DOCTORATE for CRNA's?

NGACRNA · Jan 5, 2005

Many, if not most, CRNA schools currently require enough hours of their students to allow them to give a doctorate. At least a "clinical" doctorate, if not a PhD. The latter would require so much time for the dissertation that it would either increase the program length, or reduce clinical hours. Considering that NP and CNS schools have a lot less hours than CRNA programs, we should be getting doctorates now.

Oh, and the AACN is not necessarily the CRNA's friend. They'd like to require more "core" classes for all MN degrees, and few schools of nursing are going to reduce "their" core, so the CRNA programs have to cut back on clinical hours and add more, shall we say "less practical" courses.

Pete495 · Jan 5, 2005

I believe we've discussed this issue before, but I cringe at the concept of making nursing a doctorate level education. As if nursing isn't more academic than it already is, at least from my point of view anyway. If anything though, I think this tactic will scare nurses away rather than provide needed education for a field that is short of clinical nurses and nurse educators. Part of the attraction of nursing is that it does not take as long to get through advanced practice, as compared to being a physician at least. Even if the time is less than that required to be an M.D. or D.O., there will still be an altered perception that it requires so much time, "I might as well be a doctor."

In regards to making CRNA's obtain their phd for certification, clinically speaking, I really don't see the point. I do believe it would contribute to research and probably provide more education for younger CRNA's, but I think it's important to remember that anesthesia is clinically focused. Personally, I do not have an "heavy" interest in research and dissertations. I suspect this is why many nurses go on to be CRNA's. It's because it is a high degree of nursing. The question remains, if one makes this a doctorate program, are you taking the nursing out of CRNA?

loisane · Jan 5, 2005

I think it is INCREDIBLY important to remember that the terms "doctor" and "physician" are NOT interchangeable. Because the discipline of medicine was one of the first to require doctoral education, our language has evolved in such a way that the difference between the two terms has become fuzzy.

I preach on this alot. Yes, I know the average person does not appreciate the difference. But if the professional community would be meticulous in their language, I think we could eventually make an impact on society at large. I personally never use the term "doctor" when I really mean "physician".

And the term "doctorate" is not interchangeable with "PhD". There are various forms of doctorates. Not all are research focused. Remember, physicians don't (typically) earn research doctorates.

I know many of you break out in hives at the mention of theory/academics/philosophy. But these things are at the root of what we do/say/are. To equate doctoral education with medicine, implies to me that the thinking is that all health care is the practice of "medicine", and nursing and all the rest are just sub-component pieces of medicine. It is as if to say nurses don't need doctorates, because we have the physicians for that, nursing is dependent upon medicine.

Or is nursing one piece of "health care", that also includes medicine and other disciplines? If health care is composed of many interrelated disciplines, any of these individual disciplines can offer academic education at the doctoral level. Experts in any of the disciplines would earn doctorates as evidence of their expert status in their particular discipline.

Nursing needs to do more of this. The APN roles are a natural fit for doctorate as entry level degree. Many other disciplines have already made this transition (psychology, physical therapy, pharmacy).

loisane crna

USFguy · Feb 7, 2005

I think it is INCREDIBLY important to remember that the terms "doctor" and "physician" are NOT interchangeable. Because the discipline of medicine was one of the first to require doctoral education, our language has evolved in such a way that the difference between the two terms has become fuzzy.
I preach on this alot. Yes, I know the average person does not appreciate the difference. But if the professional community would be meticulous in their language, I think we could eventually make an impact on society at large. I personally never use the term "doctor" when I really mean "physician".
And the term "doctorate" is not interchangeable with "PhD". There are various forms of doctorates. Not all are research focused. Remember, physicians don't (typically) earn research doctorates.
I know many of you break out in hives at the mention of theory/academics/philosophy. But these things are at the root of what we do/say/are. To equate doctoral education with medicine, implies to me that the thinking is that all health care is the practice of "medicine", and nursing and all the rest are just sub-component pieces of medicine. It is as if to say nurses don't need doctorates, because we have the physicians for that, nursing is dependent upon medicine.
Or is nursing one piece of "health care", that also includes medicine and other disciplines? If health care is composed of many interrelated disciplines, any of these individual disciplines can offer academic education at the doctoral level. Experts in any of the disciplines would earn doctorates as evidence of their expert status in their particular discipline.
Nursing needs to do more of this. The APN roles are a natural fit for doctorate as entry level degree. Many other disciplines have already made this transition (psychology, physical therapy, pharmacy).
loisane crna

The practice-based DNP or DrNP (Doctor of Nursing Practice) is critical to advancing the science and art of nursing. I can't wait till the DrNP goes into effect at Columbia University in NYC. I think CRNA's and frankly, all APN's diserve a clinical or practice doctorate at this point in time. Just as an MD may get a PhD as well to be qualified as a medical scientist, a CRNA or NP, CNM, CNS with a DNP or DrNP (they need to standardize the degree title) can get a PhD or DNS/DNSc/DSN (again, standardization for sake of consistency) to qualify as a nurse scientist. Nurse scientists are critical to health care as they implement many studies in areas often overlooked by MD's. They also can serve as competent faculty in endowed research professorships at schools with the help of the National Institute for Nursing Research. It's time for nursing to come into it's own and stop seeing itself as skilled technicians but as health care experts.

loisane · Feb 7, 2005

It's time for nursing to come into it's own and stop seeing itself as skilled technicians but as health care experts.

Well said!!!!!!!

loisane crna

sway · Feb 7, 2005

This is such an important topic, I can't belive it hasn't gotten more hits. I have always thought that the PharmD model seemed excellent, and would personally wecome the option to obtain a doctorate. I suppose eventually it could become manditory, but that should probably be phased in over many years, once there's even enough programs. More knowledge and skill are always a good thing, and worth the price. Why are you even considering CRNA when you're already an RN?

I think the most intersting thing about this is the semantics of it. Calling eachother 'doctor' is a strong lure for many people...but as loisane says, it's totally weak.

aRNnAR · Feb 8, 2005

I've read where VCU is making it's NA program a Doctorate program....it will be a Bachelors to Doctorate program that will take 3yrs to complete...no Masters in between. They will also offer a transitional program for CRNAs with a MS. The students will be awarded a DNAP...Doctorate of Nurse Anesthesia Practice. It's a clinical Doctorate..not a research PhD, which they already offer to masters prepared CRNAs. I know a cpl of other programs offer Doctorates for CRNAs, but none as specific to CRNAs. I am an RRNA at TWU & think it's a great move to make the DNAP the entry-level degree for CRNAs....& only takes "slim to none" longer than the MS programs that already exist. It will add to the professionalism & expertise of NA, & could even mean increased salaries.

apaisRN, RN, CRNA · Feb 8, 2005

The "doctor" title might improve public perception and slow the ASA down a little in their critique of CRNAs. If CRNA and MD are both clinical doctorates, who cares if one started out as a nurse?

Personally, I'm challenged enough by starting an MSNA program this fall, and I hope they don't implement this requirement until I'm done! Would love to do a transition program afterward though.

squinkybear1 · Feb 12, 2005

Research is a case for the doctorate. But, maybe all nurses, whether diploma or DNSc degree holders, should be required to perform X hours of direct patient care per year and continue participation in patient-focused research in order to maintain their licenses. Nursing is not a science. It is an art that incorporates science and research. The doctorate might be seen as being more political than practical, allowing membership into an exclusive (not inclusive) club. As nurses we need more cooperation.

Also, who is going to offer the fellowship monies to see thousands of nurses through doctoral programs and who is going to convince the public that a nurse with a doctorate is still the nurse that they perceive a nurse to be?

My chosen doctoral program costs over $100,000 in tuition. Am I nuts? I'll be paying for my master's degree until I'm 70 years old. That hasn't elevated my salary or my credibility. My skills and my clinical experience speak volumes that a few letters behind my name could never match.

stklgs · Feb 14, 2005

My program has discussed switching to a DNP

jewelcutt · Feb 14, 2005

They're in the process of developing a DNP at my school, but I have to say I'm not really interested in it. The reason being is that it has a lot of nursing theory, more research, and stuff I don't believe to be related to nurse anesthesia, just all the stuff I hate about nursing. They say this is a clinical doctorate but the curriculum of 36 hours all in nonclinical stuff doesn't make sense to me. I honestly can't see any CRNA that only wants to practice clinical want to do this. I cringed when I read the proposed curriculum, there is no way in hell I would do it, I can't even stand the five core nursing classes I have to take now. Now if it were a true clinical doctorate it would include classes on certain clinical specialties and involve perhaps only a little bit of the stuff mentioned above.