[Jengirl18]

I agree with the above post that a Doctoral degree is not needed to be a good clinician (PAs and NPs are already doing it), although I am all for continuing one's education. I am watching to see how this whole DrNP thing unfolds. I have heard through the grapevine that in the future, there will be a legal name for the DrNPs, when addressing themselves to a patient. In the clinical setting, it may be "Hello, I am NP Doctor X" instead of Dr. X (so the patients are not confused by physicians and NPs). I can just see in the future that it will be played out in court, unfortunately.

[AmiK25]

[As for Columbia, the outline I viewed offered doctoral classes in health policy, research and statistics, epidemiology, legal issues, informatics and practice management.[/quote]

And that's the problem. In what way do those classes make you a better practitioner in the clinical area. They are calling the DNP a "clinical doctorate" as opposed to a research doctorate, but those courses have nothing to with the clinical area. If the DNP included more clinical courses, such as a residency or fellowship in a certain specialty, I would be more willing to support it. As it is now, it will do nothing but cause more problems!!

[Jengirl18]

And that, AmiK25, is what PAs are dumbfounded by. Unfortunately, in the future, I think PAs will feel the need to get a Doctorate also in order to be at an equal "degree" as DNPs (which really is unneccessary).

[MacD]

I am constantly amazed at the concern others have for the title Doctor when it is associated with a nurse or NP. It is the scope of practice which is important. We don't concern ourselves about titles when it is a Physical Therapist with a PhD nor any other doctorate. If you are concern about patients being confused. Patients make mistakes all the time when it comes to titles Nurse, Doctor, etc. Ever heard of a Medical Assistant being call Nurse? It is the professional's responsibility to handle or redirect the patient as necessary. Please, lets worry about things that really matter.

[Coffeegirly]

I also think you have to research the DNP program. Many of them offer the epidemiology, statistics and the other courses that have been mentioned. However, other programs do stress clinical expertise in the practitioners chosen area.

I would have said these same things many years ago. Why a DNP? It's academic, just another degree.. it's oppressive, it's ivy tower stuff, etc. But as I've been working many years, I've come to slowly change my mind. I do lack knowledge, a lot of it. I practice darned well and yes, my surveys would be better than an MD's....but so? It's all about the patient. Y

The person who made the comment about the docs who laugh at Dr. NP's.... there will always be those. But there will always be many more who will look at us with greater respect and always those that never will. We need to look at who we serve rather than argue amongst ourselves. Nursing is notorious for that. Heck, we can't even decide what the basic level of education should be!! In addition, now we let people go directly from a BSN to MS. Huh? Don't we need years of practice? Because frankly, I don't think a year or two cuts it... but that's just another thread.

So here we are... rather than moving forward, we stagnate and bicker about these issues. Someone wants to make some rules... but not everyone agrees. In most professional groups, a of people get together, study something, come to a concensus, present their decision to the representatives and vote. Decision made. I believe that's been done but we bicker and often can't come to concensus because I think when it comes to these issues, people who graduate from various levels of nursing, for example, thinks their program is best and they should have to change because of this and that.

Change is hard. There are reasons for them. I don't think all change is bad and maybe sometimes we should actually look foro the positives. jmho.

[christvs]

Originally Posted by markdanurse

The big deal is not about staying a nurse forever. There are reasons for this argument, and maybe you missed them as they are dispersed throughout these postings. So here's a brief outline for you:

1. Doctoral education is expensive no matter which way you choose to go. NP's don't get paid nearly as much a physicians. Simple cost-benefit analysis here. Heavy student loans have to be paid back, and if you're only making $60-70,000/year as an NP, you DON'T want a heavy student loan burden. And don't expect the schools to charge less for doctoral level education for nurses...they are in this for the money, NOT for the profession.

2. It won't bring any more respect to the profession. Physicians will always see the term "nurse" in your title whether you are a nurse practitioner or a doctor of nursing practice. Nurses seem to have the idea that more education equals more respect. Simply not so. In fact, it is a logical fallacy...just like "more is better". Nurses as a whole need to get rid of the stigma of subservience, inferiority, and inequality attached to the profession of nursing before we get anywhere with this profession. How can this be done? Nurses becoming independent contractors that are NOT attached to the room charge of hospitals with the right to bill the insurance companies for services rendered. You better bet that physicians and the public would treat us better if we weren't just a part of the room charge, but a separate and important group of professionals in the healthcare team necessary for patient care. (My apologies to the Florence Nightingale nurses who disagree.)

3. MSN prepared NP's know more than enough to practice competently, as demonstrated by studies in JAMA showing outcomes equal to and even better in some areas than the physicians managing the same illnesses. There is no evidence to show a doctoral degree is needed to produce a more competent NP, CNS, CNM, or CRNA. Personally, I think this should be a personal choice for NP students...choose either an MSN or DNP...not something that gets shoved down every professional nurse's throat because a group of nurse leaders who probably never worked at the bedside say it will be good for the profession.

4. Now is not the time for this debate. We still have diploma and ADN programs operating. A little more than 50% of all RN's are ADN's. We cannot even bring the minimum requirement for a professional nurse to the BSN level. Just a few years ago, we finally gained consensus to the MSN being the minimum entry requirement to advanced practice nursing, and now we want it to go to a doctoral level??? Why? Let's get nursing as a whole to gain consensus as to the MINIMUM entry requirement for the professional RN instead of messing around with the advanced practice arena.

5. Role confusion. Much of the public still does not know what NP's are and what they can do. Now we are going to require doctoral degrees for minimum entry requirements. So NP's are now "doctor nurses"? Sounds obvious to those of us who are nurses, but what about the public? Seriously people. If you wanted to be a "doctor", it's called "medical school". Being that NP's do 80 - 90% of what physicians do, and call it "advanced practice nursing", NP's that want a doctoral title can go back to medical school to gain that title and not confuse the public.

6. Gaining the DrNP degree will not increase the scope of practice for advanced practice nurses, will not help the group gain enpaneling as providers for insurance companies, and will not allow the group to do anything other than what they already do. So how does it help the group again?

Unless NP's want to enter academia, let's just leave well enough alone.

So that's what the argument is all about, my 25 year old Southern Beauty inquisitor.

I agree with everything you said 100 %. Well put. I'm currently in an MSN program to become an NP and I think the DNP should be a choice, and definitely not forced upon every NP.
-Christine

[ErinRNBSN]

I think a ND is a great idea and avenue to promote nurses to a higher level! I am currently completing an MSN for ANP, and would love to go on further. Has anyone heard anything about the AMA requesting that a law go into effect that all APN's are supervised??? I hear this through the grapevine at work. Just wondering if anyone has any news??

[alwaysintheknow]

Originally Posted by ErinRNBSN

I think a ND is a great idea and avenue to promote nurses to a higher level! I am currently completing an MSN for ANP, and would love to go on further. Has anyone heard anything about the AMA requesting that a law go into effect that all APN's are supervised??? I hear this through the grapevine at work. Just wondering if anyone has any news??

I saw this coming..........

AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES

http://216.239.51.104/search?q=cache:QX2Sq5oPB6kJ:www.ama-assn.org/ama1/pub/upload/mm/471/211a06.doc+ama+resolution+211&hl=en&gl=us&ct=clnk& cd=6


I say this is going to be a big issue in the coming years now that docs know about the DNP and see this as direct competition and a threat to them. I guess the forum of public opinion will decide. The cat is out of the bag.

[alwaysintheknow]

Originally Posted by markdanurse

Has anyone else heard the following?:

Columbia School of Nursing will introduce a four-year "doctor of nursing practice" doctoral program that teaches much broader skills, such as evaluating clinical studies and setting up independent practices. As they gain these new skills, nurse practitioners are branching out beyond primary care to fill a growing need for personnel in many areas of medicine, including specialties such as long-term care providers for the elderly.

I think this is an absurd idea for nurse practitioners. A 4 year doctoral degree to become a nurse practitioner? This will actually be a REQUIREMENT to become an NP by the year 2015 if certain nursing interest groups get their way. WHY is there such a big push for this if nurse practitioners really aren't planning on competing with physicians like the special interest groups claim? The degree will teach NP's how to set up INDEPENDENT PRACTICES...how is this not competing with physicians? NP's having a doctoral degree may want to be referred to as "Doctor"...how is this not competing with physicians? I think this requirement may very well hurt the profession as a whole by doing the following: Decreasing the number of NP applicants, creating friction between physicians and NP's due to title use and physicians viewing NP's as competition, and create more role confusion for the public regarding nursing and the concept of the nurse practitioner.

Let's look at this idea folks. One goes to school for his or her BSN (Typically 4 to 5 years). Then one goes to school 4 more years for the Doctorate of Nursing Practice Degree. That's 8 to 9 years. Then he or she gets a position starting at $60,000 - $70,000 a year, if he or she is lucky (I have met NP's starting out as new gaduates making $54,000/year). No residency will be required like traditional medical school, but you can bet the universities offering such a program will charge you quite a pretty penny for the doctoral degree. (Just look at schools offering the PharmD, the DPT, the Aud.D, etc. These programs ARE EXPENSIVE, costly, and time consuming.) Then, to make things more fun, NP's will have to go against the grain of the medical profession (the AMA, including specialty groups of MD's and DO's) to fight for priveleges to practice independently in states unaccepting of the NP as an independent provider. Then there will be fights about getting empaneled by insurance companies for direct reimbursement for services provided. This will not be a smooth transition...this will be a war! The AMA is a powerful entity, both politically and socially.

Now don't get me wrong. I WANT to become an NP. But I want to get mine in 30 months as opposed to 4 years. I DO NOT want to be a doctor. I do NOT want to be called "doctor". I especially do not want to be a "doctor nurse". If I wanted to spend all that time in school, like the new degree proposes, I would GO to medical school. This way I would get a well respected MEDICAL DEGREE in the same amount of time, complete my residency, and then start out making $130,000/year (on average) instead of $60 - 70,000 a year. Oh, and I wouldn't have to worry about "physician collaboration", independent practice restrictions, being reimbursed by insurance companies, prescriptive privileges, or public confusion about my role in the healthcare system. And don't fool yourselves, many other intelligent people will see things my way too, which will lead to LESS NP's, which is a BAD thing for the profession.

Nursing isn't ready for this idea right now. There are too many other issues nursing needs to worry about first. What do you think about this issue?

You are right....check ut above link.

[Coffeegirly]

It's not nursing that isn't ready for this, it's the AMA that isn't ready for this. They are threatened big time. I can only hope that nurses don't run off afraid which has often been the history because the AMA is so big and powerful. Yet nursing is large but predominantly female. With more and more males entering, let's hope our voice changes more and we all start feeling stronger and more empowered to stand up to this group called the AMA who is clearly threatened by us. No one wants to take anything away from their role. I don't know about you but I respect them. They have expertise and knowledge way beyond mine... I have my own. Why they would think I would be a threat to them is silly. Are they worried about patient satisfaction and $? probably.

That's the reality of it all. It's politics.