Do DNPs get compensated more

Jules A, MSN · Jun 28, 2015

PAs are educated in a medical model and only a medical model; they also have "physician" in their title...I don't.

I only wish I was educated in a medical model.

IsabelK · Jun 28, 2015

I appreciate that you took the time to make this point - we do not provide "mid-level" care. Mid-level is a term that docs like to use in referring to us in trying to maintain a hierarchical structure with the "physician as captain". Well, healthcare in the US spends more money than any other country in the world, our outcomes are near the bottom in many categories....maybe its time for the captain to retire...

I wrote a paper for my DNP about NP outcomes. Most outcomes are equal to or better than physician outcomes in terms of diabetes, health maintenance, and others. We are not mid level. Thank you for the comment.

IsabelK · Jun 28, 2015

I only wish I was educated in a medical model.

Than go to PA school or medical school. I am a nurse first.

PG2018 · Jun 30, 2015

Than go to PA school or medical school. I am a nurse first.

Since we are HIRED as medical clinicians, all NPs, it would behoove the old stone to turn so that we can all champion a more medically-oriented education. You are a nurse first, I am a health team clinician FIRST because that's what I have been hired to do. Nurses aren't the only professional body taught about holistic care, however, they're often the only ones charged and paid to tend to entirely not medical matters. Becoming a NP, I knew I'd be hired to do medical care so no amount of "nurse first" ideology is going to actually treat the patient or pay anyone. Frankly, I am ashamed that the NP curricula across the nation aren't more uniform, and I'm even more embarrassed about what the curricula are composed of. In my three year master's program, a year of study was devoted to extraneous material that doesn't really befit the "nurse first" or medical mentality. It's this NP "nurse first" mentality that is holding us back professionally and politically.

Jules A, MSN · Jun 30, 2015

It's this NP "nurse first" mentality that is holding us back professionally and politically.

and financially.

IsabelK · Jul 2, 2015

Actually, I don't see it that way. Being a nurse first is what sets NPs and other APRNs apart from a strictly medical model. Nursing school is not supposed to be about spoon feeding you--you need to take a fair amount of responsibility for your own education. As for extraneous material: um, I suppose ethics, evidence-based practice, leadership and management skills, integrated behavioral health, and similar classes such as biostatistics don't count as important? Funny thing--here I must be mistaken and wrong. Oh, and I suppose using all of these things along with "medical education" doesn't make fur appropriate NP education.

I still maintain that if you don't perceive yourself as an APRN, you lose the distinction between you and the medical model guy. And if you negotiate correctly, pay can be higher than what many NPs get...oh, wait, that would require useless business and negotiation skills.

guest538567 · Jul 2, 2015

I am genuinely curious. What it is about being a nurse first that sets NPs apart from other medical providers?

I value my experience as a staff nurse and still utilize a foundation that began at the bedside. However, I think you would be hard pressed to find substantial differences in the practices of an experienced provider educated in the nursing model vs that of a provider educated in the medical model. I hear holism frequently cited, although I think this is a practice philosophy that can be incorporated into any discipline.

I am generally disappointed in the state of NP education. I attended a reputable regional school that was highly ranked in national assessments (for whatever those are worth). However, I generally found my program to be easy and was able to work full time. I would not have been able to do this had I attended a medical program (ie. PA school). I think many programs lack a significant amount of rigor and standardization found in other disciplines. There also seems to be a wide range of quality in curriculum even after the consensus model attempted some basic standardization. I would love to see NP programs adopt a focus on hard sciences and increased clinical rigor.

PG2018 · Jul 4, 2015

As for extraneous material: um, I suppose ethics, evidence-based practice, leadership and management skills, integrated behavioral health, and similar classes such as biostatistics don't count as important? Funny thing--here I must be mistaken and wrong.

Yeah, you're right. They don't count as important, and you're stepping outside of your boundaries in assuming things that are far from correct. No one is going to hire you for that set of classes or whatever skillset you developed from them unless you're pursuing academic/research careers, and then they would likely be builders for your CV.

Those are soft skills that don't directly transition into employment. Instead, they just come in handy. I don't think a MSN, already a time constrained degree program, warrants a year's worth of the material you mentioned. Sure, I think statistical knowledge and research methodology awareness helps the learner, and those are typically requirements of every master's program. Even in a prior life when I was considering a mostly recreational MA in history I would've had coursework in research and statistics. Leadership and management skills weren't covered either. A stab was made in undergraduate nursing, but it turned out to be more of a slash than stab.

So speaking of money, I didn't even have a course in school devoted to negotiation. Funny enough, lawyers don't seem to get that either (have a few in the family), and most of us would believe they are trained negotiators. Negotiation is a life skill - one you learn in life. My salary is quite the statistical outlier, and I'm only stating that to suggest that NP curricular models had nothing to do with it. Rather, everything I brought to the table is why my earning power is a high. Frankly, nursing didn't do anything in that meeting except give me a license to practice, and I and my patients would be far better served by medical depth and breadth rather than nursing theory or stats.

As another stated, "hard sciences" and "clinical rigor" are rather absent in NP education nationwide. Holistic practice is a mindset, and that will help you, as a NP, do your job much more than any holism philosophies. It would be nice to have been presented more education in a formal training program -one I incidentally paid for thinking I would receive said education- instead of having had to devote more attention to what wasn't covered. By the way, no education is about "spoon feeding you," and I don't think anyone has suggested that NP training teach us everything (an impossible goal) but rather do a much better job teaching us what we need to know.