CRNA Doctorate??

[Brenna's Dad]

After reading the new AANA educational program policies and hearing about the renewed interest in increasing doctorate prepared nurse anesthetists (both clinical and PhD), I am curious what doctorate options for nurse anesthetists are currently available.

Are there any doctorate programs that focus specifically on anesthesia, pharmacology, biology etc, or must you participate in a more generalized nursing science program.?

[MmacFN]

Vicky

Again, where did you read this or are you simply making an assumption?

[DebbieSue]

Well, if the DNP does not take off nationally, it will be because the current Masters-prepared APNs will put up a fight. In every article I have read about the DNP, the one question everyone asks is, "What about the current APNs?"

I have a friend who is currently setting up one of those replace-the-MSN DNP programs, and there will be few, if any, additional courses. I very highly doubt if the AACN (the credentialling org) is going to make it hard to convert. The whole point that everyone acknowledges started this all is that APNs AT THEIR CURRENT PRACTICE LEVEL are comparable to other allied health practice doctorates. I wouldn't be surprised if the trend becomes BSN-to-Ph.D when the BSN-to-DNP becomes common. This whole thing is about getting rid of the Masters level. As long as other professions have ed programs that are Bachelors to Doctorate, then the push is going to be to do that in nursing, too.

I don't think that a regulation mandating a switch to DNP will work in anesthesia because so many of the programs are not MSN and the instructors have non-nursing Masters degrees. There will be no official or unofficial 'grandfathering' of those Masters up to the DNP. I'm sure that the AANA will eventually get around this somehow. As far as faculty goes, I know that the program my friend is starting is going to be taught by 'grandfathered' DNPs. She will be one of them. And I am talking a very prestigious School of Nursing--one of the top 10 in the nation. An interesting point, however: the head of the anesthesia program is not talking about the DNP yet, probably because the AANA is not completely on board yet. The only anesthesia programs that could make the change quickly are MSN ones. My friend is working on the NP and CNS switch.

This bandwagon is already rolling.....and programs are jumping on all over the place. And doing what they have to do to make it happen.

As far as podiatry goes.....like nurse anesthesia, nurse midwifery, nurse practitioning, and the CNS, it is a deep but narrow knowledge-base. I don't think that doing foot surgery as it is done by them is any more advanced than what a CRNA or NP or CNM or CNS does....it is just different.

All the allied health advanced practice (including nursing) is deep but narrow. MDs/DOs knowledge base is deep and broad. That's what MDs get out of all the additional years of school and residency. That's what they should get credit for. That's what they get paid for-- and why they are paid more.

This is an interesting discussion....

Debbie, RN, MSN, CNS

[Jengirl18]

I'm with you Vicky. There is no reason for a Doctorate if it isnt more academic. There's no reason to dumb down degrees. Let it be something that NPs can be proud of that they earned, not one that ppl will think that was given away. It's also misleading to the patients.

[UCDSICURN]

Vicky

Again, where did you read this or are you simply making an assumption?

That's how the grand-fathering worked before. CRNA's didn't always need a master's degree and when they transitioned to having the master's as the entry-level degree requirement for CRNA's, they grandfathered all practicing CRNA's so they could keep practicing with their BSN's with CRNA certificates.

[MmacFN]

ah

interesting. Well maybe it will occur that way

[UCDSICURN]

Looks like the brakes have been on for this movement anyhow, at least for the time being.

http://www.aana.com/education/dnp/pdfs/interim_dnp_position_stmt.pdf

[MmacFN]

UCD

thanks for the info/update!

[DebbieSue]

The point that Jen and Vicky are missing is that the DNP is being created specifically to replace the advanced practice MSN level of education. This is the whole point: advanced practice RNs practice at a very high level. Let's put them on an even playing field with, let's say, doctorate-level pharmacists, PTs, chiropractors, optomotrists, etc. since they practice at the same level as these others already. It's the BSN-to-MSN-to-doctorate progression that is going to change in nursing. The MSN is going to disappear--at least in the advanced practice specialties (i.e., NP, CRNA, CNM, CNS).

It will not be a 'dumbed-down' doctorate--what we have now is a 'too-smart' practice-Masters in nursing.APNs (with a Masters degree) are as advanced in their practice as other allied-health doctorates. The powers-that-be in nursing want advanced practice nurses to get the credit they deserve, and the money, and are trying to convert the practice-Masters to a practice-Doctorate for this reason. It's essentially going to be a change in-name-only, since the nursing-practice-Masters is already equivalent to the practice-Doctorate in other fields. That's why I say there will be 'grandfathering'. You have to think of grandfathering in this specific situation--and forget about the 'grandfathering' that has happened at other times in nursing. CRNA practice is already doctorate-level practice, as is the practice of NPs and CNMs and CNSs. Nursing has unfortunately for decades and decades thought of the doctoral level as being only about research and the Ph.D. That is now known to be a fallacy: research is one but not the only way to be a doctorate-level nurse. The powers-that-be finally got their heads out of the ivory towers, looked at what APNs actually DO, were pretty darned impressed, and realized that the 'levels' as they have been set for all these years are wrong. Advanced practice is not somehow 'less' than doing research. Again, it is just different. What CRNAs do, for example, is certainly not 'less' than what a researcher does. It is simply a different body of knowledge. In fact one could say, since actual practice is what nursing is really all about, that advanced practice is just as good as, if not more illustrious than, research. That certainly is a new way of looking at things, isn't it??? The AACN has acknowledged this and is trying to make things right.

I personally think things got off kilter because, for many, many years, the Ph.D. was the only doctorate degree that one could get in a nursing program. I mean, nursing schools in universities offered a BSN, an MSN, and a Ph.D with Education and Administration tracts. These well-educated nurses were as far removed from actual practice as they could possibly be. Meanwhile, some of the nurses in the trenches, so to speak, were moving into advanced practice roles totally outside the 'control' of the University crowd and outside of the 'usual' BSN-MSN-Ph.D. route. These were the nurses becoming nurse midwives, nurse anesthetists, nurse practitioners, and clinical nurse specialists. They learned the job on the job and not in the university setting. That doesn't mean, however, that these advanced roles did not require alot of very high-level knowledge. Only fairly recently has the dissemination of that high-level knowledge happened in MS programs. Even so, the knowledge is not MSN-level; it really is doctorate-level knowledge and, thus, the DNP-related goals of the AACN are appropriate. The AACN is actually playing catch-up trying to get the advanced practice programs positioned correctly within the levels of the schools of nursing. It has taken a long time to do this because the bulk of doctorate-prepared nurses in this country are not advanced PRACTICE nurses, but instead are advanced RESEARCH nurses. All those Ph.D.s really did not know where to position these programs but had the bias that if it was nursing practice, it couldn't be as demanding as nursing research. That's the reason that 3 out of the 4 advanced practice roles at first required only a certificate, and only much later required a Masters degree. Finally, advanced practice nursing has grown up and gotten the full attention of the-powers-that-be in nursing.

This is why I believe that the move toward the DNP is a VERY good thing for the profession as a whole and the advanced practice roles specifically. It certainly is about time.

The logistical issues, such as finding doctorally-prepared teachers, will not derail this coming change because it is really a fundamental change in nursing as a whole: finally acknowledging the supremacy and importance of hands-on patient care for even the highest 'level' nurses. The focus has moved away from seeing only the 'ivory tower' Ph.D.s as the 'stars' of the profession.

...thus spake Debbie....

[MmacFN]

good info debbie

I guess the question is how will it change the Core classes in the CRNA program now which allows it to be a MSN program as well. Im not expert, but when i think of doctorate in any profession, i consdier it highly research oriented in nature. Would you say this is how the classes will change?

As it currently stands the MSN core classes in the CRNA program are mostly fluff and useless by the admission of both teachers and students. How would the Doctorate classes be different, I wonder?

[DebbieSue]

Mke, you are not thinking in the advanced practice mode yet.

The core courses in the MSN programs are not 'fluff'. If you only look at it all from a putting-people-to-sleep aspect, they might not help you do that any better. Masters level core courses help you 'grow up' as a nurse, help you see the big picture and your place in the big picture.

All doctorate programs are not heavy into research. The Ph.D. is. But that is not the doctorate degree of the allied health practice doctorates. There are research doctorates and there are practice doctorates. They do not have the same focus.

More important things call.....like going downstairs to watch 'Big Love' My brain is fried.

[Nitecap]

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.

Nah I dont think they would. Listen nobody likes change but when its for the overall advancement or protection of the profession. The CRNA's that dont want to go ack that extra 6 months to the the DNP can keep practicing as they are. Those that wish to go back will go back. This move is all about the future not the present. Eventually al the masters prepared CRNA's and those with only certificates that were gradfathered in will retire and the entire CRNA work force will have the DNP.

I dont think its a move to knock on any CRNA's that dont want the DNP. Its merely a move to ensure advancement ect.

Listen nobody knows what the future holds for CRNA's and allied hlth practitioners in general. Even if its just a move to have a better title its a good idea. As professionals we deliver a needed service to the public. The public then judges us on our reputation, practice, research, documentation of safetey and excellence. To the public and lawmakers Joe Blow CRNA, DNP sounds way better and more credible than Hairy Back CRNA, MS or Wing Nut CRNA, cetificate practitioner. Support from the uniformed public is what keeps the profession at the status it is. If 6months of extra schooling and and a title change can help elevate that status than im all for it. This profession is alive and strong today largely due to proactice moves by its leadership to actualy implement changes to advance the profession before the time came the it was dire to change it. By staying ahead of the game we will continue the legacy of excellence no doubt.

[MmacFN]

Sorry debbie, i we will have to agree to disagree.

I have been doing advanced practice for some time as well as doing peer reviewed research and publication. This isnt my first rodeo just a different set of clowns!

If you are telling me that these classes are not "fluff" then you need to explain their relevance.

Health Policy, Legal & Ethical Dimensions of Practice

Epidemiology for the Health Professions

Informatics for Advanced Nursing Practice

These are just a few and i could list many. The majority of these classes are "Check off the box" situations. Ive taken a few already. There are similar classes in the BSN and any other degree which everyone can agree, have no relevance to practice. The MSN isnt any different.

Mke, you are not thinking in the advanced practice mode yet.

The core courses in the MSN programs are not 'fluff'. If you only look at it all from a putting-people-to-sleep aspect, they might not help you do that any better. Masters level core courses help you 'grow up' as a nurse, help you see the big picture and your place in the big picture.

All doctorate programs are not heavy into research. The Ph.D. is. But that is not the doctorate degree of the allied health practice doctorates. There are research doctorates and there are practice doctorates. They do not have the same focus.

More important things call.....like going downstairs to watch 'Big Love' My brain is fried.