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

[morgorm]

Hey Markdanurse, you rock! I am 100% with you, you absolutely NAILED it ! Thanks so much for making the points I've been arguing and doing it so very clearly! Please keep up the good work and consider sending your well thought out prose to the relevant journals. Thank You:balloons:

[amzyRN]

But, what can we do to prevent it from becoming a requirement? Is there anything we can do to stop it or make it expand scope of practice? For those of us who oppose it and I think there are many in academia who do, can we really prevent it as a requirement? Thanks much,

J

[Miss Mab]

Excellent post, Markdanurse.

My greatest concern, aside from my personal career dilemma, is the negative impact on nursing as a whole when the awareness of this "requirement" really gets out there and trickles down to our young people.

The kind of student or professional likely to pursue such advanced study is exactly the kind of person to go ahead and research, do a cost/benefit analysis as mentioned and, in my opinion, be more likely to look around at the medical career fields in general and say, "forget this." The career path almost no longer makes sense--at least to many just starting out. The traditional line about 'do you want to do nursing or medicine' really doesn't hold that much water when you are contemplating collaborative practice as a midlevel in healthcare today.

I continue to fear we will lose our "brightest" to other disciplines. That would be a shame. And for what? Monetary gain for academia? Because it certainly doesn't sound like for better practice, at least from the current programs I have researched.

Sad....

[n_g]

The biggest beneficiaries of the DNP will be the PA's. People will realize that they can achieve the same scope and pay in half the time and cost by going the PA route.

[westcoastgirl]

I definitely agree. Recently 2 people at work whom I've been advising informally were looking at NP or PA and both are opting for PA route now due to the DNP requirement.

I like and respect my PA colleagues, and sad to say I can understand why the 2 motivated and bright people would come to conclusion DNP is a worse choice than PA for them. very sad for the NP profession

[prairienp]

the biggest beneficiaries of the dnp will be the pa's. people will realize that they can achieve the same scope and pay in half the time and cost by going the pa route.

i understand there is a movement of the pa to the doctorate now. historically the pa has usually followed the np, certificate to bachelors, bachelors to masters and i suspect masters to doctorate.

i do not understand how you feel the cost and time are the same. the number of clinical hours is far more for the pa and in general the cost is significantly higher.

[n_g]

I am aware of the DrPASc. It's a pilot program by the military for PA's.

You have to keep several things in mind. If the scope and pay does not increase with longer training, then why force students to spend an extra two years of time and money pursuing it? Just so that people can stroke their personal egos? Do you think that the docs care if you have a DNP or DrPASc? They will treat you the same as if you have a NP or PA. Neither the docs, Medicare, the insurance companies, and the hospital credentialing committees will care because you're still not a board-certified physician.

I suspect that there will be a lot of resistance from students about moving the PA degree to the DrPASc. Furthermore, the docs have strong say in PA matters. Docs sit on the PA governing boards and PA's are covered by the boards of medicines. If docs feel threatened, they won't let the DrPASc become the standard.

As others have pointed out on other boards, medical schools have increased their enrollment by +20%. Interestingly, this occurred after the DNP was introduced. Yet the number of residency slots remain the same. What does this mean? In the near future, medical graduates, especially from lower-tiered schools may not get a residency. The number of students affected could be in the hundreds or higher. If this happens, the medical organizations will find a way for them to utilize their training. These non-residency medical graduates will compete with NP's and PA's for midlevel positions. This is how the medical organizations are responding to the threat that the nurses have put forward with their claims of equivalence with the DNP. This is something that everyone should watch out for.

[core0]

i understand there is a movement of the pa to the doctorate now. historically the pa has usually followed the np, certificate to bachelors, bachelors to masters and i suspect masters to doctorate.

i do not understand how you feel the cost and time are the same. the number of clinical hours is far more for the pa and in general the cost is significantly higher.

i would disagree there is a movement to the doctorate. there is one pa doctorate post graduate program run by the army in em. they have stated that all their programs will probably move toward the doctorate in the next few years. however, these are only available to high time active duty pas and the structure is such that this format would not work in the civilian world.

as far as the pa world following the np world i would also disagree. if i remember correctly the ab program was offering a bachelors and the cha/pa program was offering a masters to pas long before np programs were offering such degrees. there has been a general shift toward masters programs but pa education remains competency based and more than 15% of programs are certificate based (to include cc's).

as far as costs. at least here at emory the cost of pa school is less than np school despite the fact that there is less class time and didactic time. some of the cc programs for pas can be extremely inexpesive.

david carpenter, pa-c

[amzyRN]

While surfing the web for info about the DNP, I came across the student doctor forum and was surprised by the animosity directed at nurses in general and also that there seemed to be a fear of the DNP. I guess many of the med students and other doctor affiliates who were posting on that site feel very threatened by nurses delving into "their terrain." They feared that DNP students would compete with their residency programs or something of the sort and also felt like the DNP would expand scope of practice for NPs. It doesn't really change my position that as it stands the DNP curriculum does not interest me. I was just a little disappointed with the attitude on the student doctor forum, but that's probably another topic. Happy new year,

J

[prairienp]

I would disagree there is a movement to the doctorate. There is one PA doctorate post graduate program run by the Army in EM. They have stated that all their programs will probably move toward the doctorate in the next few years. However, these are only available to high time active duty PAs and the structure is such that this format would not work in the civilian world.

As far as the PA world following the NP world I would also disagree. If I remember correctly the AB program was offering a Bachelors and the CHA/PA program was offering a masters to PAs long before NP programs were offering such degrees. There has been a general shift toward masters programs but PA education remains competency based and more than 15% of programs are certificate based (to include CC's).

As far as costs. At least here at Emory the cost of PA school is less than NP school despite the fact that there is less class time and didactic time. Some of the CC programs for PAs can be extremely inexpesive.

David Carpenter, PA-C

I was basing my information on the movement towards the doctorate from reading the PA forum. At first many were against, until a couple thought it could be done on line post PA school and that would work. Like the master's at Nebraska which is often referred to as an easy/cheap masters for the currently practicing PAs.

I will find out more about costs and post later

[prairienp]

I would disagree there is a movement to the doctorate. There is one PA doctorate post graduate program run by the Army in EM. They have stated that all their programs will probably move toward the doctorate in the next few years. However, these are only available to high time active duty PAs and the structure is such that this format would not work in the civilian world.

David Carpenter, PA-C

Now I am confused, while searching the PA Forum I found this:

3. Finally the doctorate for PAs. The PA doctorate is inevitable. I am aware of three programs that have had clinical doctorates ready for at least three years but have not put them into play for political reasons. Now that there is a DScPA these will programs will inevitably proliferate. The concern is that now that there will be four levels of educational credential for a PA (or 5 if you count certificate programs), will outside or internal agencies try to define the PA profession by educational level instead of competency. This is the primary objection even to naming the masters as the preferred degree. The students that LESH trains are as able to take care of patients as anyone. Their lack of a doctorate or masters does not stop them from becoming excellent clinicians.

The doctorate for PAs is fine. We need increased research by PAs so this can only be beneficial. Where it would not be beneficial is to let it be the start of mandating degrees for PAs. It may already be too late, but going away from clinical competence as a standard is to lose what it means to be a PA.

David Carpenter, PA-C

[HeartsOpenWide, RN]

While surfing the web for info about the DNP, I came across the student doctor forum and was surprised by the animosity directed at nurses in general and also that there seemed to be a fear of the DNP. I guess many of the med students and other doctor affiliates who were posting on that site feel very threatened by nurses delving into "their terrain." They feared that DNP students would compete with their residency programs or something of the sort and also felt like the DNP would expand scope of practice for NPs. It doesn't really change my position that as it stands the DNP curriculum does not interest me. I was just a little disappointed with the attitude on the student doctor forum, but that's probably another topic. Happy new year,

J

Doctors have had this attitude since they were created. Take midwives for examples, they were delivering babies in the bible. Then OB come around and make it illegal for midwives to even practice (yes a while ago) and then felt threatened (and some still do today) when the midwives were coming back.

It would be quite progressive for this requirement, I worked for some FNPs that did not even have their BSN degrees, one of which graduated in the mid to late-ninties. I just do not see the point of a PHD, why not just become a doctor then......