HELP DNP vs FNP

nursemaple2 · May 25, 2015

I find DNP confusing myself. I understand there are DNPs of education or management, not just clinical specialties. They don't get an NP. So their operate under an RN license with a DNP.

elkpark · May 25, 2015

I find DNP confusing myself. I understand there are DNPs of education or management, not just clinical specialties. They don't get an NP. So their operate under an RN license with a DNP.

It shouldn't be confusing. The DNP is a degree, and there are many different concentrations ("majors") available, just as the MSN is a degree, and there are many different concentrations available within MSN programs. In addition to education and nursing administration, there are also DNP programs that prepare individuals for the other advanced practice roles (CNM, CRNA, CNS). The fact that the name of degree includes the letters "N" and "P" does not mean that everyone who takes a DNP degree is a nurse practitioner.

elkpark · May 25, 2015

It has nothing to do with people disrespecting doctoral level degrees. It's that someone in a clinical setting besides an MD is being called doctor. No one cares about a PhD in English in a hospital. The same can be said of a DNP.

Of course it's true that "no one cares about a PhD in English in a hospital," but there are lots of doctorally prepared healthcare professionals from disciplines besides medicine, and why is it inappropriate for them to use the standard title for the degree they have earned? My specialty is psych, and, throughout my career, I've worked in settings in which the psychiatrist was Dr. So-and-So and the doctorally prepared psychologists were Dr. Somebody-Else, and no one suggested there was anything wrong with the psychologists using the title commonly associated with their degree, and, heck, even seriously mentally ill individuals didn't have any trouble understanding who was the physician and who was the psychologist, and what the differences were between them. It's just not that big a deal (except, apparently, for some physicians who believe they somehow own the title "Dr." and some nurses who object to it for reasons I can't begin to understand).

IsabelK · May 25, 2015

Then take some extra classes or CEUs. That is not what the DNP is. It's clinical application and can be for NPs or non-NPs. There were more non-NPs in my class than NPs and I learned a lot from them. It's not meant to teach you skills you should have learned already.

And by the way--I took a pharm class in my program.

Jory, MSN, APRN, CNM · May 25, 2015

I have no clue and actually don't recall ever calling a PharmD "Dr". I'm not saying it isn't snarky just that it happens and with regard to nurses our over the top alphabet soup tends to illicit eye rolls especially among physicians. Some of it is probably because now there is a doctorate of everything and as we have discussed in nursing very little weeding out process so everyone and their granny is getting this designation.

I actually do. Years ago, pharmacy school was only a couple of years past your BS and having a doctorate in pharmacy was very rare. Almost all of the "old school" pharmacists that I have met I have referred to as "Dr".

Now that it is the norm, they go by first names in the hospital.

I once schooled a fourth year medical student on the DNP.

The doc I worked for liked to send out referral responses the old fashioned way..on paper. I made sure he got the correct title in the salutation.

I came into his office in front of the medical student and said, "The proper address is Dr. Smith but she is not a medical doctor, she is a nurse practitioner." The medical student LAUGHED.

I said to him the next morning, "I couldn't help but notice you laughed when I explained to the physician about the nurse practitioner having a doctorate...why do you think it's funny?"

He said, "No offense, but I don't think it should be allowed."

I said, "Ok...you are getting ready to graduate from med school..you'll have an MD right?

He said, "Right"

I said, "So you have earned the right to be called Dr. because that is the highest level of education in your field correct?"

He said, "Correct".

I said, "OK...and the day after you graduate...where can you get a job and start working as a physician?"

He said, "Well, I can't..I have to finish a residency first."

I said, "Exactly...she is in independent practice. She doesn't desire to be a physician, if she did, she would have went to medical school. The thought process is different as a nurse practitioner, it's a DIFFERENT focus. She spent at least two years on her master's and then at least two years on her doctorate, that's the same four years post-BS that you put in..therefore, she has earned it. You folks do not have an exclusive right to the title. We need to work together to educate the public. NP's respect your profession, nurse practitioners would like the same courtesy."

Jory, MSN, APRN, CNM · May 25, 2015

It has nothing to do with people disrespecting doctoral level degrees. It's that someone in a clinical setting besides an MD is being called doctor. No one cares about a PhD in English in a hospital. The same can be said of a DNP.

...and this is part of the problem. ACCEPTING this attitude from physicians.

It is not confusing to the public...you educate the public. If you keep letting physicians beat you down, the profession will go down with it.

Be part of the solution, not help them make the problem worse.

synaptic · May 25, 2015

unless people have the urge to teach unless the DNP was free i personally wouldn't go for it. Instead I'm going to get a post masters in pych. because it actually lets me bill for something different and has some economic impact.

If a degree doesn't add to some sort of ability to increase in pay, if its not free, or if you do not want to do research, you have to ask yourself if it is worth going into more debt for. There seem to be many worthless degrees popping up recently. It makes the schools more money but does it really benefit anybody else?

Id rather keep the money in my pocket, because I'm pretty sure me and anybody else who wants to further his or her education can do so by picking up a few books on the topic and reading them, without paying college tuition for something with no monetary benefit.

Just my 2 cents though, may or may not be super accurate advise but hopefully some people will not decide not to make these colleges pockets fatter for no benefit to themselves.

Jules A, MSN · May 25, 2015

We need to work together to educate the public. NP's respect your profession, nurse practitioners would like the same courtesy."

My objections largely come from what I believe to be a deficient NP education on all levels when compared to PAs and MDs. This is compounded by the increasing numbers of people, especially those with no nursing background, who are now being pushed through NP schools both on the masters and doctorate level. If I felt this tract produced superior clinicians I would be supportive but I do not. I'm guessing the old outcome studies we are so fond of will not hold up over the next decade.

Since I have concerns about the quality of NP education in general it is increasingly concerning that the latest trend is to have more nurses educated on a doctorate level without an increase in our true clinical acumen for those who are becoming NPs. I feel the medical model is superior and think all the additional nursing fluff makes us look silly to physicians and physicians are the standard I strive to emulate in my practice. I do not believe the DNP is a superior preparation for a clinician, not that it isn't valuable on other levels, but in my experience we need more NPs who are more skilled with regard to diagnosing and prescribing. If we truly had something comparable to the MD I'd be all over calling us Dr but until then I'm not a fan. It will be interesting to see the comparisons of Masters vs. DNP outcomes.

allnurses Guide · May 25, 2015

Nurses are the worst profession I know of that does not support each other professionally.

Other healthcare professions have had a doctorate degrees for years, decades, or more (podiatrists, dentists, psychologists, pharmacists, ST/OT/PT), but when nurses decide to move to a doctorate degree one of the biggest naysayers for the move is nurses themselves. It isn't just the DNP that nurses do this with either. Nurses argue what entry level RN education is the best no matter what the research states. Nurses continue to tell people that APNs should only be allowed to work under physician supervision despite myriad amount of research that shows the safety and benefits of having APNs work independently. Nurses argue that because we are nurses we shouldn't be allowed to use the title doctor in clinical setting despite having earned the degree even though these same people do not seem to have any problem with other non-physicians using the title doctor in the clinical setting.

The DNP is meant to round out our education at a level that will help make us more qualified to be healthcare leaders, provide recognition for the increased amount of credit hours it takes to earn an APN, and the DNP is meant to help bring research into practice at an accelerated pace. The DNP is a relatively new degree. The essentials of DNP are not perfect and they will never be perfect, but it is starting point and it allows each DNP school to have a wide variability in what they offer. Nurse are not physicians we don't get a DNP and become generalists as medical students do. We get our DNP to further specialize our knowledge.

The DNP is not going get you more money in most cases. The knowledge you get from a DNP most people cannot just pick up a book and learn by themselves. It currently takes about 17 years to bring research into practice. We are spending billions of dollars in the United States trying to increase the rate of bringing quality research into practice. Most nurses even with Masters degrees do not know how to assess quality research and then bring that research into their practice.

Nurses need to respect the effort other nurses put into getting their doctorate (or any degree for that matter), and let those individuals determine how they use the title of doctorate in the clinical or academic setting. Nurses using the title of doctor in the clinical setting does nothing to harm anyone, and only gives those nurse a chance to further educate patients and others on the abilities/education nurses can and do bring to healthcare.

"We have met the biggest enemy of nursing and it is nurse themselves."

Anonymous1257 · May 25, 2015

Elkpark these are clinical specialists using their title in clinical settings. Please read my post more closely before attempting o correct me. The DNP is not currently viewed as this by many, hence what I said previously.

wtbcrna a very well written post and I think it highlights the disorganization within the profession. My concern, and the concerns of many I speak with who look down on the DNP, is that it seems to only exist to put money into the pockets of schools. It qualifies the holder for virtually nothing that an MSN doesn't already qualify the holder for, and can be earned in shady, disreputable online schools. Would you have surgery performed by someone who earned his or her degree online? Why on earth does a nurse holding an MSN need two extra years to earn a DNP, but three-year bridge BSN-DNP programs exist? Can anyone be expected to take that seriously?Dramatics aside, it breeds disrespect for the DNP as a clinical degree, as a doctoral degree, and for the profession as a whole. If the educational process involved in earning the degree can be standardized at the highest levels and clearly defined (you need look no further than these forums to understand that even many nurses have no idea what the DNP is or what is meant to be) then it stands to further our profession greatly. The critics, like myself, need to see that happen before jumping on the bandwagon and being sniggered at by the rest of the medical field.

Elvish, BSN, DNP, RN, NP · May 25, 2015

It qualifies the holder for virtually nothing that an MSN doesn't already qualify the holder for, and can be earned in shady, disreputable online schools. Would you have surgery performed by someone who earned his or her degree online? Why on earth does a nurse holding an MSN need two extra years to earn a DNP, but three-year bridge BSN-DNP programs exist?

My 'three-year bridge BSN-DNP program' is actually 8 semesters, it just looks like three years because they give us a full load in the intervening summer semesters as well as spring and fall. Most of the didactic learning is online because we are from all over the state, but our school is an actual brick-and-mortar school that we actually have to go to for several days a semester. Clinical rotations we do closer to home.

Your post isn't making a strong argument against the DNP, it's making a strong argument for doing away with shady online schools that don't provide a rigorous education. I've got no problem with people who want to use a title for a degree they've worked for.

Anonymous1257 · May 25, 2015

Your post isn't making a strong argument against the DNP, it's making a strong argument for doing away with shady online schools that don't provide a rigorous education.

You've hit the nail on the head my friend! This is exactly what I want and is exactly what needs to happen if we ever expect our clinical doctorate to be treated as more than a piece of paper. As I've stated a number of times, I believe a clinical doctorate for APRNs has incredible potential to further our field. I also believe, for the reasons I've stated in previous posts, that the current state of the DNP on the whole is insufficient.

As to your personal example, thank you for sharing. So 8 semesters including summers is actually a semester shy of three full years, correct? And as to being on campus a few days a semester, I only have to say that there is a great deal of incidental learning that is being missed out on in a scenarios such as these.