DNP Fluff

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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 cardiac, ICU, education.
PAs regularly work in sub-specialties and have done so for many years. 60% of graduating PAs enter sub-specialties immediately out of PA school. There is even one PA who has the title of "lead surgeon" of a heart/lung transplant team.

That is misleading, he is the lead donor surgeon meaning he only "operates" on people at the organ donation phase - after cardiac death. Although he does teach.

http://www.annalsthoracicsurgery.org/article/S0003-4975(13)01707-4/abstract

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Specializes in cardiac, ICU, education.

I think the DNP is another 'Buyer Beware' situation. My DNP had no fluff classes. Every class I took prepared me with advanced assessment, advanced pharm, advanced patho, etc., and then translational research which is ultimately the job of a DNP - to translate research to practice. I seriously don't know how people do these programs online. You loose so much. I am grateful for my training, I completely see the difference from MSN until now.

As for RockMay's input, I had to complete my biocem, anatomy 1&2, stats, and assessment and pharm courses in my undergrad, so I didn't need to take them in graduate school, only the advanced courses. NP's have less of a advanced pharm requirement because they take at least one if not 2 pharm classes in their BSN.

PA's are smart and definitely provide a service in healthcare, but they are very technical in their training and have virtually no training in informatics, quality courses, and no research. DNP's are taught some of those "fluff" classes because they are the ones starting the QI projects, writing practice policies, and running the hospitals. PA's do not. But I do think it is interesting that the vast majority of physicians do not know the difference between the 2 and will hire either one.

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Specializes in Critical Care, Emergency, Education, Informatics.

Sorry your concept of PA education is completely wrong. They do in fact get informatics, research, QA and QI. PA's are involved in education, research, management. They manage research programs, they are actively involved in policy and I can identify many instances where PA's are involved in running hospitals.

They aren't any more technical in their training than any other health care provider. They get more patho, pharm, spend actual time in cadaver labs (although using more plasticized cadavers now). They get many hours of clinical reasoning. They do get lab practice in technical skills, such as suturing, splinting/casting etc, but they are by no means more "technically" oriented.

Is either NP or PA education model perfect. No. They both have strengths and weakness. But "we're better than they are" attitude doesn't help either of us. I can come up with just as much anecdotal cases were the NP/DNP couldn't tie their shoelace without help.

When I hire, I don't hire NP's or PA's I hire clinicians who can fulfill the need that I have, because in the vast majority of the cases, either will work. Just like for the vast majority of jobs there isn't a difference between and MD and a DO.

Oh, the job of every clinician is to translate research into practice not just the DNP.

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Specializes in cardiac, ICU, education.
Sorry your concept of PA education is completely wrong.

Are you a PA? It does not appear so in your title. The reason I ask is because I sit on a university curriculum committee and I am very aware of what a DNP is required to learn and I work with our PA program as well as some nurses decide to go the PA route for the very reasons I stated. No where in my post did I say one was better than the other, but they do have a different focus.

Let me try to be more clear in what I was saying before. Searching and evaluating is different than translating into research. A good DNP program will spend the entire program focusing on that concept. Every class will, to some degree, promote and expect the translation into practice. In fact, that is what a capstone project ultimately does. Do some PA's do that in practice? Sure, but it is not why they are in school and they do not have the advanced training in translating to practice. It takes YEARS to become proficient at translation. When I create a QI project I always tap into the expertise of the hospital's nurse scientists and when I publish, I use biostatisticians. Even my extensive background in research is not enough. I have taken qualitative, two quantitative, stats, advanced stats, translational, leadership and outcomes management classes (which were both clinicals with a QI project), not to mention my capstone.

I said PA's are more technical because they are and technical is not a dirty word. Surgeons are more technical than FPs.

PA's may get education in some research practices, in fact the arc-pa standards address this by saying that the curriculum "must include instruction to prepare students to search, interpret and evaluate the medical literature, including its application to individualized patient care." But it is not a thread throughout their curriculum, and the quality class is the same one as our BSN nursing students get.

However, the DNP must have the following program elements before they are accredited (I apologize for the formatting):

  1. Use analytic methods to critically appraise existing literature and other evidence to determine and implement the best evidence for practice.
  2. Design and implement processes to evaluate outcomes of practice, practice patterns, and systems of care within a practice setting, health care organization, or community against national benchmarks to determine variances in practice outcomes and population trends.
  3. Design, direct, and evaluate quality improvement methodologies to promote safe,timely, effective, efficient, equitable, and patient-centered care.
  4. Apply relevant findings to develop practice guidelines and improve practice and the practice environment.
  5. Use information technology and research methods appropriately to:
    • collect appropriate and accurate data to generate evidence for practice
    • inform and guide the design of databases that generate meaningful
      evidence for nursing practice
    • analyze data from practice
    • design evidence-based interventions
    • predict and analyze outcomes
    • examine patterns of behavior and outcomes
    • identify gaps in evidence for practice

[*]Function as a practice specialist/consultant in collaborative knowledge-generating research.

[*]Disseminate findings from evidence-based practice and research to improve healthcare outcomes

I have never met a PA who runs a hospital, but I will take your word for it.

Oh, the job of every clinician is to translate research into practice not just the DNP.

I beg to differ, bachelor's programs do not prepare PA's or BSN's to translate. Not every PA is master's prepared.

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Specializes in cardiac, ICU, education.

CraigB-RN

Don't take my word for it, there was a nice presentation done at Columbia by a PA who got a PhD. This PA talks about the lack of PA research and the lack of translating research into practice by PA"s

"emphasis of PA training and practice has always been on clinical care "

http://www.columbia.edu/~cjd11/charles_dimaggio/DIRE/resources/Misc/paResearchBeamer.pdf

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I think the DNP is another 'Buyer Beware' situation. My DNP had no fluff classes. Every class I took prepared me with advanced assessment, advanced pharm, advanced patho, etc., and then translational research which is ultimately the job of a DNP - to translate research to practice. I seriously don't know how people do these programs online. You loose so much. I am grateful for my training, I completely see the difference from MSN until now.

As for RockMay's input, I had to complete my biocem, anatomy 1&2, stats, and assessment and pharm courses in my undergrad, so I didn't need to take them in graduate school, only the advanced courses. NP's have less of a advanced pharm requirement because they take at least one if not 2 pharm classes in their BSN.

PA's are smart and definitely provide a service in healthcare, but they are very technical in their training and have virtually no training in informatics, quality courses, and no research. DNP's are taught some of those "fluff" classes because they are the ones starting the QI projects, writing practice policies, and running the hospitals. PA's do not. But I do think it is interesting that the vast majority of physicians do not know the difference between the 2 and will hire either one.

You can't count an undergraduate intro to pharm course as credit into your graduate education. You can only count prescriber-level courses when being trained to be a prescriber. This is why the "they took it in RN school" is never an appropriate argument.

What NP school requires biochem? Please provide a link so I can become aware of the singular instance where this occurs. An "intro" or "principals" course doesn't count. It must be a full biochem course.

PAs certainly take research courses. The PA program near me has two research courses and includes a requirement of a capstone project doing novel research which is highly guided. The IRB gives approves when it includes human subjects. Most nurses and NPs don't even know what IRB stands for.

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This seriously should be the minimum requirement of any program that leads to diagnosing/prescribing privileges and at the very least I can not believe DNP programs don't require additional pharm courses. I would write the check today to apply to a DNP a program that offered the above unfortunately I'd have to be content with doing a "capstone" project on "The holistic benefits of holding your patient's hand" or something equally as flimsy in place of clinical hours, SMH.

I don't mind the "benefits of holding your patient's hand" sort of stuff--if it were a PhD program. But a DNP is not a research degree! If I want to start my own business or be a CNO/DON, then fine, give me all those management/theory classes. But please, don't tell me that the DNP is a clinical degree (because there are those with DNPs who will tell you this).

Please, don't get me started on the flimsiness of our "advanced" pharm and patho classes. The professors practically gave us the answers on our final exam for patho, and I found several mistakes in our pharm book, which I complained about. The chair said she had tried different textbooks and students complained that they were too hard. I'd rather have too hard than too easy. If I'm supposed to be an advanced practice RN, that's what I want! That's the whole point!

I have written all about this in some other posts. What is it going to take to change this?? I love the nursing model of care vs the physician model of care, but once the education goes past the baccalaureate, it's a mess, IMO.

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Specializes in cardiac, ICU, education.
The IRB gives approves when it includes human subjects. Most nurses and NPs don't even know what IRB stands for.

Way out of line. Every single MSN and NP knows what an IRB is and so do the majority of BSN's. That is a ridiculous statement.

You can't count an undergraduate intro to pharm course as credit into your graduate education. You can only count prescriber-level courses when being trained to be a prescriber. This is why the "they took it in RN school" is never an appropriate argument.

Of course you can, That is your weakest argument. Notwithstanding the fact that you just destroyed your own stance because then you can't count PA intro pharm courses either.

A RN gives meds all the time in the hospital. I teach nurses at the BSN and graduate level. What they learn in undergrad is completely relevant to their graduate studies. Experience beats classroom or lab learning, they take everything they learn in school and apply it to the hospital. Just ask any adult learning theorist. All things being equal, I will say I would want a new NP to prescribe my meds over a new PA because it is quite likely the NP has been giving meds for years before they started prescribing.

What NP school requires biochem?

Any CRNA DNP program, and many with an acute care focus, and if you read my post I said my was completed in undergrad which is a requirement in any BSN that I know of. In one breath you say that undergrad should not count but then say that the PA program has it when many PA programs are Bachelor's degrees. You can't have it both ways. And does biochem make you a better PA? There is a lot of other classes that I would think would be more valuable.

Mine does, but I am not putting it up here. My colleague went here and they required one before you got into the program and one during,

US Army Graduate Program in Anesthesia Nursing | Nurse Anesthesia Programs | Army Nursing Program

PAs certainly take research courses.

Anyone can. But capstones are not required in PA programs. If you know of one that has one, great.

It is too bad so many went to such bad programs. Like I said before, it is a buyer beware issue, but that is the same for any school. Just because something is "required" it doesn't mean it is challenging.

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Specializes in cardiac, ICU, education.
But a DNP is not a research degree!

You are right, but neither is a PA. A PhD is a research degree. A DNP is a clinical practice degree.

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Specializes in cardiac, ICU, education.
I would write the check today to apply to a DNP a program that offered the above unfortunately I'd have to be content with doing a "capstone" project on "The holistic benefits of holding your patient's hand" or something equally as flimsy in place of clinical hours, SMH.

You design your capstone based on the specialty you want to pursue. Many are very clinical in nature.

Ones my friends or colleagues have been a part of (I am not a capstone advisor):

Provider Adherence to Evidence-Based Asthma Guidelines in a Community Health Center

Cardio Pulmonary Resuscitation Decisions in Nursing Home Residents

Polycystic Ovarian Syndrome: A Management Algorithm for Primary Care Providers

Measuring Endoscopic Performance for Colorectal Cancer Prevention Quality Improvement in a Gastroenterology Practice

etc.

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Specializes in cardiac, ICU, education.

It seems everyone here is so focused on pharm courses. A physician usually only has one year of pharm. Why don't they have more? Because like nurses, they get pharm experience in every clinical they do. Pharmacology is just a starting point.

I think everyone on here is having a different argument. You cannot compare a BPA with a DNP. Requirements are not the same as options. Anyone has the option to take anything. If you want more pharm, by all means take more if that is what you think makes someone a great practitioner.

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Specializes in Family Nurse Practitioner.
It seems everyone here is so focused on pharm courses. A physician usually only has one year of pharm. Why don't they have more? Because like nurses, they get pharm experience in every clinical they do. Pharmacology is just a starting point.

1 YEAR of pharm vs 1 semester pretty much says it all, imo.

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