from physicians has been a minor hurdle in comparison to nursing against it self. Why cannot it decide on one route to be an RN? Why can't standardize education to be an NP? Why can't it have an actually clinical doctorate instead of renaming the same degree over and over again (DNS, DNSc, DNP, etc)? Why can't it have one advanced degree that encompasses all type of care, of all ages, and all settings (inpatient , outpatient, surgical, em, FP, psych, ob/gyn) that is covered by one exam? Why does it have multiple accrediting bodies? Nursing simply must look at a mirror to see it's biggest obstacle.

And you are the reason some doctors are up in arms. That don't care about nursing one way or the other until that hear your anti-physician rhetoric. How you will rise to the top but all the other poor dregs of medicine will be left to burn where there is weeping and gnashing of teeth. Trying to get to the top by stepping on the faces of others is doing nothing but harm.

Specializes in FNP.
No offense intended but I DO practice independently.

Ron

I'm not offended in the least. I think that's great. I only said it isn't something I am presently thinking about. I'm a neophyte, entry level new graduate. At this point, I dream only of finding a mentor who really wants to support and coach me. Being independent of said mentor is the furthest thing on my mind right now. We can discuss it again is 15-20 years. :cool:O

Specializes in Psych, EMS.

I just wanted to congratulate you and fellow DNP students for being pioneers in our profession. As far as the claim that it is clinically useless..that may be arguably the case now..but who knows if it will remain true in 15, 10, or 5 years. It is so new that an enhanced scope is not yet implemented.

I admittingly know little about the DNP degree, but it seems like your goals are in perfect alliance with the philosophy behind the degree. Congrats on your weight loss, and I hope you are able to affect others with your personal and professional experience and insight regarding obesity and weight loss.

As an overweight and prospective DNP student, I am inspired by your post.

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