APRNs should only be DNPs!

Specialties Doctoral

Published

  1. Should a non practice clinician be able to obtain a DPN?

    • 45
      Yes
    • 35
      No, this is a clinical doctorate

80 members have participated

Hi all! First, I want to say that I am NOT starting this thread to start a war. I am working on my very last assignment for my DNP/FNP (graduating 5/4). 1300 clinical hours were required for graduation and was completed in Peds, Geri, clinical diagnostics, Adult 1 & 2 and OB/GYN. Anyway heres the issue...An APRN is a NP, CNS, CRNA or CNM. (I put this here because, I myself, mixed up the letters and initially thought the issue was about ARNPs). Non APRNS are those nurses who have a master's in*nursing*education, nursing administration or another area. They are not clinicians. They do not have a*patient*population they care for.*Please*review the*consensus*documents for further*explanation. RMU accepts only APRNs in our post master's DNP*program. Other DNP programs accept non APRNs. This is*the*debate. *Can a*post*master's DNP program be*appropriate*for an APRN who does not have a patient population?

Specializes in ACNP-BC, Adult Critical Care, Cardiology.

Actually, the DNP paved the way for institutions offering DNS and DNSc to transition them to PhD. There are still many professors with this degree but I doubt if one can still find a DNS or DNSc program now. ND's were the precursor to the DNP. The decision was made to not stick with ND so as not to confuse it with the other ND (Doctor of Naturopathy).

Historically, (at least the institution I work for) DNSc was begun because some institutions would not recognize a terminal (doctoral) degree for nurses at the PhD level. The degree was one way to circumvent the opposition from the institution's graduate school from granting PhD's in Nursing. It is a sore issue in some institutions for years until wide acceptance of a PhD in Nursing ocurred.

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I agree with the above poster in that the DNP is a practice-based degree though not necessarily limited to clinical practice. I have closely followed the DNP development from inception and, while some specific programs will describe their DNP as a clinical degree, the standards for the degree across the board do not strictly limit it to clinical practice. I would also contend that the DNP curriculums unanimously do not add any real clinical content. I'm sure that comment will have someone up in arms and I don't mean it to diminish the content or rigor of the degree. Notwithstanding, the content is focused exclusively on practice-related issues which could potentially have clinical significance (hopefully so). The majority of programs offer curriculums weighted heavily towards EBP with informatics, systems, and leadership content included. My point being, while all of that, in theory, could produce better clinicians, it could also produce better administrators, educators, and other areas of nursing practice. Therefore, I don't think it would make any sense to limit the degree to clinicians who, for decades before the DNP came around have been shown to be competent and successful without it.

Sorry, but none of that produces a better clinician (unless, by informatics, you're talking about learning how to better evaluate the clinical literature). They don't improve your ability to diagnose and manage patients. They help you run a business better, which is a completely separate issue. A better business acumen =/= an improved clinical acumen.

Other than that, I agree with the rest of your post. Since it doesn't appear that the DNP is a clinical doctorate, I don't think it should be restricted to only clinician-NPs. In fact, I'd argue that it's more geared toward those that are in administration, education, etc, rather than actual clinicians.

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Historically, (at least the institution I work for) DNSc was begun because some institutions would not recognize a terminal (doctoral) degree for nurses at the PhD level. The degree was one way to circumvent the opposition from the institution's graduate school from granting PhD's in Nursing. It is a sore issue in some institutions for years until wide acceptance of a PhD in Nursing ocurred.

The version of this that I've heard over the years is not that schools (at least the ones with which I've had experience) wouldn't allow a PhD in nursing, but that the nursing programs couldn't (or didn't want to) meet the academic standards and requirements for a PhD program (the standards and requirements that all the other departments that do offer PhDs meet). PhDs are granted by the university as a whole and the requirements/expectations are standardized across academia; the "other" nursing doctorates (DNsc, DNS, ND, etc., and now DNP) are granted specifically by the SON, and the requirements for that aren't as rigorous or stringent. (That's how it's been explained to me when I've asked about this at different schools in the past, at least.)

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.
The version of this that I've heard over the years is not that schools (at least the ones with which I've had experience) wouldn't allow a PhD in nursing, but that the nursing programs couldn't (or didn't want to) meet the academic standards and requirements for a PhD program (the standards and requirements that all the other departments that do offer PhDs meet). PhDs are granted by the university as a whole and the requirements/expectations are standardized across academia; the "other" nursing doctorates (DNsc, DNS, ND, etc., and now DNP) are granted specifically by the SON, and the requirements for that aren't as rigorous or stringent. (That's how it's been explained to me when I've asked about this at different schools in the past, at least.)

I think you're right too. I was just going by what I heard locally and from reading an article published in opposition of the early development of the DNP by two prominent faculty from UCSF and UPenn that stated:

"In many schools, such as the University of Pennsylvania and the University of California San Francisco, the rationale for offering the DNS was the lack of supported and sustainable faculty research programs, the limited number of faculty holding PhDs, and, most importantly, the resistance of those in power in university administration to grant nurses the privilege to study for and receive a PhD. It was a relief for leaders of university graduate programs, who controlled the development and implementation of doctoral degrees in the university, to be able to propose instead a professional degree other than the PhD. In most cases, that degree (such as DNS) was offered and administered by the school rather than by the university. When the school was able to prove that they had developed the critical mass of doctorally prepared faculty, and demonstrate that the faculty members had an appropriate research program trajectory, these schools submitted a new application to change their program and, therefore, grant a PhD degree (see entire NLN issues of 1986-87& 1989; Downs, 1989; Grace, 1983)."

Full article at: The Case Against the DNP: History, Timing, Substance, and Marginalization

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Specializes in FNP, ONP.

I agree with llg. I think that the DNP can encompass Nurses from a variety of backgrounds and need not be restricted to those of us that are advanced practice providers. It isn't simply about clinical performance, and that misunderstanding has probably been the biggest obstacle to date.

I do think the DNP is here to stay. I don't think it should be the minimum for entry to practice. I used to, but I have changed my mind. I believe that in one generation, DNP prepared nurses will evolve into the leadership of their respective disciplines and the profession as a whole.

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Specializes in FNP-C.

I say enough with this battle and just join 'em! It's inevitable anyway. I'm gonna do it just to also tell my friends "hey you got a law doctorate, I also got a nursing doctorate! Hey wait a minute, you have a medical doctorate, me too! but it's a nursing doctorate so a little different". :w00t:Sorry Just needed a laugh and thought I'd bring out my immaturity out here and keep my professionalism in the clinic.

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Specializes in ER, HH, CTICU, corrections, cardiology, hospice.

How many doctorates do we need?

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I'm Doctor Feelgood. What more do I need?

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I was honestly under the impression the DNP was made for more non-clinical roles. My mom will graduate with her DNP from a prestigious school in May. She works per diem clincially, but she is a full time nursing professor. She is getting her DNP because it's required to teach, not for any clinical reason. Most of the people in her class also seem to be mostly managers/educators/researchers. I know doctorate programs are tailored to each person, but my mom didn't do any specific clinicals for it. I guess it varies, but I've always seen it as a degree of educators and researchers, not clinical nurses.

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Specializes in Critical Care, Emergency, ACNP, FNP.

The Doctor of Nursing Practice (DNP) adds no new clinical content. It is a practice doctorate and not a clinical doctorate per se. Nursing practice incorporates the values and principles of nursing to skillfully assist clients (individuals, families, communities, health systems, nations) progress to their maximum potential. Therefore, DNP education reinforces and expands (advances) nursing knowledge application irregardless of the setting (clinical, administrative, political, etc.).

In part, it grew out of a response to 2 landmark papers by the Institute of Medicine (IOM) published in 2000 and 2001 where nursing was essentially urged to take on more leadership in healthcare in general. That healthcare, urged the IOM, should be evidence-based, serviced by a more educated workforce, and streamlined to bring research to practice in a more timely and efficient manner. Given that nursing comprises the largest sector of healthcare professionals, and the most trusted based on consumer surveys year after year, it made and makes sense to enlarge the training on this type of leadership among advanced practice nurses. Furthermore, masters level nursing (MSN) education continued and continues to require increasingly more credit and clinical hours. In fact, MSN programs often have as many or nearly as many credit hours as doctoral programs of other healthcare disciplines. Adding the leadership and evidence-based practice-focused courses to the already credit-packed MSN curriculum clearly justifies making them doctoral instead of unfairly limiting practitioners to MSN level while charging them for and requiring hours worthy of a doctorate.

Having said all that, and these are merely just a few of the reasons for the necessity of DNP-level training, it is clear to me that non-clinical advanced practice nurses (meaning those not involved in direct clinical care) should also be included among DNPs. This is not a fluff degree. Sure, more clinical content would be beneficial for those in the clinical tracks. Yet this fact does not detract from the significance of the DNP to nursing practice specifically, and healthcare in general.

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Specializes in Critical Care, telemetry, Legal.

While I may be reiterating some of the above information, I believe the DNP role is what will eventually replace the ANP, GNP/FNP roles. Many universities are phasing out their ANP/FNP programs and going to a DNP program. I just graduated from UMASS Boston with my ANP/GNP Post-Master's Cert program. I could have continued on and completed the requirements for the DNP degree (they too updated their program offerings for the DNP), but at this point, after researching salaries, there is no real justification for doing so if you ask me. Not yet. As for requiring all NPs to have their DNP-I don't think that is necessary. Many NPs are very seasoned and experienced; and I think sticking to the NP label is adequate. I am finding that patients are confused by this label anyway. "you're a what?" I get that a lot. Anyway, my thoughts on the subject.

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As an Clinical Nurse Educator, I don't want a PhD. I want to have a DNP, because I am working daily with the bedside nurses. I am not a researcher, I do use EBP daily, but I am working at the bedside with the staff. I think a DNP is better for this type of educator. I certainly think that the PhD is necessary, but I think there should all areas of practice allowed to get their DNP. This is a struggle, though, as there are minimal accredited DNP programs for a nurse educator. Many clinical nurse educators need to complete the clinical class, such as Adv. Patho, Pharm, and Assessment. We are still at bedside. I would like the opportunity to get my DNP and not a PhD. Thanks.

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