DOCTORATE as Required Entry Level for Advance Practice Nurses?

Nurses Activism

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The American Association of the Colleges of Nursing (AACN) is now calling for a doctorate in nursing for advanced nursing practice roles, 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 required entry level for advanced nursing practice.

http://www.aacn.nche.edu/Media/NewsReleases/DNPRelease.htm

AACN Adopts a New Vision for the Future of Nursing Education and Practice

Position on the Practice Doctorate Approved by AACN Member Schools

WASHINGTON, DC, October 27, 2004: In a historic move to help shape the future of nursing education and practice, the American Association of Colleges of Nursing (AACN) has adopted a new position which recognizes the Doctor of Nursing Practice degree as the highest level of preparation for clinical practice. At its Fall Semiannual Meeting held October 25, 2004, AACN member institutions voted to move the current level of preparation necessary for advanced nursing practice roles from the master's degree to the doctorate level by the year 2015.

"This courageous move on the part of nursing education represents a milestone in the evolution of the nursing profession," said AACN President Jean E. Bartels. "This bold first step puts in motion a future that recognizes and validates the unique expertise of nurses engaged in clinical practice at the highest level."

Currently, advanced practice nurses (APNs), including Nurse Practitioners, Clinical Nurse Specialists, Nurse Mid-Wives, and Nurse Anesthetists, are prepared in master's degree programs that often carry a credit load equivalent to doctoral degrees in the other health professions. AACN's newly adopted Position Statement on the Practice Doctorate in Nursing calls for educating APNs and other nurses seeking top clinical roles in Doctor of Nursing Practice (DNP) programs. The changing demands of this nation's complex health care environment require the highest level of scientific knowledge and practice expertise to assure high quality patient outcomes.

The Practice Doctorate is designed for nurses seeking a terminal degree in nursing practice, and offers an alternative to research focused doctoral programs (i.e. PhD programs). Though only a handful of practice doctorates currently exist, more than a dozen new programs are taking shape nationwide, and several have expressed interest in seeking accreditation. The Commission on Collegiate Nursing Education (CCNE), the nation's premier accrediting agency for baccalaureate and graduate nursing programs, has agreed to initiate a process for the accreditation of practice doctorates.

To facilitate this sweeping change in nursing education, the AACN Board of Directors created two task forces with diverse representation from both large and small nursing institutions. The first task force is charged with creating an "Essentials" document for practice doctorates which outlines the basic competencies that must be built into these educational programs. This document will be similar in nature to the other Essentials documents originated by AACN for baccalaureate and master's degree education. The second task force will focus on implementation of the new position statement and will address issues related to moving existing APN programs to the doctoral level and providing efficient bridge programs for master's prepared nurses interested in pursuing a DNP degree.

As part of its work, AACN will continue its collaboration and consensus development with a variety of stakeholders, including advanced practice nursing groups, the higher education community and healthcare providers. "The transition to the practice doctorate will take careful planning and require the collective efforts of all AACN member institutions and the larger nursing community," said Dr. Bartels. "Nursing education has a unique opportunity here to rally around a shared vision for the future and work together to move the profession forward."

AACN's Position Statement on the Practice Doctorate in Nursing may be downloaded at http://www.aacn.nche.edu/DNP/pdf/DNP.pdf. To further clarify its position and address constituent concerns, AACN has developed a Frequently Asked Questions (FAQ) sheet to further explain the move toward the practice doctorate. The FAQs may be accessed online at http://www.aacn.nche.edu/DNP/DNPFAQ.htm. Please direct any questions, concerns or comments related to this AACN action to [email protected].

The American Association of Colleges of Nursing is the national voice for university and four-year-college education programs in nursing. Representing more than 570 member schools of nursing at public and private institutions nationwide, AACN's educational, research, governmental advocacy, data collection, publications, and other programs work to establish quality standards for bachelor's- and graduate-degree nursing education, assist deans and directors to implement those standards, influence the nursing profession to improve health care, and promote public support of baccalaureate and graduate nursing education, research, and practice. See http://www.aacn.nche.edu.

CONTACT: Robert Rosseter

(202) 463-6930, x231

[email protected]

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Specializes in med/surg.

Can you say MSN entry level to practice?

Not usually a griper, but come on...these roles were created to provide care in areas underserved by the pricey MDs. Will any of these DNPs even be interested in providing care to the disenfranchised? Oh, and do/will we have enough doctorally prepared nurse educators to prepare the DNPs?

Can you say MSN entry level to practice?

Not usually a griper, but come on...these roles were created to provide care in areas underserved by the pricey MDs. Will any of these DNPs even be interested in providing care to the disenfranchised? Oh, and do/will we have enough doctorally prepared nurse educators to prepare the DNPs?

MSN entry level for what? If you're refering to entry level nursing...I doubt we would ever see that in our life. Look at how long the push for BSN as entry level has been going on and it still has not occured. Why would the DNP not want to provide care to the disenfranchised? The education and nursing model is not changing here. The ending degree is what's changing. For the most part, MSN students are instructed by doctorally prepared nurse educators already.

Can anyone say what the practical value of this new requirement would be? When I say that, I mean something other than "Well, other professions require it, so we should too".

Can anyone say what the practical value of this new requirement would be? When I say that, I mean something other than "Well, other professions require it, so we should too".

The practical value is primarily political. Having a doctorate as the entry-level for a particular profession, in this case advanced practice nursing, sets a profession up to move towards autonomy. I would say that the quest for autonomy and all the things that go with it (e.g., direct access, private practice, independence from physicians) is the primary reason that the all of the recent transitions to entry-level doctoral degrees have occurred. Saying that your given profession is required to complete a doctorate with a one year residency is far more impressive than saying your field requires a two-year masters with no residency when convincing politicians and insurance companies to support changes in legislature governing your scope of practice and increases in reimbursement, respectively.

I do not believe the MSN will ever become the entry level for nursing. I do believe in the future the BSN will completely replace the ADN for entry level as an RN. I also believe the DNP will replace the MSN as the entry-level degree for advanced practice nursing. The MSN will likely remain for those wanting to earn a degree in administration or as a stepping stone to the PhD.

Thats just my two cents

Specializes in MICU.

Chicoborja

I totally agree with u. it's just a matter of time.

Eve

Specializes in Nephrology, Cardiology, ER, ICU.

I live near a CRNA program that is now going to the DNS (doctor of Nursing Science). This is being phased in gradually over the next two years! Their MSN program for the CRNA already requires 80 hours. To compare this to my MSN program of 39 hours certainly feeds the fire that this CRNA program is worthy of a doctorate.

One problem that just came to mind relates to those colleges that belong to universities that are not doctoral-granting institutions. Many smaller colleges/universities award the master's as their highest degree available. I wonder if this transition will force smaller programs to either close or collaborate with neighboring institutions to offer the degree jointly. With the nursing shortage, closing programs would not be wise. However, isn't the shortage of nurses exclusive to RN, LPN/LVN, and CNA. There isn't a shortage of NP and CNS, is there? How bout CRNA? In any case, I bet the MDAs will through a big fit about CRNAs being DNPs! :chuckle

I see this as a way for hospitals and third party payers to increase advanced degree nurses' role in primary care and push MDs into more specialized work, to cut costs. They can pay the DNSc more than the MSN to give incentive to go for the doctorate, but less than the MDs, without missing a beat with quality of care. It's the same quality/economic factors at play that makes CRNAs so coveted by hospitals and anesthesia groups. With the doctorate, it will be easier to widen scope of practice laws and get more autonomy.

As for LPNs and assoc. degree RNs...they'll never go away. You gotta have' em. There's just not enough BSN programs out there to fill all the nursing entry level positions.

At any rate...General practioner and Family practioner MDs are not going to like it one bit.......nope, they're not. :angryfire

Ken

Specializes in ICU/CCU/MICU/SICU/CTICU.

Its funny this post is here tonight. I have been searching all over the internet for a DNS program. I can find PhD programs all over the place. I did find some info for a few DNS. I came across a site that is showing they are starting up a Doctorate of Nursing Practice (DrNP) is what they have the letters as, but Columbia University has one in the making. They are waiting on the approval now. It also stated that with this role, that 3rd party payors would be looking into reimbursing this level as the number of General Practitioner MDs decline.

Yes, there is a shortage of anesthesia providers (CRNAs and MDAs).

CardioTrans-->Try searching for a program that awards DNSc (Doctor of Nursing Science) I've never seen DNS used before, only DNSc.

Specializes in Research,Peds,Neuro,Psych,.
I don't see the value in this. What's wrong with master's prepared practitionners? I personally couldn't imagine investing in a doctorate degree to be a CNS when a lot of staff nurses with their ADNs are better compensated.

True!!

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

I wonder how many potential ARNP's are just going to pass on this idea. Especially general practioners.

College profressors and PharmD's seem to do o.k. with their doctorate. So do CRNA's and perhaps midwives. What about the ARNP in the phycians practice or working at the VA and such. Is it going to worth all the time and effort to make what they make?

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