Doctoral degree to become an NP???

amzyRN · Sep 17, 2007

the majority of those in academia who oppose the dnp are in schools who can't offer a doctorate. there is a great deal of consensus within the profession and academia, i don't recall a plan implemented as quickly in the past. programs offering the dnp completion degree are exploding. the professionals are seeking the dnp although the degree is not required for their current role. academia is responding to the need of the profession by developing and offering these dnp completion programs.

some of the faculty at ucsf (that has the best np program in the country) opposes the dnp as entry into practice. at least this is what i have read thus far. i know some other institutions do have dnp, like columbia. i haven't seen an explosion of programs yet though. if these programs were offered at the best programs in the country, i'd be more apt to think there was more merit to them. i guess we will just have to see. check it out though if there is actually a consensus among faculty. let me know what you find. in one of my earlier posts, i included a link to a paper written by faculty at ucsf who opposed the dnp. thanks for the information,

j

Editorial Team / Admin · Sep 17, 2007

I haven't seen an explosion of programs yet though. If these programs were offered at the best programs in the country, I'd be more apt to think there was more merit to them

Here is a sticky thread with link to available dnp programs. Others will be added:

https://allnurses.com/forums/f34/doctor-nursing-practice-dnp-programs-225729.html

HealthyRN · Sep 17, 2007

Some of the faculty at UCSF (that has the best NP program in the country) opposes the DNP as entry into practice. At least this is what I have read thus far. I know some other institutions do have DNP, like Columbia. I haven't seen an explosion of programs yet though. If these programs were offered at the best programs in the country, I'd be more apt to think there was more merit to them. I guess we will just have to see. Check it out though if there is actually a consensus among faculty. Let me know what you find. In one of my earlier posts, I included a link to a paper written by faculty at UCSF who opposed the DNP. Thanks for the information,
J

There has been an explosion of programs! In less than two years, there are over 40 dnp programs that are currently accepting students. According to the AACN (http://www.aacn.nche.edu/DNP/DNPProgramList.htm), there are over 140 other schools that have plans for the DNP. This is huge for the nursing profession in which things are usually very slow to change.

On a side note, I don't place much stock in the ranking of grad programs. They are usually surveys that are not conducted in a rigorous or scientific manner. However, according to US World News, USCF is ranked second for the FNP program. University of Washington is ranked first and they do have a DNP program. Many other high ranking schools also have DNP programs: Case Western Reserve University, Columbia, John Hopkins, Purdue, and University of Maryland to name just a few.

HealthyRN · Sep 17, 2007

I think it needs to be part of the discusion. I'm qustioning why it's a academic and faulty group that is driving this. A change like this should be driven from the workers or the proffesion itself. There are always arguments here about conflict of interest with insurance groupls and pharmacutical companies. The cycnic in me ( and I fully admit this) questions the true motivation.
I know I"ve been a big advacate of evidence based practice and comments, but I'm going to be a hypocrite and use anecdotal infomation here. My wife's office is right across the hallway from a PharmD program, I've worked with Doctorate trained PT's, and even an CFO who got a PHD in health care economics. All I've heard from them was that the DOctorate made no difference in how they work or who they are percieved by other people. In the case of the PT, it actually kept her from getting a coupple jobs. She was told that they didn't need a another Dr, they needed a Physical THereapist. There is even a study out there, thet showed disatisfaction in PharmDs. (Sile WL, Randolph DS. A CLinical Look At Clinical Doctorates. Chronical Rev 2006;52;B12.). Again anecdotaly, one of the best CRNA's I know doesn't have a degree at all. Well he may now i'ts been long enough. He was a diploma nurse and graduated from a certificate CRNA program. THe MDA's all look up to him, and ask him his opinion of things. It had nothing to do with the letters after his name, it all had to do with the clinical competence that he had shown over the years and the respect he had earned.
The mroe I read comments and responses here, the more I feel that it's an ego thing and not a true advancement of the proffesion motivating this. That's fine, ego can be a good thing. But be honest about it. As I look at this issue in trying to plan for my future, I get the impression, that again nursing isn't just missing the target, they are using hte wrong target. We're focusing on a set of letters after our name and not on identifying the true issue that needs to be fixed. This is the same problem when looking at all levels of nursing education. In another post an auther claimed that a certain study proved that BSN's were safer, so BSN were the only way we should be heading. Ok but now lets really work to fix a problem and identify exacly what it is about the BSN program that makes a difference and share that knowledge with all the non BSN nurses out thre. Show the world and the medical community that we can in fact help save patients with the science of nursing. What is lacking in an MSN level NP program that needs to be changes. More clinical, more whatever, I don't know and I don't think anyone else does either. It's time we found out, and address thos issues.
My personal choice is prob going to complete a dual MSN and then a PhD. If I choose to work clinicaly, I"m confident that I won't even have to worry about being grandfathered in, I and most of the current crop of NP's who are over the age of 40 will never see the need to even worry about the need to be grandfathered.

I understand what you are saying and I also question the true motivation of some of the groups involved in the push for the DNP. In the case of your PT friend, did this happen when the DPT was relatively new? When any degree is new to a field, there is some misunderstanding regarding the degree. Today the DPT is becoming more common and master's degrees are being phased out. My sister is a DPT and she is very much in demand. I would be surprised to learn that this had happened to your friend recently. Anyone who would state that they need a PT and not a doctor could not know anything about the PT field today.

The Chronicle article that you posted was very interesting. However, it is not a scientific study. Please don't misrepresent it as such. The author is giving his opinion regarding clinical doctorates. As the PharmD has been around for over 50 years, I doubt that the disatisfaction in the pharmacy profession directly relates to the PharmD itself. More likely it stems from the current situation in health care. This would probably be occuring if pharmacy still only required a bachelor's degree. Also, note that pharmacists are not suffering from a static salary. They are among the highest paid health care professionals.

I agree that the MSN programs could be revamped to include more clinical time. But how many more credits should be added before it becomes ridiculous to call it a master's program? Many master's programs are only 30-40 credits. Most NP programs are 60+. Shouldn't there be some recognition for the additional time and training that is put into an NP program compared to other master's programs?

CraigB-RN, MSN, RN · Sep 17, 2007

Your right I did misrepresent the article. And you might just be right about the job satisfaction. But that does play into some of my concerns. We don't have FACTS, just thoughts and suppositions, combined with emotion. Not a good way to make serious career choices. And I admit up front I played right into it myself. Your also correct in your thought on how much more can we add without making a MSN program more than an MSN? Hmm I almost got myself in trouble and started to compare it to MS level PA programs. :)

Questions, Questions and to date I don't see anyone really trying to answer them. Maybe one of the Phd nurses will focus on this and try to get some answers. Since I've been hearing about the arguments on education since I entered nursing, (1978) and have seen no real changes, except that now it's not unusual for people to have almost BSN numbers of credits when they get out of an ADN program.

The Cynic in me predicts that there will be no change in job satisfaction or income 10 years after the DNP becomes comon place. And I have no thoughts at all about us being better providers. Better educated, no question, but better providers. Ask me again in 10 years.

amzyRN · Sep 24, 2007

There has been an explosion of programs! In less than two years, there are over 40 DNP programs that are currently accepting students. According to the AACN (http://www.aacn.nche.edu/DNP/DNPProgramList.htm), there are over 140 other schools that have plans for the DNP. This is huge for the nursing profession in which things are usually very slow to change.
On a side note, I don't place much stock in the ranking of grad programs. They are usually surveys that are not conducted in a rigorous or scientific manner. However, according to US World News, USCF is ranked second for the FNP program. University of Washington is ranked first and they do have a DNP program. Many other high ranking schools also have DNP programs: Case Western Reserve University, Columbia, John Hopkins, Purdue, and University of Maryland to name just a few.

I read the earlier article against the DNP by one of the faculty at UCSF and it was compelling in my opinion. I agree that sometimes ranking universities is definitely biased, probably based on funding and such. But from what I read in the article (posted earlier) there is no evidence that the DNP will expand scope of practice or patient saftey, etc. Perhaps that will come later. People should have the option of the DNP if they choose. But for me personally, I am going to try to get the masters and NP license before the DNP is required. If I wanted to go on to get a 4 year clinical degree, I would have went to medical school. I already have a science BA in another field which took extensive study and will acquire a second degree BSN. I'm just not up for the 4 year nursing doctorate afterward if it doesn't expand my scope of practice or increase my salary. But of course I may change my mind later on.

This DNP degree/issue (as a requirement) reminds me of the practice doctorate called a PsyD. There are more clinical hours, more classes in psychology, etc., but in practice the PsyD's do the same thing as Masters prepared clinicians. PsyD's come out of school with more debt, no increased pay, no expanded scope of practice, and are maybe not any better of a practitioner than a masters prepared clinician.

So far, from my understanding, the DNP is similar in that, though it may be enriching for the individual (as more education usually is), it will not necessarily yield a greater salary, an expanded scope of practice, greater esteem for the nursing profession, or even make a better NP.

I checked out some of the curricula at USF in San Francisco, and from what I read, it looked like the DNP included way more research education. Frankly from what I read it looked like a bunch of milarky!

It looked super super boring from what I read.

I don't think learning more about research (in nursing theory of all things) will yield a better NP. And I am not going to jump through the DNP hoop if it's just a move based on ego. I don't like taking bogus classes just to call my self doctor. And that is one of the reasons I didn't want to do med school. But at least med school doesn't give classes in research. And so I'd definitely consider going into another field if the DNP is mandated.

In short, If the DNP is just for more prestige and the classes are in research and not more advanced clinical techniques, and doesn't expand scope of practice or increase salary, then on a practical level, it's lame. Everyone will see the DNP for what it is, if it is for ego/esteem, and they will laugh at the people who pursue it for those reasons. If it is a degree based on genuinely expanding the knowledge base, then it has merit. It must also increase the salary of the NP! Thanks for all of your insight and thoughts, I really enjoy reading your posts!

J

psycharnp · Nov 3, 2007

Don't take this wrong, but you have certainly captured the glass is half empty version. The alternative view is the very thing that kept me "in the program". My mantra was this: "I have to have continuing education anyway; it may as well eventually add up to something". The hospital I work for will provide free CE, with just enough substance to be "easy"; just enough to keep my license alive, or I can spend time, money and effort on quality CE's that will add up to realizing my true professional potential.

The great thing about most graduate school programs is that they are designed with the working wo/man in mind. You can accomplish this one night a week, full time, or any thing in between.

One thing I found oddly disappointing is that the physicians I know were much more supportive of my going to NP school than my sister nurses.

My belief is that Nursing is an attractive profession today because you can get in at the level of C.N.A., LPN, or R.N. and begin making money according to your level of education relatively soon. Add to that, if you choose to go on to the master's level or now doctorate you can. The alternative is to not be able to do this.

I do agree with you in that I believe it is important to keep the masters preparation available as opposed to make DNP the entry level. What I hope we do not do is fall into an advanced practice version of the ridicules, divisive and counterproductive "Associates VS. BSN" exercise in futility.

As for myself: my wife and I went to BSN school together and later MSN/NP school together. Last year we completed the PMH-NP program and are practicing as in Kansas ARNP. We are now applying to the DNP program, not because we believe we will make more money, but because it affords additional professional development.

I love it that I belong to a profession that affords both decent pay early on and the option to move forward at the speed most convenient for my situation, without forcing my peers to necessarily move at that same rate, but instead at their own chosen speed.

Of course the bad thing about graduate school is it makes you into somewhat of a prolific writerL

One last insight which I will modify to say a 6 year DNP program. This insight also helped to "keep me in the program". The insight is this: it may take you say 6 years to become a DNP; now how old will you be in 6 years if you don't start the program?

CraigB-RN, MSN, RN · Nov 5, 2007

Don't take this wrong, but you have certainly captured the glass is half empty version. The alternative view is the very thing that kept me "in the program". My mantra was this: "I have to have continuing education anyway; it may as well eventually add up to something". The hospital I work for will provide free CE, with just enough substance to be "easy"; just enough to keep my license alive, or I can spend time, money and effort on quality CE's that will add up to realizing my true professional potential.
The great thing about most graduate school programs is that they are designed with the working wo/man in mind. You can accomplish this one night a week, full time, or any thing in between.
One thing I found oddly disappointing is that the physicians I know were much more supportive of my going to NP school than my sister nurses.
My belief is that Nursing is an attractive profession today because you can get in at the level of C.N.A., LPN, or R.N. and begin making money according to your level of education relatively soon. Add to that, if you choose to go on to the master's level or now doctorate you can. The alternative is to not be able to do this.
I do agree with you in that I believe it is important to keep the masters preparation available as opposed to make DNP the entry level. What I hope we do not do is fall into an advanced practice version of the ridicules, divisive and counterproductive "Associates VS. BSN" exercise in futility.
As for myself: my wife and I went to BSN school together and later MSN/NP school together. Last year we completed the PMH-NP program and are practicing as in Kansas ARNP. We are now applying to the DNP program, not because we believe we will make more money, but because it affords additional professional development.
I love it that I belong to a profession that affords both decent pay early on and the option to move forward at the speed most convenient for my situation, without forcing my peers to necessarily move at that same rate, but instead at their own chosen speed.
Of course the bad thing about graduate school is it makes you into somewhat of a prolific writerL
One last insight which I will modify to say a 6 year DNP program. This insight also helped to "keep me in the program". The insight is this: it may take you say 6 years to become a DNP; now how old will you be in 6 years if you don't start the program?

It still comes down to me the way you describe it that just oging to med school would fill the bill. It might even be cheaper if you go to a state school. 4 years for BSN, maybe 5 depending on wait lists and such. 6 years for DNP, after you've worked a couple years as a nurse. Hmm wow 12 years I could almost be done with my residency. Yes I admit the sarcasm was intended. I just remember the arguments that you didn't need that much schooling to provide good primary care.

I just don't don't know on this one. I do know that expanding the knowlege and clinical requirment of NP Programs would be a good thing, but I"m not sure a DNP is the way to go. I"m just to much the cynic to think it's anything but a punch in the nose to the medical community. With a big red flag attached to draw attention to it. I've always thought that as nurses institutionaly we always choose the wrong battles. Maybe the NP educational model is flawed and we just need to address that and not start a new inflated degree path. What happens next?

SN2bExpAt · Nov 14, 2007

All throughout my 2nd year of nursing school I would spend a lot of my free time looking at both Canadian and American schools that offered an NP Masters stream. It is three years in Ontario. You have to complete a Masters then a 1 year certificate program (online, no less) to become a Nurse Practitioner. We like to stuff as much threoretical malarky (thank you whoever said that above) such as Nursing Issues, Leadership, and two research methods classes to distance ourselves from American programs. A lot of trivial knowledge that helps 0% when it comes to diagnosing a patient, which is pure BS.

Unfortunately, some Canadians define themselves by saying how unlike the Americans we are. Nursing actually provides a quantifiable basis for this theory, too. All you have to do is compare the Canadian Registered Nurses Exam to the NCLEX. We have a lot more pshychosocial basis vs objective and physiology based testing.

I see this pattern spilling into the American nursing landscape, now. Unless that extra year in the DNP proposal is purely clinical and scientific (REAL science, not the qualitative "Anxiety and patient response yada yada" BS research that made me want to hang myself when I was forced to read it), then it will be more useless "fluff" courses that have no practical basis in diagnosing a patient.

I see this as another evolution in the dogma of making nursing practice as professionally recognized as, well let's face it, MD's. Canada is no exception, either. We make BSN entry to practice in every province except Manitoba, the last bastion of diploma training. You see, in an effort to make us as "professional appearing" as PT's, OT's, BSc lab techs, we addressed this nation's nursing shortage by cutting those off who could answer the call. We basically shat on all the Diploma nurses coming out of Manitoba. When these students quickly realize that American hospitals pay for their staff to upgrade to BSN, they will not stay here.

What I am saying in the above is that this incessant drive to show the world how special we are, usually at the expense of our checkbooks, is driving me to wonder if I want to remain a part of that culture. This drive for recognition is making me seriously reconsider my post BN studies altogether. What do I tell my future kids when they ask me, "nursing school or medical school?" Let's face it, with an equal amount of time to do DNP and medical school, would you have made your university decisions the same way?

I am feeling this ever so in my undergrad studies. The kind of people that are so driven to bolster the nurses image to the medical community is making me realize I do not want to turn into one of those types of professors. I am already spitting nails at the 100% useless fluff courses that make up a baccalaureate, why would I want to endure more of the same for another 3 years? Currently it is two, but that is still time wasted in my eyes. Tell me how "Trends in Nursing" or "Nursing Leadership" or "qualitative research methods" will help me diagnose JRA, rheumatic fever, or a simple staph infection? Even if you get something interesting like an autoimmune disorder, you have to refer it to an MD because it falls out of NP scope of practice. As soon as it gets complicated (and interesting) you have to realize your limits and refer the patient elsewhere. I could not live like that, knowing that if I had just spent one more year "elsewhere", I would be recognized as competent to deal with cancer, autoimmune, really cool diagnostic differentials, etc. Unless DNP entry to practice offers that kind of autonomy, people will quickly realize the "alternative" opens up a whole other world where you are limited by your imagination; not by ANA, state, or national legislation which castrates your role as a health care provider.

I know, with the combined experience of holier than thou nursing professors, clinical instructors, and now this push for DNP entry to practice, my mind is made up for my pursuit of grad studies and NP is no longer on the radar.

amzyRN · Nov 15, 2007

Interesting post above notes that if the DNP becomes the standard (a 4 year degree) and scope of practice doesn't expand, then would potential NPs go on to med school instead? Just to note after med school, there is usually a residency, but that doesn't have to be so bad. Though, I'm already in the middle of an Accelerated BSN program to become an RN, I'm now considering med school instead of NP school. I don't like wasting my time on fluff either and the DNP degree so far seems pretty lame to me. So, my question is, perhaps for a different thread, if DNP is required would people consider med school instead of NP school?

J

westcoastgirl · Nov 18, 2007

I would not have applied to NP school if the DNP was my only choice.

more tuition, uncertain quality of the extra year, when I could have spent one more year to become a MD?

my personal opinion is going to DNP will drive away interested and qualified applicants which is sad for nursing

SN2bExpAt · Nov 18, 2007

It is the paradoxical effect of more is less.

More requirements for NP = less applicants to grad school.

I am guessing people with ambition apply to NP grad school. These people, motivated people whom should have a good grasp of foresight, will see that "three is weak" and "four gets you so much more."

I've got to start trademarking these catchphrases. How about this one: "the PE of DNP."