Doctoral degree to become an NP???

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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

Then why get the BSN? It obviously added no value at all and nobody wants to pay anything extra for it. I guess my question is, what is the point in it?

Many advanced positions, whether in direct patient care or management, require a minimum of a BSN, if not an MSN. If I planned to work as a bedside nurse for my entire career, in all honesty, I probably wouldn't have spent the extra money for a BSN. Even so, I think your statement takes a very narrow view of nursing and education.

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Many advanced positions, whether in direct patient care or management, require a minimum of a BSN, if not an MSN. If I planned to work as a bedside nurse for my entire career, in all honesty, I probably wouldn't have spent the extra money for a BSN. Even so, I think your statement takes a very narrow view of nursing and education.

Do the advanced positions pay more money? If so, then you misrepresented yourself before. The BSN is worth the extra money because it qualifies you for positions that pay MORE money that an ADN is NOT qualified for. Isn't that the truth? So then there is some truth to the statement that BSNs get paid more than ADNs. Otherwise nobody would get a BSN. Thanks for proving my point. I don't take a narrow view of nursing education. I just say that additional education needs to add more value primarily because it costs more and people wouldn't be willing to pay for it if it didn't mean making more money, whether that would be at the beginning of their career or later in it. It's like I have said before, more education doesn't necessarily produce a better product for the customer. What does a BSN do for the patient that an ADN doesn't do?

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Do the advanced positions pay more money? If so, then you misrepresented yourself before. The BSN is worth the extra money because it qualifies you for positions that pay MORE money that an ADN is NOT qualified for. Isn't that the truth? So then there is some truth to the statement that BSNs get paid more than ADNs. Otherwise nobody would get a BSN. Thanks for proving my point. I don't take a narrow view of nursing education. I just say that additional education needs to add more value primarily because it costs more and people wouldn't be willing to pay for it if it didn't mean making more money, whether that would be at the beginning of their career or later in it. It's like I have said before, more education doesn't necessarily produce a better product for the customer. What does a BSN do for the patient that an ADN doesn't do?

Perhaps I am just an ivory tower academic but the issue should not be what makes you more money. The issue should be what prepares you the best to take care of patients.

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Perhaps I am just an ivory tower academic but the issue should not be what makes you more money. The issue should be what prepares you the best to take care of patients.

I guess that is the real issue. That is why I asked the question in my earlier post - if a masters prepared nurse practitioner already effectively cares for patients, why is there a need for increased education. Furthermore, if the ADN can already take care of patients, why is there a need for the BSN? If the more basic education is enough to adquately take care of patients, then there should be some compelling need for the extra education in order to make it a standard and it should be standard for everyone. Otherwise it would seem to be of no real use.

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I guess that is the real issue. That is why I asked the question in my earlier post - if a masters prepared nurse practitioner already effectively cares for patients, why is there a need for increased education. Furthermore, if the ADN can already take care of patients, why is there a need for the BSN? If the more basic education is enough to adquately take care of patients, then there should be some compelling need for the extra education in order to make it a standard and it should be standard for everyone. Otherwise it would seem to be of no real use.

While I agree that the DNP currently doesn't add more clinically useful knowledge, I don't get how one could make the leap in logic that because the DNP doesn't add more, the masters is perfectly adequate and so we should just stop the extra education.

Your argument, as seen in previous posts is to make the cost issue central. Your contention is that masters prepared nurse practitioners can already effectively take care of patients; that extra education (whether DNP or MD) just costs the patient money. Those patients you cannot take care of you can just shuffle off to someone else who knows what to do.

Since cost is so paramount to you, why don't we just let 3rd year medical students have practice rights? They too can see 80-90% of patients in primary care. They could very easily take care of colds, strep throat, the flu, simple BP issues, simple DM issues, cellulitis, joint issues and the like that make up most of primary care. Plus they could do it for a fraction of the cost that NPs could do it since they currently don't get paid. This way, instead of paying $80 to see an NP, the patient could see a third year and pay 80% of that. The cost saving would be huge for the whole system. Then the patients the M3s couldn't handle could just be dumped onto a specialist who knew what to do. Plus, each year there are 20,000 M3s who could really help alleviate that primary care shortage.

This is the same argument you are making. It sounds ridiculous in a different light doesn't it?

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While I agree that the DNP currently doesn't add more clinically useful knowledge, I don't get how one could make the leap in logic that because the DNP doesn't add more, the masters is perfectly adequate and so we should just stop the extra education.

Your argument, as seen in previous posts is to make the cost issue central. Your contention is that masters prepared nurse practitioners can already effectively take care of patients; that extra education (whether DNP or MD) just costs the patient money. Those patients you cannot take care of you can just shuffle off to someone else who knows what to do.

Since cost is so paramount to you, why don't we just let 3rd year medical students have practice rights? They too can see 80-90% of patients in primary care. They could very easily take care of colds, strep throat, the flu, simple BP issues, simple DM issues, cellulitis, joint issues and the like that make up most of primary care. Plus they could do it for a fraction of the cost that NPs could do it since they currently don't get paid. This way, instead of paying $80 to see an NP, the patient could see a third year and pay 80% of that. The cost saving would be huge for the whole system. Then the patients the M3s couldn't handle could just be dumped onto a specialist who knew what to do. Plus, each year there are 20,000 M3s who could really help alleviate that primary care shortage.

This is the same argument you are making. It sounds ridiculous in a different light doesn't it?

No, it really doesn't sound ridiculous at all. The only problem with your suggestion is that the M3s don't have any experience at all and as a result wouldn't be as qualified as an NP would be. Are you disagreeing with the fact that the masters prepared nurse practitioner is perfectly adequate to take care of patients?

Let me ask you something, why do you think that making cost a central issue is a problem? For any other service a person buys, it is very central. I don't understand why buying non-emergent healthcare services would be any different. You act as though 99% of the time that non-emergent healthcare services require the expertise of a rocket scientist. I vehemently disagree. I see no reason that people shouldn't be allowed to determine what level of professional is right for them and in the process be offerred some different levels of education, price, and value. That is the way a true "PRIVATE SECTOR" system would work. If you want to include an M3 in the mix as a choice for people, that doesn't sound so ridiculous to me as long as you have them pass a licensure exam and get some experience prior to being licensed for independent practice. What you misunderstand is that I am all for competition in this arena, regardless of where it comes from. I don't say that all of the competition has to come from NPs, I just say we need more competition from sources other than a traditionally trained physician.

The reasoning behind this is not because I dislike physicians, it is because healthcare costs are truly unsustainable at their current rate of growth. We have to find all of the cost effective measures that we can to be able to have an economy that can still function and compete. Do you even realize that at current growth rates there are projections that healthcare will overtake the GDP in just a few decades? Do you know what that means?

Do you really think that under that scenario we can afford not to try to do everything we can to lower healthcare costs?

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Do the advanced positions pay more money? If so, then you misrepresented yourself before. The BSN is worth the extra money because it qualifies you for positions that pay MORE money that an ADN is NOT qualified for. Isn't that the truth? So then there is some truth to the statement that BSNs get paid more than ADNs. Otherwise nobody would get a BSN. Thanks for proving my point. I don't take a narrow view of nursing education. I just say that additional education needs to add more value primarily because it costs more and people wouldn't be willing to pay for it if it didn't mean making more money, whether that would be at the beginning of their career or later in it. It's like I have said before, more education doesn't necessarily produce a better product for the customer. What does a BSN do for the patient that an ADN doesn't do?

Actually, the salaried positions that I have checked into to this point, and there have been quite a few, would pay LESS money than I make now. Obviously I can't know how much every single salaried position in the country, where only a BSN is required, will pay. What I do feel pretty comfortable saying is that I seriously doubt that ANY of those positions can pay what I make now, especially when you consider that salary typically means working as many hours as necessary for the same paycheck, therefore further reducing the actual hourly compensation that a salaried person makes. I didn't know this when I went into nursing or I may have chosen not to obtain the BSN. As for any position that requires an MSN or higher degree, you can't compare since that would necessitate spending more money to make more money, and that's assuming that the position would pay more, and some don't.

Now, after three posts, I have participated WAY more in this discussion than I intended because I don't like the nasty way you come across in your posts. Plus, this tangent about BSNs may be more off topic than staff will be happy with, so I'm ending my participation here. Comment if you will about whatever silly point you think I may have proven for you this time, but I won't respond.

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no, it really doesn't sound ridiculous at all. the only problem with your suggestion is that the m3s don't have any experience at all and as a result wouldn't be as qualified as an np would be. are you disagreeing with the fact that the masters prepared nurse practitioner is perfectly adequate to take care of patients?

i mean we're talking sematics here. fine. change m3 to m4 in my example. i'll repost it here:

since cost is so paramount to you, why don't we just let 4th year medical students have practice rights? they too can see 80-90% of patients in primary care. they could very easily take care of colds, strep throat, the flu, simple bp issues, simple dm issues, cellulitis, joint issues and the like that make up most of primary care. plus they could do it for a fraction of the cost that nps could do it since they currently don't get paid. this way, instead of paying $80 to see an np, the patient could see a fourth year and pay 80% of that. the cost saving would be huge for the whole system. then the patients the m4s couldn't handle could just be dumped onto a specialist who knew what to do. plus, each year there are 20,000 m4s who could really help alleviate that primary care shortage.

it's still just as ridiculous

let me ask you something, why do you think that making cost a central issue is a problem? for any other service a person buys, it is very central. i don't understand why buying non-emergent healthcare services would be any different. you act as though 99% of the time that non-emergent healthcare services require the expertise of a rocket scientist. i vehemently disagree. i see no reason that people shouldn't be allowed to determine what level of professional is right for them and in the process be offerred some different levels of education, price, and value. that is the way a true "private sector" system would work. if you want to include an m3 in the mix as a choice for people, that doesn't sound so ridiculous to me as long as you have them pass a licensure exam and get some experience prior to being licensed for independent practice. what you misunderstand is that i am all for competition in this arena, regardless of where it comes from. i don't say that all of the competition has to come from nps, i just say we need more competition from sources other than a traditionally trained physician.

the reasoning behind this is not because i dislike physicians, it is because healthcare costs are truly unsustainable at their current rate of growth. we have to find all of the cost effective measures that we can to be able to have an economy that can still function and compete. do you even realize that at current growth rates there are projections that healthcare will overtake the gdp in just a few decades? do you know what that means?

do you really think that under that scenario we can afford not to try to do everything we can to lower healthcare costs?

making cost the central issue is problematic because it obscures the real central issue, quality.

i mean listen to yourself, you're advocating for people who don't have enough training to be added to the mix as competent providers. and you say you are advocating for the patient? it sounds to me like you are just advocating for yourself.m4s already have taken 3 licensing exams by the time they finish m4 btw.

here is a post by another poster who went to np school and then decided to go to medical school. since he/she has been through it, i think you should take his/her perspective with a bit more than a grain of salt:

"i have a unique perspective on this. i am a physician (i.e. i actually went to medical school). i was also a nurse and took np classes.

there is absolutely no comparison between the two. zero. most np programs contain less actual "medical" classes than you get in one semester of real medical school. mine was 15 credit hours. the rest is nursing theory, research, nurse political activism and such. it is so unbelievably different, you can't compare the two. the truly scary thing is that they don't how much they don't know.

nps, dnps have absolutely no right to independent practice. i think there is a role for them such as running coumadin clinics, helping with post-op evals, vaccinations and other such limited practice.

they simply do not have a fraction of the knowledge that the worst fm physician has. not even close.

imagine this. would you let a fourth year medical student open up a clinic and do primary care? h@(( no! and the fourth year medical student already has vast more medical education than an np or dnp.

if this does not bother you, it should."

/\straight from the mouth of a nurse who went through both np and md school. /\

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i mean we're talking sematics here. fine. change m3 to m4 in my example. i'll repost it here:

since cost is so paramount to you, why don't we just let 4th year medical students have practice rights? they too can see 80-90% of patients in primary care. they could very easily take care of colds, strep throat, the flu, simple bp issues, simple dm issues, cellulitis, joint issues and the like that make up most of primary care. plus they could do it for a fraction of the cost that nps could do it since they currently don't get paid. this way, instead of paying $80 to see an np, the patient could see a fourth year and pay 80% of that. the cost saving would be huge for the whole system. then the patients the m4s couldn't handle could just be dumped onto a specialist who knew what to do. plus, each year there are 20,000 m4s who could really help alleviate that primary care shortage.

it's still just as ridiculous

making cost the central issue is problematic because it obscures the real central issue, quality.

i mean listen to yourself, you're advocating for people who don't have enough training to be added to the mix as competent providers. and you say you are advocating for the patient? it sounds to me like you are just advocating for yourself.m4s already have taken 3 licensing exams by the time they finish m4 btw.

here is a post by another poster who went to np school and then decided to go to medical school. since he/she has been through it, i think you should take his/her perspective with a bit more than a grain of salt:

"i have a unique perspective on this. i am a physician (i.e. i actually went to medical school). i was also a nurse and took np classes.

there is absolutely no comparison between the two. zero. most np programs contain less actual "medical" classes than you get in one semester of real medical school. mine was 15 credit hours. the rest is nursing theory, research, nurse political activism and such. it is so unbelievably different, you can't compare the two. the truly scary thing is that they don't how much they don't know.

nps, dnps have absolutely no right to independent practice. i think there is a role for them such as running coumadin clinics, helping with post-op evals, vaccinations and other such limited practice.

they simply do not have a fraction of the knowledge that the worst fm physician has. not even close.

imagine this. would you let a fourth year medical student open up a clinic and do primary care? h@(( no! and the fourth year medical student already has vast more medical education than an np or dnp.

if this does not bother you, it should."

/\straight from the mouth of a nurse who went through both np and md school. /\

hmmm, why did you make the suggestion if you weren't on board with it? isn't that what you call a straw man?

your poster here says that they took some np classes, not that they went through the entire degree program. it makes them no more credible than you are to say what the curriculum is or what it should be. furthermore, this poster never says what the education qualifies an np or a physician to do, just that it is better. it is very easy for you to argue superlatives when you don't apply your argument to what the education qualifies a person to do. when you contend that the most education is needed to perform the smallest task in any given industry, which is exactly what you are arguing, i will say you are being ridiculous. that is basically what you contend. nobody besides a doctor can treat a simple because in .001% of cases it could be something more serious, and only a doctor can identify the serious illness in the .001% of cases. sorry, but i am perfectly willing to take that risk and go with the numbers on this one. the statistics are overwhelmingly in my favor. thanks for offerring all of the expensive unnecessary education, but i think i will pass on it and save myself a whole lot of money.

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hmmm, why did you make the suggestion if you weren't on board with it? isn't that what you call a straw man?

first, that's not what a strawman is. perhaps you should look it up.

second, it was not a suggestion, it was a farce. hyperbole. that apparently was missed by some...

your poster here says that they took some np classes, not that they went through the entire degree program. it makes them no more credible than you are to say what the curriculum is or what it should be. furthermore, this poster never says what the education qualifies an np or a physician to do, just that it is better. it is very easy for you to argue superlatives when you don't apply your argument to what the education qualifies a person to do.

from the posters other comments, it sounds like they finished the np and practiced for a little while. i think that makes them completely capable of commenting. here are some other comments by the same person:

" listen [unnamed poster], you don't seem to understand. have you been to medical school? no, right? i have been to both!! there is a huge difference!!! the fact that you continue to argue this point is a bit ridiculous don't you think?

you can say you want the "experienced specialist" or that education doesn't equal better care or whatever ego-sustaining garbage you want, the point is the physician is the top of the food chain in medicine. if you want to practice medicine, go to medical school.

i feel for you. i really do. i spent many years spouting off the same stuff that's said here by many of the midlevels "experience matters more" "i can do the same thing as a doctor" "i spent x years doing y and that makes me the same as a doctor." it's simply not true. you simply can't understand the huge difference unless you've done both. sorry.

i am strongly against the expansion of the nps because, knowing what i know now i realize how dangerous it can be. the nursing agenda is manipulative and self-interested. it truly scares me what i could have done to people.

the problem is you don't know what you don't know. the vast majority of medicine is pretty straight forward, easy in fact. it's the 5% that will get you. you can't diagnose a problem if you have never even heard of it. that's the problem. that's why i've seen bad mistakes made by nps. innocuous rash or life-threatening kawasaki's disease. get it?"

from the same guy/girl:

"you still don't get it do you? myself and others have gone around and around about this with you. your posts illustrate the problem i have with a lot of midlevels: you don't know how much you don't know. it's scary. it will result in injury to patients.

i will call your "covered all this also in nursing school and as an np student" and "we might understand pathology because we take courses called 'pathophysiology'."

i'm a nurse. i've taken both undergraduate and graduate (np) "pathophysiology." i was a tenured track full time faculty at a school where i taught nursing classes. i also went to medical school. there is no comparison in the level or depth between the two!!!!!

you think you understand the difference but you cannot. talk to me when you finish medical school and tell me they are even close to the same. every np i know will tell you the same thing. they are the biggest critics of the expansion of midlevels (particularly nps) because they realize, in hindsight, how little they knew and how much they thought they knew. scary.

i am not against midlevels and certainly not against nurses. in fact, i probably value a good nurse more than most because i've been there. i am against under qualified people trying to play doctor without undergoing the equivalent education."

/\ this says it all

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it's scary. it will result in injury to patients.

/\ this says it all

this is basically your argument summed up in one statement. my argument is that there are nps out there practicing independently as we speak and it hasn't resulted in injury to patients. how can you support that argument in light of that fact? that is what doesn't make any sense.

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wowza , i personally wouldn't waste anymore time on someone who has no idea about medicine in general. he's just trolling for arguments!
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