NPs practicing as DRs

Specialties NP

Published

  1. Is the current DNP a "Clinical Doctorate"

    • 53
      Yes
    • 72
      No

99 members have participated

This has been a heated discussion between some of my friends and I, so I thought I would bring it to the forum.

Should people who are going through a DNP programs and taking the SAME test we all took for our MSN - NP for national certification think their education 'doctorate" is a clinical doctorate?

Until there is a national standard and an elevation of the test (think along the USMLE) then I think anyone who thinks their DNP is a clinical doctorate is a joke.

your thoughts. . . . .?

Specializes in cardiac, ICU, education.
There are some that offer fellowships in pain or critical care medicine. It is a whole new world and I am dismayed to see RNs fighting against these changes instead of pushing for improvements as the DNP will help our profession.

Hey I agree, I just see the point that we really need to decide on all levels what the entry to practice will be for both RN's and NP's. We are confusing everyone out there - us included. The cost of the DNP will be prohibitive but if someone wants to advance their education to make nursing even better, than God bless em.

Specializes in Anesthesia, Pain, Emergency Medicine.

Yep, I agree with you on that point. I would take a peds fellowship trained anesthesia provider over one who is not. The issue is that there are few fellowship trained anesthesia providers except in big urban areas.

I've done pedi cases for over 20 years without any complications. Much of anesthesia is an art. It is difficult to explain but take the pedi population. Some anesthesia provider have them wake up "wild" almost every time. My pedi cases almost always wake up calm and sleepy. So what is the difference? Again, hard to explain but there are no "recipes", each anesthesia providers uses various drugs, combinations and dosages he likes and thinks the pt. needs.

I also agree with you about the dnp and fellowships. It is heading that way but I think the schools make more money with a "generic" dnp/dnap.

There is no "regional" fellowship that I'm aware of.

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The reason I talked about this article specifically is that Franklin Dexter is a past colleague of mine. He was a consultant on a project I did in Wisconsin to make an OR more efficient.

Oh believe me not all of them are. The largest hospital group in the state has eliminated every CRNA position system wide and went to an all MD group. They hired over 50 MDAs to replace the CRNA's.

Yes, the team approach makes more money, but there is a lot of push back recently. It depends on the group and the culture at said hospital. In fact a group in our state fired all of the MD's (or eliminated their contract because they were independent) because they would not come in at night to supervise the CRNAs which led to some serious problems. Another group took over and it is in their contract to be in-house while any surgery is happening.

It makes my blood boil when MDA's don't fulfill their obligations and I am sure there are many competent CRNA's out there. I would think with this DNP push, however, they would consider a fellowship for specialties. I know they have a pain one, but I think our MDAs who are cardiac, peds, regional, etc., fellowship trained are superior to anyone practicing and if me or my kids were going to be put to sleep, they would be the provider.

Specializes in Anesthesia, Pain, Emergency Medicine.

I agree. If I had it to do over again, I think I would wait until a fellowship DNP was offered.

Specializes in Anesthesia, Pain, Emergency Medicine.

Yep, my reply was directed at PMFB

He wrote the following which is simply not true.

In any case, in a level I, MDA's must be available 24 hours a day and in every state that I know of they have to be in house. In Wisconsin they have to be within 20 min of the hospital when they are on call. Either your CRNAs are not doing level I cases or the MDAs are not practicing properly.

That is not what I said. I said that a level I hospital must be staffed.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

yes, there would be more, there just isn't enough to do right now.

*** ok but i have to tell you that i am very skeptical that enough residency trained anesthesiologists would be interested in working in rural, undeserved areas. maybe i am wrong.

a level i trauma is a hospital status and mode of accident or injury.it is not an anesthesia term - it is an er term

*** yes i understand exactly what it means to be level i or ii or ii or iv trauma hospital. i was part of a hospital committee trying to decide what we would have to change to go from level ii to level i. however that is all off topic. i didn't make the claim the hospital was a level i trauma hospital.

when i say level i or level ii trauma it is a tool we use to note the severity of the injury. when traumas are paged out to the trauma team they say "trauma level i or trauma level ii. the sicu nurses who are part of the trauma team don't respond to level iii or iv traumas.

for instance: a gunshot wound is a level i trauma, but they may not need surgery, but a patient - who fell from a 8 foot ladder -and broke his arm initially is listed as level ii but then turns out to need surgery.

*** yes exactly. how this became about the trauma level certification of a hospital i don't understand.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
yep, my reply was directed at pmfb

he wrote the following which is simply not true.

in any case, in a level i, mda's must be available 24 hours a day and in every state that i know of they have to be in house. in wisconsin they have to be within 20 min of the hospital when they are on call. either your crnas are not doing level i cases or the mdas are not practicing properly.

*** uh i didn't write that. even in your post it clearly attributed that quote to msn10.

Specializes in Anesthesia, Pain, Emergency Medicine.

You are correct. My apology.

Specializes in cardiac, ICU, education.
In any case, in a level I, MDA's must be available 24 hours a day and in every state that I know of they have to be in house. In Wisconsin they have to be within 20 min of the hospital when they are on call. Either your CRNAs are not doing level I cases or the MDAs are not practicing properly.

I correct the statement to say Level II needs 20 minutes, but Let me clarify my statement, The teaching hospitals with anesthesia residents (not chiefs) need in house supervision by an MD which are level I. However, according to trauma I level certification:

11-5 When anesthesiology chief residents or CRNAs are used to fulfill availability requirements, the staff anesthesiologist on call is (1) advised, (2) promptly available at all times, and(3) present for all operations.

If your hospitals aren't doing that especially at teaching ones, then, well, they sound noncompliant.

*** We have two DNPs who are not advanced practice nurses. One works in the employee education department and another is an ICU nurse. They both got their DNP through U of P and nobody calls them doctor.
U of P is a joke
Specializes in FNP, ONP.

I feel compelled to add that I have a colleague that got her NP from U of P and she is an outstanding NP. I think she was a nurse for a year or two first. Frankly, I don't like her, and we certainly are not friends so my defense of her is purely objective and I can acknowledge that she is very, very good at her job. So while as a graduate of "The New Ivy," as Duke likes to be known, I do admit to believing I probably received a superior education, I need to be fair and give credit where credit is due and I don't think it is fair to refer to U of P as a joke. Do I want my kids to go there? No. But I'm not willing to say that everyone who comes out of there should be embarrassed to say so.

I feel compelled to add that I have a colleague that got her NP from U of P and she is an outstanding NP. I think she was a nurse for a year or two first. Frankly, I don't like her, and we certainly are not friends so my defense of her is purely objective and I can acknowledge that she is very, very good at her job. So while as a graduate of "The New Ivy," as Duke likes to be known, I do admit to believing I probably received a superior education, I need to be fair and give credit where credit is due and I don't think it is fair to refer to U of P as a joke. Do I want my kids to go there? No. But I'm not willing to say that everyone who comes out of there should be embarrassed to say so.
I don't mean to seem like I am saying all graduates are jokes, just the school. They screw their students over in many circumstances and are sketchy when it comes to how they handle student loans, etc.
Specializes in Critical Care.

she is a good clinician in spite of u of p, not because of them, if i had to guess...

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