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

I would say, that I disagree with parts of Mr Mittman's assertions as well. I don't believe that we will be "forced" to have them. I agree with him that the DNP was poorly planned and is not being executed well. I also agree with him that joint residencies are becoming more necessary (although I believe, mine and Dave's reasons differ for this). The AAPA cannot even agree on a base degree (which I also agree with, I was an associates degree graduate as a PA, and I went on to finish my Master's much later), and I'm sure as Mr Carpenter would agree, sitting in the HOD and listening to the degree debate concerning a Master's minimum requirement is one of them more mind numbing experiences one can have.

I think that David is correct, I think that most PA's and the AAPA would disagree with the assertion that we will all be "forced" to have doctorates.

Actually I would much rather listen to that than "discussion" over abortion or stem cell research. Of course we get to listen to more discussion about 10 year recertification -- again. I believe that this will be a good time for our alternate to learn about life in the HOD.

David Carpenter, PA-C

Up Vote Up Vote ×

Perhaps someone could explain to me how these results relate to the discussion.

http://www.abcc.dnpcert.org/exam_performance.shtml

For comparison, 96% and 85% of 1st time allopathic and osteopathic takers passed in 2007 (latest stats available).

Up Vote Up Vote ×
Perhaps someone could explain to me how these results relate to the discussion.

http://www.abcc.dnpcert.org/exam_performance.shtml

For comparison, 96% and 85% of 1st time allopathic and osteopathic takers passed in 2007 (latest stats available).

Wrong thread:

https://allnurses.com/nurse-practitioners-np/dnps-failing-test-375228.html

Up Vote Up Vote ×

Thanks, Dave. Sorry.

Up Vote Up Vote ×
Actually I would much rather listen to that than "discussion" over abortion or stem cell research. Of course we get to listen to more discussion about 10 year recertification -- again. I believe that this will be a good time for our alternate to learn about life in the HOD.

David Carpenter, PA-C

Ahhh, yes, the stem cell research position statement debate......I agree, that was worst. I don't mind the 10 year re-cert discussion, as I actually agree with that personally.

Up Vote Up Vote ×

Doctoral degree to become an NP???

I know myself and many of my fellow students in my program were there because it was convenient (not a full two years) and we didn't have to give up our lives or our jobs...

Do the schools (powers that be) not care or not think that enrollment will probably decrease due to the chunk of time that now will have to be invested (3.5+ years vs 2 years).

Since we have some PAs in this discussion: Any thought this may drive some perspective students into the PA profession?

Does anyone really believe that once the DnP takes hold there is going to be a great mind shift and all the parties involved in health care (patients, physicians, hospitals, insurance companies, etc.) will come running to us with arms wide open.

Up Vote Up Vote ×
Doctoral degree to become an NP???

I know myself and many of my fellow students in my program were there because it was convenient (not a full two years) and we didn't have to give up our lives or our jobs...

Do the schools (powers that be) not care or not think that enrollment will probably decrease due to the chunk of time that now will have to be invested (3.5+ years vs 2 years).

Since we have some PAs in this discussion: Any thought this may drive some perspective students into the PA profession?

Does anyone really believe that once the DnP takes hold there is going to be a great mind shift and all the parties involved in health care (patients, physicians, hospitals, insurance companies, etc.) will come running to us with arms wide open.

Its hard to say if this will change the number of RNs that go to PA school. RNs have always been a significant player in the PA student population. Depending on the program they run between 5-70% of the new students. The barrier will be the full time nature of most PA programs. Traditionally many NP students have been able to work at least part time if not full time during school. In contrast most PA programs either discourage or prohibit working during school. So the question is full time for two years more attractive than 4 years part time. This should be fairly easy to track in CASPA by looking at the RN composition of PA classes as different parts of the country move toward the DNP. The cofounding problem being distance education programs.

The other issue is going to be completion rates. The data from MBA programs shows the graduation rate dramatically drops once a program is longer than 2 years. It remains to be seen if this translates to the NP field.

The bigger problem that I see (as was discussed earlier in this thread) is the marginalization of the current MSN (and cert) NPs. The few articles I have seen lately discuss the need for the DNP to handle the complexity of patients in medical practice. This implies that the non-DNP NPs are not able to handle these patients. This is an iherent problem with tieing competency to a certain degree. When the degree requirements change suddenly the providers with a different degree appear less competent. Unfortunately the NP profession has a history of marginalization of those who do not have the current degree. History appears to be repeating itself here.

David Carpenter, PA-C

Up Vote Up Vote ×
Its hard to say if this will change the number of RNs that go to PA school. RNs have always been a significant player in the PA student population. Depending on the program they run between 5-70% of the new students. The barrier will be the full time nature of most PA programs. Traditionally many NP students have been able to work at least part time if not full time during school. In contrast most PA programs either discourage or prohibit working during school. So the question is full time for two years more attractive than 4 years part time. This should be fairly easy to track in CASPA by looking at the RN composition of PA classes as different parts of the country move toward the DNP. The cofounding problem being distance education programs.

The other issue is going to be completion rates. The data from MBA programs shows the graduation rate dramatically drops once a program is longer than 2 years. It remains to be seen if this translates to the NP field.

The bigger problem that I see (as was discussed earlier in this thread) is the marginalization of the current MSN (and cert) NPs. The few articles I have seen lately discuss the need for the DNP to handle the complexity of patients in medical practice. This implies that the non-DNP NPs are not able to handle these patients. This is an iherent problem with tieing competency to a certain degree. When the degree requirements change suddenly the providers with a different degree appear less competent. Unfortunately the NP profession has a history of marginalization of those who do not have the current degree. History appears to be repeating itself here.

David Carpenter, PA-C

Yep, and anecdotally at least, I have had several RN's, probably 4 or 5 come up to me over the past several months asking for more information about PA school, as they don't want to complete the DNP. Although, for one of them, they were more attracted to PA school for the more generalist education. How this plays out remains to be seen. Some of the NP's I work with seem to be pretty angry about the whole process involving the DNP, and several have said that they have absolutely no plans to complete any more schooling.

Up Vote Up Vote ×
Specializes in ED, Tele, Psych.

gee - i'm off the board a couple of days and miss pages and pages of material...

the two requirements posted earlier for support were (correct me if i'm wrong on these):

1 - improved outcomes? NP yes, DNP not studied as the DNP is too new - NPs have demonstrated comparable outcomes with improved patient satisfaction, more patient education, and less frequent use of prescriptions.

2 - improved access? NP yes, DNP no evidence either way, again it is too new to have been studied effectively - greater numbers of providers has increased access, one major barrier to improved access in rural areas remains the geographic distribution of "supervising" or "collaborating" physicians and the nightmare billing process with the patchwork of state laws and federal requirement for "collaboration" for medicare. in other words, access will improve with more independence (practice and financial) for NPs. if somebody wants to improve access to care then they should work to do that and not to back the economic interests at the expense of patient care (i'll pull the studies that show NP practice patterns reflect physician patterns more in places and populations that require "collaboration" than those that don't).

the DNP in it's current fractured structure will not likely alter either quality of care or quantity of NPs in the immediate future. what it could do is improve the skill set for NPs so they weren't learning on the fly after graduation and standardize the skill set - unfortunately this was not well thought out in advance and now we must work to fix the DNP immediately following roll-out instead of rolling out a program that had been successfully piloted (ie the Columbia model).

what is more likely to improve access is removal of artificial practice barriers based on physician group economics instead of patient care and quality is already comparable in primary care - although there is a very steep learning curve after completion of NP programs that the physician is carried through by taxpayer dollars (residency).

for those NPs in practice - the decision to return to school is a personal one and nobody is requiring it. those wishing to become an NP - the DNP is a reasonable thing to require and appropriate with several caveats - it should be standardized and clinical in the four specialties (not 'practice'), for the NP it should include more material on patho, pharm, policy, teaching, et al and less on strict research material, "theory", and leadership courses - the first two belong in the realm of the PhD and the last is for administrators & managers (ie MBA material).

last but not least, good for you taking on ACNPs into the ED. not having PAs precept makes no sense to me - they are very good at what they do and we need more inter-disciplinary contact during the training of health care professionals, not less. if we could get all health care team members (nurses, physicians, pharmacists, public health professionals, social workers, physical therapists, et al) to see this as well, perhaps we could break down the training silos and actually improve health care in America.

Up Vote Up Vote ×

I got this this morning: http://www.lowellsun.com/lifestyles/ci_11976226

Up Vote Up Vote ×
Specializes in ED/trauma.

Okay, you all have very good points/advice. So my question is if you were the VP of Patient Care Services at a major teaching hospital what changes would you propose? Given the impact of technology on human health and quality of life over the next 50 years, how do you think the discipline of nursing will evolve to meet the needs of clients: and in light of the influence of technology and information systems specifically how should nursing education curriculum, practice qualifications, and practice models be different. How can we best prepare for the furture?

Up Vote Up Vote ×
Okay, you all have very good points/advice. So my question is if you were the VP of Patient Care Services at a major teaching hospital what changes would you propose? Given the impact of technology on human health and quality of life over the next 50 years, how do you think the discipline of nursing will evolve to meet the needs of clients: and in light of the influence of technology and information systems specifically how should nursing education curriculum, practice qualifications, and practice models be different. How can we best prepare for the furture?

Hmmm is this what you mean?

Schools with both medical and nursing programs (if it has a PA program include them also):

A&P classes with both NP students and Medical Students (mandatory)

Microbiology with both NP students and Medical Students (mandatory)

Advanced Pharmacology with both NP students and Medical Students (mandatory)

Genetics and Embryology with both NP students and Medical Students (mandatory)

Advanced assessment with both NP students and Medical Students (mandatory)

Procedures with both NP students and Medical Students (mandatory)

Some type of business class (Coding, billing, etc.) with both NP students and Medical Students (mandatory)

Theory and Research Applications with both NP students and Medical Students (mandatory)

Medical ethics with both NP students and Medical Students (mandatory)

I realize all the clinicals can't be the same but with 4 year programs there should be some time for some shared clinicals that can apply to both NP students and Medical Students.

Increase overall clinical exposure/hours...........

Maybe from the get-go if we/they have to learn together when we/they get out and go play in the sandbox we/they will play together in a more friendly manner.

:twocents:

Up Vote Up Vote ×
+ Join the Discussion