Clarification on the DNP requirement of 2015

Specialties Doctoral

Published

Hi-

I'm a bit confused about the whole 2015 DNP requirement for APRNs. Does this mean a DNP, instead an MSN, is required in order to become a Nurse Practitioner starting 2015? Is this applied uniformly in all States or do States have their own "flexibility" on how this is handle? (I live in MA.)

If DNP is required, I wonder if MSN programs will be phased out and replaced by DNP programs or maybe integrated into the DNP programs. In a clinical setting, will the scope of practice expand for someone with a DNP vs someone with an MSN? Or are they moving to DNP because they believe that MSN programs are already very much a doctoral program relative to other health professions?

Thanks in advance for your thoughts.

umbdude

Specializes in Anesthesia.

There are literally thousands of research articles studying the quality of APRN care. http://www.npjournal.org/article/S1555-4155(13)00410-8/fulltext This is just one literature reviews that look at the quality of care between NPs and physicians.

There is more than enough evidence to advocate for independent practice of APRNs.

This is the reason we are moving to a clinical doctorate.

[h=4]"INTRODUCING THE DOCTOR OF NURSING PRACTICE[/h]

  • In many institutions, advanced practice registered nurses (APRNs), including Nurse Practitioners, Clinical Nurse Specialists, Certified Nurse-Midwives, and Certified Nurse Anesthetists, are prepared in master's-degree programs that often carry a credit load equivalent to doctoral degrees in the other health professions. AACN's position statement calls for educating APRNs and nurses seeking top systems/organizational roles in DNP programs.

  • DNP curricula build on traditional master's programs by providing education in evidence-based practice, quality improvement, and systems leadership, among other key areas.

  • The DNP is designed for nurses seeking a terminal degree in nursing practice and offers an alternative to research-focused doctoral programs. DNP-prepared nurses are well-equipped to fully implement the science developed by nurse researchers prepared in PhD, DNSc, and other research-focused nursing doctorates.

[h=4]WHY MOVE TO THE DNP?[/h]

  • The changing demands of this nation's complex healthcare environment require the highest level of scientific knowledge and practice expertise to assure quality patient outcomes. The Institute of Medicine, Joint Commission, Robert Wood Johnson Foundation, and other authorities have called for reconceptualizing educational programs that prepare today's health professionals.
  • Some of the many factors building momentum for change in nursing education at the graduate level include: the rapid expansion of knowledge underlying practice; increased complexity of patient care; national concerns about the quality of care and patient safety; shortages of nursing personnel which demands a higher level of preparation for leaders who can design and assess care; shortages of doctorally-prepared nursing faculty; and increasing educational expectations for the preparation of other members of the healthcare team.
  • In a 2005 report titled Advancing the Nation's Health Needs: NIH Research Training Programs, the National Academy of Sciences called for nursing to develop a non-research clinical doctorate to prepare expert practitioners who can also serve as clinical faculty. AACN's work to advance the DNP is consistent with this call to action.
  • Nursing is moving in the direction of other health professions in the transition to the DNP. Medicine (MD), Dentistry (DDS), Pharmacy (PharmD), Psychology (PsyD), Physical Therapy (DPT), and Audiology (AudD) all offer practice doctorates."

American Association of Colleges of Nursing | DNP Fact Sheet

Specializes in Adult Gerontology Primary Care NP.
There are literally thousands of research articles studying the quality of APRN care. http://www.npjournal.org/article/S1555-4155(13)00410-8/fulltext This is just one literature reviews that look at the quality of care between NPs and physicians.

There is more than enough evidence to advocate for independent practice of APRNs.

This is the reason we are moving to a clinical doctorate.

"INTRODUCING THE DOCTOR OF NURSING PRACTICE

  • In many institutions, advanced practice registered nurses (APRNs), including Nurse Practitioners, Clinical Nurse Specialists, Certified Nurse-Midwives, and Certified Nurse Anesthetists, are prepared in master's-degree programs that often carry a credit load equivalent to doctoral degrees in the other health professions. AACN's position statement calls for educating APRNs and nurses seeking top systems/organizational roles in DNP programs.
  • DNP curricula build on traditional master's programs by providing education in evidence-based practice, quality improvement, and systems leadership, among other key areas.
  • The DNP is designed for nurses seeking a terminal degree in nursing practice and offers an alternative to research-focused doctoral programs. DNP-prepared nurses are well-equipped to fully implement the science developed by nurse researchers prepared in PhD, DNSc, and other research-focused nursing doctorates.

WHY MOVE TO THE DNP?

  • The changing demands of this nation's complex healthcare environment require the highest level of scientific knowledge and practice expertise to assure quality patient outcomes. The Institute of Medicine, Joint Commission, Robert Wood Johnson Foundation, and other authorities have called for reconceptualizing educational programs that prepare today's health professionals.
  • Some of the many factors building momentum for change in nursing education at the graduate level include: the rapid expansion of knowledge underlying practice; increased complexity of patient care; national concerns about the quality of care and patient safety; shortages of nursing personnel which demands a higher level of preparation for leaders who can design and assess care; shortages of doctorally-prepared nursing faculty; and increasing educational expectations for the preparation of other members of the healthcare team.
  • In a 2005 report titled Advancing the Nation's Health Needs: NIH Research Training Programs, the National Academy of Sciences called for nursing to develop a non-research clinical doctorate to prepare expert practitioners who can also serve as clinical faculty. AACN's work to advance the DNP is consistent with this call to action.
  • Nursing is moving in the direction of other health professions in the transition to the DNP. Medicine (MD), Dentistry (DDS), Pharmacy (PharmD), Psychology (PsyD), Physical Therapy (DPT), and Audiology (AudD) all offer practice doctorates."

American Association of Colleges of Nursing | DNP Fact Sheet

OK... 1/"1000's"(by the way, the link is empty). I never said that I didn't believe the evidence. Also, I know and believe in the available literature regarding comparable care. Remember, I am on the side of NPs... Jeez.

Why don't you discuss how getting a DNP has enhanced your practice, expanded your knowledge base? What gaps were filled that were left by the MSN. Discuss how being autonomous has and will enhance care for any population? This is where the conversation often(not always, please don't jump on that... help us all!) goes south for NPs, unfortunately. Then, they pull the IOM card. It is the inability to articulately present their case and consistently hold their guns - without losing your cool. Trust me, it works.

Specializes in Anesthesia.
OK... 1/"1000's"(by the way, the link is empty). I never said that I didn't believe the evidence. Also, I know and believe in the available literature regarding comparable care. Remember, I am on the side of NPs... Jeez.

Why don't you discuss how getting a DNP has enhanced your practice, expanded your knowledge base? What gaps were filled that were left by the MSN. Discuss how being autonomous has and will enhance care for any population? This is where the conversation often(not always, please don't jump on that... help us all!) goes south for NPs, unfortunately. Then, they pull the IOM card. It is the inability to articulately present their case and consistently hold their guns - without losing your cool. Trust me, it works.

I read all your comments about the DNP. I agree with you on almost everything except the fact on not having enough evidence. That one article I linked ( and the link worked for me) reviewed nearly 28,000 NP quality of care articles then those were whittled down to look at just the ones that could be used for comparison of physician to NP outcomes.

I have discussed before how DNP or in my case the DNAP has helped my practice. I have always worked independently. Working independently is the only system that is utilized in the U.S. military for APRNs.

That one comment about there not being enough evidence to support NP independentence just added more fuel to an already heated debate.

I also disagree that just discussing how being doctoral prepared has helped someone's practice helps, because then other MSN prepared APRNs will argue how we are just being uppity and then physician and physician wannabes think we are just out to replace them.

The nurses that believe that the DNP/DNAP will help their practice or other APRNS are the ones that are already most likely to continue their education on towards a doctorate. Physicians on the other hand will often maybe supportative to your face, but they are the same ones that will vote to deny NPs extra privileges at the hospital/clinic and state levels.

The DNP is as much a political battle as it is personal battle to overcome prejudices in our own nursing community.

Specializes in Adult Gerontology Primary Care NP.
I read all your comments about the DNP. I agree with you on almost everything except the fact on not having enough evidence. That one article I linked ( and the link worked for me) reviewed nearly 28,000 NP quality of care articles then those were whittled down to look at just the ones that could be used for comparison of physician to NP outcomes.

I have discussed before how DNP or in my case the DNAP has helped my practice. I have always worked independently. Working independently is the only system that is utilized in the U.S. military for APRNs.

That one comment about there not being enough evidence to support NP independentence just added more fuel to an already heated debate.

I also disagree that just discussing how being doctoral prepared has helped someone's practice helps, because then other MSN prepared APRNs will argue how we are just being uppity and then physician and physician wannabes think we are just out to replace them.

The nurses that believe that the DNP/DNAP will help their practice or other APRNS are the ones that are already most likely to continue their education on towards a doctorate. Physicians on the other hand will often maybe supportative to your face, but they are the same ones that will vote to deny NPs extra privileges at the hospital/clinic and state levels.

The DNP is as much a political battle as it is personal battle to overcome prejudices in our own nursing community.

I hear you. My comment about the evidence may have been misinterpreted. Sorry for that. I am never interested in adding fuel to anyone's flame... There needs to be more interest in studying the impact of the APRN/DNP role. Of course, there are definitive studies about NPs providing comparable care to MD/DOs and I respect the research.

Nurses can sometimes be their worst politicians/critics in the field. Sometimes, the harsh criticism isn't even solicited or even warranted. Sharing experiences is how I and many others learn about the DNP. Confident, honest, open people love to hear from others about their accomplishments and goals. How could anyone debase that? Sometimes it is the ones that lack the confidence(or energy) to push the profession forward, but can't recognize it in others. One nurse's success is a success for all of us - no matter how "uppity" one may seem.

The DNP is still just a suggestion by the AACN. There is no mandate or legislation in any state that requires it as of yet. There are schools that offer the DNP degree and I imagine you can squeeze out a little more pay with it. I also have been told by many educational advisors that it is going to be mandated and to enroll in a DNP program now so I don't waste time if they change it. The problem with that is, if it is changed, anyone already currently enrolled in MSN-NP programs will be grandfathered. I did a research paper on this subject in one of my classes a couple semesters back. I think it will be a long time before we see any legal requirements for DNP to practice as an NP. I'm certainly not going to spend the extra money! I

LMU (Lincoln Memorial University) also just announced new medical degree for PA 'Doctor of Medical Science'...

LMU ANNOUNCES A NEW MEDICAL DEGREE: DOCTOR OF MEDICAL SCIENCE - Lincoln Memorial University

I guess everyone feels the need to get a doctorate now...

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
LMU (Lincoln Memorial University) also just announced new medical degree for PA 'Doctor of Medical Science'...

LMU ANNOUNCES A NEW MEDICAL DEGREE: DOCTOR OF MEDICAL SCIENCE - Lincoln Memorial University

I guess everyone feels the need to get a doctorate now...

Doctor PA - talk about useless degree inflation. Meanwhile the medical (physician) side is attempting to decrease to time and financial investment to produce a physician and creating three, rather than four, year medical schools. Thus shaving at least 25% off the amount of money that a medical student must barrow to support themselves (and more and more commonly today, their family) during medical school.

Ironic that there are now at least four different degree paths to PA and some people are convinced that nursing's main problem is that there are two.

Ironic that there are now at least four different degree paths to PA and some people are convinced that nursing's main problem is that there are two.

Two? I count four (diploma, ADN, BSN, MSN) without even stopping to think about it. How do you get only two?

Doctor of medical science lol. The coordinator for LMUs pa program actual gave a speech last year saying that PAs did not want to be doctors and all this other worthless stuff. Then the next year they come out with the silly doctor of medical science degree saying that it is too much of a burden for the government to pay for residencies. So of the course the student has to pick up the tab and pay 50k for a worthless doctorate degree for PAs. Well, actually they do not have to, and if they had a brain they wouldn't. It is essentially worthless since it does not expand their scope of practice and costs almost as much as PA school itself.

LMU is a pretty money hungry school though. I mean they made a law degree program that took 4 years to get accredited. But hey people with 10th percentile on the LSAT were lining up to get in since there was no other way they could become lawyers. Anybody can get a doctorate, even if you are dismal in the intelligence category, if your willing to pay a high price. But hey, if I was a car salesman, id be selling to everybody, not just those that score well on the (insert test here).

The doctoral PA degree is also just for PAs who are already in practice, not a degree path to acquire a PA degree.

Doctor of physician assistantry. Lol... whats next Doctor of medical secretarial science? Doctor of LPNology. Doctor of respiratory therapy? Doctor of physical therapy assistance? Doctor of pharmacy technology? Doctor of medical billing theory? Doctor of hamburger flipping? Maybe in 20 years all of america will have doctorate degrees. Those boys flipping our burgers and making our coffee (no offense to restaurant workers, I had to do it to pay for some college stuff) are going to have huge lacquered, framed Doctor of Burgeratology and Doctor of Baristology next to their names at the cash register, 50k in student loan debt, making 8.15 an hour.

America, land of the stupid.

Also, if anybody wants me to send them a link to the speech where the director of the PA program at LMU states that pas do not want to be doctors that he gave a year or so ago to medical students let me know. I guess he changed his mind a year later right?

If this degree takes off for the PA community, they will obtain independent practice and be considered physicians. Notice it said you had to be a PA and have 3 years experience before the program. They will use the terminal education and the experience to obtain status as a full physician. I say cool more people to take care of people. NPs will had full independence in every state I believe within 15years or less I believe. This is a way for PAs to obtain their independence as well. We will see how history plays out, exciting times to be alive

Nursing is doing it.... Why shouldn't they?

This degree will take off very quickly because 'doctor of medical science' sounds like a MD degree...

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Two? I count four (diploma, ADN, BSN, MSN) without even stopping to think about it. How do you get only two?

I forgot there were still some diploma programs and can't take the MSN seriously. But you are right, thank you for correcting me, I stand corrected.

Now that we are talking about it there is are two more ways I remembered. California's "30 unit option", and West Virginia allows veterans with certain kinds of military medical training to challenge their RN NCLEX.

So we have at least 3 (not 4 as I previously thought) paths to PA practice. 3 for physician practice, and 4 to 6 ways to enter nursing practice, plus LPNs.

I think it's great. I think we are strong with more diversity in our ranks.

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