[brownrice]

coffeegirl:
In hindsight you see that a doctorate would be helpful, you think would put you on par with physicians?...Don't you wish you had just gone to medical school to begin with?

As far as those facing the decision as fresh Bachelor of science graduates, it will be interesting to see how many would choose a four year nursing doctorate so that they may face physicians at conferences with more confidence. I think most of these graduates will plan for med school. As for post master's students, do you think the amount of money and time you're spending to get a doctorate is really worth the return? If so, can you elaborate on how this is? I cannot see how this even begins to make sense.

[NHavenRN]

In case anyone was wondering what the AMA thinks about all this (officially):

http://216.239.51.104/search?q=cache...s&ct=clnk&cd=6

AMA Resolution re: the DNP

AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES
Resolution: 211
(A-06)

Subject: Need to Expose and Counter Nurse Doctoral Programs (NDP) Misrepresentation

...Whereas, The patient-physician relationship is the foundation of
effective medical care; and

Whereas, Patient trust is a cornerstone of good medical care delivery; and

Whereas, Quality medical care requires appropriate education, skills, training and experience, as recognized and upheld in state laws; and...

...Whereas, The quality of care rendered by individuals with a nurse doctoral degree is not equivalent to that of a physician (MD or DO); and

Whereas, Nurses and other non-physician providers who hold doctoral degrees and identify themselves to patients as "doctors" will create confusion, jeopardize patient safety and erode the trust inherent in the true patient-physician relationship; and

Whereas, Patients led to believe that they are receiving care from a "doctor," who is not a physician (MD or DO), but who is a DNP may put their health at risk...

...Fiscal Note: Implement accordingly at estimated staff cost of $10,836.
Release Date: 6/11/2006

I know this sentiment in general isn't news, but something just occurred to me... their language almost makes me wonder whether this push from the nsg community for the DNP will backfire and result in actual rollbacks to some of the recent expansions in scope of practice for NPs (potentially as pushed for more heavily by a newly outraged AMA)...but maybe that's just my paranoia talking

Edited to say - sorry, I just realized how long that was! yeesh! I cut out a lot, leaving a few highlights, but it's still long.

[Coffeegirly]

Well it's not surprising that the AMA would not support a DNP. Unless it's an MD, it won't be supported as adequate, period.

As for putting me on par with physicians? No. But with the community? yes. Also, it would give give us more respect within the other professions, especially since we already have so many entry levels within the profession that we can't even make up our minds what level our education should begin at.

Why didn't I go to med school? Because I wanted to be a nurse. I like the philosophy of nursing, not medicine. It's simple- I still like the philosophy. I get mistaken for being a doctor because of my professionalism is "like a doctor" which many patients think is a compliment. I am happy to correct them and tell them that I am a NP so that they realize that NPs are professional and knowledgable. We are good and deserve the recognition. We look at so much more than diseases. I'd rather go to school longer for a nursing related degree that I can feel good about than go to med school. I'm proud of what we do. I don't think money should be the object here, professional goals, satisfaction and philosophy should be. My opinion and life experience.

[EastCoast]

Originally Posted by Coffeegirl

I get mistaken for being a doctor because of my professionalism is "like a doctor" which many patients think is a compliment. I am happy to correct them and tell them that I am a NP so that they realize that NPs are professional and knowledgable. We are good and deserve the recognition. We look at so much more than diseases. I'd rather go to school longer for a nursing related degree that I can feel good about than go to med school. I'm proud of what we do. I don't think money should be the object here, professional goals, satisfaction and philosophy should be. My opinion and life experience.

I agree with this last paragraph except for your very first sentence.

You may be mistaken for a doctor because you haven't introduced yourself prior to your encounter. So if you get a DrNP will you clarify the difference or feel 'well...i am after all a doctor'.

Also....in my opinion professionalism does not equal 'doctor'. Ask most nurses the number of professional docs they encounter in a day and it will probably only take 1 hand. Many docs mannerism that appear professional can also be seen as quite standoffish.

My patients will often tell me they like NP's better than docs because of the of being able to feel comfortable and that we take more time to really listen to the docs.

If one of my patients told me I was like a doctor because of my manner I'd check to see if they were talking to the person behind me.

A compliment is them thinking you may be a doctor should be because you have sound clincial judgement and good outcomes.

As an aside, If I had to do it again I just would have gone to med school. I'm the first to say that and I don't stand on the premise of I couldn't ever not be a nurse. Nursing was good to me but overall I wish I'd worked as a nurse for 5 years of so and then went on to med school.
It is for me just a matter of having bad timing.

I'm a thumbs down for the DrNP. I think it's stupid and just another way to get money and make the AMA hate us even more.

[n_g]

So the AMA doesn't like DNP because it gets patients confused with whom is the doctor. What can they really do? The genie is out of the bottle.

[Coffeegirly]

In response to EastCoast, I do introduce myself as a nurse practitioner.
Yes, I too know many MDs that are unprofessional and are not any good. However, there are still many people in our society that look at MD's as professional and knowledgeable just because they have MD after their name.

I think you must know a lot of bad doctors. I know my share of them too but I also know a lot of great ones too. I'm glad to be lumped in as being professional like them (which does, I've been told, include good decision makiing and diagnostic skills btw). I don't think it's a matter of we versus they. I think it's a matter of mutual respect and if a DNP helps us achieve that, I'm all for that.

I'm sorry the timing was off for med school. I chose not to go. I believe in education- the more I know, the better. The more I learn, the better. I love it and so if I need to learn more, that's fine. If it helps my patients and my career, I'm good with it.

[Coffeegirly]

What is really at the root of those of you not wanting the DNP? Is it the money? the time? What is it?

[EastCoast]

Hmmm,
Well, it's not the money, it's not the time, I think it comes down to my belief that we are not a cohesive enough group from state to state and that it is created in the realm of 'academia' rather than clinical. I also know that there is no guarantee that just because you are a DNP you will be able to admit to a hospital or gain any further privledge in a medical environment. I consider myself well regarded in my hospital. I'm not sure however the medical staff would say okay to me admitting my PCP patients under my own name. Is that a thorn in my side? Certainly, but I'm not willing to grandstand about it as I also feel that a previous NP with marginal hospital experience put several of us in a bad position. For instance, now when reapplying for privledges the President of the medical staff has to 'approve' our competency. I work side by side with him however, i believe it was set up to get rid of those who he doesn't feel are up to par or perhaps causing him aggravation. While this would likely never happen to a doctor I can bet it would still happen to a DrNP.

It is still a world that many doc's look at NP's as trying to steal their money. As long as that bias exists we will have difficulty. If we continue to have inconsistent standards for entry, varying degree requirements we will have difficulty. Those who choose to enter DrNP I am not against. Good for them. I just think it is a white elephant that does not make you a better NP in the end. I am not sure the intents of those who make the money are pure.

It doesn't make you a doctor. It gives you an additional degree. I think that is what ****** doc's off is the attitude of the Dr.NP component. I mean why not just have PhD with a clincal component. I think truly that some people will get off with the being called doctor thing and really won't have to correct the patient. It's misleading.

[brownrice]

Coffee girl: If you like the education so much and how it benefits your yearn to learn/and is a benefit to your patients, why not just take continuing ed in the areas specific to your practice? If you gain the knowledge, does it really matter whether you have a plaque hanging on the wall because of your education? Afterall, you already have the license to practice as an NP.

[Davidtp]

Hi!

I was browsing this site and found the discussion here to be very interesting and wanted to ask a few questions.

About me, I am a 4th year medical student, I have nothing but the utmost respect for nursing as a proffession and a philiosophical movement. I want to state that off the bat since I am a guest in your forum.

I have had very positive expereinces with NP's over the course of my clincal rotations. I am interested in what the DrNP is, and how this will affect our healthcare delivery system.

For instance if a DrNP is truly to be a clincal "doctor" then it must create standards on par with allopathic and osteopathic training programs. What I mean by this is course work equivalent to MD and DO schools in the basic sciences (gross anatomy, bicochemistry, histology, physiology, pathology, pharmacology, neuroscience, etc...), and clincal exposure in all major fields of medicine.

Much the same way osteopathic programs were able to become legitimized in the eyes of the medical community.

I would support parity for DrNP's if such a commitment was made. If that is the case, I was wondering what would make these programs diffrent from traditional medical schools? For instance much is made of the notion that osteopathic education is more hollistic, and patient oriented than allopathic training. However it has been my experrience that DO programs and MD programs are virtually identical, philisophical idealogies don't really translate when learning about disease pathology.

So basically I was wondering if this is what the DrNP is envisioned to be? Will it be a 3rd type of degree, along with MD and DO that will enable entry into all medical specialties?

thanks,
David