I have a problem........

Juan,

Your point about DO programs is taken. My point is that DO's were once not allowed to practice medicine, but in many cases today, no real differentiation is made between MD and DO. We know there is a difference based on the focus of their training. If universal autonomy is the goal of Advanced Practice Nursing, the powers that be had an opportunity with the DNP to create something that, in whatever form it would take, should have addressed the issues constantly thrown at us. This could be done without abandoning the roots of nursing. Advanced Practice is different than bedside nursing and the DNP is a missed chance to remove some of the objections to advanced practice. The goal should have been to come up with something that would put AP nursing in a stronger position clinically. If the current route is the one we agree to continue on, we should accept this and stop whining about the mid-level provider label and quit bucking the states that require physician collaboration. As things stand, I am not totally against either. NP's are excellent and I am an NP student. I want the progression of my profession, but am disappointed that we are so disorganized and discombobulated that the detractors don't have to do anything but sit back and let the foolishness continue. The DNP has value, but cries out as something that academics created in order to guarantee work for themselves as opposed to being something that APRN's really need. You can "theorize" and "research" things to death. Capstones are great but have limited focus and value and sometimes you need to actually 'practice' to get the 'evidence to base things on.' More pro-active people and more clinical/academic focus. That's what we need.

Juan,

Your point about DO programs is taken. My point is that DO's were once not allowed to practice medicine, but in many cases today, no real differentiation is made between MD and DO. We know there is a difference based on the focus of their training.

The ONLY reason there is no longer a differentiation between MD and DO is that the DO programs changed to mimic the MD programs. They just included their osteopathic theory and manipulation techniques. I didn't want to go to medical school. I wanted to continue my education and training to specialize in an area of advance practice. If I wanted to be an MD or DO, I would have gone to MEDICAL school and become one.

I want to practice at the fullest scope of my practice, but not beyond it. I have been well trained to do what I do, which is provide good primary care to families, but I know my limits, use my collaborating docs as needed and refer when appropriate.

I agree, the DNP is still an academic degree, no matter what we keep getting told and I have no desire to go beyond the masters I have to get it because it will in now way help me provide better care to my patients. I might agree that it could help me run a better business, bill better, research better, meet meaningful use better...whatever, but honestly so will a book or conference on those topics.

Juan,

I am glad to hear you say this. I personally do not see mid-level provider as an insult. Yes, a better title may be warranted but I don't agree with the "equal to physician" thing. I believe that we are different, not less, not equal, not more. A necessary part of the health care team. Independence within parameters is a good thing and I think many states' collaborative agreements are too strict, but the attitude of some APN's is a little scary to me. I think if some got what they wanted they would soon find themselves in over their heads. APN salaries do need to improve to reflect the true contribution made and laws need to be enacted to allow practice to the full of the training. That being said, as things are, malpractice insurance for APN's is relatively cheap and that is something to be thankful for. Again, the powers that be missed the boat with the DNP. That being the case, we are all responsible for our own professional growth. That includes those who wish to enter the profession but seem to struggle with some concepts basic to APN's.

Our hospital just changed from MLP to APP for "Advanced Practice Provider".

I think I like this one better than any of the others I've heard. Good deal!

My DNP education did make me a better provider than I would have been without it, and it was most definitely clinically focused. I shun all titles except "Nurse Practitioner." I agree that there should be one certifying body, and I agree that it sometimes appears that the bar or advanced practice is too low in some institutions. I didn't see that at my alma mater, but I have met other NPs that I wonder about. And yes, I see nurses and NPs here on AN that embarrass me and the profession.

BlueDevil, how long did you practice as an NP with your MSN before getting your DNP and it what way do you feel the DNP made you a better provider?

I also agree that one certifying body is needed and that the bar is low in some institutions, but no one seems to agree on how to improve that. The embarrassment is common in the profession, not just here on AN, but also in real life.