DNP Article

elkpark · Dec 1, 2007

what we need is a doctorate centered purely on medical/clinical practice. a nursing version of an MD/DO, if you will.

But this is exactly what the DNP advocates are telling us the DNP is (is supposed to be, at least) -- a doctorate focused on clinical practice ...

Trauma Columnist · Dec 1, 2007

I think this take on the DNP and the resulting discussion we are having brings to light (once again) that the DNP is still misunderstood. Personally, if I had wanted to be a physician, I would have gone to med school. However, I LIKE nursing. There is nothing wrong with being there at the bedside of the patient. That said, why do we have to aspire to be an MD? Is that the APN's ultimate goal? For most of us, no. I work with quite a few APNs (different specialties) and unless we can become a cohesive group, we are NEVER going to be taken seriously by the medical community. Its okay if we disagree in private but you don't see the medical community with such dissension among the rank and file.

Burnt2 · Dec 1, 2007

I think this take on the DNP and the resulting discussion we are having brings to light (once again) that the DNP is still misunderstood. Personally, if I had wanted to be a physician, I would have gone to med school.

I agree with you 100%. The problem is, DNP's are being sold as physician equals (which is the impression anyone who reads that article will get), when clearly DNP's are not when it comes to true clinical practice.

So either they need to promote the DNP in a different light, or back up the "medical knowledge of a physician with the skills of a nurse" claim by offering the medical/clinical classes.

n_g · Dec 1, 2007

This article will become a lightening rod in the backlash movement against us.

westcoastgirl · Dec 2, 2007

I cringed reading that article, the ivory tower speak is going to negatively affect those of us working in the trenches.

In my neck of the woods one of the programs is already DNP only and constantly touting it at NP functions, who wants to come listen to the blah blah blah, while nobody in the room raises their hand wanting to go. It feels like a very one sided push from academia to me.

I can only pray my supervisors, all MDs, do not see this drivel and decide to hire only PAs for all future mid level positions.

prairienp · Dec 2, 2007

I cringed reading that article, the ivory tower speak is going to negatively affect those of us working in the trenches.
In my neck of the woods one of the programs is already DNP only and constantly touting it at NP functions, who wants to come listen to the blah blah blah, while nobody in the room raises their hand wanting to go. It feels like a very one sided push from academia to me.
I can only pray my supervisors, all MDs, do not see this drivel and decide to hire only PAs for all future mid level positions.

We all need to remember this is one voice from the ivory tower. She represents a DrNP not the DNP degree. The vast majority of DNP program directors are not saying what Dr. Mundinger is saying. Cool thing about free speech, everybody get an opinion, nobody has to listen. I still believe the DNP will result in a better prepared NP. Those that want the DrNP should go to Dr. Mundinger's program.

Trauma Columnist · Dec 2, 2007

My point is that she is furthering the void in practice levels of nursing practice. If we can't be united as a group (APNs), then we are not going to be taken seriously by the medical community.

elkpark · Dec 2, 2007

We all need to remember this is one voice from the ivory tower. She represents a DrNP not the DNP degree. The vast majority of DNP program directors are not saying what Dr. Mundinger is saying. Cool thing about free speech, everybody get an opinion, nobody has to listen. I still believe the DNP will result in a better prepared NP. Those that want the DrNP should go to Dr. Mundinger's program.

The biggest difference between the DrNP and DNP is simple semantics -- one of the big problems in nursing academia is that schools all name their doctoral degrees something different. "Clinical doctorates" have been around for a long time -- DSN, DNSc, ND, DNS (and probably several others I haven't run across or can't recall at the moment), and, now, the DNP (and DrNP -- whoop-dee-do; they both stand for "Doctor of Nursing Practice" -- I guess Columbia just thought it looked cooler to sneak that little "r" in there). (I ranted :) at length on this problem in another thread a while back, because it's a pet bugaboo of mine.)

And, yes, everyone gets to have an opinion, but Dr. Mundinger is the person who has published an article in major mainstream publication (Forbes), and her opinion (and misleading (IMHO) information) is all that most people outside of nursing, inc. most physicians, will see/hear about this controversy -- they will assume that she is speaking for the entire nursing community.

I'm not sure that the DNP programs will "result in a better-prepared NP" -- but, even if they do, so what? We could produce even better prepared NPs by making NP programs 10 year programs, but what about the law of diminishing returns? Do NPs really need to be that well-prepared?? I'm not aware that there was any problem/deficiency with the current generation of Master's-prepared NPs ... Are they all dangerously-undereducated quacks and I just haven't happened to read anything about that?

I think a lot of people are losing sight of the fact that the original idea of mid-level providers was to prepare large numbers of clinicians who could take care of most "garden variety" health problems with an education that involved significantly less time and $$$ than medical school. If NP programs are going to become more and more lengthy and expensive, then before long, as other posters here have noted, we're getting within spitting distance of the point where people might just as well go to med school.

core0 · Dec 2, 2007

the biggest difference between the drnp and dnp is simple semantics -- one of the big problems in nursing academia is that schools all name their doctoral degrees something different. "clinical doctorates" have been around for a long time -- dsn, dnsc, nd, dns (and probably several others i haven't run across or can't recall at the moment), and, now, the dnp (and drnp -- whoop-dee-do; they both stand for "doctor of nursing practice" -- i guess columbia just thought it looked cooler to sneak that little "r" in there). (i ranted :) at length on this problem in another thread a while back, because it's a pet bugaboo of mine.)
according the state bons and the nonpf the official name is dnp. it is supposed to replace the plethora of clinical doctorates that have popped up.
and, yes, everyone gets to have an opinion, but dr. mundinger is the person who has published an article in major mainstream publication (forbes), and her opinion (and misleading (imho) information) is all that most people outside of nursing, inc. most physicians, will see/hear about this controversy -- they will assume that she is speaking for the entire nursing community.
i agree. more importantly she is speaking as the dean of a major nursing program.
i'm not sure that the dnp programs will "result in a better-prepared np" -- but, even if they do, so what? we could produce even better prepared nps by making np programs 10 year programs, but what about the law of diminishing returns? do nps really need to be that well-prepared?? i'm not aware that there was any problem/deficiency with the current generation of master's-prepared nps ... are they all dangerously-undereducated quacks and i just haven't happened to read anything about that?
this has actually been discussed fairly extensively in the sticky at the top of the page. the state bons have identified pharmacology in particular as a shortcoming in np students. the only other study was by the canadians who identified time in clinicals as a shortcoming. there have been a number of other articles that suggested the same issues including one that called for np residencies similar to physician residencies.
i think a lot of people are losing sight of the fact that the original idea of mid-level providers was to prepare large numbers of clinicians who could take care of most "garden variety" health problems with an education that involved significantly less time and $$$ than medical school. if np programs are going to become more and more lengthy and expensive, then before long, as other posters here have noted, we're getting within spitting distance of the point where people might just as well go to med school.

two issues. health care has evolved since the 1960's. instead of 50 or 60 antibiotics we have several hundred. even simple issues have become more complex (look at the volumes of papers written on om for example). most of all expectations have evolved and since nps are seeing essentially the same conditions that physicians are seeing (at least in primary care) the training has to increase. we have yet to develop a system to reliably screen for "garden variety" conditions.

the issue i have is that the pharm issue really only adds three credits or so to the np curriculum or even 9 credits (to include pharm, more pathophsy and more clinical time) would not have put the total credits for an np program at odds with other masters programs. instead like any construct by committee it has morphed into the dnp.

david carpenter, pa-c

caldje · Dec 2, 2007

We all need to remember this is one voice from the ivory tower. She represents a DrNP not the DNP degree. The vast majority of DNP program directors are not saying what Dr. Mundinger is saying. Cool thing about free speech, everybody get an opinion, nobody has to listen. I still believe the DNP will result in a better prepared NP. Those that want the DrNP should go to Dr. Mundinger's program.

Don't you mean Nurse Mundinger?

JOKING! but i bet she'd be REALLY angry.

DaisyRN, ACNP · Dec 3, 2007

don't you mean nurse mundinger?
joking! but i bet she'd be really angry.

i have had numerous doctorate level instructors, e.g. phd instructors, and are they not called... "dr. xyz?"

again, it falls back on semantics... "doctor" is just naturally associated with medical doctors, but don't all doctoral-level individuals deserve the same respect, regardless of field?

with the issue of "dnp" and being in the medical field with "mds/dos"... i do not know what the best "title" is.

DaisyRN, ACNP · Dec 3, 2007

the biggest difference between the drnp and dnp is simple semantics -- one of the big problems in nursing academia is that schools all name their doctoral degrees something different. "clinical doctorates" have been around for a long time -- dsn, dnsc, nd, dns (and probably several others i haven't run across or can't recall at the moment), and, now, the dnp (and drnp -- whoop-dee-do; they both stand for "doctor of nursing practice" -- i guess columbia just thought it looked cooler to sneak that little "r" in there). (i ranted :) at length on this problem in another thread a while back, because it's a pet bugaboo of mine.)

in the aanp conference i went to last year where the dnp was discussed pretty extensively in one seminar, they approached the subject of "why should a doctorate of clinical nursing practice" be available. they suggested that its comparable to say, pharmacists going on to become pharmds. its just a way to achieve a higher level of learning in nursing.

i completely agree with (i think it was trauma... or maybe it was siri)... that we all have to be cohesive in what we're going to call it, what it means, and how practice/scope can be standardized. without that, what credibility do we have?

according to dr. linda rounds (current texas bne president), she said that they're working on a changing to a standardized np program, like a pa program... with subspecialties (pnp, neonatal np, acnp, fnp) offered after everyone has received the same education as an np. to me, i think it makes a lot of sense. and to be completely honest, i understand the trend to hire pas over nps... especially in areas where nps aren't as populated... with all the inconsistency and misunderstanding of nps diversity in education/roles. it's frustrating to me... and i know the great things an np can offer. heck, i will be one tomorrow! *lol*

i do not know what the answer is... sure one state can standardize np programs, but what happens to the rest of us? will we be grandfathered in? what if we move to another state?

how did it get so badly distorted???