Full Practice Authority of Nursing

[matthewandrew]

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?

[guest1163268]

4 hours ago, PMFB-RN said:

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. 

How would I know if you worked the floors? I don't know you personally. 

Simply commenting on what I have frequently observed of others. 

[PollywogNP, ADN, BSN, MSN, LPN, NP]

Your theory is that more DNP degrees  is “furthering” the profession. And somehow this leads to expanding scope of practice in states that limit nurse practitioner practice, states where NPs are under MD supervision. Sounds like you live in a state lacking full independent practice and also recent DNP graduate that spent time taking classes that do not change current NP practice such as “ one semester 5 credit course in IV cannulation & insertions.”

No for me the return on investment to obtain a DNP after 20 years NP practice considering my recent raise is not worth the time or money and will not change current practice environment. I work in FQHC in rural area, love my job.

So what state are you working in? How do you with your DNP plan to change your state scope of practice to expand practice for NPs? What NP organizations are you involved with?  Curious what your DNP thesis topic was. Await your responses. 

[guest1163268]

13 minutes ago, PollywogNP said:

 

 

Scenario :

I have a real estate business on the side that does quite well. I own an AMGC60 and a '95 Toyota Camry. 

On almost every possible day I'm driving my Camry because it's a vastly superior car re ride quality, reliability and quietness. I adore that car! The AMG is just for fun and show and when I need some attention. 

If I'm driving a long distance, which car do you think I'm driving? 

[PollywogNP, ADN, BSN, MSN, LPN, NP]

7 hours ago, Curious1997 said:

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! 

Apparently your experience with NPs is inpatient environment per your description. Most FNPs are in primary care. Until recently most entering NP practice had years of experience. 

[chare]

1 hour ago, Curious1997 said:

5 hours ago, PMFB-RN said:

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. 

How would I know if you worked the floors? I don't know you personally. 

[...]

Had you taken a minute or two to read his profile and review his posting history you could have easily determined this.

1 hour ago, Curious1997 said:

[...]

Simply commenting on what I have frequently observed of others. 

An incorrect observation, based on a lack of investigation.

[Tegridy]

residencies and fellowships are the only thing that should lead to more scope. Let's be honest, if the consult services didn't have the attending physician we would be downgrading care by pursuing consults. Usually the midlevels don't do anything legit until the attending comes around. Usually since I know a few really great NPs who can run the show but its few and far between.... don't get me started on the hospitalist groups

[PMFB-RN, RN]

4 hours ago, Curious1997 said:

How would I know if you worked the floors? I don't know you personally. 

Simply commenting on what I have frequently observed of others. 

You could have reviewed my other posts here on AN, you could have asked me, or best of all, simply avoided fabricating lies about me.

[Jedrnurse, BSN, RN]

I'm amazed at how nasty this thread got and how quickly.

Re: increased clinical competence- Wouldn't decent continuing ED and more clinical practicum hours help practitioners become better at their jobs more than jumping up to the next degree (and debt) level?

[vintagegal, BSN, DNP, RN, NP]

On 10/25/2021 at 9:42 PM, PMFB-RN said:

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

So there is no difference between AA prepared nurses and BSN ???

 

[PMFB-RN, RN]

4 hours ago, vintagegal said:

So there is no difference between AA prepared nurses and BSN ???

 

I wouldn't say that. For example my hospital has a 9 month nurse residency program for new grads gkunh directly into critical care. It's intense and challenging. We started the residence back in 2005. For years we hired new grads from associates,  bachelor's,  and direct entry MSN programs interchangeably.  The only thing we have found predictive for success in the program is the graduates age. Older people are more often successful than younger ones.

     But we no longer hire new grads from BSN programs into the residency for the SICU, though they are still hired for MICU, PICU, NICU and the ED. The reason for that is that we require a three year contract for those hired into the residency. 10 years in we noticed that less than 25% of the new grads from BSN programs were completing the 3 year contract vs 100% of associate degree grads were completing the 3 year contracts.

    So there must be some difference between them. Though I've never been able to detect a difference among staff nurses.

[CommunityRNBSN, BSN, RN]

I’m not trying to start up the same old debate again. But. I am currently enrolled in a well-regarded local brick-and-mortar MSN program to become an NP. It is one of the best programs available in my area. But I, and the other students, have real concerns about the level of preparation that we are getting. It’s pretty half-assed in the classroom. And for clinicals, students can arrange them ourselves or elect to have help from the university. You can imagine the total lack of standardization there. If you arrange it yourself, the only interaction the Univ really has with the process, other than approving the site, is keeping track of your hours. The students themselves are absolutely top-notch, experienced nurses, but our level of preparation is just so so far off from what an MD receives, I’m embarrassed. I DO think that a well-prepared NP is worth their weight in gold, and I’ve been treated by many NPs in the past, so I trust them. But I think that the profession needs to get its act together if it really wants NPs to continue expanding their scope. (For the record, I do live in a state where they can practice independently!  Only after a few years of working under an MD, thankfully.)

Edited to add: I don’t want us to be “just like MDs” btw. The strength of nursing is that it is NURSING, so a different approach to education is a good thing. But the clinical preparation for practice needs to be more rigorous than it is. 

[PMFB-RN, RN]

2 hours ago, CommunityRNBSN said:

I’m not trying to start up the same old debate again. But. I am currently enrolled in a well-regarded local brick-and-mortar MSN program to become an NP. It is one of the best programs available in my area. But I, and the other students, have real concerns about the level of preparation that we are getting. It’s pretty half-assed in the classroom. And for clinicals, students can arrange them ourselves or elect to have help from the university. You can imagine the total lack of standardization there. If you arrange it yourself, the only interaction the Univ really has with the process, other than approving the site, is keeping track of your hours. The students themselves are absolutely top-notch, experienced nurses, but our level of preparation is just so so far off from what an MD receives, I’m embarrassed. 

I think your embarrassment is well founded. 

    However that is a totally different topic. The dnp programs don't add a single clinical hour or practice related class.

     The NP and CRNA DNP program I'm familiar with simply added 9 months of DNP classes on the to front of their program,  then out the students through the exact same preperation as when it was an MSN program.