Clinical Doctorate in Anesthsia

Specialties CRNA

Published

I've read and heard that eventually, 2011 - 2013, the entry level degree into Nurse Anesthsia will be a Doctorate (comparable to PharmD). Can anyone at this time offer any specifics on how this is to be implemented?

I was pretty excited about reading this. I hope that it is more than just a measure to appease egos and status and more of a venture into an advanced knowledge base (research and clinical).

Do you think that it is even needed?

Specializes in ECMO.

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they are still nurses. and what is a nurse? someone who holds the RN license. i think you could assume they have the same basic education. diff skills. everyone knows that duh! i wouldnt let a med surg nurses float to ICU. im not that ignorant. nor would i let a med surg nurse into a CRNA program. yes i have worked beside many nurses. in OR, cath, intermediate ICU...

Im sure being a moniter tech you don't "let" nurses do much. You're in

over your head. Let some of the nurses you work beside read some of you're

posts. I'm willing to bet they'll straighten you out.

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The faculty are needed before it produces DrNP graduates! I don't see how this helps the faculty shortage! [/Quote]

But these programs already exist. Don't you think it possible, and even quite likely, that faculty are already enrolled in these programs, as an alternative to research doctorates?

I'm not sure about nursing but in many other fields tenure for faculty members (associate professor rank) requires an academic doctorate (e.g., PhD, EdD, ScD). The DrNP does not qualify as such.

This is an incorrect assumption. DNP is a terminal degree, a full fledged academic doctorate. It is not a research doctorate. Neither is a MD, by the way! True, a PhD is the top of the totem pole, and qualifies a person for higher academic positions. But do not count out practice doctorates. I know several tenure track faculty in this category.

they do not hold PhDs and would not significantly differ from MSNAs nor would they be likely to frequently publish in peer-reviewed journals as prinicpal investigators

Why not? MDs hold practice doctorates, and they are often prinicpal investigators.

Many might consider Nurse Anesthesia more medicine than nursing.

Many might, but they would be wrong. This is a matter of fact, not opinion. I do not hold a degree in medicine, by definition I am not a physician and my actions are not medical actions. I am a nurse by education, licensure and certification. Just because someone thinks that it "looks like medicine" doesn't make it so.

There are those who go into nursing with that sole goal in mind because they are interested in medicine and not nursing.

If they do, they are not getting what they want. It doesn't change the facts.

Nurses and other allied health professionals are all important members of healthcare; however, physicans are and will remain the most completely and thoroughly trained healthcare members for the foreseeable future. This isnt meant to undermine the services provide by or education provided to nurses but rather to keep things in perspective.

You are entitled to that opinion. I disagree, and hold the opinion that health care will continue to evolve in such complex ways that no single person or discipline can possibly have all the answers. We will work more and more in integrated teams. The old paradigm of physician at the top of the pyramid will not only begin to be less efficient, it will begin to become counter productive (some might say it already is, in some settings).

Clinical/practice doctorates are a natural evolution in advanced practice nursing.

loisane crna

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Specializes in Neuroscience ICU, Orthopedics.
Many might, but they would be wrong. This is a matter of fact, not opinion. I do not hold a degree in medicine, by definition I am not a physician and my actions are not medical actions. I am a nurse by education, licensure and certification. Just because someone thinks that it "looks like medicine" doesn't make it so.

This is a point of interest that I am personally trying discern and understand, in terms of its application. How does one differentiate model of practice, that of an MD from a CRNA, in the application of anesthetising agents and all other peripheral components associated with such?

It could very well be that each model mimics the other under certain condtions, but because a CRNA is licensed and certified as an RN, therefore the CRNA's model of practice cannot be termed or thought of, in its application, as anything but nursing? Is this what you are saying?

You are entitled to that opinion. I disagree, and hold the opinion that health care will continue to evolve in such complex ways that no single person or discipline can possibly have all the answers. We will work more and more in integrated teams. The old paradigm of physician at the top of the pyramid will not only begin to be less efficient, it will begin to become counter productive (some might say it already is, in some settings).

Clinical/practice doctorates are a natural evolution in advanced practice nursing.

loisane crna

loisane, I really think that you are on the money with that statement because one has to realize the natural progression of things in that all things evolve. For this reason alone we should perhaps remove our blinders and think a bit more outside of the box -- in terms of how current healthcare, and its providers, will evolve.

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A couple points here;

I have gone through pretty much the most rigorous AP, pharm etc that a master's level nursing program can offer. I am friends with alot of MD's, residents and med students. I can say that from their accounts that they were tortured with even more depth than I was. Now if I were to advance onto RN doctorate, I doubt this is intended to make me an MDA equal. From my understanding, a doctorate in nursing involves alot of abstract theory, statistical analysis and research. I like to think of myself as open minded, but I fail to see how this is going to make me a master of regional techniques. The intention of entry level RN doctorates is to help alleviate the nursing faculty shortage which is much worse that the actual nursing shortage. Finding CRNA instructors is like finding hen's teeth.

The preparations for CRNA and MD are incomparably different.

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A couple points here;

I have gone through pretty much the most rigorous AP, pharm etc that a master's level nursing program can offer. I am friends with alot of MD's, residents and med students. I can say that from their accounts that they were tortured with even more depth than I was. Now if I were to advance onto RN doctorate, I doubt this is intended to make me an MDA equal. From my understanding, a doctorate in nursing involves alot of abstract theory, statistical analysis and research. I like to think of myself as open minded, but I fail to see how this is going to make me a master of regional techniques. The intention of entry level RN doctorates is to help alleviate the nursing faculty shortage which is much worse that the actual nursing shortage. Finding CRNA instructors is like finding hen's teeth.

The preparations for CRNA and MD are incomparably different.

I agree with you on many points. All of us SRNAs (RRNAs whatever) go through some of the most rigorous interviewing processes, pharm etc that we can imagine...many of the MDs are tortured more extensively. CRNAs are not MDs, nor should they ever claim to be. However, nor should an MD reduce us to babysitters for their patients. There is a lot of lack of respect on both sides. That has to stop. As for the DNP, I agree it's just a nice way to find additional instructors. I think its kind of a waste of time. It will not increase CRNA independence.

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Trauma,

Im a SRNA with Bradley University and they have not implemented the doctorate yet. There have discussed changing it but they havent discussed how the cirriculum would change. The actual degree would be a DNP (Doctorate of Nursing practice).

Bradley University in Peoria, IL has already started the DNSc degree for the CRNA program.
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These clinical doctorate degrees are a great thing. A masters or PhD degree in Nursing is no longer the highest we can go in our profession. Now we have a post-masters clinical program with a residency component. In my home state (NY) the Board of Regents (aka the powers that be) approved the clinical doctorate nurse (DrNP) program at Columbia U, and word is that other universities around the country are developing programs of their own. The program at Columbia is not the same as the DrNSc degree (which is more research-based). I've been reading about it on their website and its very interesting stuff for anyone out there who's interested in becoming a primary care APN.

http://cpmcnet.columbia.edu/dept/nursing/academics-programs/drnpfaq.html#3

http://www.regents.nysed.gov/2005Meetings/February2005/0205heppca3.htm

Now, before anyone goes and starts an angry MD vs DrNP thread, please understand that this has nothing to do with physicians. This is a new type of advance practice 'super nurse' (if you will) who is also a clinical doctor, and who is able to independently provide primary care services to anybody. Also, unlike NPs, DrNPs in NY are able to independently bill and be reimbursed at the same rates that the physicians receive. I think this is really awesome!

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Specializes in ECMO.

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Specializes in Neuroscience ICU, Orthopedics.
what do u mean i dont let nurses do much? um my supervisor is a nurse. of course i respect them. heck the only reason i got a job as a mt was because i wanted to go to nursing school. then i found out it wasnt for me. i dont want to be a doctor either, so im not picking favorites. and i stand by what i said. like for example i would not let a med surg nurse float to a icu. its against our hospital policy also bc many nurses dont feel prepared. administration didnt put out this rule, the nurses demanded it. they have specials groups. like a tele nurse can float to ortho, med/surg/, onc...psych are by themselves....er can go to micu, iicu, sicu......you see what im saying? what else do i need to be straightened out on?

Ramiro,

Help me out, here. And I am not trying to exasperate things for you. Why are you of the opinion that CRNA's should not practice without MD/MDA supervision? Is it something that you have witnessed that makes you feel that supervision is necessary, is it because of educational requirements for CRNA's, or CRNA's clinical exposure?

Again, as some of the previous posters have stated, it would very beneficial to understand a CRNA's scope of practice, and CRNA's history in the art of anesthesia. So, if you look at it in terms of anesthesia and the applicaton thereof, and considering how one might define the scope of practice of MDA's under this light, why is supervison for CRNA's a necessity? And let me offer up that I am not a CRNA, nor have I made it into nursing school, yet. But, I do hope that I can eventually become a CRNA.

Also, we should keep in mind that the point of topic here concerns clinical doctorates in anesthesia: a much needed educational vehicle, enabling CRNA's to hone and increase their skills and/or knowledge base, that reflects an evolving healthcare system or is it merely "set-dressing" as a form of self-aggrandizement and self-preservation?

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To the above poster, with all due respect, calling yourself a "dr" or using such title in the clinical arena, unless you are a physician, to a patient is misleading at best.

This statement is inaccurate. DrNPs in New York are permitted to use the title "dr" in the clinical area and it is not at all misleading because, strange as it may sound, they are clinical doctors---just of a different sort.

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Now, before anyone goes and starts an angry MD vs DrNP thread, please understand that this has nothing to do with physicians. This is a new type of advance practice 'super nurse' (if you will) who is also a clinical doctor, and who is able to independently provide primary care services to anybody. Also, unlike NPs, DrNPs in NY are able to independently bill and be reimbursed at the same rates that the physicians receive. I think this is really awesome!

Just remember that scope of practice is determined by individual states, NOT nursing schools and nursing organizations. Maybe it's that way in NY, but it's not in most other states.

And at least for anesthesia, isn't it really just a title? I haven't read anything here that indicates any different scope of practice or responsibility with a DNP compared to a master's, bachelor's, or no-degreed CRNA.

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