Full Practice Authority of Nursing

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Specializes in Family Nursing & Psychiatry.

Do you think that doctorates in nursing (DNP, PhD) help contribute to full practice authority for the profession? I think that as more nurses obtain their terminal degree, this furthers the profession and helps expand scope of practice. 

What are your thoughts?

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

How can increasing the cost of one's professional preparation help expand scope of practice?  

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Specializes in Family Nursing & Psychiatry.
44 minutes ago, PMFB-RN said:

How can increasing the cost of one's professional preparation help expand scope of practice?  

Tell that to medicine, osteopathy, podiatry, dentistry, psychology, etc. It’s not just parity, nursing knowledge is so expansive that the degrees nurses hold should reflect it. If nurses are the experts in nursing practice, they should have doctoral degrees. 
 

If you don’t think doctorates are too costly, what do you think will help nurses get full practice authority?

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

What I see medicine doing is decreasing the cost of professional preparation. One of my state's two medical schools has opened two branch campuses in small cities and is offering a three rather than four year medical degree. (medical school tuition is paid by the year) There is starting to be some recognition that the shortage of primary care physicians is largely a result of the high cost/debt of medical education and they are taking steps to mitigate the cost in order to allow more graduates to seek a career as primary care physicians.

   Meanwhile advanced practice nurses, the traditional providers of quality primary care, especially in under served areas, are busy increasing the financial investment and barriers to practice. 

   Speaking of medicine, there are at least three paths that can lead to licensure as a physician in the USA. The MD, DO and MBBS degrees can all qualify one for residency training and then licensure as a physician in the US. One of them, the MBBS degree, isn't even an actual doctorate degree. Medicine seems to have no issues what so ever with there being multiple paths to practice.  

   I don't understand why nursing views multiple paths to practice as a problem. I have my own hypothesis on why, but it's not very flattering. 

   Advanced practice nurses in my state of Wisconsin already have full practice authority and have since long before the DNP became a thing. I suggest the best path to full practice authority is lobbying for changes to state laws. 

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
6 hours ago, matthewandrew said:

Tell that to medicine, osteopathy, podiatry, dentistry, psychology, etc. It’s not just parity, nursing knowledge is so expansive that the degrees nurses hold should reflect it. If nurses are the experts in nursing practice, they should have doctoral degrees. 
 

If you don’t think doctorates are too costly, what do you think will help nurses get full practice authority?

I noticed that you elected not to answer my question. 

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Specializes in Family Nursing & Psychiatry.
2 hours ago, PMFB-RN said:

I noticed that you elected not to answer my question. 

Good point. Terminal degrees will be more costly compared to masters degree. I think more training and education for nurses will pay for itself in the long run. Just like comparing the BSN to the ADN. 
 

Think of it as value added.

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Specializes in Occupational Health.
7 hours ago, PMFB-RN said:

I suggest the best path to full practice authority is lobbying for changes to state laws. 

This is PFNB-RN's suggestion and I agree with it.

As of July 2021, 23 states and the District of Columbia have granted nurse practitioners (NPs) the ability to practice independently. 

https://www.AANP.org/advocacy/state/state-practice-environment

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Specializes in Former NP now Internal medicine PGY-3.
13 hours ago, PMFB-RN said:

What I see medicine doing is decreasing the cost of professional preparation. One of my state's two medical schools has opened two branch campuses in small cities and is offering a three rather than four year medical degree. (medical school tuition is paid by the year) There is starting to be some recognition that the shortage of primary care physicians is largely a result of the high cost/debt of medical education and they are taking steps to mitigate the cost in order to allow more graduates to seek a career as primary care physicians.

   Meanwhile advanced practice nurses, the traditional providers of quality primary care, especially in under served areas, are busy increasing the financial investment and barriers to practice. 

   Speaking of medicine, there are at least three paths that can lead to licensure as a physician in the USA. The MD, DO and MBBS degrees can all qualify one for residency training and then licensure as a physician in the US. One of them, the MBBS degree, isn't even an actual doctorate degree. Medicine seems to have no issues what so ever with there being multiple paths to practice.  

   I don't understand why nursing views multiple paths to practice as a problem. I have my own hypothesis on why, but it's not very flattering. 

   Advanced practice nurses in my state of Wisconsin already have full practice authority and have since long before the DNP became a thing. I suggest the best path to full practice authority is lobbying for changes to state laws. 

Except MBBS actually takes like 4+ years to obtain and is real medical school and requires a real residency. 

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
50 minutes ago, Tegridy said:

Except MBBS actually takes like 4+ years to obtain and is real medical school and requires a real residency. 

I don't know what you mean by "except". I'm very well aware of the training and education graduates of MBBS programs receive. I already pointed out that the MBBS qualifies one for residency training and licensure as a physician in the US. 

    Obviously MBBS programs are real medical schools.  Nothing _I_ said suggested or implied they are anything else. 

   You are arguing against points never made. 

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
11 hours ago, matthewandrew said:

Good point. Terminal degrees will be more costly compared to masters degree. I think more training and education for nurses will pay for itself in the long run. Just like comparing the BSN to the ADN. 
 

Think of it as value added.

   Can you point me to some data that supports what you "think" will happen?

     I don't think you choose a very good comparison with BSN vs ADN. I haven't seen any data that indicates staff nurses with BSNs make more money than those with ADNs and there is no difference in their practice. 

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Specializes in Family Nursing & Psychiatry.
52 minutes ago, PMFB-RN said:

   Can you point me to some data that supports what you "think" will happen?

     I don't think you choose a very good comparison with BSN vs ADN. I haven't seen any data that indicates staff nurses with BSNs make more money than those with ADNs and there is no difference in their practice. 

Why do you think hospitals, especially Magnet, prefer BSN? Education. Yeah they qualify for the same tests, but BSN is more time and more comprehensive. More time in school is more opportunity for growth. Same concept for continuing education. I’m sure you’re satisfied with the status quo. Good for you. Some of us want to push the profession forward with advance practice and terminal degrees. 

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
18 minutes ago, matthewandrew said:

Why do you think hospitals, especially Magnet, prefer BSN? Education. Yeah they qualify for the same tests, but BSN is more time and more comprehensive. More time in school is more opportunity for growth. Same concept for continuing education. I’m sure you’re satisfied with the status quo. Good for you. Some of us want to push the profession forward with advance practice and terminal degrees. 

Having worked in four states and two countries as a staff RN and another four states as a traveler, and having a huge network of critical care nurse friends, my experience is that Magnet is not desirable. It's one of the criteria used when determining if a hospital may be a good place to work. Magnet indicates its less likely to be a good employer.

    I have a pretty good idea of why some hospitals, especially Magnet prefer BSN, but it's not because of better patient outcomes. If patient outcomes was the criteria then the evidence indicates that having nurses certified in their field (CCRN, CEN, etc) results in better patient outcomes.

    In my view you and like minded people are not pushing the profession forward. Exactly the opposite. 

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