I realize there are many people who find no value in a DNP. I have to say that I’m a little disappointed in my BSN-DNP program, especially in the era of the pandemic. One of the things that shocked me was sitting in an advanced assessment course and overhearing cheering from some students. What were they celebrating?
Passing their NCLEX.
How are you sitting in an NP Program learning to practice medicine (yes, I said it) and not even a licensed nurse? When I have conversations with new grad nurses it just astounds me. To further my dismay, the rigor just doesn’t seem there. For those doing online programs, especially new grads, how do people expect online tests/a few papers/500hrs of clinicals to produce an independent practitioner? I’m in-seat at a prestigious public school and it still seems like a total mind-bending affair.
The more I think about it, the more I wish the DNP would have a higher bar for entry, deeper dive into sciences, offer more clinical rotation hours, offer Step 1/2, and offer more residency/fellowship training. I realize there are many of you who would scoff at this, but hear me out. If the DNP is going to be the terminal degree pushed on nursing, where is the value? Are people honestly okay with standing next to a residency trained MD/DO and saying they’re equivalent? If you’re being honest, you can’t say that. So, then what?
A recent survey by MDs and DOs showed virtually no difference in their practice and perception of care— despite osteopathic medicine touting holistic medicine and inclusion of manipulative therapy. Why can’t nursing step in to fill the care shortage, provide this type of care, and show our colleagues we deserve to practice medicine next to them? There are many who were trained in the 70s, 80s, and 90s who feel they were well prepared. That’s not the world we live in today, however. Online programs have diluted rigor, over saturated the market, and reduced pay.
It’s time for a change and it’s time to say enough is enough. Not everybody deserves to be an NP. Everybody does deserve the best care possible, however. If nursing is truly about taking care of patients they should support this. Help the DNP evolve like the DO did, but keep your roots.
I don't see the DNP becoming more clinically focused because it's not a degree for only NPs. I think all these different pathways can be confusing, but dnp programs with NP tracks are still two separate pathways combined into one. I'm not sure if DNP programs with NP tracks can change their curriculum, but then it also confuses things for NPs who go back for their DNP degree.
I think we should just respect the DNP degree for what it is—a nursing practice degree focused on population health and translational research. I'm currently in a DNP program, and although I wish I was a degree path that offered more clinical sciences, the non-NP students who are nurse managers, CNOs, and nurse educators are loving the program because it's right up their alley.
I don't see the DNP becoming more clinically focused because it's not a degree for only NPs. I think all these different pathways can be confusing, but DNP programs with NP tracks are still two separate pathways combined into one. I'm not sure if DNP programs with NP tracks can change their curriculum, but then it also confuses things for NPs who go back for their DNP degree.
I think we should just respect the DNP degree for what it is—a nursing practice degree focused on population health and translational research. I'm currently in a DNP program, and although I wish I was a degree path that offered more clinical sciences, the non-NP students who are nurse managers, CNOs, and nurse educators are loving the program because it's right up their alley.
Well said and thank you. I, also, am an APRN getting my post-masters DNP. I did think about a PhD, but at the end of the day, I want to be a clinician who is prepared for translating research and leadership in community and population health. Because I am an APRN, my clinical hours must include expanding on my clinical practice by working toward/attaining clinical skills I did not get (or need) to graduate with my MSN. That said, my didactic DNP classes are leadership and research focused. It is all material I did not get in my clinically-focused MSN.
My school has a separate DNP track for those with non-APRN MSNs, though many classes are shared in common. Now would I make adjustments to the curriculum? Yes. Do I think it should be like the PhD or put me at the same level as an MD? No.
I work in a state with FPA after 2 years of full time practice with supervision from either and experienced NP or physician in the same specialty. We have a good number of psychiatrists so FPA is not a barrier to finding psychiatrists as someone suggested. Very few NP's have gone back for their DNP in this area. There is no monetary incentive to do so in my organization, a large academic medical center.
The local university attempted to transition to a DNP entry for NP training. Applications fell considerably and they reinstated the MSN track. Most dnp programs do not add clinical training beyond that in the MSN program. Capstone hours are usually focused on a project and do not involve actual clinical training. It's unfortunate that the DNP is leadership and policy focused in most programs rather than adding more advanced clinical training. That said, if you plan to teach at the graduate level or yearn for a position in nursing leadership, the DNP makes sense. I'm happily teaching undergraduates in the clinical setting and my MSN is fine.
It's unfortunate that nursing educators chose not to develop a clinical doctoral degree. Many of us would have jumped at that opportunity.
I’m in an MSN program now, and I’m quite dismayed with the rigor of the program. The bar needs to be set much higher. I’m taking advanced pathophysiology now and have learned *nothing* more than what I already new.
I refuse to go for a DNP unless it becomes a CLINICAL doctorate. Should I chose to pursue my doctorate, it will be in another field (business or law).
Though I heard about the complaining about the quality of NP programs, I thought that by attending a well know, reputable state school would make my situation different but it hasn’t. I’m 1/2 through the program but I hope the second half is better. No way would I ever consider an NP comparable to a MD/DO! It’s very sad that there are people who believe that.
Specializes in ACNP-BC, Adult Critical Care, Cardiology.
My program from many years back offered the Pathophysiology course in the university's School of Medicine. The faculty were physicians but the frustrating part was that many of the lecturers would preface their session with "this 3 hour lecture takes an entire semester to teach but we will power through it". Hmm, OK.
While it would be optimal to have more clinical courses most of the education that you seek is available from CEU, and other programs after graduation. Many of my clients come to me precisely because I am not an MD because they seek evidenced based, holistic, and nutritional approaches barely touched upon by their allopathic physicians. That said it is silly to have a DNP that isn’t more clinically focused. If one is seeking more insight in to research, business or administration the better choice is clearly a PhD or MBA integrated with their NP education.
The more I wish the DNP would have a higher bar for entry, deeper dive into sciences, offer more clinical rotation hours, offer Step 1/2, and offer more residency/fellowship training. I realize there are many of you who would scoff at this, but hear me out. If the DNP is going to be the terminal degree pushed on nursing, where is the value? Are people honestly okay with standing next to a residency trained MD/DO and saying they’re equivalent? If you’re being honest, you can’t say that. So, then what?
A recent survey by MDs and DOs showed virtually no difference in their practice and perception of care— despite osteopathic medicine touting holistic medicine and inclusion of manipulative therapy. Why can’t nursing step in to fill the care shortage, provide this type of care, and show our colleagues we deserve to practice medicine next to them?
While I am not an NP, my interest in curriculum and instruction lead me here. First I want to say, it is not usual for a student in a program to ruminate on how they can improve the program or even make the end point something they want but is not being addressed by nature of the graduate outcome statements. I have always wondered why programs that provide that degree competency aren't the student's first choice. Kind of like 'retreading' tires for more rigorous terrain instead of buying new.
What is normally absent from these discussion is how the new program would be structured such as achievement levels within the program..year one; year two; etc. Sometimes is is just described in general terms --- like an MD program with holistic medicine included. Taking one program and forcing it to change to a different program just creates chaos in a world where nursing education is poorly understood among lay people.
I applaud the idea of a new program that is more closely aligned with what our health system needs. To gain momentum that goal needs to be stated (more supervised and structured clinical is a start but just a broad component). Just know that creating a program is a herculean task. Should the DNP not be doing what it was intended for, perhaps it should be doomed to extinction like the B.Sc.Nursing education; BAN, and the DNS, all of which I have seen disappear in my lifetime. The MSNE is still limping along.
Keep in mind that you will find little variation between one program and the next. That is because most are based upon national "consensus" guidelines. Thus, even if a school thought it would be a "great" idea to offer an additional year of advanced pharmacology, physiology and clinical hours you will find pretty much 0% that actually do. Also, if a DNP failed to offer the "administration heavy" courses that detract from clinical acumen (if only by way of dilution) then they would lose their DNP program certification.
Also, if a DNP failed to offer the "administration heavy" courses that detract from clinical acumen (if only by way of dilution) then they would lose their DNP program certification.
That does have to be considered for accreditation. I am now seeing Post-DNP certificates available.
On 10/31/2020 at 2:33 PM, Thanksforthedonuts said:
I’m in an MSN program now, and I’m quite dismayed with the rigor of the program. The bar needs to be set much higher. I’m taking advanced pathophysiology now and have learned *nothing* more than what I already new.
I refuse to go for a DNP unless it becomes a CLINICAL doctorate. Should I chose to pursue my doctorate, it will be in another field (business or law).
Though I heard about the complaining about the quality of NP programs, I thought that by attending a well know, reputable state school would make my situation different but it hasn’t. I’m 1/2 through the program but I hope the second half is better. No way would I ever consider an NP comparable to a MD/DO! It’s very sad that there are people who believe that.
What you're talking about is exactly how I felt going through NP school. It was difficult but not challenging and the books/exams were embarrassing. I used medical school textbooks during NP school.
Do not hold your breath that the second half of your program will be better. Sorry, my friend.
You do realize DNP is a degree and not a role, correct? I have a DNP and am not an advanced practice nurse.
The DNP was originally intended to be a terminal degree for APRNs only. You can see the AACN's original paper on the subject from 2004. It later opened up to be more inclusive though some argued against this - asking why shouldn't APRNs have a unique terminal degree - a degree the public can associate with APRNs in the way they might a MD, DO. The AACN went a different way with the DNP degree however and made in inclusive of other paths such as leadership, informatics, public health nursing. I'm not questioning there wisdom - there is definitely arguments pro and con.
I've posted on this before and I think it's time for the nursing profession to make some changes to the DNP to make everyone happy. This is what I'd propose.
1) BSN-DNP programs with APRN specialization should use the extra coursework allowed for in a doctorate to provide more clinical didactic and clinical training. Yes there should be sufficient content in research interpretation and translation. No there should not be time spent in these programs on leadership, healthcare finance, healthcare policy, etc.
2) DNPs for non-APRNs should be available for those who would like to advance in the nursing profession and universities should have some flexibility in how to define these. For example, those seeking content in leadership, financial management, policy, population health, should be able to find a program that suits their needs. This is important stuff and we need nurses who can do lead organizations.
3) As for the post-masters DNP I'm not sure. Ideally, these should be phased out (over a long time) as should the MSN for APRN specialties. New APRNs should be DNP prepared but with changes to DNP requirements (see #1)
There is a pervasive feeling at the AACN that all DNP students need to meet the same competencies of research translation, leadership, policy, finance etc. I believe this is be a huge mistake and a source of most of the angst on this and other forums. Allow DNP-APRN programs to double down on clinical content and unburden them from non-clinically focused courses. Let those who want to lead this profession from the C-suite (or want those skills) to seek a DNP with that content. Everyone can be happy.
Angeljho, MSN, NP
392 Posts
I don't see the DNP becoming more clinically focused because it's not a degree for only NPs. I think all these different pathways can be confusing, but dnp programs with NP tracks are still two separate pathways combined into one. I'm not sure if DNP programs with NP tracks can change their curriculum, but then it also confuses things for NPs who go back for their DNP degree.
I think we should just respect the DNP degree for what it is—a nursing practice degree focused on population health and translational research. I'm currently in a DNP program, and although I wish I was a degree path that offered more clinical sciences, the non-NP students who are nurse managers, CNOs, and nurse educators are loving the program because it's right up their alley.