HELP DNP vs FNP

Riburn3, BSN, MSN, APRN, NP · Jul 30, 2015

Cost is the underlying factor of all my arguments. Although I do want a DNP, on a meta level, how do you convince a group of hundreds of thousands of APRNs with MSNs already working, making good money, to go back to school and drop tens of thousands of dollars for a degree that is going to have a negligible impact on their day to day? I know this isn't a requirement, and it likely won't be, but it is a goal of the AACN to get MSNs to become DNPs, and it's a problem that needs some solving if they truly want to reach that goal.

I get the argument for the transition to BSN-DNP programs so long as they don't significantly delay market entry.

Jules A, MSN · Jul 31, 2015

Since graduating with their DNP:
"62% develop, implement/evaluate practice initiatives.
51% have increased their scope of practice
61% function to the full capacity of my role"
Also, the majority of the DNP graduates surveyed were leaders in their facilities on interdisciplinary teams, and 60-80% of these graduates utilized EBP more/translated it into their own practice and their facilities practice.
Picking that one line out of that giant survey hardly that you did hardly does it justice.

My most recent experience with a DNP was a guy teaching our BLS renewal class. Ummm ok thanks "Dr." XYZ. It didn't seem to me the hospital values his expertise and I'd guess is not paying him much. Since I had done this as a ADN I was underwhelmed.

Perhaps this is because I'm only masters prepared but I didn't think surveys were all that high on the research food chain?

I read another article that was posted as supporting superior NP outcomes and it was a survey that was sent to both NPs and their employing physicians. Really? I'd hope that my boss would rate me satisfactorily since he hired me and is paying me to represent his practice. Please send me a survey because I'm surely going to check the box that says I'm an EBP rockstar too.

I would still like to see someone post their newly inflated salary they received as a result of their DNP designation.

allnurses Guide · Jul 31, 2015

I would like to see what happened to the salaries of NPs during the transition to MSN.

You can always find ancedotal evidence of why whatever degree or profession is not that great because of one or two individuals.

Why is that nurses seem to be the only profession that openly mocks other nurses for seeking advanced education?

Just because I support advocating the transition to the DNP as the future I don't think I will ever put down another APN because of whatever degree they happen to have or not have.

synaptic · Jul 31, 2015

I wonder if the other health professions debate each other like this. I'm not saying this mockingly, I just wonder if they do. Nursing seems to have the most complex array of education options of around. I suppose medical fellowships provide a large array also but those add specific skills to a providers belt. I'm not saying that a dnp does not but the benefits of different nursing degrees seem to have hazier borders than other medical/health professions

IsabelK · Jul 31, 2015

IsabelK, you are a rockstar!! Rock on! Congrats on your accomplishments - it is inspiring!!!

Thank you Let me know if you just need to talk....

Nurse2long · Jul 31, 2015

Thanks for presenting the evidence wtbcrna!

Jules A, MSN · Jul 31, 2015

I would like to see what happened to the salaries of NPs during the transition to MSN.

I would also and I guess this means you did not receive a significant increase from getting your DNP? That is probably my biggest complaint not just the designation itself or loose admissions but that only in nursing would we accept that spending thousands of dollars and years of our time without being significantly compensated is acceptable and even pleasurable. Again just a personal thing but when it comes to my professional life I manage it like a business person and expect to be compensated appropriately. When I read about NPs making less than I made as a RN it blows my mind.

No clue about how other professions interact with each other but I would say simply based on the ridiculous number of options we have to get letters behind our names as nurses likely contributes to some of the contention. There are people still saying LPNs are going to be phased out and I have heard that since the early 80s. I received an email from a nurse in administration recently and she listed 7 sets of ABCs after her name in the signature. To me that is just ridiculous and I think if we stopped "protesting too much" and simply fostered competent hands on clinicians with extensive prescribing skills at the NP level we would be more respected and have more of a feeling of community.

PG2018 · Jul 31, 2015

The rationale behind the DNP blows my mind. The cheapest program in the country is still too expensive in relation to the salary increases that adding DNP to one's name will bring about. If one truly wants to learn more about "research translation" then I recommend the DNP, but how many nurses really want to learn more about that? How many of us wake up one day wanting to take a series of classes through which we do research and draft a policy change? Well, I had two research courses in my MSN program. One was an exactly replica of my undergrad research methodology, and the other was called research utilization for advanced practice (or something similar). In it, we did a lot of research, drafted a series of documents, and ultimately drafted a policy change for an area psych hospital. Of course, insurance won't reimburse it so it was never implemented, LOL. Despite this, what will the DNP do for you and do for nusing?

Ok, many nurses will be doctors. Many will probably move into higher ed since they get to avoid the true, grand daddy of research degrees - the illustrious PhD. Unless the DNP includes a new practice certification, no one is going to increase their scope of practice. Few will make more money. The woman who managed my PMHNP program makes 60% of what I make, in her primary job, and she has the "real" doctorate - the PhD and REAL research behind her name. (She actually does fMRI work.) Many will remain RNs and move into some type of management role or stay on the floor rolling patients and fetching juice. I really felt most of what I did as a RN could have been OJT rather than university BSN preparation.

I'm not offended when people choose to study research translation or the handful of healthcare management courses that DNP programs include. It does tick me off when people say something akin to "if you want to learn medicine go to medical school." You know that makes sense. If I had been interested in healthcare in my youth I would've likely done that. However, I became a NP because it allowed me to pursue an area of interest and continue living my life. There was nothing altruistic about it, yet BECAUSE I'm a NP I see that other NPs are being churned out of their "respective" NP prep programs deficiently trained. Yes, cite the research that says NPs do equal jobs. I'll dig up the research that says we spend more money on diagnostics and spend too long with patients so we in effect render ourselves moot. When you examine economics you have to examine everything. There's no reason a NP can't learn the science of medicine, apply it to his or her field, and make a lot of money doing it.

I get it. The DNP isn't just for NPs, yet I think nursing continues to do itself a disservice by allowing a DNP to exist in our present manner of education. We are not going to soon see hordes of nurses changing the way healthcare is presented because they have a DNP. We will continue to see RNs trained in apprentice/diploma programs. We continue to offer an associate's degree in nursing, and we continue to champion university preparation with BSNs. We preach that BSN kids are going to become managers only to hit the hospitals rolling patients and fetching juice. Economically, I think hospitals need less RNs and more techs. Throw in this LPN creature and you've got an even more peculiar beast to tame. And then of course we have the APRNs. Are they CNS's, NPs, CRNAs, CNMs...? You know, from state to state, a physician does pretty much the same thing. Across the nation, APRNs are quite variable both in terms of training, legal scope, and job function. At a time when medicine is starting to realize we've been spending too much time and money training physicians we need to look inwardly as well. It's time we decide how one will become a nurse and advanced practice nurse. We need to demand this. Decide what is important and what isn't. For a BSN going to medsurg it's not community health and informatics. For a NP going to clinic it's not the theories of Orem, Leninger, and dozens of others past nurses. For those budding DNPs, just what is going to be your role?

allnurses Guide · Jul 31, 2015

I am active duty military so my salary wouldn't change as a nurse no matter what degree I get.

Having my doctorate does make me more competitive for promotion and the eligibility to work full time in academia while on active duty.

PG2018 · Jul 31, 2015

I am active duty military so my salary wouldn't change as a nurse no matter what degree I get.
Having my doctorate does make me more competitive for promotion and the eligibility to work full time in academia while on active duty.

Not only do I commend your military service, I laud your ability to leverage your DNP. In civilian life, I don't think the add-ons matter as much. Commendations and achievement are honored by the military. For civilian nurses, physicians, pharmacists, nurses, et al don't share that sentiment.

allnurses Guide · Jul 31, 2015

Not only do I commend your military service, I laud your ability to leverage your DNP. In civilian life, I don't think the add-ons matter as much. Commendations and achievement are honored by the military. For civilian nurses, physicians, pharmacists, nurses, et al don't share that sentiment.

I tell colleagues all the time that unless you have specific plans for the DNP/DNAP then it isn't worth getting it at this time or possibly ever. The financial cost outweighs the benefits for most people. I certainly wouldn't have paid 45k just to have someone call me Doctor, which the only time I use my academic title is in educational correspondence.

The focus of the DNP needs to be at the BSN-DNP/APRN level where the students can take 1-2 extra semesters and get their DNP and is much more cost effective.

PG2018 · Jul 31, 2015

I tell colleagues all the time that unless you have specific plans for the DNP/DNAP then it isn't worth getting it at this time or possibly ever. The financial cost outweighs the benefits for most people. I certainly wouldn't have paid 45k just to have someone call me Doctor, which the only time I use my academic title is in educational correspondence.
The focus of the DNP needs to be at the BSN-DNP/APRN level where the students can take 1-2 extra semesters and get their DNP and is much more cost effective.

I'll buy this and have shared the same sentiment. At the expense of still sacrificing some -ologies and clinical training, a DNP can teach some new NPs the business of medicine if they are offered the right courses. The research stuff is extraneous to me, but I've learned that most nurses don't have a clue when it comes to business. For the business of medicine, reaching the maximum number of patients, the most efficiently, with the greatest reimbursement seems second. It seems like a lot of NPs are content to spend a half-hour discussing a lisinopril refill.