DNP required soon?

Specialties Doctoral

Published

"The American Association of Colleges of Nursing (AACN) has recently released a position statement calling for the Doctor of Nursing Practice (DNP) degree to be the terminal degree awarded for advanced practice nurses."

I've been reading some articles about the recent changes to the terminal degree for a CRNA. Does this basically mean that by 2015 many CRNA programs will be DNP instead of the Masters? What will happen to all those MSN program grads...will they have to go back for the DNP? Thanks in advance for any input.

A legal opinion on who may call themselves Doctor

http://www.medscape.com/viewarticle/563176?src=mp

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English Co-Conspirator: Can you repost as a quoted piece? The Medscape site isn't being friendly.

-DIGNOUT

Specializes in Anesthesia.

Interesting that there are seven States where the AMA has gotten law3s passed to deny a nurse, no matter the doctorate degree, from being called 'Doctor.'

??

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Are Nurses With a Doctor of Nursing Practice Degree Called "Doctor"?

Question

I am thinking of going back to school to earn a DNP. If I earn this degree, can I be called "Doctor" when I practice? How must I identify myself to the public as a nurse practitioner?

Response from Tracy Klein, RN, MS, FNP

Clinical Instructor of Medicine and Adjunct Faculty, Nursing, Oregon Health and Sciences University, Portland, Oregon; Advanced Practice Consultant (Nurse Practitioner), Oregon State Board of Nursing, Portland, Oregon

The Clinical Doctorate

Practitioners, employers, credentialers, and the public may soon notice that the title "Doctor" applies to many health practitioners who are not physicians or dentists. The clinical doctorate (doctor of nursing practice [DNP]) signifies completion of a clinically focused, rather than research-focused, advanced degree program. Beginning in 2015, the DNP has been targeted as the accreditation standard for advanced practice nursing in accordance with the American Association of Colleges of Nursing (AACN) guidelines.[1] Whether schools and colleges of nursing will revise their program offerings in time to meet this deadline remains to be seen, but clearly the tide is turning toward doctoral preparation for allied health professions at the advanced practice level.

In this regard, nursing follows other professions, such as medicine, physical therapy, pharmacy, clinical psychology, and naturopathy. The call for interdisciplinary practice and education, envisioned by the Institute of Medicine in its report Health Professions Education: A Bridge to Quality, predicts that more professionals with the title "Doctor" will be working together in the same settings.[2] Many of these professionals will not be physicians.

Current Law

According to the 2007 Pearson Report, only 7 states (Georgia, Illinois, Maine, Missouri, Ohio, Oklahoma, and Oregon) have statutes or regulations prohibiting a nurse practitioner (NP) or other doctorally prepared health professional from using the title "Doctor.[3]" Several other states have provisions in law allowing nonphysician healthcare professionals to use the title "Doctor" as long as they also include their title of licensure or specialty (NP, physical therapist, etc) in patient communication. The American Medical Association (AMA) has identified use of the professional title of "Doctor" as a topic for legislative initiative on behalf of its membership. Resolution 211, passed by the AMA House of Delegates, accused nurses and other "nonphysicians" with doctoral degrees of misleading patients "to believe that they are receiving care from a doctor.[4]" The resolution states further that the AMA resolves to work with individual states to "identify and prosecute those individuals who misrepresent themselves as physicians to their patients.[4]"

Although the AMA resolution has no binding effect on individual state law, it does indicate intent to mount a campaign that challenges the abilities of nurses and other health professionals to claim the title "Doctor," even if a degree is earned and recognized by the public.

How Can I Approach This Question in My Professional Setting?

The first recommendation is to clearly understand what your state titling law, generally found in your state's Nurse Practice Act, requires that you must call yourself. Although all NPs are required to meet registered nurse (RN) licensing requirements, in Utah, the RN license is expired when the NP is granted. Check with your state Board of Nursing to determine whether the practice title in your state is "ARNP," "CRNP," or whether you should use a specialty title, such as "FNP." Professionally, this is the title that you must use on all materials that you present or hold out to the public. There may also be a requirement that "RN" is used for any nursing practice.

National certification titles, such as APRN-BC, CNM, or RNC, designate that a certification exam was passed, but these titles do not tell the public whether you currently hold a state professional license. Similarly, professional degrees, such as MSN or PhD, are earned titles that may be legally used in any setting, but do not by themselves tell the public clearly in what capacity you are licensed to practice. Using these titles in addition to your legal title of licensure may or may not be required when practicing in a clinical or academic setting.

The second recommendation is to begin working with other health professionals in your employment setting to implement nurse-positive language as advised by the Center for Nurse Advocacy. They rightly note that the way nurses refer to other professionals models language that is then adopted by patients and by the media. As the Center for Nurse Advocacy observes, "media, like most people, often use the term doctor to mean physician. Although this usage is deeply ingrained, it gives many people the impression that physicians are the only health care workers who can earn doctoral degrees.[5]"

Clearly, this is not the case, as more advanced practice nurses seek doctoral degrees for professional or clinical goals. Be ready for the discussion where you practice; understand and use your licensure title appropriately and assertively; and initiate nurse-positive language where you practice. The AACN has a document that reviews talking points in response to the AMA Resolution 211 that could be used in the workplace, or by your professional organization, to introduce the concept that doctorally prepared nurses are likely to be a strong presence in healthcare for many years to come.

In summary, you must always use your legal title of licensure in the state that you practice in your communications with the public. You may use your academic degree credentials in all settings, to indicate educational credentials. You can legally use the title "Doctor" in conjunction with the appropriate licensure title in the majority of states. In states where the legal statutory language is unclear, your professional organization on a state or national level should be contacted to initiate appropriate legislative or interpretive action, so that you may confidently use the title you worked diligently to earn.

Submit a Question on Legal/Professional Issues for Advanced Practice Nurses

Posted 10/11/2007

References

American Association of Colleges of Nursing. Commission on collegiate education moves to consider for accreditation only practice doctorates with the DNP degree title. 2005. Available at: http://www.aacn.nche.edu/Media/NewsReleases/2005/CCNEDNP.htm Accessed July 22, 2007

Institute of Medicine. Health Professions Education: A Bridge to Quality. Washington, DC: National Academies Press; 2003. Available at: http://www.nap.edu/catalog/10681.html Accessed July 22, 2007.

Pearson L. The Pearson Report. Am J Nurs Pract. 2007;11:2.

American Medical Association House of Delegates. Resolution 211 (A-06). June 13, 2006. Available at: http://www.ama-assn.org/ama1/pub/upload/mm/471/211a06.doc Accessed July 22, 2007.

Center for Nurse Advocacy. Should we refer to physicians as "doctors"? Available at: http://www.nursingadvocacy.org/faq/nf/physician_vs_doctor.html Accessed July 22, 2007.

Hello,

The new entry level degree for Physical Therapists is the DPT (doctor of physical therapy). You better beleive that most if not all physical therapists with this degree will have their patients call them doctor, whether in the hospital setting or not. CRNA'S will have the DNP doctor of nursing practice, which in my mind and i suppose the minds of other is equal if not greater than the DPT. Simply due the nature of the profession. Physical therapists have an incredibly meaningful job and I am not trying to deduct from that so of all of you people who have a 3d cousin whos best friend's college roomate is a physical therapist, and are going to want to post in his defense, can stop that train of thought now. I am just saying that CRNA'S have more prescriptive authority (giving anesthesia), are more of an immediate help/necessity to the patient, and provide an extremely specialized service to over 26 million patients (roughly). Yet, we are scared to call ourselves "Doctors", even when the rest of society and the american public has no problem using the term for other types of "practice doctorates" besides the MD's and DO's. It's about time we give ourselves some credit (not me yet), you all give yourselves credit. You don't have to go to med school to be able to enjoy the respect of the word "Doctor". However, you do need to have the self-respect to realize that you deserve to wear the term proudly.

P.S. for those of you worried about the confusion it will cause the patient by referring to oneself as "Doctor" w/o being and MD or DO, it isn't the nurse, nurse anesthethist, or doctors responsibility to educate the patient on Doctoral suffixes, job descriptions, and types. They have much greater things to worry about that whether or not you have a DNP or MD behind your name. If its really that big of a deal, why don't we just have a set of flash cards next to every bed, so the patients can educate themselves on our titles and responsibilities.

my 2 cents, take it or leave it...

Specializes in Critical Care, Emergency.
Hello,

The new entry level degree for Physical Therapists is the DPT (doctor of physical therapy). You better beleive that most if not all physical therapists with this degree will have their patients call them doctor, whether in the hospital setting or not. CRNA'S will have the DNP doctor of nursing practice, which in my mind and i suppose the minds of other is equal if not greater than the DPT. Simply due the nature of the profession. Physical therapists have an incredibly meaningful job and I am not trying to deduct from that so of all of you people who have a 3d cousin whos best friend's college roomate is a physical therapist, and are going to want to post in his defense, can stop that train of thought now. I am just saying that CRNA'S have more prescriptive authority (giving anesthesia), are more of an immediate help/necessity to the patient, and provide an extremely specialized service to over 26 million patients (roughly). Yet, we are scared to call ourselves "Doctors", even when the rest of society and the american public has no problem using the term for other types of "practice doctorates" besides the MD's and DO's. It's about time we give ourselves some credit (not me yet), you all give yourselves credit. You don't have to go to med school to be able to enjoy the respect of the word "Doctor". However, you do need to have the self-respect to realize that you deserve to wear the term proudly.

P.S. for those of you worried about the confusion it will cause the patient by referring to oneself as "Doctor" w/o being and MD or DO, it isn't the nurse, nurse anesthethist, or doctors responsibility to educate the patient on Doctoral suffixes, job descriptions, and types. They have much greater things to worry about that whether or not you have a DNP or MD behind your name. If its really that big of a deal, why don't we just have a set of flash cards next to every bed, so the patients can educate themselves on our titles and responsibilities.

my 2 cents, take it or leave it...

so, whose job is it then?

Specializes in Critical Care, Emergency.
Hello,

The new entry level degree for Physical Therapists is the DPT (doctor of physical therapy). You better beleive that most if not all physical therapists with this degree will have their patients call them doctor, whether in the hospital setting or not. CRNA'S will have the DNP doctor of nursing practice, which in my mind and i suppose the minds of other is equal if not greater than the DPT. Simply due the nature of the profession. Physical therapists have an incredibly meaningful job and I am not trying to deduct from that so of all of you people who have a 3d cousin whos best friend's college roomate is a physical therapist, and are going to want to post in his defense, can stop that train of thought now. I am just saying that CRNA'S have more prescriptive authority (giving anesthesia), are more of an immediate help/necessity to the patient, and provide an extremely specialized service to over 26 million patients (roughly). Yet, we are scared to call ourselves "Doctors", even when the rest of society and the american public has no problem using the term for other types of "practice doctorates" besides the MD's and DO's. It's about time we give ourselves some credit (not me yet), you all give yourselves credit. You don't have to go to med school to be able to enjoy the respect of the word "Doctor". However, you do need to have the self-respect to realize that you deserve to wear the term proudly.

P.S. for those of you worried about the confusion it will cause the patient by referring to oneself as "Doctor" w/o being and MD or DO, it isn't the nurse, nurse anesthethist, or doctors responsibility to educate the patient on Doctoral suffixes, job descriptions, and types. They have much greater things to worry about that whether or not you have a DNP or MD behind your name. If its really that big of a deal, why don't we just have a set of flash cards next to every bed, so the patients can educate themselves on our titles and responsibilities.

my 2 cents, take it or leave it...

so, whose job is it then?

Specializes in Nurse Anesthetist.

well said Conz3434 !!!

Specializes in CVICU.
If the debate here is about calling CRNAs "Doctor" based on the degree, I'm fine without that higher level of education and just being referred to as "Master"...yes, that has a nice ring to it

:twocents:

LOL. I almost fell out of my chair

most people with their PhDs do, in fact, go by doctor but they certainly don't do so in a hospital setting. A person with a PhD in organic chemistry would not introduce themselves as Dr. So-and-so for obvious reasons.

They don't??? Doctor is not a physician designation--it is an academic one. Does the PhD radiologist who delivered the radioactice iodine for my thyroid cancer call himself a doctor because of his PhD or because of his MD?

A DNP is a professional doctorate as a MD is a professional doctorate. Doctor refers to the 'doctorate' not physician.

That the public may be comfused should not be the issue. Once upon a time nurse wore a cap to designate themselves as nurses. What is wrong with explaining that we are nurses who hold a doctorate?

We are our own worst enemies sometimes:angryfire

Specializes in Nurse Anesthetist.

Although I love this debate, I cringe at the thought of having to endure more Nursing Research and and another thesis. Holy Toledo, I've been out 5 years and I still haven't recovered from the tortures of Cal State Fullerton!

Specializes in Critical Care, Emergency.

Doctor is not a physician designation--it is an academic one.

in terms of history and the public, yes, it IS a physician designation.

Does the PhD radiologist who delivered the radioactice iodine for my thyroid cancer call himself a doctor because of his PhD or because of his MD?

i don't know what this is supposed to mean.

Doctor refers to the 'doctorate' not physician.

this is unfortunately argumentative.

That the public may be comfused should not be the issue.

this is exactly the issue.

Due to the culture that we live in saying doctor in any type of healthcare setting is misguided unless one has completed medical school, internship, residency and passed all the perscribed testing. I don't feel that the person that has completed a DNP, PharmD or PhD would be so bold as to think they would not be misunderstood. Most individuals that I know that have this title are very aware of what they do and don't know. This would then lead me to believe that they should understand why the title should be used with caution at different times. I also don't feel that the patient really cares what high degree goes after the name but more what kind of care is delivered. We all have examples of really educated people making mistakes. Yeah the whole human error thing.

I am slightly saddened by the idea that we(healthcare providers) have become more concerned about titles and not about what is best for the patient. Confusion on top of pain , nausea, fear, helplessness, and all the other things that happen when an ill or injured person comes to us is not needed. We are all a team and in most cases we all should have the same goal.

Speaking to nurses vs doctors vs ect ect ect. Once again what is best for the patient. Own who you are and what you are doing, every part of the team is needed. Is a nurse as well versed in the intrinsic vs extrinsic pathway and its effect on the patient in DIC post trauma and eclampsia, probably not. Can the nurse learn yes. Is a MD/DO as well versed it what it takes to get four studies set up for the patient get them to the test sites and what is needed while at the test sites to maintain care all while understanding that oral care shortens length of stay? Probably not but can a (danger here) Doc learn. Yes.

In my opinion Doctor xyz and Nurse pqrs have roles to play and as we ahve learned on without the other and M+M slides a little further into the grim reapers court. Short of the long just be nice and humble the patients like it. Unless its a busy night in the ED and your patient just punched a team member then order the vit H with an assertive tone.

Due to the culture that we live in saying doctor in any type of healthcare setting is misguided unless one has completed medical school, internship, residency and passed all the perscribed testing.

"misguided"? What are you talking about? After graduation from medical school, having taken only 3 steps of the USMLE series, that person is called a "doctor" before they set foot in a hospital their first year of internship. They are called "doctor" upon graduation and still to go through a residency, maybe a fellowship and more boards. Are you suggesting these medical graduates not be called "doctor" till they have completed GME and have an unrestricted license?

They are called "Dr." so and so because they earned an MD- a medical doctorate, plain and simple. They are not a "physician" and can't function as one, but are still called "Dr." so and so.

If the AMA lobby is so concerned about pt. confusion, why don't make it clear that until they are done with their residencies and have their licenses, these "DRs" are like bicycles on training wheels!

Misguided- who?

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