Doctoral degree to become an NP???

Published

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

Hello. I am a PNP. I am thinking about going for my DNP or pHd in nursing. Do you know what the actual difference is between these and whihc would be the best to achieve?

Thanks!

Dee

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Hmmmm ... I was particularly struck by a couple of quotes from the news release above --

"The Doctor of Nursing Practice degree was developed in 1999 to respond to a national need for increased access to comprehensive patient care. More than 200 schools have or plan to establish a DNP program. This degree builds on nursing licensure as an advanced practice nurse by adding expanded knowledge and skill in nursing and medical aspects of care for complex illness. The growing burden of chronic illness in the United States will require an even greater focus on collaborative and team-based care."

Gee, I guess that, in my little backwater rural community, I hadn't noticed that there is a big "national need for increased access to comprehensive patient care." And, apparently, a need that current mid-level providers are simply incapable of meeting! The press release also sounds like all DNP people are all going to be existing APRNs, which is not what the schools are saying -- they're talking about phasing out MSN advanced practice programs entirely and having people go directly into DNP programs from BSN programs, as I understand it

"The Council for the Advancement of Comprehensive Care (CACC) was established in 2000 to further the development of standard clinical competencies for graduates of Doctor of Nursing Practice (DNP) programs. The Council determined that a national certification process would provide the public with a reliable way to identify advanced nurse clinicians with the DNP degree who can provide comprehensive care. Council membership is comprised of nurses, physicians, health care organization representatives and health and public policy experts."

Oh, goody! The people who are trying to ram this down our throats have their own organization to say that they're doing the right thing! I still think the whole thing is little more than a boondoggle to make money for the unis starting up the DNP programs, and I hope that the rest of us will refuse to go along with it.

There is a huge problem with this that I can see already.

I have absolutely no desire to do anything with a DNP other than to be an NNP.

When this DNP program came the minimum standard of becoming an NP at one of the schools that I was looking at, it appeared to be INFERIOR to the NNP Master's program.

I don't want to be a "nurse-of-all-traits", I want to be very highly specialized in ONE area.

Something like this can seriously damage an NP's ability to specialize if she is wasting her time working in other areas where she will not spend ONE day of her career.

I was assured that the base of the program was an NNP focus, if I choose that specialty. So I would be a DNP-NNP upon graduation...I was more than fine with that.

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Thanks for the response Hopefull. So, basically the DNP will cover a variety of areas and not just our specialties. I do not like the sound of that. I was going to go for my pHd in nursing, but i have been hearing that all NP's may have to go for the DNP in order to work as an NP. I know the pHd is basically about research and all. I just really want to specialize in my area. I need to think all this over. Thanks again.

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There are a few things that I find weak about many dnp programs. One is that the curriculum in most programs is rather weak - clinically speaking; especially for those of us who are already practicing NPs. Looking around at most of the programs shows that the focus of the DNP is on policy development, leadership, systems improvement, economics, finance, and a few other similar courses. Now, evidence based practice, biostatistics, and outcomes management are good courses for a clinician. However, the former do not make me a better clinician.

I have read several forums about the DNP; and it seems that many practicing clinicians are not yet sold on the idea. How will the DNP make us better clinicians?

I wonder, how many already working NPs are going to benefit from the current curriculum that predominates the DNP?

I also remember that NPs were created to fill a gap in the physician shortage. So, before we know it, aspiring students will have to get a DNP before they can practice as an NP. With nursing school enrollments dropping, and the number of available PhDs to be nursing instructors dropping, what will happen to the number of NPs coming out to the field? Will this extra time, money, effort, and cost create a drop in the number of NPs? Will the gap we were designed to fill become wider now?

I would say, where I am at, that I do about 85% of what a physician does, but get paid about 40% of one. Hey, that's fine with me, I am one who would never imagine that an NP could replace an MD. Here's what I got: 4 year BSN + 2 year MSN = 6 years. My colleagues: 4 years undergraduate + 4 years of medical school + 1 year of internship + 3 years of residency = 12 years. Residents don't get paid squat either. I digress... will the DNP arise in the stake holders a sense that we are more competent as NPs than us board certified ones are now? Thusly, motivating a significant pay increase for DNPs?

This is truly a fascinating time to be a nurse; lots of evolution and change, lots of new ideas, and lots of conflicting interests. But I see what lies ahead, and despite my personal thoughts about the DNP, I'm going to get it.

Sorry about my looonnnnngggggg meandering aimless post.

Long live nurses!

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there are a few things that i find weak about many dnp programs. one is that the curriculum in most programs is rather weak - clinically speaking; especially for those of us who are already practicing nps. looking around at most of the programs shows that the focus of the dnp is on policy development, leadership, systems improvement, economics, finance, and a few other similar courses. now, evidence based practice, biostatistics, and outcomes management are good courses for a clinician. however, the former do not make me a better clinician.

i have read several forums about the dnp; and it seems that many practicing clinicians are not yet sold on the idea. how will the dnp make us better clinicians?

i wonder, how many already working nps are going to benefit from the current curriculum that predominates the dnp?

i also remember that nps were created to fill a gap in the physician shortage. so, before we know it, aspiring students will have to get a dnp before they can practice as an np. with nursing school enrollments dropping, and the number of available phds to be nursing instructors dropping, what will happen to the number of nps coming out to the field? will this extra time, money, effort, and cost create a drop in the number of nps? will the gap we were designed to fill become wider now?

i would say, where i am at, that i do about 85% of what a physician does, but get paid about 40% of one. hey, that's fine with me, i am one who would never imagine that an np could replace an md. here's what i got: 4 year bsn + 2 year msn = 6 years. my colleagues: 4 years undergraduate + 4 years of medical school + 1 year of internship + 3 years of residency = 12 years. residents don't get paid squat either. i digress... will the dnp arise in the stake holders a sense that we are more competent as nps than us board certified ones are now? thusly, motivating a significant pay increase for dnps?

this is truly a fascinating time to be a nurse; lots of evolution and change, lots of new ideas, and lots of conflicting interests. but i see what lies ahead, and despite my personal thoughts about the dnp, i'm going to get it.

sorry about my looonnnnngggggg meandering aimless post.

long live nurses!

where did you read that those offering the dnp completion program were seeking to create a better clinician? clearly, those returning for the post masters dnp will have the opportunity to seek additional clinical expertise if desired. the programs i know best allow you to select what will make you a better provider. some will find health policy they key to their future. many will find health promotion, while others will gain a greater understanding of running their own clinic. if the additional education leading to the dnp opens doors for nps we will all be better served. thus, the real direction is a better prepared np.

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An excellent reply; I like how you think. Which made me think.... hmmmmm You are right. So maybe its not such a bad thing after all. And yes, I admit, I didn't study the NONPF, AACN positions and statements to the depth that I could have. So, after reviewing all of that stuff, I could begin to see some structure to the DNP plan.

However, I sure wish post-NP dnp programs had more medically oriented courses such as histology, radiology, and more in the trenches kind of stuff. Not that I don't get this kind of stuff at work every day anyway. And this still does not answer the question as to why so many NPs lament the curriculum of current DNP programs - who consider them to be clinically weak. Just search this forum and a few others.

Of course, its not fair for me to whine about that; since I already got the NP portion out of the way; and now need to get the more leadership/systems improvement/outcomes management stuff under my belt. But wait! I already had leadership, health finance, health economics, systems improvement, and outcomes management during my MSN. How many more times do I have to take this stuff?

Great reply though, thanks!

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Specializes in ER, ICU, Trauma, Flight, EMS.

I am in an ACNP program right now and I fear that the regs may change while I am still in progress. This topic came up during orientation at my institution, but no real forecast was decided. Take us seriously as a profession, maybe it is good. Considering the present shortage as someone mentioned, maybe not so good. Personally, I think we need something to raise the standard of performance. I welcome the idea, but am not too sure on how to best implement.

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Specializes in FNP.

I'm just not sure it's worse the pain and frustration of endlessly reading these posts. It's important to know that these attitudes are out there, but don't let your practice or your self-image be influenced by them. Continue providing the care that only you can provide, and continue growing in knowledge and excellence.

Dana

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Specializes in FNP.

Somehow the posts that I was responding to disappeared. What I mean by the post above was it's probably healthier for one's psyche to stay away from the student doctor forums.

I'm just not sure it's worse the pain and frustration of endlessly reading these posts. It's important to know that these attitudes are out there, but don't let your practice or your self-image be influenced by them. Continue providing the care that only you can provide, and continue growing in knowledge and excellence.

Dana

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Specializes in ER; CCT.
Somehow the posts that I was responding to disappeared. What I mean by the post above was it's probably healthier for one's psyche to stay away from the student doctor forums.

You are absolutely right. When I take a step back, I now just see it as nothing more than hate speech provided by those who have never touched a patient and are sure to be faced with serious problems when they do.

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Specializes in SICU.

  • Translation and Synthesis of Evidence for Optimal Outcomes
  • Quantitative Research Methods
  • Epidemiology and Environmental Health
  • Legal and Ethical Issues
  • Clinical Genomics Advanced Seminar
  • Practice Management
  • Informatics

Do they really think I would pay good money (not to mention the time investment) for a ciriculum like this? And this is going to enhance my practice how? I thought this was a CLINICAL Doctorate:stone

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Thank you for the thoughtful and well-organized reply, markdanurse.

I won't try to comment point-by-point on your reply. I would like to say that it is much easier to change (I would say mess with) the advanced practice requirements as opposed to the entry-level requirements--simply due to the numbers of practitioners involved. There is national support by patients and providers for the RN, who provides a well-known service whatever his/her education. In contrast, the APRN is not so well-known.

I will be the first to admit that I do not know a lot of NPs who are only in practice; however, I have not met one who has expressed support for the idea of the DNP. In my MSN program--which, when I started, was a terminal degree--the faculty (including some licensed NPs) seemed much more enthusiastic about the DNP even while being somewhat confused as to what advantages it would incur.

Much as I will do anything to support nurses and nursing, I have a very hard time with this concept. I do not see how I am to benefit, or how my profession is to benefit (other than some schools making some big $ off increased revenues). The fact that this program was "voted" to be the entry degree to practice by 2015, without a guarantee or plan for program availability, boggles my mind.

Joan

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