DNP Fluff

Published

Just from comparing nurse practitioner DNP vs MSN course lists I felt these were fluff classes. I recently started the first semester of a DNP program and my opinion is evolving. Currently, I think the extra classes add some value. However, spending hours comparing various leadership frameworks, exploring personal ethics, contemplating system structures, and stressing the OCD qualities of an APA paper seems a huge misuse of time. I see no reason these topics could not be covered through a series of seminars.

In the first year, my class will spend 5x more time working on topics like this than learning something I find interesting like pathophysiology. I know many of my classmates have expressed disappointment in the agenda for this first year. Personally, I can feel a moral dip as I turn the page to another topic unrelated to learning how to diagnose and treat patients.

Specializes in Urology.
Personally, I feel that the DNP concept is not totally absurd but the way the DNP product” is being sold to the larger nursing community needs re-examination. Majority of nurses who pursue roles as NP's (and other advanced practice providers) do so to meet a desire to remain as clinicians. Our ideal day to day practice revolves around seeing patients, assessing, diagnosing, and treating them. Along that process, there has to be some awareness of revenue generation and cost-containment efforts but the biggest part of our intellectual exercise in seeing patients is an understanding of pathophysiology and the ability to use current evidence supporting our treatment decisions. This should be the bulk of our education as NP's which I felt would have been more than adequately addressed in a Master's degree program offering.

On the other hand, those of us practicing NP's who desire advancement and leadership in the larger healthcare establishment or are interested in involvement in driving the future of healthcare policy should have the option to pursue doctoral education that addresses these higher” aspirations. For me, this would be where a DNP comes in handy. I think it's a mistake to make the DNP an entry to practice requirement. I think some of those pursuing the DNP (particularly those in BSN to DNP programs) do not yet have the professional maturity to enter leadership roles but are totally ready for a role as an advanced practice healthcare provider. These individuals do not need to get hammered with fluff” courses in epidemiology, health policy, health care lobbying, etc. but rather a solid background in preparing to be a safe and competent healthcare provider.

Juan really hit the nail on the head here. The DNP is being touted as a clinical doctorate but in reality its leadership focused. I agree on not having the DNP as an entrance to practice requirement but as politics go, the would like to have us uniformed around the other allied health professions that do (PT, Pharm, etc). Given that NP's have already proven to provide great care at a masters level, there isn't really any benefit to patients from the DNP or MSN preparred NP in terms of clinical practice. I do wish we had a more clinical oriented doctorate, I know anesthesia jumped ship and created their own (DNAP) that has more clinical focus than the traditional DNP. I'm just waiting it out to see where it goes from here.

Up Vote Up Vote ×
Specializes in Critical Care, Emergency, Education, Informatics.

The CRNA's have always done a better job at this education model than the NP side has, my co workers who when into DNP anesthesia program are all doing almost twice the amount of clinical as before. I don't know about the nurse midwives.

I recently sat at a local APRN conference and the whole discussion from nurses younger than say 35 and their whole focus was being called Dr. Nothing about the clinical competency. The nurses over 35 were all complaining about how this was doing nothing to help them be a good provider.

Nursing missed the boat on this one. It's going to happen by default as there are fewer MSN programs out there.

Up Vote Up Vote ×

yup there is fluff just like the BSN and the MSN, just suck it up and do it!

Up Vote Up Vote ×
Specializes in Critical Care, Emergency, Education, Informatics.
I agree that it might be hard to validate my latter statement, but when a selection process is more rigorous, you are more likely to recruit 'smarter' applicants.

You should actually sit in on a selection sometims. You'll find out quickly that although that statement makes sense, it isn't true. then sit in a classroom and your RAPIDLY find out that it isn't true.

Up Vote Up Vote ×
Specializes in Critical Care, Emergency, Education, Informatics.
My cousin (an internist) who has precepted 100s PA/NP would disagree... I would also disagree with my limited experience. NP don't know [insert] in basic science.

That isn't an indication of smarter. Just education.

Of the 35 PA students in the class I'm getting ready to teach right now, only a few have actually "Science" degrees. There are English majors, two resp therapist, a lab person (who does know his science), some general ED peeps, and few other mixed bags degree's. There is even one health library major and a PharmD.

In that mix there is a huge variation of when they know comming into the program.

I do have to ask about your knowledge of basic science to be able to judge if someone else has a certain knowldege level?

Up Vote Up Vote ×
That isn't an indication of smarter. Just education.

Of the 35 PA students in the class I'm getting ready to teach right now, only a few have actually "Science" degrees. There are English majors, two resp therapist, a lab person (who does know his science), some general ED peeps, and few other mixed bags degree's. There is even one health library major and a PharmD.

In that mix there is a huge variation of when they know comming into the program.

I do have to ask about your knowledge of basic science to be able to judge if someone else has a certain knowldege level?

I guest we are talking past each other... I know some PA students don't have science degree, though most PA schools requires bio 1/2, gen chem 1/2, orgo 1/2, biochem and genetics, and some schools require microbiology for admission... All I was saying was that the average PA student that comes out of PA school will have more basic science knowledge than NP. That's an indisputable fact!

Regarding my knowledge of basic science, let say I have taken graduate level courses in genetics, biochem, anatomy, physiology, pathophysiology, histology, embryology, Immunology, microbiology, neuroanatomy etc... Not sure why my knowledge of basic is relevant to this when one can just look at PA/NP schools curricula and compare them.

Up Vote Up Vote ×
Specializes in Outpatient Psychiatry.
Juan really hit the nail on the head here. The DNP is being touted as a clinical doctorate but in reality its leadership focused. I agree on not having the DNP as an entrance to practice requirement but as politics go, the would like to have us uniformed around the other allied health professions that do (PT, Pharm, etc). Given that NP's have already proven to provide great care at a masters level, there isn't really any benefit to patients from the DNP or MSN preparred NP in terms of clinical practice. I do wish we had a more clinical oriented doctorate, I know anesthesia jumped ship and created their own (DNAP) that has more clinical focus than the traditional DNP. I'm just waiting it out to see where it goes from here.

Have patients received improved services from DPTs, AudDs, or PharmDs? I doubt it but of course have no quantitative data. It seems counterintuitive to transition from pharm BS (five years) to PharmD (min 6 years) and now an expectation for them to complete residencies? Incorporate a bit more diagnostics and clinical medicine, and we won't need anything but pharmacists. I'd that their aim? I think so. So the lessons here generalized to NPs is that a clinical doctorate will help with "parity." A leadership degree will not.

Up Vote Up Vote ×
Specializes in Outpatient Psychiatry.
I guest we are talking past each other... I know some PA students don't have science degree, though most PA schools requires bio 1/2, gen chem 1/2, orgo 1/2, biochem and genetics, and some schools require microbiology for admission... All I was saying was that the average PA student that comes out of PA school will have more basic science knowledge than NP. That's an indisputable fact!

Regarding my knowledge of basic science, let say I have taken graduate level courses in genetics, biochem, anatomy, physiology, pathophysiology, histology, embryology, Immunology, microbiology, neuroanatomy etc... Not sure why my knowledge of basic is relevant to this when one can just look at PA/NP schools curricula and compare them.

Why are nurses so afraid of these courses? Well, a third of my BSN cohort couldn't pass a test on pharm calc so they were dropped. Nursing is a qualitative field. I suppose the body of nursing should only work "bedside care." Most of the career nurses I saw in clinical settings told the bright eyed 20somethings "you don't need to know that stuff as a nurse." In hindsight they're correct. Nursing, as the duties hospitals require, needs no scientific underpinnings particularly when they look to physicians for approval to do any but change the bed sheets. However, if nurses studied science and received a bit more autonomy it seems like aides could run the units under the oversight of scientifically trained RNs (less RNs at higher compensation). That's the picture painted for me when I called up the old alma mater to inquire about going back to school for nursing (there wasn't a fitting PA school here then). But my own sass and gumption led to a solo career field and big income. I got where I wanted, but the ride was very uncomfortable.

Up Vote Up Vote ×
Specializes in Family Nurse Practitioner.
yup there is fluff just like the BSN and the MSN, just suck it up and do it!

Or don't and start demanding an appropriate education for the amount of money spent that will help elevate our profession's clinical attributes so we aren't continuing to rely on the flimsy facade of being holistic.

Up Vote Up Vote ×
Specializes in Outpatient Psychiatry.
Or don't and start demanding an appropriate education for the amount of money spent that will help elevate our profession's clinical attributes so we aren't continuing to rely on the flimsy facade of being holistic.

I'm not even holistic. The system's indoctrination failed me!

Up Vote Up Vote ×
Specializes in Critical Care and ED.

I guess what's really relevant is the quality of the school. I attend a prestigious grad school (just announced as in the Top 25 in the country) and we do a full year and a half of clinicals, along with graduate level pathophysiology, genetics and pharmacology taught by doctors and Pharm MDs. We have excellent sim lab facilities and our clinicals are arranged for us at the top 3 hospitals in the state where we learn to intubate, put in central lines and chest tubes (it's an acute program). We had actually relatively little fluff in my program, just 3 of the classes could be defined as fluff...ther rest are core graduate practicums, Advanced Physical Diagnosis, Acute Care Management of Complex Problems, and grad level science. I just completed the pharmacology class and it was one of the toughest I've ever done, and the health assessment class had me sweating bullets. Find a better program and you'll get better results.

Up Vote Up Vote ×
I guess what's really relevant is the quality of the school. I attend a prestigious grad school (just announced as in the Top 25 in the country) and we do a full year and a half of clinicals, along with graduate level pathophysiology, genetics and pharmacology taught by doctors and Pharm MDs. We have excellent sim lab facilities and our clinicals are arranged for us at the top 3 hospitals in the state where we learn to intubate, put in central lines and chest tubes (it's an acute program). We had actually relatively little fluff in my program, just 3 of the classes could be defined as fluff...ther rest are core graduate practicums, Advanced Physical Diagnosis, Acute Care Management of Complex Problems, and grad level science. I just completed the pharmacology class and it was one of the toughest I've ever done, and the health assessment class had me sweating bullets. Find a better program and you'll get better results.

sounds like a good program but how much it cost tho? Some of the better schools seem to be upping their prices to the PA school range area.

Up Vote Up Vote ×
+ Join the Discussion