Doctoral degree to become an NP???

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The American Association of Colleges of Nursing (AACN) is calling for the requirement of doctorate in nursing for advanced practice nurses, such as nurse practitioners, nurse midwives, clinical nurse specialists, and nurse anesthetists. This new degree will be called a Doctor of Nursing Practice and, if the AACN has its way, will become the entry level for advanced nursing practice.

AACN Position Statement on the Practice Doctorate in Nursing

I dont want my above post to confuse anyone as to give my position so I'll give my take on the issue.

NPs can have independence. Their scope of practice should be CLEARLY defined and CONFINED to primarily preventative efforts though. As a healthy person I would much rather see an NP and as a sick person I would much rather see a doc. I think midlevels do have an independent role in healthcare and should be afforded the opportunity to break the monopoly physicians have on healthcare. I think it would be VERY beneficial to the health of our society to encourage independent practice of preventative health practitioners who treat minor ailments and screen for major ones and then refer them to their counterparts more trained in that area. Why is that such a stretch?

Keep PAs with physician collaboration as dependent providers and let them take over the current midlevel position thata works collectively and cooperatively with physicians. (we're happy with that and also have a more similar training to physicians with stronger science background needed to collaborate on the more serious health concerns and critical care and surgical cases) Then, let the NPs create their own niche as long as it is clearly defined. It makes sense to me and people might be better off for it?

Caldje-

Thank you for your thoughts.

You have brought up a practice model that simply cannot be possible. What you propose is a design in which an already fractured system becomes even more splintered. Who do you want taking care of you on your "sick" days? Will it be the person with whom you have a relationship and who knows your history? Or, do you want to go to the most expensive, least continuous form of care we have today, the ED?

The major flaw here is the concept that people always know when they are seriously sick vs. NP-level sick as you propose. Sick folks rarely carry that unclean-and-ill sign we all sometimes wish for.

I am currently studying for the second step in my medical licensure odyssey. In my question study book I'm seeing about 20% of the questions starting with the stem "a well-appearing _ y.o. _ comes to the office for a well-visit, labs and v/s show________" This is then followed by a list of 5-15 tragic illnesses that are typically asymptomatic at their early stages.

This is not just an infuriating device to trip up the medical student. These questions are built around the real deal. The day to day practice of health care.

Can an NP see these folks and get it right? You betcha. However, I believe there must be a physician to oversee the not-so-obvious reapers lurking behind that "well" facade.

There is also the whole -who can afford preventive care? query. That is a real sticky question.

BTW-I went to medical school to be an Emergency Physician. The stand alone NP/DNP (heeeheee) is a guaranteed route for my job security. Not that EPs are lacking business.

Your second point that the scope must be well defined is an impossibility with today's advanced practice climate. Midlevels defy any constraints on their practice. Limited prescribing was not enough. Full rights were not enough. Intermittent doc supervision was seen as constraining. Stand alone practice with admitting prileges was still inadequate. Now the very title is up for grabs. I will say again that the AACN will not rest until its members are seen as physician equivalents regardless of ability.

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1st of all, let me say that I use step 2 ck books to study so I am very aware of what they have in them. It is one of the frustrating things about PAdom, I am studying for the same test you are yet will not get the same credit for it.

2nd of all. You're concerns lack an important aspect, any faith in NPs at all. Sure, there are constraints to practice, just like a FP doc is constrained to FP scope of practice and just like a GI doc won't likely be doing an orchidectomy anytime soon. However, there is nothing to prove or any reason to even suggest that NPs do not refer when necessary. You're being a little alarmist. good luck in med school.

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Thanks and back at ya.

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Specializes in Education, FP, LNC, Forensics, ED, OB.

please, stay on topic: doctoral degree to become an np

if you wish to discuss clinical outcomes as they relate to the np/phycisian, you may do so by starting another thread.

thank you.

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I dont want my above post to confuse anyone as to give my position so I'll give my take on the issue.

NPs can have independence. Their scope of practice should be CLEARLY defined and CONFINED to primarily preventative efforts though. As a healthy person I would much rather see an NP and as a sick person I would much rather see a doc. I think midlevels do have an independent role in healthcare and should be afforded the opportunity to break the monopoly physicians have on healthcare. I think it would be VERY beneficial to the health of our society to encourage independent practice of preventative health practitioners who treat minor ailments and screen for major ones and then refer them to their counterparts more trained in that area. Why is that such a stretch?

Keep PAs with physician collaboration as dependent providers and let them take over the current midlevel position thata works collectively and cooperatively with physicians. (we're happy with that and also have a more similar training to physicians with stronger science background needed to collaborate on the more serious health concerns and critical care and surgical cases) Then, let the NPs create their own niche as long as it is clearly defined. It makes sense to me and people might be better off for it?

So what you are suggesting is that I, with my 5 years of independent rural health experience and 2 years of emergency department experience, should be only doing preventive visits and URIs, UTI's? You are suggesting that I am incapable of differentiating serious illness from minor complaints?

Interestingly I had a 35 year old who came in for "food poisoning" with complaints of diarrhea and vomiting and some abdominal cramping and chest wall tenderness from the persistent vomiting. Although he had absolutely no cardiac risk factors, my instinct and experience told me that there was more to this story and the "chest wall" pain ended up as an acute MI. The patient was cathed in a timely fashion and all was well. I can guarantee you that had the physician on that day seen the patient he would have been discharged with no cardiac workup.

The moral of my story is, I think NP's are more than capable of differentiating the serious illness from the run of the mill complaint and our talents would be wasted by what you are suggesting.

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My, my. Well not just the comment I pulled out of the previous post, but the whole conversation. What a nasty feeling turn it has taken!

In all my years as a nurse and NP, I have never ever met a single doctor that I thought was a decent businessman. They often appear so because they have more to work with, but in so far as the management of it.... not really executive office material.

But I digress.....

I also chose to be an NP. Medical school was certainly an option for me. I suppose if I wanted to go to med school, I still could. As recently as last year I did consider it, but in the end it wasn't worth it. I am a FNP working ER. I don't make the ER doc salary, but I am right up there with family physicians working in private practice (and half the work days). I recently found out I am not too far off the hospitalist mark where I am either.

I have all the hospital privileges I want. I have the respect of my physician and nursing colleagues. All that considered, the rigors of medical school aren't that attractive.

I have looked at a couple of DNP programs. I don't think it is necessarily a bad idea. This argument about confusion with "real doctors" is ludicrous. I always introduce myself as NP, and no matter how many times I correct patients, I always end up being called "doctor" or get some comment like, "same thing" or "you are MY doctor". So the argument is that a DNP will cause this kind of confusion is just unfounded. The confusion already exists.

I agree 100 % with what you are saying here about the insanity of the concerns that NP's will misrepresent themselves as physicians. I have never introduced myself as "Dr...". The only time I use my title is in the academic setting. I am often confused as a physician and I sometimes correct patients several times and spent quite a bit of time explaining what an NP is. I have absolutely no desire to be thought of as a physician and I think I can say the same for most of my colleagues. The NP's in my ED continue to have the best patient satisfaction scores in all aspects of care.

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Specializes in Education, FP, LNC, Forensics, ED, OB.

o.k., i'll try again..........

please stay on topic - doctoral degree to become np

if not, will have to close this thread.

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Are they willing to pay for the additional education to obtain this degree. I know what I owe now for the last 7 years of college. I will be paying on this until I am 98.

What WILL they think of next?

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If this is so, I might think more about getting my ND rather than going the NP route. Does anyone know how soon this could be a requirement? I have heard that it couldn't happen before five years.

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Specializes in ICU, ER, HH, NICU, now FNP.

They arent going to change it for those who are already there. MS level NP's will be grandfathered in and right now its more of a wish (on the part of certain parties) than a requirement.

In addition, if you want the DNP later you can go through Case Westerns bridge program and do the DNP in about 30 hours.

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I just came across this thread and found it very interesting. I am looking at 2nd degree BSN program and combined BSN/MSN programs and I am wondering if I should just do the BSN progam. I just looked at several doctorate programs courtesy of the link posted by Siri (thanks!!) and some are accepting BSN students. I am feeling more confused. Part of the reason I decided not to go to med school at this time, as several others have noted, is the time and financial committment. Also I have seen most NP programs offer concentrations in certain fields but several of the doctorate programs I looked at are more generalized. Are most doctorate programs specialized or generalized and what happens to nurses who obtains an MSN or DNP in the generalized programs, what are they prepared to do? Are they go to make them all generalized and then make nurses do "residency" like doctors do when they pick their specialization?

I have to agree with the posting of other people that I am against the doctorate degree. With the current nursing shortage, they are going to increase it and not decrease it, although as someone else noted there is not a shortage of NPs (I know a nurse who received who NP but still practices as a nurse because she can't find a NP job). Also the talk about creating a doctorate degree because of the advances in nursing doesn't make sense to me. They are saying nurses need BSNs over associates degrees for the same reason but the difference in education for a BSN over an associates is general ed classes. Yes, the general ed classes might make you a more well rounded person and help you think more critically but that doesn't make you a better nurse. I have no doubt that when I graduate from my BSN progam, the nurse who has an associate degree and has been practicing for years will be able to do circles around me.

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