DNP seems like a waste...

manusko · Feb 8, 2014

Right it's a recommendation but in MN where I plan to practice there are only 2 nurse practitioner/crna schools that only require masters. The article stated Minnesota as being one of the top 5 states in regards to DNP programs. This pretty much sums up my point (found in the fact sheet you provided from AACN; "Nursing is moving in the direction of other health professions in the transition to the DNP. Medicine (MD) Dentistry (DDS), Pharmacy (PharmD), Psychology (PsyD), Physical Therapy (DPT), and Audiology (AudD) all offer practice doctorates." Again, if I wanted to be a doctor I would go to medical school for 4 years. I'm all about being the best one can be but as an NP in many states you are working under an MD. Why would I go to the same amount of school as MD to have a much lesser scope of practice and pay?[/quote']
Essentially you are adding 8 months to a yr of schooling for the DNP. Medical school is 4 yrs compared to a DNP which is 3 years. Following your DNP you can practice as a NP or CRNA in your field of practice. After medical school the new doctor goes into a residency for several more years before they will practice in the same setting as you.
NP
Nursing BSN 4 yrs
DNP 3 yrs
Family practice physician
BS 4 yrs
Medical school 4 yrs
Residency 3+ yrs.
Not really the same amount

allnurses Guide · Feb 8, 2014

Right it's a recommendation but in MN where I plan to practice there are only 2 nurse practitioner/crna schools that only require masters. The article stated Minnesota as being one of the top 5 states in regards to DNP programs.
This pretty much sums up my point (found in the fact sheet you provided from AACN; "Nursing is moving in the direction of other health professions in the transition to the DNP. Medicine (MD), Dentistry (DDS), Pharmacy (PharmD), Psychology (PsyD), Physical Therapy (DPT), and Audiology (AudD) all offer practice doctorates."
Again, if I wanted to be a doctor I would go to medical school for 4 years. I'm all about being the best one can be but as an NP in many states you are working under an MD. Why would I go to the same amount of school as MD to have a much lesser scope of practice and pay?

You are preparing for a lifetime in a professional career. The DNP gives you more future choices and hopefully is a degree that does a better job of matching the credit hours with the degree while preparing graduates to better utilize EBP throughout their career.

As it has already been pointed out another 1-3 semesters of school getting your DNP still does not come close to the 11-12years to become a primary care physician.

[h=4]"INTRODUCING THE DOCTOR OF NURSING PRACTICE[/h]

In many institutions, advanced practice registered nurses (APRNs), including Nurse Practitioners, Clinical Nurse Specialists, Certified Nurse Mid-Wives, and Certified Nurse Anesthetists, are prepared in master's-degree programs that often carry a credit load equivalent to doctoral degrees in the other health professions. AACN's position statement calls for educating APRNs and nurses seeking top systems/organizational roles in DNP programs.
DNP curricula build on traditional master's programs by providing education in evidence-based practice, quality improvement, and systems leadership, among other key areas.
The DNP is designed for nurses seeking a terminal degree in nursing practice and offers an alternative to research-focused doctoral programs. DNP-prepared nurses are well-equipped to fully implement the science developed by nurse researchers prepared in PhD, DNSc, and other research-focused nursing doctorates.

[h=4]WHY MOVE TO THE DNP?[/h]

The changing demands of this nation's complex healthcare environment require the highest level of scientific knowledge and practice expertise to assure quality patient outcomes. The Institute of Medicine, Joint Commission, Robert Wood Johnson Foundation, and other authorities have called for reconceptualizing educational programs that prepare today's health professionals.
Some of the many factors building momentum for change in nursing education at the graduate level include: the rapid expansion of knowledge underlying practice; increased complexity of patient care; national concerns about the quality of care and patient safety; shortages of nursing personnel which demands a higher level of preparation for leaders who can design and assess care; shortages of doctorally-prepared nursing faculty; and increasing educational expectations for the preparation of other members of the healthcare team.
In a 2005 report titled Advancing the Nation's Health Needs: NIH Research Training Programs, the National Academy of Sciences called for nursing to develop a non-research clinical doctorate to prepare expert practitioners who can also serve as clinical faculty. AACN's work to advance the DNP is consistent with this call to action.
Nursing is moving in the direction of other health professions in the transition to the DNP. Medicine (MD), Dentistry (DDS), Pharmacy (PharmD), Psychology (PsyD), Physical Therapy (DPT), and Audiology (AudD) all offer practice doctorates."

https://www.aacn.nche.edu/media-relations/fact-sheets/dnp

MrsStudentNurse · Feb 9, 2014

Essentially you are adding 8 months to a yr of schooling for the DNP. Medical school is 4 yrs compared to a DNP which is 3 years. Following your DNP you can practice as a NP or CRNA in your field of practice. After medical school the new doctor goes into a residency for several more years before they will practice in the same setting as you. NP Nursing BSN 4 yrs DNP 3 yrs Family practice physician BS 4 yrs Medical school 4 yrs Residency 3+ yrs. Not really the same amount

I fully understand the amount of time required. Not all MD's do residency and many OD's do not. So no residency is not required. Second, every DNP program I've looked at requires 2 years post BSN experience so virtually it's the same minus maybe a year if one does residency.

allnurses Guide · Feb 9, 2014

I fully understand the amount of time required. Not all MD's do residency and many OD's do not. So no residency is not required. Second, every DNP program I've looked at requires 2 years post BSN experience so virtually it's the same minus maybe a year if one does residency.

The AACN does not require any post BSN experience so that is just an individual school requirement. Almost every physician has done a residency since most places won't credential non residency trained physicians. You are still talking about 7 years of formal college education versus 12+ years.

msn10 · Feb 9, 2014

I fully understand the amount of time required. Not all MD's do residency and many OD's do not. So no residency is not required. Second, every DNP program I've looked at requires 2 years post BSN experience so virtually it's the same minus maybe a year if one does residency.

Legally, only a one year internship is required before an MD can "hang a shingle" and practice, but I have never heard of an MD practicing without a residency. No one, but no one would hire them even into a private practice. Notwithstanding no insurance company would cover their malpractice.

I am sorry, but you do not understand the amount of time required.

manusko · Feb 9, 2014

I fully understand the amount of time required. Not all MD's do residency and many OD's do not. So no residency is not required. Second every DNP program I've looked at requires 2 years post BSN experience so virtually it's the same minus maybe a year if one does residency.[/quote']
What is 2 years post BSN? It's not a residency. It's experience and a fulltime paycheck. Also the amount of clinicals can not be compared to what a doctor does. I knew people that were accepted to a NP program straight out of their BSN. Also many people work throughout their NP program. Ask a physician how much they were able to work during school.

manusko · Feb 9, 2014

I fully understand the amount of time required. Not all MD's do residency and many OD's do not. So no residency is not required. Second every DNP program I've looked at requires 2 years post BSN experience so virtually it's the same minus maybe a year if one does residency.[/quote']
I did some research and you are right. Physicians can practice without a residency. The only problem is that there are very few states that will allow this and many insurance groups will not reimburse. The recommendation is that these doctors would have to be cash payment only due to lack of insurance claim ability.
Family practice residency is 3 years minimum. You could complete your FNP before someone who started medical school the same time as you started nursing school. Also you would be working as a FNP for 4 years before that doctor started working after residency.

subee, MSN, CRNA · Feb 9, 2014

I went to CRNA school in the 80's when programs were small and admissions were much more selective. I also applied to med school but decided that I preferred doing nursing for the rest of my life....not medicine. So I understand why someone would prefer DNP over MD(I NEVER had to go to a partners' meeting:) ). However, I do agree that many of the NP programs are sloppy and need to become more stringent if these people are going to be doing much of the care that was allotted to MD's. I have been a nurse for 41 years and never heard of MD being accepted onto staff without residency. But I did know one that went straight into law school out of med school without practicing as MD.

MrsStudentNurse · Feb 9, 2014

Legally only a one year internship is required before an MD can "hang a shingle" and practice, but I have never heard of an MD practicing without a residency. No one, but no one would hire them even into a private practice. Notwithstanding no insurance company would cover their malpractice. I am sorry, but you do not understand the amount of time required.[/quote']
I'm sorry but yes I do understand the amount of time. Unless you're psychic and can read my mind?

MrsStudentNurse · Feb 9, 2014

I did some research and you are right. Physicians can practice without a residency. The only problem is that there are very few states that will allow this and many insurance groups will not reimburse. The recommendation is that these doctors would have to be cash payment only due to lack of insurance claim ability. Family practice residency is 3 years minimum. You could complete your FNP before someone who started medical school the same time as you started nursing school. Also you would be working as a FNP for 4 years before that doctor started working after residency.

Right I agree it's not the norm. My whole point is I understand their intentions are to have NP's be as close to the level of knowledge of MD's thus more school and I'm all for that. However the pay gap and scope of practice for the difference in education (4 years if not including bsn experience) of a DNP and MD doesn't seem to align. From what I've found an MD/OD will be getting paid about double on average not including the years of paid residency. I guess if that extra year of education is just THAT integral then okay but that's where the question lies.

allnurses Guide · Feb 9, 2014

Right I agree it's not the norm. My whole point is I understand their intentions are to have NP's be as close to the level of knowledge of MD's thus more school and I'm all for that. However the pay gap and scope of practice for the difference in education (4 years if not including bsn experience) of a DNP and MD doesn't seem to align. From what I've found an MD/OD will be getting paid about double on average not including the years of paid residency. I guess if that extra year of education is just THAT integral then okay but that's where the question lies.

First, I think you mean MD/DO, but since they have the same scope of practice it is easier to just refer to them as physicians.

Scope of practice of NPs is highly dependent on the state you work in with more and more states having completely independent practice for APNs all the time.

The average salary for an NP is around 100K/yr. Nurse Practitioner Salary | Indeed.com

The average salary for an FP is is about 180K/yr, so very close to 2x the salary. http://www.medscape.com/features/slideshow/compensation/2013/familymedicine

Salary is dependent on many factors, but in many ways it has to do with how much each individual provider can bill for. There is even another thread on here that talks about the move to equal pay for equal services i.e. NPs making just the same as physicians.

Nothing in the DNP fundamentals from the AACN does it talk about trying to increase the education levels of NPs/APNs to make them equivalent in education or close to the education of physicians. That is not the focus of a DNP at all. APNs have already proven they can and do provide at least equivalent care as physicians often at lower costs.

IMHO you should get the degree that is going to best serve you in the future, and in that regard I think the DNP is the best solution for someone thinking about getting NP.

"DNP curricula build on traditional master's programs by providing education in evidence-based practice, quality improvement, and systems leadership, among other key areas.
The DNP is designed for nurses seeking a terminal degree in nursing practice and offers an alternative to research-focused doctoral programs. DNP-prepared nurses are well-equipped to fully implement the science developed by nurse researchers prepared in PhD, DNSc, and other research-focused nursing doctorates.

[h=4]WHY MOVE TO THE DNP?[/h]
- The changing demands of this nation's complex healthcare environment require the highest level of scientific knowledge and practice expertise to assure quality patient outcomes. The Institute of Medicine, Joint Commission, Robert Wood Johnson Foundation, and other authorities have called for reconceptualizing educational programs that prepare today’s health professionals.
- Some of the many factors building momentum for change in nursing education at the graduate level include: the rapid expansion of knowledge underlying practice; increased complexity of patient care; national concerns about the quality of care and patient safety; shortages of nursing personnel which demands a higher level of preparation for leaders who can design and assess care; shortages of doctorally-prepared nursing faculty; and increasing educational expectations for the preparation of other members of the healthcare team.
- In a 2005 report titled Advancing the Nation's Health Needs: NIH Research Training Programs, the National Academy of Sciences called for nursing to develop a non-research clinical doctorate to prepare expert practitioners who can also serve as clinical faculty. AACN's work to advance the DNP is consistent with this call to action.
- Nursing is moving in the direction of other health professions in the transition to the DNP. Medicine (MD), Dentistry (DDS), Pharmacy (PharmD), Psychology (PsyD), Physical Therapy (DPT), and Audiology (AudD) all offer practice doctorates." https://www.aacn.nche.edu/media-relations/fact-sheets/dnp

locohacnp · Feb 10, 2014

As an Adult NP and an ACNP,I practice in a state where independent practice is legal. However, many of the physicians in the community where I practice,have not embraced our practice. I can only wonder if these particular physicians feel threatened? I have two associates ANP and FNP) who recently opened an independent practice. Now I believe that patients have a choice between the medical model(old fashioned) and the NP care delivered holistically,with compassion, and with patience. It is not about the degree, it is about truly caring for patients with compassion and empathy. Patients have a choice about the care they desire.