Serious question-how do you explain the DNP to the average layperson?
I'm not a NP (MSN-Ed) and I am currently in an education and leadership focused DNP program. I work in nursing education and am excited about the knowledge and opportunities that my advanced studies will bring. While still evolving (and rightly so), I believe that having a terminal practice degree is a great step for nursing. My question, though, is how do you explain what this means to the layperson? I thought I knew, until this week, when I attempted to explain it to my mother-in law. She asked how school was going and then said, "So...are you going to be an NP now?" I offered that it expanded my current skills and knowledge, as well as opportunities for leadership and faculty positions. She just seemed baffled that if it wasn't "seeing patients", what was it? I also made the parallel to the PhD, but pointed out the difference. It was a pretty short conversation as she lost interest quickly...
So, how do you explain the DNP to your friends and family; especially if you are considered part of the educated but non-advanced practice group?
An APRN is already a proven safe and effective provider with outcomes on par with our physician colleagues. The DNP validates the amount of credit hours that APRNs are already having to have, and the DNP incorporates advanced training in research and leadership to ensure the nursing profession is able to grow with future healthcare needs.
The cheaper cost alone has already decided this. MD's would be smart to go into cardiology, hematology/oncology or some type of advanced surgical specialty if they want job security and enough income to pay off their $300,000 student loan debt. In 10 or 15 years all the pediatricians, OBGYN, family practice, hospitalists, almost all anesthesia etc will be provided by APRN's with a DNP and it will cost patients half the cost of todays medical expense. The times, they are a-changin as Bob Dylan would say.
I get the point that you're trying to make - but honestly APRN's are not going to replace doctors in any capacity. I'm sure that there will be some areas that will be more saturated with NP's due to cost savings and lack of MD interest, but there will always be a need for MD's. Thankfully so because neither the MSN-NP nor DSc-NP compares to medical school (often times combined MD/PH.D, MD/MPH) + residency + whatever extra post-residency years that an MD/DO can do. It's really good to know your limits as a provider (scope of practice, knowledge deficits) and know what resources to go to when you get stuck on a case (I'm not just talking browsing Pub-Med, UptoDate, and Med-Scape) but when to call a consult, refer out, or just have a mentor/partner whose knowledge base is wider than yours so you can say "Hey, I think this... what's your take on it?".
If they were speaking as a family practice CRNP then that is a very accurate and astute explanation. Who needs all the excess details when all they are truly wanting to know is can you diagnose, prescribe and treat? "That's right Ma'm but I'll even spend time talking with you and educating and I'll charge you half the cost!" Obama thinks CRNP>MD. Insurance companies think CRNP>MD.
I definitely wouldn't say this is a good thing. Cheaper doesn't always mean better (and it doesn't necessarily mean your services are actually cheaper - in some places NP's get the reimbursement of MD's but are paid out at a lower rate by the employer), and good outcomes doesn't always mean "has the capacity to run the most difficult cases". Anesthesia in some of the states I've worked in is a huge cluster - you've got MD/DO, CRNA, and MA anesthesiologists/Anesthesiology assistants all wanting a job (most have to leave the state for a job).
I'm sure if they could figure out a way to wing it they'd have one CRNA oversee a bunch of Anesthesiology assistants if they thought they could get away with it, maximize the hospitals billing and minimize the payout to the providers - up until a lawsuit happened and then it wouldn't be the Hospital or the Insurance companies taking the hit - it would be the providers.
In one of the states where I've lived we have Obstetricians, Nurse-Midwives, Licensed Midwives (no nursing experience, they are Direct entry and intern under a practicing midwife and take a licensing exam) and unlicensed midwives (intern under a practicing midwife, don't take a licensing exam).
You could just as easily say - well we can just get a Direct entry licensed midwife (way cheaper, even than the nurse midwives) and just have them run labor and delivery (they actually have pretty good outcomes too). But does that replace the education and experience a Nurse-Midwife would have? Does that replace the education and experience an MD or DO obstetrician has? No.
I'm not knocking on the DNP - I admire people that want a terminal degree in their practice area. That's exactly how I would describe it - The DNP is a Non-research oriented doctorate that is a terminal degree for nursing. It doesn't broaden your scope of practice... or make you comparable to a MD/DO but it is the highest degree you can get in nursing.
On a couple occasions I have heard advanced practice DNP students describe themselves as going to "be just like a doctor" (in this case meaning physician).
If they were speaking as a family practice CRNP then that is a very accurate and astute explanation. Who needs all the excess details when all they are truly wanting to know is can you diagnose, prescribe and treat? "That's right Ma'm but I'll even spend time talking with you and educating and I'll charge you half the cost!" Obama thinks CRNP>MD. Insurance companies think CRNP>MD.
The cheaper cost alone has already decided this. MD's would be smart to go into cardiology, hematology/oncology or some type of advanced surgical specialty if they want job security and enough income to pay off their $300,000 student loan debt. In 10 or 15 years all the pediatricians, OBGYN, family practice, hospitalists, almost all anesthesia etc will be provided by APRN's with a DNP and it will cost patients half the cost of todays medical expense. The times, they are a-changin as Bob Dylan would say.
In this climate of seeing continual need to reinforce, educate, and legitimize the role of APRNs, the two above posts are NOT helpful. If any of you has encountered faculty saying any of the above, you are not in a program that is appropriately defining what APRN is. The more brazenly APRNs come out saying, "we'll replace doctors!", the worse that makes APRNs look. We should not want to replace doctors.
There is no "mandate." The only group that has chosen to embrace the mandatory-doctorate concept is the CRNAs, and they have set a date of 2025. The rest of the advanced practice world is not jumping on the AACN's bandwagon (at least, not so far). Yes, plenty of schools are converting their MSN programs to DNP programs, but plenty of others haven't and have indicated they don't intend to. You might want to be sure you understand the facts before you make such sweeping and definitive statements.
Agreed, and to further your point, it is up to the states to make the leap. How many times I feared the DNP in 2015 rumor. My bachelors wasn't done until 2014, and I didn't want to immediately jump back into school. Called my BON. At this time, they haven't even THOUGHT of DNP bring required.
*Just to be clear I'm not aware of what Midwifes are doing in regards to progressing from MSN to DNP.
Lawyers will also love CRNPs, since as soon as babys start dying from complex diseases such as inborn errors of metabolism which were not caught by the CRNPs, the will reap the dollars and enjoy the new ferrari they got from some unprepared nurse practitioner.
So, basically, a role that has existed throughout much of human history (midwifery) and has been recognized as a profession with a professional organization and education requirements for quite some time now, will SUDDENLY!!! stop having good, well-established outcomes and will immediately cause a direct increase in "complex diseases such as inborn errors of metabolism". This will happen because suddenly, all of the well trained and experienced midwives already practicing independently will completely forget how to do their jobs when this horrible future gets here. Someone, quick! Get Europe on the phone! This will be catastrophic to the countries who use mostly midwives! Anyone here from England?!
Another ridiculous comment from a layperson. Your comments alone give away your lack of education. I personally know multiple overall healthy mothers who used midwifes for their delivery of an uncomplicated pregnancy. I'm sure there will be some OBGYN's around for surgical and complex disease process pregnancies.
Anecdote won't get you too far in these conversations.
some nurses think way too highly of themselves. I mean cmon when you have to resort to calling people laypersons to invalidate his or her claim you know you are in fallacy.
Aren't you the same person taunting DNP "dokters" with Seuss-esque rhymes in another thread? I think that thread alone may have invalidated your whole posting history and future for any of us who unfortunately read that garbage. I can't believe you actually may have typed this with a straight face.
I have chips on my shoulder all the time, usually not for long periods since they just dip them in me, but yeah he does. if somebody made fun of my profession i could care less. People get so angry when their profession is spoken of truthfully.
I mean cmon we all know we will never be equal to or replace the docs. Can we do good on our own? YES. does our schooling completely prepare us. NO. Are nurse pracs in england better trained. YES, because you have to work in your specialty for several years before you get to get your prac. And np/pracs are also more specialized over there.
But to those who think we are equal to docs is fallacy. I am sure an NP could be equal to a doctor. if both were practicing for 10 years and the NP took their job more seriously and studying a ton at home. But this is usually not the case.
"We can do everything the doctor can" "We are not meant to replace or compete with doctors" "We do everything just as good as doctors"
All of those phrases come out of the same peoples mouths all the time. Essentially they contradict themselves, 1 and 3 state the same argument, 2 is a contradiction in comparison to the others.
We are providers, for which we take on the easier cases and refer out to the more difficult cases. the DNP will not close the gap. Sorry folks. Its just another letter than lets you do research. And for those who state that it "adds to their practice," then you are pretty much saying we are not ready to practice without it because your saying your patients are not getting top quality care without being treated by a DNP.
Specializes in Nurse Leader specializing in Labor & Delivery.
And for those who state that it "adds to their practice," then you are pretty much saying we are not ready to practice without it because your saying your patients are not getting top quality care without being treated by a DNP.
What you said above makes no sense. Skill and learning are not finite. Physicians read journals and go to conferences (and yes, even get other degrees) because IT ADDS TO THEIR PRACTICE. That does not mean that NOT doing those things makes them incompetent.
An NP without a DNP can be a perfectly competent, knowledgeable practitioner. Desiring more education is NOT tatamount to admitting that their MSN program did not adequately prepare them.
What the hell is wrong with wanting a terminal degree simply for the intrinsic challenge and personal edification?
I have chips on my shoulder all the time, usually not for long periods since they just dip them in me, but yeah he does. if somebody made fun of my profession i could care less. People get so angry when their profession is spoken of truthfully.
I mean cmon we all know we will never be equal to or replace the docs. Can we do good on our own? YES. does our schooling completely prepare us. NO. Are nurse pracs in england better trained. YES, because you have to work in your specialty for several years before you get to get your prac. And np/pracs are also more specialized over there.
But to those who think we are equal to docs is fallacy. I am sure an NP could be equal to a doctor. if both were practicing for 10 years and the NP took their job more seriously and studying a ton at home. But this is usually not the case.
"We can do everything the doctor can" "We are not meant to replace or compete with doctors" "We do everything just as good as doctors"
All of those phrases come out of the same peoples mouths all the time. Essentially they contradict themselves, 1 and 3 state the same argument, 2 is a contradiction in comparison to the others.
We are providers, for which we take on the easier cases and refer out to the more difficult cases. the DNP will not close the gap. Sorry folks. Its just another letter than lets you do research. And for those who state that it "adds to their practice," then you are pretty much saying we are not ready to practice without it because your saying your patients are not getting top quality care without being treated by a DNP.
Wow..Please speak for yourself and not other APRNs, especially not CRNAs.
I have chips on my shoulder all the time, usually not for long periods since they just dip them in me, but yeah he does. if somebody made fun of my profession i could care less. People get so angry when their profession is spoken of truthfully.
I mean cmon we all know we will never be equal to or replace the docs. Can we do good on our own? YES. does our schooling completely prepare us. NO. Are nurse pracs in england better trained. YES, because you have to work in your specialty for several years before you get to get your prac. And np/pracs are also more specialized over there.
But to those who think we are equal to docs is fallacy. I am sure an NP could be equal to a doctor. if both were practicing for 10 years and the NP took their job more seriously and studying a ton at home. But this is usually not the case.
"We can do everything the doctor can" "We are not meant to replace or compete with doctors" "We do everything just as good as doctors"
All of those phrases come out of the same peoples mouths all the time. Essentially they contradict themselves, 1 and 3 state the same argument, 2 is a contradiction in comparison to the others.
We are providers, for which we take on the easier cases and refer out to the more difficult cases. the DNP will not close the gap. Sorry folks. Its just another letter than lets you do research. And for those who state that it "adds to their practice," then you are pretty much saying we are not ready to practice without it because your saying your patients are not getting top quality care without being treated by a DNP.
The way online schools are churning out NP these days is frightening... NP/PA have their role in healthcare, but to think DNP will replace FM/IM/OBGYN/Anesthesiologist is shortsighted. I think NP students should ask for a more standardized and rigorous education... But instead of doing that, they are touting the crazy idea that they are equal to MD/DO. The NP curriculum is filled with fluffy stuff instead of hard science...
I get the point that you're trying to make - but honestly APRN's are not going to replace doctors in any capacity. I'm sure that there will be some areas that will be more saturated with NP's due to cost savings and lack of MD interest, but there will always be a need for MD's. Thankfully so because neither the MSN-NP nor DSc-NP compares to medical school (often times combined MD/PH.D, MD/MPH) + residency + whatever extra post-residency years that an MD/DO can do. It's really good to know your limits as a provider (scope of practice, knowledge deficits) and know what resources to go to when you get stuck on a case (I'm not just talking browsing Pub-Med, UptoDate, and Med-Scape) but when to call a consult, refer out, or just have a mentor/partner whose knowledge base is wider than yours so you can say "Hey, I think this... what's your take on it?".
I definitely wouldn't say this is a good thing. Cheaper doesn't always mean better (and it doesn't necessarily mean your services are actually cheaper - in some places NP's get the reimbursement of MD's but are paid out at a lower rate by the employer), and good outcomes doesn't always mean "has the capacity to run the most difficult cases". Anesthesia in some of the states I've worked in is a huge cluster - you've got MD/DO, CRNA, and MA anesthesiologists/Anesthesiology assistants all wanting a job (most have to leave the state for a job).
I'm sure if they could figure out a way to wing it they'd have one CRNA oversee a bunch of Anesthesiology assistants if they thought they could get away with it, maximize the hospitals billing and minimize the payout to the providers - up until a lawsuit happened and then it wouldn't be the Hospital or the Insurance companies taking the hit - it would be the providers.
In one of the states where I've lived we have Obstetricians, Nurse-Midwives, Licensed Midwives (no nursing experience, they are Direct entry and intern under a practicing midwife and take a licensing exam) and unlicensed midwives (intern under a practicing midwife, don't take a licensing exam).
You could just as easily say - well we can just get a Direct entry licensed midwife (way cheaper, even than the nurse midwives) and just have them run labor and delivery (they actually have pretty good outcomes too). But does that replace the education and experience a Nurse-Midwife would have? Does that replace the education and experience an MD or DO obstetrician has? No.
I'm not knocking on the DNP - I admire people that want a terminal degree in their practice area. That's exactly how I would describe it - The DNP is a Non-research oriented doctorate that is a terminal degree for nursing. It doesn't broaden your scope of practice... or make you comparable to a MD/DO but it is the highest degree you can get in nursing.
As WTBCRNA said in a post right above yours, there is no credible research that shows APRN's provide sub par care compared to their MD counterpart, in any area they happen to work in. Of course for advanced cases with difficult pathophysiology you'll do the safe thing and refer the patient to the best person for that particular case. I've worked in an MD's office where I saw him do this very often.
Of course MD/DO's will not disappear or even become rare to find. They are an important and valued part of the medical community. There are many places in the US that are considered medically underserved and with the CRNP being added to the list of providers the goal is to provide medical care to even those areas. The other goal is decrease the cost of healthcare because I think anyone with a calculator can agree the costs are astronomical.
As I learned in nursing school from my doctorate prepared professors, your opinion is only as good as the credible research it's based on.
The way online schools are churning out NP these days is frightening... NP/PA have their role in healthcare, but to think DNP will replace FM/IM/OBGYN/Anesthesiologist is shortsighted. I think NP students should ask for a more standardized and rigorous education... But instead of doing that, they are touting the crazy idea that they are equal to MD/DO. The NP curriculum is filled with fluffy stuff instead of hard science...
AndersRN, what exactly is your background? I am having difficulty believing that you are even an RN. Every post that you have made is denigrating the DNP and APRNs in general. Since you profess not to have a DNP or are an APRN what exactly gives you this great insight into the curriculum or profession of APRNs or DNPs. Are you claiming to be an expert based on reading the nursing school webpages showing the curriculums of APRNs and DNPs?..
The idea for APRNs is to provide efficient, safe, cost-effective care working with and/or without physicians in the healthcare system. There isn't one APRN school or APRN association that advocates the removal/replacement of physicians.
A little history lesson: Anesthesiologists have been seeking to supplant CRNAs not the other way around. CRNAs have been an organized profession a lot longer than MDAs.
AndersRN why don't you post research that shows inferior care by APRNs when compared to physicians surely this should be easy since the AMA and ASA are two of the best funded PACs in United States.
wtbcrna, MSN, DNP, CRNA
5,128 Posts
An APRN is already a proven safe and effective provider with outcomes on par with our physician colleagues. The DNP validates the amount of credit hours that APRNs are already having to have, and the DNP incorporates advanced training in research and leadership to ensure the nursing profession is able to grow with future healthcare needs.