CRNA Doctorate??

Jengirl18 · Mar 25, 2006

Hopefully, if CRNA does go Doctorate, it will be of more substance than the 40-50 credit hours required for the DrNP... Mostly nursing theory classes. Other doctorate degrees take 2-3 years to complete.

DebbieSue · Mar 25, 2006

The move toward making the DNP the standard ed. level for all advanced practice RNs is the 'next big thing'. I, for one, agree with it. First of all, it's about time that there is a CLINICAL doctorate in nursing. In this case the 'NP' in DNP stands for Nursing Practice (not Nurse Practitioner). So there will be 2 tracks: one the research-focused Ph.D., and the clinical practice DNS. In this day and age of Doctor of Chiropractic and Doctor of Podiatry, advanced practice nursing really NEEDS to go in this direction.

Please let's not diss the other advanced nursing practice specialties. When you do that, it just shows that you are seriously lacking a broad viewpoint and experience in the field and/or don't have the maturity that is required of advanced nursing practice. You can't compare apples and oranges. What gives anyone on this board the right to downplay the schooling and expertise that nurse midwives need everyday in their practice? Or acute care NPs? Or neonatal NPs who essentionally do everything that an MD can do as far as management of tiny vulnerable premies and procedures, etc.? CNSs develop and design system-wide programs that can and do change the entire practice of all the nurses in a system.

I'm sorry about the people who want to zip from not-yet-a-nurse to CRNA, but I don't see any reason why there should necessarily be options to make that transition quick. I , for one, don't think that transition should be able to be quick. It just smacks so much of "I'm an auto mechanic, but want something that pays better and I heard that you can become a nurse anesthetist, whatever that is, in 7-ish years beginning-to-end, and really rake in the bucks...." Or a marine biologist, or an engineer, or a paramedic. I think that part of the reason that nurse anesthesia is considered the 'poor relation' of advanced practice nursing specialities is that so many people seem to ignor the N in CRNA. Wanting the 'glory', but not willing to do the up-front 'growing as a nurse'. And not doing anything to grow nursing as a profession after becoming CRNA. It's the same as saying, "Let's see, I have always dreamed of delivering babies...what is the absolute quickest way I can get to do that? Oh, and by the way, I'm just going to have to try to put up with those pesky requirements that I go through nursing school, become a nurse, and practice for a year." Holy god, keep that person away from me when I'm pregnant!!!!

And there is no way that any anesthesia DNP program would be equal in time to becoming an anesthesiologist. Puhleeze! 4 years pre-med, 4 years med school, and then residency, which is always at least 3-4 years. And besides, there are huge fundamental differences between nursing and medicine.

OK, off my soapbox.

I wish the DNP thing was happening right now. I'm just hoping the current, Masters-prepared APNs get grandfathered in somehouw.

VickyRN, MSN, DNP, RN · Mar 25, 2006

I have commented on this issue before. There is one near insurmountable hurdle to the CRNA Doctorate issue that most people are overlooking: the lack of qualified CRNA faculty with doctorates. Until this issue is resolved, it will be impossible to implement a mandatory CRNA Doctorate.

https://allnurses.com/forums/1153995-post16.html

https://allnurses.com/forums/1173853-post84.html

MmacFN · Mar 25, 2006

debbie

While I think that DnP is a great step and certainly the next logical move to solidify knowledge specific to a profession (the definition of profession), we have to be realistic as well.

Nursing, NP, CRNA etc; they are all in a state of shortage because all of them come from experienced RNs which are already in crisis. The numerous other professions you mention with masters and doctorates are in no such shortage and are not in danger of it happening anytime soon. The nursing shortage is only expected to get worse.

While I am all for education, this is not the time to push. The reality is that if there is more time added to the CRNA program (or any advanced RN program) there will be fewer applicants and fewer graduates yearly along with longer education expense and time. This isnt going to help, it is going to cause the opposite effect.

Ask yourself; why is it that AAs (regardless of training) are slowly gaining acceptance? Its easy, the same reason CRNAs did. CRNAs started out of nessicity based on the need for a surgeon to have someone do anesthesia. In the begging this was done by interns who had no interest in anesthesia but only surgery. There was also no economic reason for MDs to take on anesthesia. A niche was created that was being filled at Mayo hospital by RNs. Why is that? The answer is easy, because there was a shortage (or an abscence) of interest by other parties to do the job. When physicians decided they wanted a piece of the pie; this signifigantly changed.

Now here we are, many years later at an equal footing (clinically) as physicians within the anesthesia field. While the role of "leaders" in the anesthesia field has since been usurped by physicians, there is a clear place for CRNAs and more than enough jobs to support both factions. Now the tables are turning.

Currently, there is a signifigant shortage of CRNAs across the country. There is a niche for other groups to exploit. While i dont think the profession is in jeaprody, I think we are walking a dangerous path. If you have noticed, AAs are becoming more common and lobbying for practice in many states. It will be hard for states not to open to them as the shortage gets worse, the same thing has been happening with paramedics and LPNs in ERs where there are shortages. Essentially, allowing other providers to do the jobs we have fought to carve out for nurses.

Consider adding even one more year of education (and cost) to any RN job (advanced or otherwise) and how that would affect the volume of applicants. This would exponentially increase the "niche" already in existance. Why is this an issue? Many would agree that CRNAs are very established and the "standard" only second to MDA for anesthesia. However, if you read your CRNA history, the largest detractors (and sometimes supporters) vs CRNAs have been physicians. AAs represent exactly how CRNAs were seen at the begging of the profession, the handmaidens of physicians. Enter a program which pops out AAs in 1/2 the total time (or less in 70% of cases) and are absolutely subservient to the physician as well and you have a serious competitior in a market sorely needing anesthesia. Think now of the large hospital systems who make a fortune from surgeries. All the sudden, your shutting down ORs because of an acute lack of anesthesia.... AAs all the sudden dont look so bad.

In anycase, based on the history of CRNAs, the continuous friction between the MDA and the CRNA (at least politically) and lastly, the hospitals need for anesthesia and it should be clear why adding years(s) to the education is a bad idea in the currently times.

DebbieSue · Mar 26, 2006

I don't see any reason why any time should be added to the current educational programs in order to convert them from MSwhatever to DNP. I think that the DNP acknowledges that the level of practice is very high, certainly equivalent at least to chiropractors, optomitrists, podiatrists, etc., etc. And even if the DNP were not rewarded until after one year of practice--that wouldn't be adding any actual time to the process. You could still take the CRNA boards and start to practice. I think it should be: same educational requirements as now + one year of actual practice = DNS. You would be a CRNA after passing boards and before the year of practice, getting paid, etc. And the DNP would be awarded to you after a year of practice. It's like being a Ph.D. even before you have completed your dissertation--people do get to call themselves "Ph.D.s (pending)" before they are totally done. It could be the same with the DNP--you would call yourself a DNP, but to keep that credential, you would have to complete a year of practice. And there would be a deadline by which time one would have to complete the practice year.

And if the Masters-prepared advanced practice nurses get grandfathered in when the DNP starts (at which time the Masters programs will disappear) why then all anesthesia faculty would become grandfathered-DNPs and would/could continue as faculty.

It is my understanding that the DNP education is going to replace the Masters education. Not be in addition to it. And since one big sticking point is going to be NOT creating a system that totally screws all the Masters-prepared APNs currently in practice, I really think that there WILL be a stipulation to somehow grandfather the current MSN APNs to being DNPs.

I think the TRUE stumbling block most likely to occur is not a longer program, or lack of faculty, but the bugaboo of how non-nursing Masters programs, like MS in Anesthesia, or MS in Health Science, or any of the other non-nursing Masters degrees that CRNAs come out with, how they are going to transition to DNP? I mean, will only MSNs be able to grandfather to DNP?? Anesthesia is the only advanced practice nursing specialty that allows non-nursing Masters. I'm pretty sure that midwifery Masters are all nursing Masters, and I'm sure that the nurse practitioner and nurse specialist Masters are all nursing Masters. Anesthesia has a number of non-nursing Masters degrees. I don't understand why this is, since it is a NURSING specialty.

Anyway, this is all just pipe-dreaming. Unitl I start to actually see the BSN to DNP happening, this is moot. And also, regardless of what credentials one has, to others in the healthcare systems, a nurse is a nurse is a nurse, etc. I doubt if most docs even know what the term 'advanced practice nursing' means........And no way within the hospital will we ever be allowed to be called 'Doctor' anything. (Although I know of PhD psychologists who have priveleges and are called Dr. within the hospital and while in the company of psychiatrists.) Having CRNAs given the title Doctor would make the ASA and AMA go ballistic--but it would be great for APNs to actually get the recognition for what they have been doing all these years.

God, I have forgotten what my reason for 'reply'ing actually was......

MmacFN · Mar 26, 2006

hey debbie

That is an excellent point. I agree with you. If there is no added time then there isnt a reason to hold back on DnP.

Sadly, i also agree that even if there is a Doctorate involved, there would be absolutely no recognition of that within the hospital. However, i also believe that it would look good for the profession to have this "step up" as it were.

Jengirl18 · Mar 26, 2006

Hey guys, I'm still learning about the scope of practice of a DrNP. Pardon me if I disagree with one of the above posts, but I dont think you can compare the level of a DrNP to a Podiatrist. Podiatrists are licensed to perform surgery autonomously and go to school full time for 4 years and also do a residency. From what I have been reading, DrNP is only a few more credit hours than an NP, so I dont think they are on the "same level" as Podiatrist. Both are well respected professions.

VickyRN, MSN, DNP, RN · Mar 26, 2006

And if the Masters-prepared advanced practice nurses get grandfathered in when the DNP starts (at which time the Masters programs will disappear) why then all anesthesia faculty would become grandfathered-DNPs and would/could continue as faculty....
I really think that there WILL be a stipulation to somehow grandfather the current MSN APNs to being DNPs.
I think the TRUE stumbling block most likely to occur is not a longer program, or lack of faculty, but the bugaboo of how non-nursing Masters programs, like MS in Anesthesia, or MS in Health Science, or any of the other non-nursing Masters degrees that CRNAs come out with, how they are going to transition to DNP?

No, that is not the way it works. CRNA's with Masters degrees would be allowed to continue to practice as CRNA's by the act of grandfathering (much like the diploma nurses in Canada were grandfathered in prior to the mandatory BSN enacted in many provinces - These nurses are still diploma, allowed to continue to practice as RN's, but are not BSN's). In this hypothetical scenario, these Masters CRNA's would not be awarded a DNP by virtue of grandfathering. They would simply be allowed to continue to practice as CRNA's - period. If they want the DNP title, then they would have to "pay the price" by furthering their education. The same holds true for nursing faculty - They all would have to further their education to earn the doctorate title behind their name. And, you cannot conduct a doctorate program with Masters-prepared faculty. Unfortunately, most of the faculty in CRNA programs only possess a Masters degree.

MmacFN · Mar 26, 2006

vicky

Are you currently a CRNA? Im just wondering where you have read this?

Nitecap · Mar 26, 2006

vicky
Are you currently a CRNA? Im just wondering where you have read this?

Yeah I have not heard this. The degree would be meaningless if we could just grandfather everyone in. And programs will be lengthened no doubt. More emphasis will be placed on didactics and research theory classes. If a CRNA wants the extra title they will have to go back to school and take the extra coures. When implemented all new grad CRNA's will have the clinical doctorate.

VickyRN, MSN, DNP, RN · Mar 26, 2006

Yeah I have not heard this. The degree would be meaningless if we could just grandfather everyone in. And programs will be lengthened no doubt. More emphasis will be placed on didactics and research theory classes. If a CRNA wants the extra title they will have to go back to school and take the extra coures.

Exactly... Which again brings up my point - Where are you going to find adequate qualified doctorally-prepared CRNA faculty to make this DNP requirement possible?

rn29306 · Mar 26, 2006

More emphasis will be placed on didactics and research theory classes. If a CRNA wants the extra title they will have to go back to school and take the extra coures.

I would be willing to bet the majority of practicing clinicians would tell the AANA to stuff it.

And I would volunteer be the first.