Doctoral degree to become an NP???

[VickyRN]

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

[chris.mobile.fnp]

You have time to continue to research. GO shadow an FNP in an office and one who works in the hospital setting, it will give you an idea of what you are in for. Most FNP's are glad to have people interested come see what they do. Best wishes to you as you continue on in your education!

[justme1972]

I'm about 4 years from being able to apply to an NP program...I am actually extremely concerned that the program may change before I get there....does anyone see this happening anytime soon?

[Lit4745]

As a recent graduate from a MSN, FNP program it makes me feel ill. Here what I worked so hard for over the last 3 and a half years is being devalued by the DNP program.

Hello, and congratulations on all of your hard work. I would be willing to bet that you had some valuable clinical and work experience as well, before entering the FNP program. I am quite disgusted by the plan. First of all, all you ever hear is those in power that are making the decision for practicing nurses saying" there are not enough master's prepared nurses". It is a well know fact that there is a shortage.

They meet in large groups to discuss "strategies" for recruiting people into nursing, with a plan to obtain their masters or doctorate degree. One of their "grand plans" is to go into middle and junior high schools and get more people interested in nursing.

I think that there is a large group of practicing nurses that they are forgetting about. I work and network with a lot of nurses who have a BSN and would love to return to school for a master's degree in Nurse Educator, Nurse Practitioner or CNS role. It is interesting to note that practicing LPN can challenge some of the required coursework for an RN degree. And, in fact, in my state, with my BSN, I can take a few classes, work under a mentor-teacher and obtain my teaching certificate in less time than I can get a MSN. I have a BSN and 25 years of nursing experience, so that is a joke to me. My clinical experience is ICU and 7 years of working with a cardiologist (hospital rounds and office). But none of that seems to count to the powers that be. To get an MSN, I have to sit in a classroom and hear about nursing theory and Florence Nightingale all over again.

If they are so concerned about the "shortage" of masters prepared nurses why don't they offer some options to those BSN prepared nurses who have to work at least part time and give some credit for their work experience.

Also, to require a doctorate in nurse for FNP is an interesting premise when they already are turning away applicants to all levels of nursing programs.

I think it would be interesting to see how many BSN nurses would return to school, if they didn't make it so hard to get your master's degree.

It is also interesting that in the program I started, I had more clinical experience already than many of the MSN faculty that were going to teach me. Does anyone else out there want to go back to school but are frustrated by the myriad of requirements, excessive writing of papers, and redundancy of information.

It is unfortunate that there are probably thousands of nurses with years of invaluable clinical experience that would probably make wonderful nurse practitioners. They are already providing more instruction and teaching regarding their patients' meds, treatment, etc than the physician. But, sadly, they can't go back to school and work because of the required classwork and the fact that none of their experience can even can't toward the required hours, and no challenge exam is offered even in health assessment (which many are already doing) or pharmacology.

It appears that they would rather "recruit" an eight grader, than someone with years of clinical experience.

[GrnHonu99, RN]

I cannot answer for certain, but knowing the track record and dogmatism of the AACN crowd, they will probably push their Doctor of Nursing Practice (DNP) as the only acceptable doctorate for this role.

Probably is right. It's already happened in my area. ASU has already discontinued all of their MSN programs and is moving the first set of students through the new DNP for all NP roles. The only MSN left there is educator. I didn't believe it because I had heard 2015....so I went there in person..it's true. Before I left, the director of the program made sure to mention that they strongly reccommend all nurses pursing an advanced role should enroll in a DNP program..... as she wasn't sure how the laws would change in requiring nurses to obtain a DNP for advanced roles in the future. Yep. Thanks. Unfort. in my area there aren't many other options in way of education so, i'm still debating.

[GrnHonu99, RN]

Case Wester does an MS to DNP bridge that is 25 or so hours - but it costs out the WAZOOOOOOOOOO! And requires travel.

I wondered why they were cleared for clinical hours in Az!

[HealthyRN]

Hello, and congratulations on all of your hard work. I would be willing to bet that you had some valuable clinical and work experience as well, before entering the FNP program. I am quite disgusted by the plan. First of all, all you ever hear is those in power that are making the decision for practicing nurses saying" there are not enough master's prepared nurses". It is a well know fact that there is a shortage.

They meet in large groups to discuss "strategies" for recruiting people into nursing, with a plan to obtain their masters or doctorate degree. One of their "grand plans" is to go into middle and junior high schools and get more people interested in nursing.

I think that there is a large group of practicing nurses that they are forgetting about. I work and network with a lot of nurses who have a BSN and would love to return to school for a master's degree in Nurse Educator, Nurse Practitioner or CNS role. It is interesting to note that practicing LPN can challenge some of the required coursework for an RN degree. And, in fact, in my state, with my BSN, I can take a few classes, work under a mentor-teacher and obtain my teaching certificate in less time than I can get a MSN. I have a BSN and 25 years of nursing experience, so that is a joke to me. My clinical experience is ICU and 7 years of working with a cardiologist (hospital rounds and office). But none of that seems to count to the powers that be. To get an MSN, I have to sit in a classroom and hear about nursing theory and Florence Nightingale all over again.

If they are so concerned about the "shortage" of masters prepared nurses why don't they offer some options to those BSN prepared nurses who have to work at least part time and give some credit for their work experience.

Also, to require a doctorate in nurse for FNP is an interesting premise when they already are turning away applicants to all levels of nursing programs.

I think it would be interesting to see how many BSN nurses would return to school, if they didn't make it so hard to get your master's degree.

It is also interesting that in the program I started, I had more clinical experience already than many of the MSN faculty that were going to teach me. Does anyone else out there want to go back to school but are frustrated by the myriad of requirements, excessive writing of papers, and redundancy of information.

It is unfortunate that there are probably thousands of nurses with years of invaluable clinical experience that would probably make wonderful nurse practitioners. They are already providing more instruction and teaching regarding their patients' meds, treatment, etc than the physician. But, sadly, they can't go back to school and work because of the required classwork and the fact that none of their experience can even can't toward the required hours, and no challenge exam is offered even in health assessment (which many are already doing) or pharmacology.

It appears that they would rather "recruit" an eight grader, than someone with years of clinical experience.

So what do you want the future to hold for nursing education? I respect your 25 years of experience, but I do not believe that experience should ever be a replacement for education. You have spent 25 years in the role of an RN, not as an NP. The roles are different. Yes, your experience would be very useful, but I think that there would still be a lot for you to learn.

I also don't believe that universities make it excessively difficult to obtain a MSN. There are very few master's programs in other fields in which you are able to attend part-time. In the program that I am attending, you can take up to 5 years to obtain the MSN. Classes are offered mostly in the evenings. Also, there are the online programs in which you don't ever have to go to a lecture!! In my opinion, it doesn't get more adult or family-friendly than this.

[jjjoy, LPN]

I think a part of Lit's frustration is that some of the requirements don't seem all that relevant to professional practice. MDs don't study the philosophical underpinings of practicing medicine and I'd assume the bulk of writing assignments would be directly related to patient care as a physician, such as a case study. Some of the requirements of some nursing programs can seem rather pointless and just an exercise in jumping through hoops in order to get qualified. If the requirements and coursework made more sense (currently many do, but there are some that don't), then it might be less frustrating.

It looks like there's a trend for other health care professions to move to a "doctoral" program for professional practice. Note it's not a PhD... "doctor of philosophy" which is usually research based, but it's a "doctor of physical therapy" for example. Nursing is looking to add a "doctor of nursing practice". It's generally considered a professional degree like doctor of law or doctor of medicine.

[Lit4745]

So what do you want the future to hold for nursing education? I respect your 25 years of experience, but I do not believe that experience should ever be a replacement for education. You have spent 25 years in the role of an RN, not as an NP. The roles are different. Yes, your experience would be very useful, but I think that there would still be a lot for you to learn.

I also don't believe that universities make it excessively difficult to obtain a MSN. There are very few master's programs in other fields in which you are able to attend part-time. In the program that I am attending, you can take up to 5 years to obtain the MSN. Classes are offered mostly in the evenings. Also, there are the online programs in which you don't ever have to go to a lecture!! In my opinion, it doesn't get more adult or family-friendly than this.

I feel that you misunderstood me. I too believe in education. I dont mean to suggest that experience should replace education, onlyl that our experience shsould be considered and another way to validate knowledge other than writing papers on topics that aren't relevant to fNP practice. For instance, in one class I enrolled for a 3 credit course. I was in the FNP program. It was an elective so I registered for a course in nursing education. The course was curriculum design. It was a summer course, over 10 weeks. That course required 20 papers (2 each week) 5-7 pages long in APA format. The first five papers were on nursing history, ie theory and Florence Nightingale. I am proud of my nursing heritage. I had learned much of that material when I got my BSN, which was just prior to enrolling in MSN program. She wouldn't accept any of those papers or coursework, including lesson plans and other material. By the way I am a good writer and graduated BSN with a 4.0, so you can see it is not that I was not a good student.

as far as my 25 years of practice not being an FNP, I might let you know that many nurses are practicing already in what might be considered a somewhat advanced role over a bedside nurse. I already had 15 years critical care experience when I went to work in a Cardiology Group practice. The doctor I assisted everyday is well respected nationally in involved in many research studies, his specific area of interest being congestive heart failure.

Each morning, I arrived at the hospital before my physician, and began rounds. I checked everyone's cardiac rhythm. For new patients in the ER, I went to see them and began taking their history. I got all of the charts together on each floor and begin writing in the progress notes the clinical information and updated him on the prior evening events before he went in to see the patients. It was a large practice and we would typically see about 40 inpatients everyday, then go to the office in the afternoon. I went into the room of ALL new office patients and began taking history before he would come in. He trusted my clinical ability to make some decisions after being given direction by him and taught a lot about cardiology.

ANyway, in 1997 when the law changed and Nurse practitioners could bill and therefore bring money into the group, my job changed overnight. The group hired nurse practitioners, which I totallly understand. Guess who oriented the new nurse practitioners to the floors of the hospital, his patients, his routine, what tests he ordered for specific patients, and even how to read EKG. I did that willingly because I admired and respected the physician I worked with for 10 years. Also because my main priority was may patients. I don't see how you can say that I functioned as just an RN , not an FNP. ALL of the duties I had been doing were taken over by a new graduate FNP, just because they can bill Medicare and Insurance.

I am not asking for a free MSN, or not to have to return to school. By the way, I was highly recommended by my nursing BSN instructors and all of the physicians I worked with. I was accepted a 3 FNP programs. I graduated with a 4.0.

My point is this: If an LPN can challenge some coursework. why not an experienced RN with a BSN? Do we not have knowledge in history taking, pathophysiology or pharmacology? I have talked to a lot of nurses in their late 30;s and 40's who know that they cannot continue to do bedside nursing with it's total care requirement. There should be an option where they could use their clinical experience in an accelerated program for RN to BSN, at least in education. Instead the nursing profession would rather get someone into the system without any bedside experience and take them straight through school to an MSN or DNP. That piece of paper (diploma) means more than any experience. I'm not saying it takes the place of all courses. Yes, they sould focus on the advanced practice role. But why repeat courses and require 20 papers for a 3 hour course? That is keeping a lot of great nurses from returning to school. Ask any nurse that is practicing today. Most of them will tell you that most of what they know and use clinically, they learned AFTER graduation. That knowledge is a foundation. Experience should mean something. Think of an example of something you learned in clinical practice. You will never forget that experience. When a similar patient comes up, you remember.

I think education is wonderful, but so is experience. I don't want to get a MSN to learn how to be a writer. I want to be able to take care of sick people. I stand by what I have learned in 25 years of critical care nursing and working daily for 10 years with a board certified cardiologist. By the way I also worked in the research department of our practice, explaining and helping to enroll patients in clinical trials.

good luck in your educational endeavors. I wish you well.

[HealthyRN]

I feel that you misunderstood me. I too believe in education. I dont mean to suggest that experience should replace education, onlyl that our experience shsould be considered and another way to validate knowledge other than writing papers on topics that aren't relevant to fNP practice. For instance, in one class I enrolled for a 3 credit course. I was in the FNP program. It was an elective so I registered for a course in nursing education. The course was curriculum design. It was a summer course, over 10 weeks. That course required 20 papers (2 each week) 5-7 pages long in APA format. The first five papers were on nursing history, ie theory and Florence Nightingale. I am proud of my nursing heritage. I had learned much of that material when I got my BSN, which was just prior to enrolling in MSN program. She wouldn't accept any of those papers or coursework, including lesson plans and other material. By the way I am a good writer and graduated BSN with a 4.0, so you can see it is not that I was not a good student.

as far as my 25 years of practice not being an FNP, I might let you know that many nurses are practicing already in what might be considered a somewhat advanced role over a bedside nurse. I already had 15 years critical care experience when I went to work in a Cardiology Group practice. The doctor I assisted everyday is well respected nationally in involved in many research studies, his specific area of interest being congestive heart failure.

Each morning, I arrived at the hospital before my physician, and began rounds. I checked everyone's cardiac rhythm. For new patients in the ER, I went to see them and began taking their history. I got all of the charts together on each floor and begin writing in the progress notes the clinical information and updated him on the prior evening events before he went in to see the patients. It was a large practice and we would typically see about 40 inpatients everyday, then go to the office in the afternoon. I went into the room of ALL new office patients and began taking history before he would come in. He trusted my clinical ability to make some decisions after being given direction by him and taught a lot about cardiology.

ANyway, in 1997 when the law changed and Nurse practitioners could bill and therefore bring money into the group, my job changed overnight. The group hired nurse practitioners, which I totallly understand. Guess who oriented the new nurse practitioners to the floors of the hospital, his patients, his routine, what tests he ordered for specific patients, and even how to read EKG. I did that willingly because I admired and respected the physician I worked with for 10 years. Also because my main priority was may patients. I don't see how you can say that I functioned as just an RN , not an FNP. ALL of the duties I had been doing were taken over by a new graduate FNP, just because they can bill Medicare and Insurance.

I am not asking for a free MSN, or not to have to return to school. By the way, I was highly recommended by my nursing BSN instructors and all of the physicians I worked with. I was accepted a 3 FNP programs. I graduated with a 4.0.

My point is this: If an LPN can challenge some coursework. why not an experienced RN with a BSN? Do we not have knowledge in history taking, pathophysiology or pharmacology? I have talked to a lot of nurses in their late 30;s and 40's who know that they cannot continue to do bedside nursing with it's total care requirement. There should be an option where they could use their clinical experience in an accelerated program for RN to BSN, at least in education. Instead the nursing profession would rather get someone into the system without any bedside experience and take them straight through school to an MSN or DNP. That piece of paper (diploma) means more than any experience. I'm not saying it takes the place of all courses. Yes, they sould focus on the advanced practice role. But why repeat courses and require 20 papers for a 3 hour course? That is keeping a lot of great nurses from returning to school. Ask any nurse that is practicing today. Most of them will tell you that most of what they know and use clinically, they learned AFTER graduation. That knowledge is a foundation. Experience should mean something. Think of an example of something you learned in clinical practice. You will never forget that experience. When a similar patient comes up, you remember.

I think education is wonderful, but so is experience. I don't want to get a MSN to learn how to be a writer. I want to be able to take care of sick people. I stand by what I have learned in 25 years of critical care nursing and working daily for 10 years with a board certified cardiologist. By the way I also worked in the research department of our practice, explaining and helping to enroll patients in clinical trials.

good luck in your educational endeavors. I wish you well.

Thank you for taking the time to clarify your post. I did misunderstand what you were saying. I agree that 20 papers are excessive for a 3-hour course. Also, focusing on nursing theory and the history of nursing in an FNP program probably does little to prepare a nurse for the FNP role. I can certainly understand your frustration.

Perhaps it may depend on the university though. I graduated a little over a year ago with my BSN and I attended a large, well-known state unversity. We covered very, very little nursing theory. Florence Nightingale was mentioned only in passing and I know her contributions to nursing only because I took the time to reasearch her myself. I haven't started my FNP program yet, but the course descriptions seem to be very clinically focused.

[prairienp]

my point is this: if an lpn can challenge some coursework. why not an experienced rn with a bsn? do we not have knowledge in history taking, pathophysiology or pharmacology? i have talked to a lot of nurses in their late 30;s and 40's who know that they cannot continue to do bedside nursing with it's total care requirement. there should be an option where they could use their clinical experience in an accelerated program for rn to bsn, at least in education. instead the nursing profession would rather get someone into the system without any bedside experience and take them straight through school to an msn or dnp. that piece of paper (diploma) means more than any experience. i'm not saying it takes the place of all courses. yes, they sould focus on the advanced practice role. but why repeat courses and require 20 papers for a 3 hour course? that is keeping a lot of great nurses from returning to school. ask any nurse that is practicing today. most of them will tell you that most of what they know and use clinically, they learned after graduation. that knowledge is a foundation. experience should mean something. think of an example of something you learned in clinical practice. you will never forget that experience. when a similar patient comes up, you remember.

i think education is wonderful, but so is experience. i don't want to get a msn to learn how to be a writer. i want to be able to take care of sick people. i stand by what i have learned in 25 years of critical care nursing and working daily for 10 years with a board certified cardiologist. by the way i also worked in the research department of our practice, explaining and helping to enroll patients in clinical trials.

good luck in your educational endeavors. i wish you well.

many universities will allow you to challenge any course. if you feel you already have the knowledge talk to the course instructor, an exam will be created and you can skip all the course work.

[Lit4745]

[ So true. I agree with what you said. I was originally educatetd as an associate degree nurse, and went to work in critical care upon graduation. I now have 25 years of critical care experience. I have worked many times beside a BSN prepared new graduate and experienced ADN nurses. I can tell you that there is no substitue for experience. Education is only a foundation for practice. Ask any practicing nurse and they will tell you that most of what they know and actually use for decision making is experience. Now, with a nationwide nursing shortage the powers that be want to require a DNP for the FNP. They would also like to do away with ADN programs. What happens to those who just want to practice bedside nursing? And after all is said and done, isn't that usually the first medical personnel one is evaluated by when entering the health care system. Who is going to do the routine, mundane everyday tasks that bedside nurses do? How many people out there are interested in going to school for four years before being employed, only to do bedside care (start iv's, clean poop, take people to x-ray, etc? Does it really require a 4 year degree to do that? By the way, I did return in 200 and obtain my BSN. I can honestly say that that extra education DID NOT change the way I do patient care, at the bedside. I did it because a BSN is required to enter an FNP program, which was my goal.

I was naive, and thought that the FNP program would teach me things I could use in independent practice such as pharmacology, about disease and illnes, how to diagnose, etc. WRONG!!!! In reality the first courses I have taken are Nursing theory (ie. Dorothea Orem and Florence NIghtingale). Let's see, if I go in to assess a patient who presents with chest pain what do i do? Oh, that's right I refer to Dorothea Orem's model of care to assess the patient. This is the very reason why nursing in not taken seriously by physician, who we must practice with collaboriatively in the real world.

Now, they want to require a DNP. And even more ludicrous, guess where their primary recruiting strategy is? To middle school students. They want to find someone interested in nursing and upon graduation take them straight through to the DNP.

What about all of the practicing nurses in may agegroup (35-45) who would like to return to school? How about tailoring a program for them? And, what if they provided a chal.enge exam for some coursework , clinical checkoff, or credit for work experience.?

It's sad, because there are a lot of nurses who would like to return to school. But, after talking to those who have find out that the educational requirements are mostly writing papers and a repitition of what they learned in BSN programs.

Many of those nurses who are excellent clinicans, have told me "I would go back to school, but I can't write all of those papers". I wonder how many papers MD's had to write before obtaining their degree.

It's sad, but I think in a few years there won't be many nurses left to care for sick people. And those that are working will be stretched even more thin. Those in power only think it is bad now. Just wait about 5 or 10 more years. quote=vtprenursingstudent;1746989]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.

[Lit4745]

So true. I agree with your point. I started an FNP program in my area. I had more clinical experience than most of my instructors. They didn't want to hear what I had to say about what was going on in the real world. Just to let you know, at the time I was working with a cardiologist. I rounded with him in the hospital everyday and we saw office patients in the afternoon. I arrived at the hospital in the morning BEFORE the MD and got an update on alll of the patients. I worked up all the new patients in the ER. I did all the patient teaching at discharge. I made sure they understood their discharge meds. I actually spent more time with the patient than the MD. I enjoyed that aspect of my role. I went back to school so I could function at an advanced role. I naivelly thought that the FNP program would teach me more about medicine, disease and illness, and how to take care of sick people. WRONG!!!! More nursing theory, nursing research, etc, etc. More semester hours of fluff that you won't use in practice than in pharmacology of pathophysiology. But, if you speak out or say anything to disagree with the instructors, watch out. Most of them aren't even actually practicing but think they know what it is like in the real world. Now, they think that MORE SCHOOL, ie the DNP is what is needed. Sounds like job security for a bunch of instructors. All of these forces is the reason why nursing is not respected by the medical community. I had the respect of the physician I worked with because of my experience (25 years in critical care), caring, compassion, and how I took care of his patients. Not because of a master's degree or doctorate. But sadly, experience doesn't mean anything. And to those of you returning to school, who want to graduate, just keep your mouth shut, jump throught the hoops, and repeat back what they teach verbatim, regardless of whether it is true in the real world of health care. The nurses of the future will be highly educated, but will they be able to take care of sick people, make the family happy, take an increased patient load (because of the nursing shortage) and do all of the tasks that we do everyday that could be provided by a CNA? I don't mind cleaning up blood, vomit or poop, but I resent the fact that education is valued so much over experience. Oh, and before anyone thinks I am against education, I don't. I can spit out a paper like they require and had a 4.0 grade point in my BSN program. But, when I returned to the bedside, it was my experience that mattered to the patient and my compassion, not what grade I made on a paper about the Dorothea Orem nursing model. Thanks.