[elkpark]

Originally Posted by pinoyNP

Just a follow-up article to the one published in the Wall Street Journal. Looks like the certification exam for DNP's is starting in November 2008. I wonder what the BON's take is on this.

http://www.businesswire.com/portal/s...67&newsLang=en

Hmmmm ... I was particularly struck by a couple of quotes from the news release above --

"The Doctor of Nursing Practice degree was developed in 1999 to respond to a national need for increased access to comprehensive patient care. More than 200 schools have or plan to establish a DNP program. This degree builds on nursing licensure as an advanced practice nurse by adding expanded knowledge and skill in nursing and medical aspects of care for complex illness. The growing burden of chronic illness in the United States will require an even greater focus on collaborative and team-based care."

Gee, I guess that, in my little backwater rural community, I hadn't noticed that there is a big "national need for increased access to comprehensive patient care." And, apparently, a need that current mid-level providers are simply incapable of meeting! The press release also sounds like all DNP people are all going to be existing APRNs, which is not what the schools are saying -- they're talking about phasing out MSN advanced practice programs entirely and having people go directly into DNP programs from BSN programs, as I understand it

"The Council for the Advancement of Comprehensive Care (CACC) was established in 2000 to further the development of standard clinical competencies for graduates of Doctor of Nursing Practice (DNP) programs. The Council determined that a national certification process would provide the public with a reliable way to identify advanced nurse clinicians with the DNP degree who can provide comprehensive care. Council membership is comprised of nurses, physicians, health care organization representatives and health and public policy experts."

Oh, goody! The people who are trying to ram this down our throats have their own organization to say that they're doing the right thing! I still think the whole thing is little more than a boondoggle to make money for the unis starting up the DNP programs, and I hope that the rest of us will refuse to go along with it.

[core0]

I have a question that I am not sure has been addressed. What about the CNS here? According the the website you have to be certified as an NP to take the NBME test. Where does that leave CNS in states with prescriptive authority. I am assuming that a CNS can attend a DNP program. In that case when they graduate they will not be eligible for certification?

David Carpenter, PA-C

[pinoyNP]

Originally Posted by core0

I have a question that I am not sure has been addressed. What about the CNS here? According the the website you have to be certified as an NP to take the NBME test. Where does that leave CNS in states with prescriptive authority. I am assuming that a CNS can attend a DNP program. In that case when they graduate they will not be eligible for certification?

David Carpenter, PA-C

good point!

[elkpark]

Originally Posted by core0

I have a question that I am not sure has been addressed. What about the CNS here? According the the website you have to be certified as an NP to take the NBME test. Where does that leave CNS in states with prescriptive authority. I am assuming that a CNS can attend a DNP program. In that case when they graduate they will not be eligible for certification?

David Carpenter, PA-C

Another proposal out there that I'm very unhappy about (I'm a psych CNS who doesn't have and DOESN'T WANT prescriptive authority), is that "advanced practice nursing" be redefined, with prescriptive authority as the defining characteristic -- if you don't have Rx authority, you're not an advanced practice nurse, plain and simple. The people who are pushing this idea envision a day when we'll all wake up one morning and those CNSs who have Rx authority will be grandfathered in and "relabeled" as NPs (even though they weren't educated as NPs and the focus of their education was entirely different!) and those of us without Rx authority (whether that's by choice or simply living in a state that doesn't grant Rx authority to CNSs) will no longer be considered advance practice nurses ... The people pushing that idea just want to eliminate the CNS role entirely (which is why I'm v. suspicious of all the carrying on now about the "CNL" role -- but that's a whole 'nother conversation).

I am particularly offended by this proposal since (as I believe you mentioned yourself in a recent post -- I'm too rushed at the moment to go back and make sure, so I apologize if I'm mischaracterizing your position) I believe that CNS practice is true advanced practice nursing, a natural extension of basic nursing practice, while nurse practitioner practice is "medicine lite" (heck, the original concept was even developed by a phsyician!)

But I'm not trying to start a CNS vs. NP debate -- shoot, some of my best friends are NPs! I just don't much cotton to the idea of being stripped of my advance practice status (that I went to a heck of a lot of trouble to earn!) because some people think we should all be pushing pills!

[core0]

Originally Posted by elkpark

Another proposal out there that I'm very unhappy about (I'm a psych CNS who doesn't have and DOESN'T WANT prescriptive authority), is that "advanced practice nursing" be redefined, with prescriptive authority as the defining characteristic -- if you don't have Rx authority, you're not an advanced practice nurse, plain and simple. The people who are pushing this idea envision a day when we'll all wake up one morning and those CNSs who have Rx authority will be grandfathered in and "relabeled" as NPs (even though they weren't educated as NPs and the focus of their education was entirely different!) and those of us without Rx authority (whether that's by choice or simply living in a state that doesn't grant Rx authority to CNSs) will no longer be considered advance practice nurses ... The people pushing that idea just want to eliminate the CNS role entirely (which is why I'm v. suspicious of all the carrying on now about the "CNL" role -- but that's a whole 'nother conversation).

I am particularly offended by this proposal since (as I believe you mentioned yourself in a recent post -- I'm too rushed at the moment to go back and make sure, so I apologize if I'm mischaracterizing your position) I believe that CNS practice is true advanced practice nursing, a natural extension of basic nursing practice, while nurse practitioner practice is "medicine lite" (heck, the original concept was even developed by a phsyician!)

But I'm not trying to start a CNS vs. NP debate -- shoot, some of my best friends are NPs! I just don't much cotton to the idea of being stripped of my advance practice status (that I went to a heck of a lot of trouble to earn!) because some people think we should all be pushing pills!

You could take it a step further. Now that the CACC has essentially stated that the DNPs practice medicine (by virtue of their certification under a test for the practice of medicine), CNS (without prescriptive authority) are the real APNs. They are still practicing nursing after all.

I think nursing itself is confused about the role of the CNS. If you move from Colorado to Georgia, you lose the ability to practice in an APN role, despite that fact that the education and ability of that nurse has not changed.

David Carpenter, PA-C

[jzzy88]

Will the DNP curriculum include more advanced science classes at some point? I know that the DNP is not supposed to expand scope of practice, but it seems like the unspoken understanding is that it will expand scope. Any info?

[dhigbee]

I'm not seeing any evidence of this, either in existing programs, or the ANCC guidelines. There's very little in the added DNP content that's aimed at direct patient care, other than the added clinical hours. (Which is why I don't "get" all the talk about special certification, or expanded scope of practice).

[pinoyNP]

Just thought I'd post AANP's response to the Wall Street Journal article on the DNP: http://www.aanp.org/NR/rdonlyres/en5...letter0408.pdf

[elkpark]

Originally Posted by pinoyNP

Just thought I'd post AANP's response to the Wall Street Journal article on the DNP: http://www.aanp.org/NR/rdonlyres/en5...letter0408.pdf

Good letter!

[prairienp]

Originally Posted by pinoyNP

Just thought I'd post AANP's response to the Wall Street Journal article on the DNP: http://www.aanp.org/NR/rdonlyres/en5...letter0408.pdf

Thanks for posting the letter. The AANP's response is exactly how I feel NPs should respond. Wasn't Dr. Mundinger program orginally DrNP and not DNP? Reserve this "new" medical exam for the DrNP from her NY program. Leave the rest of the NPs (MS or DNP) alone.