Doctor of Nursing Practice (DNP): My Personal Pro's and Con's

[Jules A, MSN]

IsabelK said:

Actually, I agree. I think a lot of this is our focus. Perhaps if I dealt primarily with healthy young adults I wouldn't be as quick to look at skin, etc.

Thankfully my young patients other than the ones with addictions issues are largely physically healthy unfortunately a fair amount of patients on my adult units are the over 40 crowd which in psych is usually fraught with a history of poor self care, noncompliance and comorbities like DM, HTN, hepatic/renal issues and HIV. The good news is thanks to our admission diagnostics we often identify and can address somatic illness that might not be treated if they weren't hospitalized for mental health reasons.

[DNP_FNP]

@RN-APN

I really couldn't agree more. Thank you for your insightful post. It is refreshing to see someone appreciate the role of the DNP. On my employment hunt, I can tell you that many of the hiring organizations were pleased that I had my DNP. One of them, an academic medical center, was very excited to bring me aboard because they knew my education would benefit the administration/quality improvement research piece they used within their clinic. The DNP is more than classes on leadership, quality, research, team work, collaboration etc... It changes the way you think about practice. The culmination of your work in a DNP program is not simply a research project or chart review. You are attempting to change practice based on evidence. For my project, I had to develop a research question and perform a true systematic review of the literature. I then had to choose a research design, determine my outcome indicators, choose a practice change model, find a site to perform the practice change (which required a LOT of communication and cold-calling). After that, I had to apply for the university and organization's Institutional Review Board to get approval for my study (which is grueling by the way). After getting approval, I then had to meet with the implementation site several times to get things moving. This included: writing research protocols and algorithms, providing info packets, question and answer sessions to be sure that everyone was doing the same things (standardization), obtaining informed consent, and training everyone in the steps of recruitment. At the end of the study, I had to collect all the data from the participants EMR and run demographic statistics within SPSS. With the limited assistance of my mentor, I then had to statistically analyze those results (dependent t-testing), make inferences, and make recommendations for practice. At the end of my project, I had to go to a National conference to present my work and then, in addition, present my research to all the faculty/staff of the graduate school of nursing as well as the chancellor, other students, and other researchers (dissertation).

The point of that diatribe was to better represent the differences between the MSN and DNP degree. I don't know any MSN programs that are this rigorous and, if so, they should be changed to a DNP program. I learned a phenomenal amount in my DNP program and I applied every principle of the stated "Essentials of DNP Education". I also learned valuable lessons in leadership, principles of spearheading and leading change (quite difficult), collaboration, teamwork, the importance of standardization and quality, and most importantly that evidence based practice changes are extremely important and a needed part of healthcare. NPs should be equipped with the skills to spearhead such projects. We may never have parity with physicians (and rightly so because we are NOT physicians), but we can contribute significantly to patient care outcomes (including increasing efficiency, reducing cost thereby increasing profit)--that alone makes the DNP degree attractive. I have never regretted getting my DNP.

Some of the posts in this particular thread imply not just an antipathy for the DNP but also for nursing in general. It seems that some feel great disdain that our role as NPs are not respected as doctors. I am very well aware the differences in education (including pharmacist, PT etc...). To make a long story short, if you hate being an NP or nurse, go be a doctor. It is never too late! Hating the DNP does nothing to move the profession forward.

[IsabelK]

DNP_FNP said:

@RN-APN

I really couldn't agree more. Thank you for your insightful post. It is refreshing to see someone appreciate the role of the DNP. On my employment hunt, I can tell you that many of the hiring organizations were pleased that I had my DNP. One of them, an academic medical center, was very excited to bring me aboard because they knew my education would benefit the administration/quality improvement research piece they used within their clinic. The DNP is more than classes on leadership, quality, research, team work, collaboration etc... It changes the way you think about practice. The culmination of your work in a DNP program is not simply a research project or chart review. You are attempting to change practice based on evidence. For my project, I had to develop a research question and perform a true systematic review of the literature. I then had to choose a research design, determine my outcome indicators, choose a practice change model, find a site to perform the practice change (which required a LOT of communication and cold-calling). After that, I had to apply for the university and organization's Institutional Review Board to get approval for my study (which is grueling by the way). After getting approval, I then had to meet with the implementation site several times to get things moving. This included: writing research protocols and algorithms, providing info packets, question and answer sessions to be sure that everyone was doing the same things (standardization), obtaining informed consent, and training everyone in the steps of recruitment. At the end of the study, I had to collect all the data from the participants EMR and run demographic statistics within SPSS. With the limited assistance of my mentor, I then had to statistically analyze those results (dependent t-testing), make inferences, and make recommendations for practice. At the end of my project, I had to go to a National conference to present my work and then, in addition, present my research to all the faculty/staff of the graduate school of nursing as well as the chancellor, other students, and other researchers (dissertation).

The point of that diatribe was to better represent the differences between the MSN and DNP degree. I don't know any MSN programs that are this rigorous and, if so, they should be changed to a DNP program. I learned a phenomenal amount in my DNP program and I applied every principle of the stated "Essentials of DNP Education". I also learned valuable lessons in leadership, principles of spearheading and leading change (quite difficult), collaboration, teamwork, the importance of standardization and quality, and most importantly that evidence based practice changes are extremely important and a needed part of healthcare. NPs should be equipped with the skills to spearhead such projects. We may never have parity with physicians (and rightly so because we are NOT physicians), but we can contribute significantly to patient care outcomes (including increasing efficiency, reducing cost thereby increasing profit)--that alone makes the DNP degree attractive. I have never regretted getting my DNP.

Some of the posts in this particular thread imply not just an antipathy for the DNP but also for nursing in general. It seems that some feel great disdain that our role as NPs are not respected as doctors. I am very well aware the differences in education (including pharmacist, PT etc...). To make a long story short, if you hate being an NP or nurse, go be a doctor. It is never too late! Hating the DNP does nothing to move the profession forward.

I wanted to thank you for this. I'll be changing jobs at the end of the month. One of the reasons my new employer hired me was because of the experience I gained doing the DNP. While I didn't look at records in the EMR, I did not many of the same things you did. I went to IRB, I did a defense, etc. I'm working on the dissemination/national part but I do do a lot within the county and area in which I live to get the word out. All of it is taking research and figuring out how to make it work in practice, not just as a theory or a "we need to do this". I am doing "this". I learned more in my DNP program than my MSN program. Not that the MSN program was a bad program--it was a fabulous program and I had some truly wonderful professors and preceptors. But I didn't really understand a lot of how to apply research to daily practice in the way that I can now. That was a struggle for me. It turned out well and I'm proud of that.

We should have parity with physicians. Not "the same job" but an equally recognized job which contributes to the overall health of our patients and the population in general. I'm also not saying "pay us the same as a surgeon", but when we do the same job as the physician PCP or cardiologist or dermatologist down the hall from us--pay us for it. Don't bill our services as "incident to", etc. Start realizing that each member of the health care team should be encouraged to be part of the discussion. This should not be a physician driven system.

Oh, and I agree: if "you" (meaning different posters) have that much disdain for nurses and nursing--go be a PA or MD.