Will DNPs be chosen over MSNs?

Specialties Doctoral

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There has been a lot of talk about the possible saturation of the NP market as well as that of other advanced practice nursing roles (CRNA for example) and I am just wondering if this is true, then will the DNP new grads have a better chance at obtaining a job then MSNs will? I am just wondering if it will be the same as when the market got tight for RNs, and BSNs were hired over ASNs and diploma nurses. Do you all anticipate the same situation occuring in Advanced Practice Nursing, even if the "requirement" isn't fully implemented?

Specializes in ICU, ER, OR, FNP.
If you are not interested in ANY aspect of leadership, then perhaps you don't need an advanced education.

So with that rationale:

Once the consensus model is the gold standard and all APNs are DNPs, every new DNP will be expected to achieve some leadership role (that's why they went back to college according to your rationale)? Who is going to do the exam, make the Dx, and write the plan? I'm confused. If the clinic is filled with highly educated upward mover DNP's (all striving for a leadership slot according to your rationale) - who sees the patients? Rest assured, it won't be me.

Some places rely on ICD9 coding to bill and get reimbursed so we can keep the lights on and get paid (yes, I suck - I do this for money). The "all chiefs and no Indians" model doesn't work long term.

Specializes in Nursing Professional Development.
In what setting do nurses hire providers? Or are you speaking of a NP owned clinic where the owner is a DNP? Nurse owned clinics vs physician owned practices are 1:1000.

Not all DNP's are hired by physicians -- some are hired by hospitals where nurses would have input into the process. Also, not all DNP's are NP's. Some are CNS's or educators -- and they are often hired by nurses.

My point is that IF most of the MSN programs are converted to DNP programs, those people with only and MSN will eventually find themselves in the minority. At that point, they will find themselves with less influence as role expectations, community standards, professional standards, etc. and the DNP's will have an advantage as they will be the majority. I don't know for sure whether or not that will happen, but it seems to be where things are headed.

You can quibble with the wording of my sentence all you want ... but your quibbling won't change the facts. Unless the trend reverses, the DNP's will eventually gain the upper hand in sheer numbers and political power. If you don't like that, you'll have to do something to reverse the current trend.

I'm old enough to remember when it became a requirement for NP's to have Master's Degrees. At first people disagreed, saying that the MSN inclusion of research, theory, leadership, etc. was not necessary for an NP. Those voices died out as the NP's without MSN's retired and a new generation of NP's who all had MSN's took over. My point is that there is a good chance that the same thing will happen with the DNP issue.

Again ... I don't think the older NP's have anything to worry about. But the younger people need to be seriously considering the possibility that they may need the DNP to have the most/best career options available to them in the future.

Specializes in Nursing Professional Development.
So with that rationale:

Once the consensus model is the gold standard and all APNs are DNPs, every new DNP will be expected to achieve some leadership role (that's why they went back to college according to your rationale)? Who is going to do the exam, make the Dx, and write the plan? I’m confused. If the clinic is filled with highly educated upward mover DNP’s (all striving for a leadership slot according to your rationale) – who sees the patients? Rest assured, it won’t be me.

Some places rely on ICD9 coding to bill and get reimbursed so we can keep the lights on and get paid (yes, I suck – I do this for money). The “all chiefs and no Indians” model doesn’t work long term.

Leadership is not the same as management. Phyisicians who see patients every day are leaders. NP's who see patients every day can be leaders, too. Just because you are a leader doesn't mean you still can't see patients on a regular basis. Leadership and management are not the same thing.

Specializes in Level II Trauma Center ICU.
So ... what role/job do you see yourself in? A staff nurse role? An APN at the bedside of an ICU patient? etc. I would start your essay by discussing the role you see for yourself and then discuss the type of leadership provided by nurses in that role. Even staff nurses can (and should) be leaders. If you are not interested in ANY aspect of leadership, then perhaps you don't need an advanced education.

Another aspect of this situation that may apply to you ... A lot of us get education that isn't exactly required to do our jobs. For example, I have a PhD -- but I have a job that doesn't require a PhD and I certainly don't use all of the advanced theory, research, and philosophy work I did in my PhD program. That doesn't mean it was a waste of time for me. It enriched my understanding of nursing and the world around me and I am glad I invested my time, effort, and money in that education. While I don't use all of it in my current job, I use bits and pieces of it. And who knows what I might find helpful tomorrow?

The DNP situation is still "new" and "evolving." It's not perfect ... but then, neither is anything else. None of us can predict the future. But we can look at the past and present -- and they indicate that nursing is moving towards higher levels of education for most roles. Don't ignore that fact as you think through what makes the most sense for you and your career goals.

Good luck with whatever you decide.

I think I am being misunderstood. Ultimately, I want to function as an ACNP in an intensive care unit. I'm currently an ICU nurse so I am well aware of the leadership skills involved with being a staff RN. The issue I had was that this essay was looking for a specific type of goal that was geared to a specific leadership positions not how I planned on using my leadership skills. They were very specific in wanting to know that I desired to function in a professional leadership role and how a DNP education would facilitate that. Specific career/job titles were listed and none of them were ACNP in an intensive care unit as that shouldn't be an end goal for a DNP candidate. That is my frustration.

I'm not contesting the trend towards DNP education, I'm merely expressing my exasperation with fact that these programs are being marketed based as a "clinically focused doctoral degree", but they seem to function as preparation for positions for those who ultimately do not desire to actually treat patients on a daily basis. My best friend is currently enrolled in a DNP program and she has stated the same assessment of her current program. Even the additional clinical hours assigned to her are for the development of her 3 yr capstone project. Even that additional clinical time is only 300-500 additional hours above the requirements of some MSN programs.

I do not deny that NPs need to increase the level of our education, I am merely stating that I would like to expand my education into pathophysiology, pharmacology etc. I've seen quite a few threads on this site posted by NPs who feel lost reading xrays, interpreting labs, etc. and they are expected to be proactive and learn these things on their own. I think NP programs should be providing that education. I have often heard physicians cite the limited clinical scope of NP education as reasons to oppose independent practice of NPs. I just feel that addressing those deficiencies in NP education would benefit the profession much more than continuing to focus on theory, policy, research and leadership development at the the expense of clinical development.

Agree ^^^^^^ 100%

Nothing will change, I hope not when there is not much of a difference in education of NP & DNP. If DNP wants to stand out, it must have a strong clinical focus since it is a "practice" doctrate degree. We have MSN/Phd RN for leadership, management, teaching position. So, I really dont understand why DNP want to focus again on leadership instead of clinical skills ??

Take the example below:

ASN prepared RN does the same job/same clinical skills as BSN prepared RN.

MSN prepared NP will also do the same job/same skills as DNP prepared NP.

There is no difference in education so why prefer one over other??

Specializes in Nursing Professional Development.
I think I am being misunderstood.

Thanks for clarifying.

Is there any way you can add electives into the DNP program that would give you the specific coursework you seek? (either your local program or a distant one). You could choose electives from other disciplines that would cover the additional physiology, pharmacology, etc. that you seek.

Another option would be to focus your capstone project on something focused on physical care, physiology, etc. At the doctoral level of education (DNP or PhD), it's expected that a lot of the specific topic education happens through the conduct of projects rather than being covered directly in coursework. For example, the coursework of a PhD program focuses mainly on research processes, philosophy, and theory. The student then becomes an expert in a specific topic (or practice area) as they use those processes to do research on their chosen topic. The PhD student might not take any actual courses in their topic area, they learn by doing readings, doing research, and practicing in their chosen practice field. You could design your capstone project to incorporate the learning of the content you seek and the completion of your project would document your expertise in that area. That's the nature of doctoral education -- less "formal programing" and much more "independent learning" through the conduct of individualized projects.

Finally, for the entrance essay itself ... I would state the type of role you seek (which is basically a NP in an acute care setting -- similar to Neonatal NP's) and then talk about the nursing leadership aspects of that role. People who function in those types of roles are expected to lead practice improvement projects, help with staff education, etc. as well as provide direct patient care. It wouldn't be much of a stretch -- and the faculty knows that roles for DNP's are still very hazy. They are probably much more interested in how well you can think these things through than your specific job plans.

Specializes in Community Health.

Whoa! I guess it depends on which DNP program you enter. I am in PA @ RMU. Clinical hours are 168 per semester and around 1360 by graduation. I don't know why everyone thinks all DNP programs aren't clinically based. With that being said, I am in the BSN-DNP program. There is also an MSN-DNP completion program that does not require any clinical hours. The rationale for that is that most MSN-NP's are already working. Why would they require them to do clinical? It's just like if you would do your ASN and BSN separate. There would not be any clinical for the BSN because you would be already working as a nurse. As far as classes go, I've had to take all of the Advanced Assessment, A&P's, Pharmacology, and so on. Please see link below...

http://sentry.rmu.edu/web/cms/academics/snhs/nursing/Pages/dnp-family-nurse-prac.aspx

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

If you are being hired by a physician, like say the head of anesthesiology is the one making hiring decisions, then the MSN is very likely to be picked over the DNP. If you can find a physician who knows what a DNP is then you have found a physician who doesn't like it.

Specializes in Community Health.

See, that's why we need to stick together as Advanced Practice Nurses instead of discounting each others degree. Then, physicians wouldn't "Dislike" the idea of a DNP. Physicians do not have a problem with any other clinically prepared doctorate except for the DNP. Podiatrists, Dentists, Pharm-D's are all clinical Doctorates. They will refer to them with no problem. It's fine for them to advance their degrees and practice, but God forbid if a NURSE does it. ASN,BSN,MSN,DNP,PhD...we are all nurses at the end of the day and we need to stand up for our profession instead of criticizing it. We have enough of the other professions doing it for us. By the way, I want to be recognized by my diagnostic and clinical skills and can care less who calls me Dr.

See, that's why we need to stick together as Advanced Practice Nurses instead of discounting each others degree. Then, physicians wouldn't "Dislike" the idea of a DNP. Physicians do not have a problem with any other clinically prepared doctorate except for the DNP. Podiatrists, Dentists, Pharm-D's are all clinical Doctorates. They will refer to them with no problem. It's fine for them to advance their degrees and practice, but God forbid if a NURSE does it.

Tell that to the people who are going around making public statements about how DNP-prepared NPs will be the equivalent of physicians -- that's what's creating the ill will and opposition within the medical community. Physicians don't have any problem with those other doctorally-prepared professionals because they don't perceive them as attempting to take over physicians' "turf." But that's not the case with some of the loudest voices touting the supposed advantages of the DNP degree.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
See, that's why we need to stick together as Advanced Practice Nurses instead of discounting each others degree. Then, physicians wouldn't "Dislike" the idea of a DNP. Physicians do not have a problem with any other clinically prepared doctorate except for the DNP. Podiatrists, Dentists, Pharm-D's are all clinical Doctorates. They will refer to them with no problem. It's fine for them to advance their degrees and practice, but God forbid if a NURSE does it. ASN,BSN,MSN,DNP,PhD...we are all nurses at the end of the day and we need to stand up for our profession instead of criticizing it. We have enough of the other professions doing it for us. By the way, I want to be recognized by my diagnostic and clinical skills and can care less who calls me Dr.

*** Criticism is healthy. Not every idea that come down the pike is a good one. We have had our share of ridiculous ideas being foisted on us. Scripting, electronic nurse tracking among them. The DNP seems to fit into this category to me. A solution to a problem that doesn't exist.

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