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

[amzyRN]

It's good to note and should be fairly obvious that a PhD can be referred to as doctor so and so and anyone with a four year doctoral degree can also be referred to as doctor. Like a pharm D would be doctor, etc. Physicians don't have the sole use of the term doctor. So in the sense that the DNP can actually clarify that to people that when you say "doctor X" you are referring to the 4 years of training. If I'm wrong on the meaning of doctor w/r/t M.D, versus PhD doctor, etc, please clarify. I'm not advocating for the DNP, but would be a strong advocate if it included a more in depth science curriculum and expanded scope of practice, but I digress...

[jjjoy, LPN]

PhD and other doctoral program aren't necessarily four years in length. I'm not sure of the history of the term nor of how institutions determine what courses of study result in a doctoral degree versus other degrees. In many fields, the PhD denotes a very specialized and focused course of study culminating with a long, detailed thesis on a very specific topic. It usually follows or includes a master's level course of study. But when it comes to other types of doctoral degrees, I know even less, except that there's usually no in-between masters level and traditionally don't require the type of in depth thesis needed to earn a PhD. Anyone else know this off-hand?

[elkpark]

But I strongly feel that other we need to stand up to the medical profession for it's own evolution, and as one revolutionary said "I'd rather die on my feet than spend a life on my knees."

I'm not talking about unpleasant experiences with individual physicians, I'm talking about the influence the medical community in each state exercises over legislation that dictates what nurses can and can't do. We have nothing to gain by antagonizing the physician community. Many physicians are very pleasant and agreeable about NPs, but that would change very quickly if they feel that NPs are attempting to challenge or intrude upon their dominant position in the world of healthcare.

I don't feel any responsibility for the "evolution" of the medical community, and I'm perfectly happy to enjoy a long, full, satisying career "on my knees." You are welcome to "die on (your) feet" if you choose, but I don't see what that's going to accomplish. :)

[n_g]

I've recently had a negative experience with a physician in my recent clinical rotation. I mentioned an abnormal value of my patient, and the physician grilled me about pathophysiology for about 20 minutes. And it was kind of like gestapo interrogation. In the end the physician said he was trying to use 'socratic' questioning to facilitate my learning, but all the interrogation did was make me uncomfortable and it sent a message to me that physicians don't want to be bothered. I thought that he would be glad that I noticed the abnormal value and since I was a student would be willing to explain his rational as to why we should ignore it, but instead he took a very antagonistic tone. It made me re evaluate my decision to go into nursing, because I have the science background to go into medicine if I want to. I also felt a little disappointed with the medical profession as a whole, because as I found out, that kind of antagonistic attitude is not uncommon.

Don't feel you were being picked on. Medical students and residents are constantly treated the same way. Your preceptor was trying to force you to think through the problem deeply not just superficially and to think quickly on your feet. Why it may feel like a harsh interrogation, there's a purpose to it. When you go in front of a panel of your colleagues including many physicians to explain why a patient that you're responsible for has died or severely injured, you'll be glad that you went through this because they will grill you hard. Being accountable for somebody's life and welfare is a huge responsibility not to mention the liability. Is this something that DNP's really want?

[amzyRN]

PhD and other doctoral program aren't necessarily four years in length. I'm not sure of the history of the term nor of how institutions determine what courses of study result in a doctoral degree versus other degrees. In many fields, the PhD denotes a very specialized and focused course of study culminating with a long, detailed thesis on a very specific topic. It usually follows or includes a master's level course of study. But when it comes to other types of doctoral degrees, I know even less, except that there's usually no in-between masters level and traditionally don't require the type of in depth thesis needed to earn a PhD. Anyone else know this off-hand?

Yep, the PhD can actually be a longer degree, like 6 to 8 years, so I think you're right about the length of the program varying.

[amzyRN]

I'm not talking about unpleasant experiences with individual physicians, I'm talking about the influence the medical community in each state exercises over legislation that dictates what nurses can and can't do. We have nothing to gain by antagonizing the physician community. Many physicians are very pleasant and agreeable about NPs, but that would change very quickly if they feel that NPs are attempting to challenge or intrude upon their dominant position in the world of healthcare.

I don't feel any responsibility for the "evolution" of the medical community, and I'm perfectly happy to enjoy a long, full, satisying career "on my knees." You are welcome to "die on (your) feet" if you choose, but I don't see what that's going to accomplish. :)

Perhaps "die on my feet" is a bad analogy, but it nurses are expected to spend their career "on their knees" to physicians then I think I chose the wrong profession to go into. For example, pharmacists are no expected to bow to physicians, but are thought of as professional on an equal footing, with a slightly different knowledge base. My interpretation of what you are saying is that nurses are again the "handmaiden," and had better bow and scrape for every scrap they can get from the physician community. If this is true, I feel I have been mislead by the nursing profession to think that nursing was an equally important career to other professionals. There are many people with the background to go into medicine or another profession, but the nursing profession has been recruiting the same people into nursing with a myth of equality. Wow, what a big disappointment. I think I should go back to my undergraduate university and take down all of the posters that advertises nursing as a respected profession and take them down, or let schools know that nurses spend their careers "on their knees" to physicians. Yuk, not something I went to school for. Thanks for you comments, I appreciate your honesty

[amzyRN]

Don't feel you were being picked on. Medical students and residents are constantly treated the same way. Your preceptor was trying to force you to think through the problem deeply not just superficially and to think quickly on your feet. Why it may feel like a harsh interrogation, there's a purpose to it. When you go in front of a panel of your colleagues including many physicians to explain why a patient that you're responsible for has died or severely injured, you'll be glad that you went through this because they will grill you hard. Being accountable for somebody's life and welfare is a huge responsibility not to mention the liability. Is this something that DNP's really want?

Yeah, I looked into that and that is true that med students and residents are grilled, but I don't know if I agree with it, because it makes people afraid to ask questions and alert physicians to something out of the ordinary, that may be potentially important. I'm still going to ask questions anyway, but other people may be very discouraged. And not all physicians do that, some are very kind and are eager for questions. Thanks for your comments

[jjjoy, LPN]

Yes, the whole analogy doesn't do justice to the sometimes (oftentimes?) strained relations between floor nurses and physicians. And I don't think anyone working in the average health facility can seriously hold the image of nurses as "handmaidens" to physicians. However, some physicians still may not appreciate the degree of competency of nurses.

I'd imagine the more opportunity a nurse and physician have to work together, the more that they can see each other as colleagues and not as some kind of bad guy who is just making more work for them. So critical care nurses may be more likely to have colleageal (sp?) relations with physicians (fewer patients and fewer physicians to deal with) while a general med-surg nurse may be less likely to (if they have too many patients and interact with too many physicians to build the kind of trust and knowledge of each other needed for good teamwork). Both physicians and nurses are overworked and when contact is minimal, it too easily becomes us vs. them.

Additionally, hospitals tend to cater to physicians because they need them to bring patients to the facility while they tend to take nurses for granted and treat them as an expense to be minimized. Thus, physician requests/complaints tend to get more attention than nurse requests.complaints. Sad but true.

However, you'll probably find that off the floor, there are many nursing positions where the nurse is on equal footing with the physicians with which they work.

You're right, though, I think, in recognizing the disconnect between what nursing school recruiters promote to potential students (advanced practice, etc) and what realities they likely will be facing as fresh new grads working on a hospital unit.

Anyway, we're waayyyy off topic here... back to DNP....

[justme1972]

Yep, the PhD can actually be a longer degree, like 6 to 8 years, so I think you're right about the length of the program varying.

That really isn't the case for what I have seen.

You do not have to have a Master's degree for many dnp programs in order to apply, you can apply directly from a BSN.

Many of the DNP programs that I have found are only 1 year longer than the Masters programs.

[jjjoy, LPN]

jzzy88 was commenting on PhD (doctor of philosophy) degrees not DNP or MD or JD or other doctorate degrees. PhD programs vary in length and can be quite long in some cases.

[core0]

jzzy88 was commenting on PhD (doctor of philosophy) degrees not DNP or MD or JD or other doctorate degrees. PhD programs vary in length and can be quite long in some cases.

Most PhD programs can be finished in as little as two years depending on the class load and teaching requirements. Most allow the candidate to take longer if necessary. However most programs now require the candidate to finish in a certain period of time. Seven years seems to be the most common time frame.

David Carpenter, PA-C

[n_g]

Yeah, I looked into that and that is true that med students and residents are grilled, but I don't know if I agree with it, because it makes people afraid to ask questions and alert physicians to something out of the ordinary, that may be potentially important. I'm still going to ask questions anyway, but other people may be very discouraged. And not all physicians do that, some are very kind and are eager for questions. Thanks for your comments

Physicians have to justify their actions when things go south. If DNP's want the same privileges as physicians such as admitting and being in charge of the patient while they're in the hospital, then they also have to be able to justify every decision based on the phys, path, anatomy, pharm, etc just like physicians. Your physician colleagues won't give you a pass just because you're a DNP.