Doctoral degree to become an NP???

Dr. Tammy, FNP/GNP-C · Mar 22, 2009

I'm getting mine, thanks, just like you're receiving yours.

You are getting what, exactly? I just wanted to clarify--are you saying you are a registered nurse pursuing graduate nursing education?

WitnessRN · Mar 22, 2009

I think there is more revelent juice in this topic than titles. So a Doctoral degree to become an NP??? Now versus later..........

The programs I have reviewed are all postmaster programs (you have to have a masters degree to enter) and they all want to review your clinicals and work history as part of their entrance requirements.

Right now we have for the most part we have ADN, BSN, MSN and PhD nurses we are now adding to that DnP...

My wonder is future programs (2015) and beyond:
- Will there no longer be any MSN nurses graduating?
- Will DnP programs double in length to get all the coursework / clinical times in?
- ADN degrees go bye bye and possibly BSN degrees to be replaced by MSN?

So it will be BSN to DNP or PhD????

Hello, great questions and I just asked them myself of the program director of the advanced nursing program in Colorado. She said that this was the last year that her university will offer a MSN. They are going to DNP. Also, I have a nursing friend that was just accepted to New Mexico State in the Psych nurse practitioner program and she is the last class there to be able to earn a MSN. It appears that several universities are moving to the DNP and stopping the MSN. They say that you will earn your MSN along the way. This program director also said that over time she thought that the certification for new NP will only be a DNP certification...who knows if that is accurate. I also called and spoke to the program director for San Diego. She said that this will be pushed through but still thought that even with the 2015 date there would be extentions. Apparently, at one point NP's didnt' have masters....they had a certificate. Then they were told they had to have a MSN and were given a decade to do so. So her thoughts were that even though the 2015 date is probably going to require a DNP for a NP to be a NEW cetified NP....the ones that are already NP's would have at least a decade to meet the new standard. However... the director in CO said that the NP's that have the MSN and not the DNP would feel out educated by their peers and potential employers could prefer the higher degree... I am not sure about that as I think clinical practice is probably more important than a degree. She also said that at some point Medicare would go with the new standard thus not reimbursing for a MSN only a DNP. I disussed this with the director at SD and she thought that is a possibility as it happen way back with the certificate NP before they became MSN but medicare gave the ten year grace period.

I am personally torn over the DNP. Not as an educational right or what one would or should be called...but on the requirement that all NP be DNP at some point in the future. I think that there is a HUGE need for mid levels and pushing to DNP will in effect in my personal opinion stop some really great nursing from becoming NP. Mainly because it will lengthen the program. The time committment will be much more involved. I also think the program will be tweaked based on the two directors I spoke to that have attented the meetings in Washington. They both thought that as some have said in this thread that the DNP needs to have a stronger clinical base. MUCH stronger. They agreed that the policy ect.. classes needed to be there to meet the doctorate level but also pointed out that this DNP is a PRACTICE degree.....therefore should be heavily weighted in practice an currently it is not.

ON a final note. You stated that many of the programs you saw were post masters ~I have seen several BSN to dnp programs that are three years to complete.

I hope that answered some of your questions.

cruisin_woodward · Mar 22, 2009

Hello, great questions and I just asked them myself of the program director of the advanced nursing program in Colorado. She said that this was the last year that her university will offer a MSN. They are going to DNP. Also, I have a nursing friend that was just accepted to New Mexico State in the Psych nurse practitioner program and she is the last class there to be able to earn a MSN. It appears that several universities are moving to the DNP and stopping the MSN. They say that you will earn your MSN along the way. This program director also said that over time she thought that the certification for new NP will only be a DNP certification...who knows if that is accurate. I also called and spoke to the program director for San Diego. She said that this will be pushed through but still thought that even with the 2015 date there would be extentions. Apparently, at one point NP's didnt' have masters....they had a certificate. Then they were told they had to have a MSN and were given a decade to do so. So her thoughts were that even though the 2015 date is probably going to require a DNP for a NP to be a NEW cetified NP....the ones that are already NP's would have at least a decade to meet the new standard. However... the director in CO said that the NP's that have the MSN and not the DNP would feel out educated by their peers and potential employers could prefer the higher degree... I am not sure about that as I think clinical practice is probably more important than a degree. She also said that at some point Medicare would go with the new standard thus not reimbursing for a MSN only a DNP. I disussed this with the director at SD and she thought that is a possibility as it happen way back with the certificate NP before they became MSN but medicare gave the ten year grace period.
I am personally torn over the DNP. Not as an educational right or what one would or should be called...but on the requirement that all NP be DNP at some point in the future. I think that there is a HUGE need for mid levels and pushing to DNP will in effect in my personal opinion stop some really great nursing from becoming NP. Mainly because it will lengthen the program. The time committment will be much more involved. I also think the program will be tweaked based on the two directors I spoke to that have attented the meetings in Washington. They both thought that as some have said in this thread that the DNP needs to have a stronger clinical base. MUCH stronger. They agreed that the policy ect.. classes needed to be there to meet the doctorate level but also pointed out that this DNP is a PRACTICE degree.....therefore should be heavily weighted in practice an currently it is not.
ON a final note. You stated that many of the programs you saw were post masters ~I have seen several BSN to DNP programs that are three years to complete.
I hope that answered some of your questions.

THANK YOU FOR GETTING BACK ON TOPIC!!!

I have applied (and been interviewed) for a BSN to DNP program. Here in Michigan, the MSN programs are already being phased out...at least in the Metro Detroit Area. Where I am going, the MSN that is starting in the fall is the last MSN program being admitted...at least for acute and critical care... U of M no longer offers a MSN, it is strictly DNP...

The program that I applied for is 3 & 1/2 years full time...I was told to expect to take 4 years to complete it b/c there will be semesters where 2 classes will be all I will be able to take due to scheduling conflicts etc.

I think most of us agree that the program needs work. We all need to voice our concerns regarding this. I was told all MSNs would be grandfathered, but that they will be competing for jobs with DNPs...I don't think an employer will care one way or the other...If I were an employer, and I had a new grad DNP (or even one with 3 years experience), vs a MSN with 13 years experience, I'd go with the MSN...I think that is obvious.

I doubt that the ADN program is going anywhere soon....I realize that a lot of places apparently do not have a nursing shortage (based on posts I've read here), but in Michigan, we are practically desperate for nurses. Fast tracking is huge here (sometimes very scary too).

My fear and anxiety is related to doing he DNP too early, before the tweaking has started...BUT, I also don't want to come back in three years to get 30 more credit hours. I'm 35, and having been continuously going to school since 1990...My husband will kill me if I don't eventually say I'm done with school.

allnurses Guide · Mar 22, 2009

A policy that precludes PA's acting as preceptors might be one of the dumbest things I've ever heard......definitely one of the dumbest in a long time.

If you're talking NP student clinicals, I know my university requires me to work with an MD or NP. No DO, no PA. Not sure why, considering DOs can do the same as an MD really.

cruisin_woodward · Mar 22, 2009

I'm getting mine, thanks, just like you're receiving yours. I don't care if the nurses want to call themselves "doctor" so long as they don't do it in front of the patients. The difference between the DNP and all the other doctoral degrees is that normally physicians don't work on the floors with the guy who has a PhD in botany. Come ot think of it, physicians normally don't cross paths that frequently with dentists, either. So the distinction and lines become a little bit clearer. How would you like it if the MA's started calling themselves nurses?

They do it all the time! and, LPN's are nurses...Not RNs, but nurses...I doubt they go into a pt's room and say, "Hi, I'm Betty, I'm your LPN, I'm not an RN though, so don't be confused." They probrably say, "Hi I'm Betty, and I'm your NURSE today".

People refer to the unit clerk as their nurse sometimes, their nursing aides etc. I don't get all crazy and territorial about it. I think as long as the DNP properly introduces themselves, "Hi I'm Dr. Smith, I am your nurse practitioner, and I am working with Dr so and so to take care of you etc". Just as a resident should, "Hi I'm Dr Jones, and I am the resident assigned to your case, and I will be working with Dr. so and so to take care of you etc"....That is a proper introduction.

For the record, and I've said this before, I don't personally care what I am called, but I don't think it's fair that someone else dictate that as a professional, with a doctoral degree that I have no right to utilize the title that I have worked hard for and earned.

silas2642 · Mar 22, 2009

You are getting what, exactly? I just wanted to clarify--are you saying you are a registered nurse pursuing graduate nursing education?

Sorry, you asked if I needed an education-- I suppose I misunderstood. I didn't realize that you meant a nursing education. I'm studying for an MD. This is why I'm so opposed to NPs/DNP's managing complex patients independently (yes, yes, I know that you're going to come back with the "x amount of states allow nurse practitioner's to practice without physician oversight)-- there is just too much to know and too little training in nurse practitioner education. There is barely enough time to learn what you need to know in med school in residency sometimes, so how can NP's with a fraction of the training possibly even compare to physicians when it comes to dx and tx of complicated diseaess?

You just have no idea what you don't know, which scares me. The standard of care is a moving target-- you have to run to keep up with it. If your base of knowledge isn't sufficient, if you don't understand the how and the why of pathophys, pharm, etc., then how do you know when you're right and when you're wrong?

JDCitizen · Mar 22, 2009

Hello, great questions and I just asked them myself of the program director of the advanced nursing program in Colorado. She said that this was the last year that her university will offer a MSN. They are going to DNP. Also, I have a nursing friend that was just accepted to New Mexico State in the Psych nurse practitioner program and she is the last class there to be able to earn a MSN. It appears that several universities are moving to the DNP and stopping the MSN. They say that you will earn your MSN along the way. This program director also said that over time she thought that the certification for new NP will only be a DNP certification...who knows if that is accurate. I also called and spoke to the program director for San Diego. She said that this will be pushed through but still thought that even with the 2015 date there would be extentions. Apparently, at one point NP's didnt' have masters....they had a certificate. Then they were told they had to have a MSN and were given a decade to do so. So her thoughts were that even though the 2015 date is probably going to require a DNP for a NP to be a NEW cetified NP....the ones that are already NP's would have at least a decade to meet the new standard. However... the director in CO said that the NP's that have the MSN and not the DNP would feel out educated by their peers and potential employers could prefer the higher degree... I am not sure about that as I think clinical practice is probably more important than a degree. She also said that at some point Medicare would go with the new standard thus not reimbursing for a MSN only a DNP. I disussed this with the director at SD and she thought that is a possibility as it happen way back with the certificate NP before they became MSN but medicare gave the ten year grace period.
I am personally torn over the DNP. Not as an educational right or what one would or should be called...but on the requirement that all NP be DNP at some point in the future. I think that there is a HUGE need for mid levels and pushing to DNP will in effect in my personal opinion stop some really great nursing from becoming NP. Mainly because it will lengthen the program. The time committment will be much more involved. I also think the program will be tweaked based on the two directors I spoke to that have attented the meetings in Washington. They both thought that as some have said in this thread that the DNP needs to have a stronger clinical base. MUCH stronger. They agreed that the policy ect.. classes needed to be there to meet the doctorate level but also pointed out that this DNP is a PRACTICE degree.....therefore should be heavily weighted in practice an currently it is not.
ON a final note. You stated that many of the programs you saw were post masters ~I have seen several BSN to DNP programs that are three years to complete.
I hope that answered some of your questions.

Yes it did.... I actually only checked the programs in my immediate area/state.

By the way AACN list of dnp programs: http://www.aacn.nche.edu/DNP/DNPProgramList.htm

JDCitizen · Mar 22, 2009

THANK YOU FOR GETTING BACK ON TOPIC!!!
I have applied (and been interviewed) for a BSN to DNP program. Here in Michigan, the MSN programs are already being phased out...at least in the Metro Detroit Area. Where I am going, the MSN that is starting in the fall is the last MSN program being admitted...at least for acute and critical care... U of M no longer offers a MSN, it is strictly DNP...
The program that I applied for is 3 & 1/2 years full time...I was told to expect to take 4 years to complete it b/c there will be semesters where 2 classes will be all I will be able to take due to scheduling conflicts etc.
I think most of us agree that the program needs work. We all need to voice our concerns regarding this. I was told all MSNs would be grandfathered, but that they will be competing for jobs with DNPs...I don't think an employer will care one way or the other...If I were an employer, and I had a new grad DNP (or even one with 3 years experience), vs a MSN with 13 years experience, I'd go with the MSN...I think that is obvious.
I doubt that the ADN program is going anywhere soon....I realize that a lot of places apparently do not have a nursing shortage (based on posts I've read here), but in Michigan, we are practically desperate for nurses. Fast tracking is huge here (sometimes very scary too).
My fear and anxiety is related to doing he DNP too early, before the tweaking has started...BUT, I also don't want to come back in three years to get 30 more credit hours. I'm 35, and having been continuously going to school since 1990...My husband will kill me if I don't eventually say I'm done with school.

I am 46 and since I graduated with my MSN this is the longest I have been out of school :-) I think I am close enough to do one or two post-masters but may leave the DnP to you all coming up behind (although I have not ruled it out).

JDCitizen · Mar 22, 2009

Sorry, you asked if I needed an education-- I suppose I misunderstood. I didn't realize that you meant a nursing education. I'm studying for an MD. This is why I'm so opposed to NPs/DNP's managing complex patients independently (yes, yes, I know that you're going to come back with the "x amount of states allow nurse practitioner's to practice without physician oversight)-- there is just too much to know and too little training in nurse practitioner education. There is barely enough time to learn what you need to know in med school in residency sometimes, so how can NP's with a fraction of the training possibly even compare to physicians when it comes to dx and tx of complicated diseaess?
You just have no idea what you don't know, which scares me. The standard of care is a moving target-- you have to run to keep up with it. If your base of knowledge isn't sufficient, if you don't understand the how and the why of pathophys, pharm, etc., then how do you know when you're right and when you're wrong?

Complex patient? What is the defininiton of complex pateint? Ask 25 doctors and get 25 different answers. Ask 25 NPs and get 25 different answers. A complex patient to one provider can be a walk in the park to another.

Actually in my being in practice over 25 years I have seen my share of doctors who were too full of themselves to ask for help. Multiple specialties in medicine and mutiple flavors of NPs. One of the reasons nurses are no longer hand maidens to the doctors is that too many doctors don't step off their high horse, we (nurses) have our own education and we are expected to be patient advocates and actually stand up to the doctors who would otherwise do harm. The legal system has been adjusting to this fact and hosptials on more than a few accasions have had to answer to this.

Having worked in family medicine along side doctors and PAs we all treated those we could treat and referred the rest. We did not lose any patients by doing this I have many a referral response addressed directly to me. My clinical judgment determined the 911, urgent consult, regular consult or no consult.

I have friends who are PAs / NPs across this country who are in indpedent practices and have been so for years.

Actually it does not matter how much education one has behind them or what title they use if that person does not admit they don't know and refer the patient they are for a better word "stupid."

Dr. Tammy, FNP/GNP-C · Mar 22, 2009

You just have no idea what you don't know, which scares me. The standard of care is a moving target-- you have to run to keep up with it. If your base of knowledge isn't sufficient, if you don't understand the how and the why of pathophys, pharm, etc., then how do you know when you're right and when you're wrong?

That's great coming from, as you stated earlier, an individual who has never practiced independently. Tell me something, are they teaching anti DNP and anti nursing rhetoric in your medical school or is this something you just picked up on the side? From which experience are you drawing the conclusions you post? Have you ever heard of the old saying, "I've forgoten more than you know?" Perhaps after you work 20 years or so in the health care industry and develop a bit more humility you might understand what this means.

JDCitizen · Mar 22, 2009

By the way to get back on topic again :-)

Looks like the stand alone dnp programs will be 3-4 years. What are the clinical hours?

Dr. Tammy, FNP/GNP-C · Mar 22, 2009

(yes, yes, I know that you're going to come back with the "x amount of states allow nurse practitioner's to practice without physician oversight)

Actually, no, I'm going to suggest that you stay in school, graduate, get a license, then work about 10 years or so with NP's then tell me how you feel they are not competent to manage complex patients.