Doctoral degree to become an NP???

platon20 · Jun 11, 2006

And who said that the NP is not to compete with the MD? In some markets they are and rightly so.

Yes NPs can compete with MDs, but not on all levels. NPs cant do surgeries yet, for example. Mark is talking about competition at ALL LEVELS, not just primary care. Mark is talking about NPs being replacement surgeons, neurologists, endocrinologists, neonatologists, the whole gamut. And you are delusional if you think NPs compete against doc at all levels. Sure, we compete for primary care, but you wont find any NPs running their own surgeries yet.

How many NPs run the medicine department at hospitals? How many NPs serve on boards at hospitals? How many NPs serve as department chair of radiology? Until NPs infliltate those levels, you cant argue that we are in full competition with MDs.

Why shouldn't the healthcare consumer have a choice?

If thats your logic, we should just allow anybody off the street to advertise their services as doctors. EVen if they only had some paramedic training. Let the public decide if that person is good enough to be a doc.

BTW, you dont really believe your own logic there. You use the title RN in your handle. What if I proposed a new training model for RNs, where we took highschool students off the street and have them skip college and go thru a special advanced track where they got nursing training for 2 years and get the RN title. Do you think thats OK? And if not, why not? Dont you think the public should have a choice of which RN provider they want?

HeartsOpenWide, RN · Jun 11, 2006

This is only going to apply to those that do not become FNP, CNM ect byt 2015 right? Every one else will be "Granfathered" in? For Gods sake. I work for two of the best FNP's in my area and neither of them even have their BSNs!

SharonH, RN · Jun 11, 2006

Yes NPs can compete with MDs, but not on all levels. NPs cant do surgeries yet, for example. Mark is talking about competition at ALL LEVELS, not just primary care. Mark is talking about NPs being replacement surgeons, neurologists, endocrinologists, neonatologists, the whole gamut. And you are delusional if you think NPs compete against doc at all levels. Sure, we compete for primary care, but you wont find any NPs running their own surgeries yet.

I can assure you that I am in no way "delusional" in regards to the competencies and scope of practice of NPs. I never said that NPs should be replacement surgeons, etc. The DNP is only referring to primary care as was I. And let's face it, even MDs need further training beyond their medical degree to perform those specialties so your argument that the DNP is pointless because it won't prepare an NP to become of those specialists is weak.

How many NPs run the medicine department at hospitals? How many NPs serve on boards at hospitals? How many NPs serve as department chair of radiology? Until NPs infliltate those levels, you cant argue that we are in full competition with MDs.

I don't know why an NP would run the medicine department since they are nurses, and I don't know what that proves exactly. But I do know that lots of hospital boards have nurses on them. You should look up your organization's board membership as well as take a look at the organizational chart. I think you would be surprised. It depends on the hospital but you might be surprised to learn that in a lot of places nursing and medicine work together to develop policy and procedure, change clinical practice, and resolve clinical issues.

If thats your logic, we should just allow anybody off the street to advertise their services as doctors. EVen if they only had some paramedic training. Let the public decide if that person is good enough to be a doc.
BTW, you dont really believe your own logic there. You use the title RN in your handle. What if I proposed a new training model for RNs, where we took highschool students off the street and have them skip college and go thru a special advanced track where they got nursing training for 2 years and get the RN title. Do you think thats OK? And if not, why not? Dont you think the public should have a choice of which RN provider they want?

That's an extraordinarily weak analogy and it is a totally different argument from mark's. I am not advocating that people with less education and less training provide services for which they are not prepared. NPs with a doctoral degree would still be NPs with a specific scope of practice and there has not been any move to change that. As long as NPs do not mislead the public into believing that they will get services they cannot offer, then there is no problem with offering the public a choice for those services which they are able to provide.

platon20 · Jun 11, 2006

I don't know why an NP would run the medicine department since they are nurses,

Oh come on, you know what I'm getting at, quit using semantics. But I'll play your game:

If you know any NPs who are department chairs in these fields, by all means let me know:

Rheumatology

Endocrinology

Surgery

Radiology

Otolaryngology/ENT

Pediatrics

Physical Medicine/Rehabilitation

Psychiatry

Neurology

Cardiology

The fact is you wonnt find a single NP anywhere in the country who is the department chair for ANY specialty. The only possible example wold be NPs being department chairs of emergency medicine in EXTREMELY rural hospitals, and even those examples are few and far between.

SharonH, RN · Jun 12, 2006

Oh come on, you know what I'm getting at, quit using semantics. But I'll play your game:

I swear to you, I have no idea where you are going with this. I don't know what an NP being the head of a department proves and how it relates to the DrNP degree.

platon20 · Jun 12, 2006

I swear to you, I have no idea where you are going with this. I don't know what an NP being the head of a department proves and how it relates to the DrNP degree.

It proves they dont have full equivalence with doctors, which is EXACTLY what markdanurse is talking about. His point was that unless the DNP program allows NPs to reach FULL equivalence with doctors, that its a waste of time and money.

zenman · Jun 12, 2006

It proves they dont have full equivalence with doctors, which is EXACTLY what markdanurse is talking about. His point was that unless the DNP program allows NPs to reach FULL equivalence with doctors, that its a waste of time and money.

If there is a market for it, then some do not consider it a waste of time and money.

markdanurse · Jun 12, 2006

"I don't know a lot about audiologists and optometrists so I will not comment on their preparation but I am flabbergasted that you think that all PTs do is put an exercise regimen together and train the patient to do them. Likewise, do you really believe that pharmacists only dispense meds and perform a drug review? You do realize both jobs require not only skills which apparently you do not see in your experience, but they also require a knowledge base to perform those tasks that you may not understand. You say that the physicians are the ones who order the PT, meds, etc and that they are the practitioners carrying out the orders. In my experience, pharmacists and PTs are often consulted as to the appropriate therapy for XYZ situation, etc. I equate your oversimplification of the scope of practice of PTs and pharmacists to someone saying that nurses don't need a degree because all they do is pass meds and put people on bedpans." -Sharon H., RN

You do pose a great argument ; however, I have worked with PT's and have much experience with them. PT's do create a plan of care, much like nurses do, set up exercise regimens, and perform wound care including debridement. They do NOT work around medications all day, they do NOT start IV's, access PICC lines or other central lines, give chemotherapy, monitor Art Lines, CVP lines, and balloon pumps, they do not do many of the things that nurses do (hold patients lives in their very hands)...yet they are required to have a doctoral degree to do their job. I used to work orthopedic rehab, and I know what physical therapists do during their day. NO, a doctoral degree IS NOT necessary to do what a PT does. In case you forgot your history, the early day physical therapists were specially trained RN's...the group broke off from nursing and created their own field...thus PT is a SUBSET of nursing. Yet, a floor nurse is not required to have a doctoral degree...or should they? Where on earth did you get the idea that I feel pharmacists and physical therapists don't need a degree. I feel they should have a degree...just not a doctoral degree. I used to be a pharmacy technician and while I did not have near the knowledge of the pharmacist, I did do almost all of the components of his or her job. You see, we had nifty little devices called computers, which had all of the patients medications listed. If a new medication caused a level 3,4, or 5 interaction, the pharmacist was notified and the physician was called. If the interaction was only a 1 or a 2, the interaction was disregarded and the medication was dispensed. The pharmacists' relied heavily on these little devices to do their jobs. The type of pharmacist you are talking about that performs consultations is called a CLINICAL PHARMACIST...which really isn't used that often out here in Arizona. I cannot tell you the number of times I have called a hospital pharmacist about how to mix a medication (back when a nurse could do so), and the pharmacist did not know off the top of his or her head and had to go look it up. Shouldn't a DOCTORALLY prepared pharmacist know this? I had a clinical pharmacist give me dopamine instead of dobutamine in a federal facility I worked for, and when I questioned him, he told me that dobutamine was the generic form of Dopamine. He was a clinical pharmacist for the federal government and had 5 years of experience as a pharmacist and a DOCTORAL degree. I had another clinical pharmacist mix me a regular insulin drip and put the WHOLE vial of regular insulin in a 100ml bag of NS...I questioned this and he corrected it, and I didn't kill my patient (and I have a mere bachelor's degree). Oh, and he too was a doctorally prepared pharmacist. The doctoral degree you seem to be so whole heartedly defending is not necessary for a PT or RPh to do his or her job. You want to impress me...have them get their PhD's instead of this stupid PharmD and DPT mambo jambo.

"There are other reasons for the doctoral degree. It has been pointed out that the amount of time spent for a master's degree is almost equivalent to the time one would spend for a doctorate in other programs. There has been derision from some quarters(mostly medicine) about the inadequate amount of time spent preparing NPs. And who said that the NP is not to compete with the MD? In some markets they are and rightly so. Why shouldn't the healthcare consumer have a choice?" Sharon H. RN

Like I said Sharon, IF the DrNP degree allowed the NP to do everything that the doctor could, then I am FOR the degree. Otherwise, the NP is still a MIDLEVEL provider and a master's degree should do just fine for a midlevel. You know, more than a regular nurse (BSN) but less than a doctor (MD) = MSN, NP. Why shouldn't NP's compete with physicians? Whether you like it or not, most NP's need to work in a PHYSICIAN'S practice to gain employment. Compete with these physicians too hard, and compete your way out of a job. The AMA really is much stronger than the ANA, and all it takes is a simple act of legislation, and NP practice could really be no more. The healthcare consumer should have a choice...I never said they shoudn't. But don't underestimate what the MD knows compared to the NP...they have four years of medical school plus a grueling 3 year residency. The DrNP prepared NP does not. Putting the title of doctor in your degree is extremely misleading to the public regarding an NP's training. MD's have WAY more training than NP's. And just to provide you with another thought, so do PA's at the master's level...27 months STRAIGHT training plus 2000+ clinical hours as opposed to the NP's 680 hours. Yet PA's seem to operate just fine at the master's level, or should that group also have to obtain a DrPA degree too?

This is nothing more than degree creep, word play, and intellectual elitism at its best.

markdanurse · Jun 12, 2006

If there is a market for it, then some do not consider it a waste of time and money.

What market? You mean the market created by crazy nursing leaders trying to make NP's the equivalent of physicians?

Do you hear patients demanding doctorally prepared NP's? Do you hear physicians demanding doctorally prepared NP's? Do you hear existing NP's demanding new grad NP's have a doctoral degree before practicing?

If perhaps you mean the market of nurses who want to be called doctor and have a million letters after their names, or the market of nurses wanting to spend tons of cash on a degree that will become quite expensive, then yes,there is indeed a market..

brownrice · Jun 12, 2006

this usa today article is timely....if np's are required to get a doctorate, just add their name to the list of college grads owing at least 100k when they graduate. this is absurd. if it were required now, i'd forget about this type education/career, take half the money i would have used for getting a doctorate, and invest in some sort of business or a house. the master's degree is on the cusp of being affordable right now, when one examines a cost/benefit model.

by sandra block, usa today
the average college senior graduated this year with more than $19,000 in debt. that's a problem joe palazzolo would love to have.
[/url]
palazzolo, 25, graduated on mother's day from rutgers university with a master's degree in public policy and student loans exceeding $116,000. his payments will average about $800 a month. it could have been worse: because of his top grades, rutgers paid palazzolo's tuition for his final year of graduate school.

usatoday.com - in debt before you start[color=#0000ce]*

platon20 · Jun 14, 2006

Markdanurse is exaclty right again.

There is ZERO PUBLIC DEMAND FOR DOCTORAL-EDUCATED NURSES!

This is an edict coming from an Ivory Tower full of PhD-level nurses who probably stopped clinical practice back in the stone ages.

The public is PERFECTLY HAPPY WITH NPS CURRENT EDUCATIONAL STATUS! We already have the data showing that masters level NPs do just as good as doctors.

If you want to have an OPTIONAL doctoral program for nurses, then fine do that. But thats NOT what these out of touch nurse leaders are advocating. They want the doctoral program to be MANDATORY FOR ALL NEW NPs. That is absolutely assinine and ridiculous.

Coffeegirly · Jun 17, 2006

The program is a blend between the DNP and the scholarly traditional research based doctorate in nursing program. It's a blend of the two programs. I think it's a great idea and gives the doctorally prepared nurse more clout and respect.

I am an NP with a postmaster's as a psych NP too and even so, I still think it's a great idea and will pursue it too. In spending time elbow to elbow with physicians at conferences, I see the value in the degree.