Full Practice Authority of Nursing

Updated:   Published

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?

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

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. 

Well I appreciate your perspective as an RN. As an NP, I have different view point. It’s good that nursing is big enough for differing opinions. As they say, to each their own. 

Up Vote Up Vote ×
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
1 hour ago, matthewandrew said:

Well I appreciate your perspective as an RN. As an NP, I have different view point. It’s good that nursing is big enough for differing opinions. As they say, to each their own. 

Do you have any data or evidence you can point me to that supports your view that making a doctorate the terminal degree for advanced practice nurses will result in increased independence? Or better patient outcomes? Or increased compensation for advanced practice nurses?

   I live in a very rural area. Advanced practice nurses are absolutely critical in providing health care in this underserved area. Without them many people simply wouldn't have access to a health care provider. We already have difficulty in recruiting APNs to the area, despite above average compensation. One of (but not my only) my concerns with what I view as degree inflation is that increasing the investment required of APNs, especially the increased time commitment and opportunity cost, will only exacerbate the problem. 

Up Vote Up Vote ×
Specializes in Family Nursing & Psychiatry.
4 hours ago, PMFB-RN said:

Do you have any data or evidence you can point me to that supports your view that making a doctorate the terminal degree for advanced practice nurses will result in increased independence? Or better patient outcomes? Or increased compensation for advanced practice nurses?

   I live in a very rural area. Advanced practice nurses are absolutely critical in providing health care in this underserved area. Without them many people simply wouldn't have access to a health care provider. We already have difficulty in recruiting APNs to the area, despite above average compensation. One of (but not my only) my concerns with what I view as degree inflation is that increasing the investment required of APNs, especially the increased time commitment and opportunity cost, will only exacerbate the problem. 

The original posting postulated will more doctorates in nursing contribute to full practice authority for nursing. It didn’t ask will requiring a doctorate be needed for entry to advance practice. Doctorates are already terminal degrees in nursing. You may be arguing a point that wasn’t brought up in the first place. 
 

The issue at hand is multidimentional, and cost, although important, is not the only factor. It’s only in nursing that we need evidence and studies to argue for more education and training for nurses at the doctoral level. 

Reality is, there will always be a shortage of healthcare professionals, nursing or medicine. People get old, people get sick. As people get sicker and sicker, so too increases the complexity of cases. This shouldn’t hold nurses from seeking terminal degrees. I would argue it should motivate more nurses to get doctoral degrees as recommended by the IOM.
 

Here’s my point as an actual advance practice registered nurse, more training will only improve advance practice. This increase in education should be reflected in the degree earned. 
 

 

Up Vote Up Vote ×
Specializes in Med-Surg/Tele/ER/Urgent Care.
On 10/27/2021 at 4:36 AM, matthewandrew said:

The original posting postulated will more doctorates in nursing contribute to full practice authority for nursing. It didn’t ask will requiring a doctorate be needed for entry to advance practice. Doctorates are already terminal degrees in nursing. You may be arguing a point that wasn’t brought up in the first place. 
 

The issue at hand is multidimentional, and cost, although important, is not the only factor. It’s only in nursing that we need evidence and studies to argue for more education and training for nurses at the doctoral level. 

Reality is, there will always be a shortage of healthcare professionals, nursing or medicine. People get old, people get sick. As people get sicker and sicker, so too increases the complexity of cases. This shouldn’t hold nurses from seeking terminal degrees. I would argue it should motivate more nurses to get doctoral degrees as recommended by the IOM.
 

Here’s my point as an actual advance practice registered nurse, more training will only improve advance practice. This increase in education should be reflected in the degree earned. 
 

 

None of theses statements have anything to do with full practice privileges. What state do you practice in? It must be a state without full independent NP practice. New Mexico has had independent practice for over 25 years, it is a rural state. DNP has not had any  impact in practice environment nor increased salaries. DNP does not necessarily increase knowledge depending on the school attended. Not to mention the over saturation of new NPs that have little to no RN experience/direct entry that have lowered salaries.

1
Up Vote Up Vote ×
Specializes in Family Nursing & Psychiatry.
58 minutes ago, PollywogNP said:

None of theses statements have anything to do with full practice privileges. What state do you practice in? It must be a state without full independent NP practice. New Mexico has had independent practice for over 25 years, it is a rural state. DNP has not had any  impact in practice environment nor increased salaries. DNP does not necessarily increase knowledge depending on the school attended. Not to mention the over saturation of new NPs that have little to no RN experience/direct entry that have lowered salaries.

Yeah, they were in reply to a previous poster if you read the thread. Nobody said doctorates are needed for full practice authority. We already know many states have granted that to APRNs without requiring the DNP. It’s obviously multifactorial. You probably don’t have a doctorate degree, hence why you don’t know what you don’t know. It’s great for you to diminish what a doctorate degree contributes to a nurse and the profession. 
 

What’s oversaturation and supposed lowered salaries have to do with full practice authority? If you’re not happy with your salary, find another job. 

Up Vote Up Vote ×
On 10/26/2021 at 10:55 PM, 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. 

I actually think that some of you are simply lazy and don't like patient care and advance degrees allows you away from patient care and strokes your fragile egos.

I have yet to see the difference between an advanced degree nurse and  an experienced nurse re knowledge and ability! 

What I do see is that advanced degrees allows the practicing individual to hang back and not participate, until it's time to garner attention! 

No amount of theoretical knowledge can substitute for experience as many Europeans embrace, with apprenticeship programs. You can study all the intricacies of starting an IV all day, but you will never get the hang until you practice real world! 

Be honest, it's a watered down MD degree with the minimal salary for wanna be Drs who can't cut the grade. Research I understand, but even that requires a certain perspective to succeed. Sure, analytics can get you through, but success is pattern recognition and intuition! 

Use it for telehealth, IMO! Stay off the units! 

2
Up Vote Up Vote ×
Specializes in Family Nursing & Psychiatry.

Just for the record, this post doesn’t deserve a real reply. Shame on you for being ill-informed. 
 

Now what will I do with the semester long course I took called Theory & Intricacies of Intravenous Cannulation Insertions 101? That was 5 credits too! Boo.  

1
Up Vote Up Vote ×
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

If you are advocating significantly increasing the investment for APNs that's fine.

    But you need to be able to articulate WHY. The only justification can be better patient outcomes, or increased compensation for APNs.

    Just show the evidence that increasing barriers to practice will result in one of those two things.

1
Up Vote Up Vote ×
5 minutes ago, PMFB-RN said:

If you are advocating significantly increasing the investment for APNs that's fine.

    But you need to be able to articulate WHY. The only justification can be better patient outcomes, or increased compensation for APNs.

    Just show the evidence that increasing barriers to practice will result in one of those two things.

We don't need theorists. We need bodies on the floor and you guys can sit in the nurse's station and do the charting etc., if you want to work the floors, which you don't. 

You'd rather cluster and discuss than lend a hand. We satisfy insurance regs for payment, which drives health care costs up, because newer more innovative practices means more marketability and more revenue from a human body that has no changes, warranting the innovation. Just take a look at back pain and its innovations! Slight modifications or even risky procedures for profit. 

Other countries practicing Universal Healthcare have far better outcomes than we do in every area, except trauma, only because we inflict far more trauma than everyone else. 

So what good is an advanced practice degree? They don't seem to go the same route with far better results? 

Up Vote Up Vote ×
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
32 minutes ago, Curious1997 said:

We don't need theorists. We need bodies on the floor and you guys can sit in the nurse's station and do the charting etc., if you want to work the floors, which you don't. 

You'd rather cluster and discuss than lend a hand. We satisfy insurance regs for payment, which drives health care costs up, because newer more innovative practices means more marketability and more revenue from a human body that has no changes, warranting the innovation. Just take a look at back pain and its innovations! Slight modifications or even risky procedures for profit. 

Other countries practicing Universal Healthcare have far better outcomes than we do in every area, except trauma, only because we inflict far more trauma than everyone else. 

So what good is an advanced practice degree? They don't seem to go the same route with far better results? 

I do work the floors. No idea why you would dishonesty and falsely state I don't want to.

    Having been both an RN and a patient in a country with universal health care I'm well aware of their better outcomes. 

   No idea why you felt the need to be condescending. 

1
Up Vote Up Vote ×
Specializes in oncology.
On 10/27/2021 at 12:35 AM, PMFB-RN said:

One of (but not my only) my concerns with what I view as degree inflation is that increasing the investment required of APNs, especially the increased time commitment and opportunity cost, will only exacerbate the problem. 

degree deflation happened quite a while ago when Master's programs substituted a "Capstone" experience for a true Masters Thesis.

A Master's degree that does not require a graduate to contribute research-based information to the discipline is along side the equivalent of a 'participation trophy'. And a Terminal doctorate awarded  for some kind of  'capstone' project is a disgrace. This all came about when the online programs proliferated and didn't have adequate qualified nursing scholars (or more truly want to pay them,)  to assist with the education of those following in their place.

1
Up Vote Up Vote ×
Specializes in Med-Surg/Tele/ER/Urgent Care.
On 10/25/2021 at 9:20 PM, matthewandrew said:

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?

 

13 hours ago, matthewandrew said:

Yeah, they were in reply to a previous poster if you read the thread. Nobody said doctorates are needed for full practice authority. We already know many states have granted that to APRNs without requiring the DNP. It’s obviously multifactorial. You probably don’t have a doctorate degree, hence why you don’t know what you don’t know. It’s great for you to diminish what a doctorate degree contributes to a nurse and the profession. 
 

What’s oversaturation and supposed lowered salaries have to do with full practice authority? If you’re not happy with your salary, find another job. 

 

Up Vote Up Vote ×
+ Join the Discussion