Is there a CLINICAL DNP?

[elkpark]

And I came, Elk, asking if anyone knew of such a beast.

Not to be argumentative, but what you asked was, "... is there such an animal as a CLINICAL doctorate for nurses? Not a PhD. Not a DNP focusing on research and policy. Not an EdD focusing on adult instruction. But rather a clinically-oriented doctorate." And I answered that question, initially briefly, and then at more length. The DNP is the "CLINICAL doctorate," the "clinically-oriented doctorate" in nursing. You are not going to find a nursing degree that is going to give you what you're looking for.

(Oh, and, BTW, where did I say anything that suggests I believe "nursing education ... has been detail deficient"?)

[HOPEforRNs, ADN, BSN, MSN]

I can't say that MSN prepared APRNs are deficient, but I have taken "the 3 Ps" at the graduate nursing level and I'm a little frightened. It was part of a CCNE and regionally accredited NP program. It was shockingly deficient and left me feeling only minimally more knowledgeable. I work with a campus based NP program that also has online versions and the 3 Ps there are very rigorous and do not compare to the ones I took. Perhaps there is a lack of consistency in APRN programs?

[TiffyRN, BSN, PhD]

To reiterate, I'm not looking for a doctorate in practice but rather enhanced scientific and clinical education.

I can't speak to where you would obtain enhanced clinical practice, but the PhD should provide substantial scientific education. My program so far has been extremely heavy on critical appraisal of research, both content & methods. Instruction on statistical methods as well as practical application of said procedures.

We have a couple of FNPs in my cohort looking to take their current knowledge into the research field. Having said that, advanced clinical practice is not a direct part of the curriculum.

[BeachsideRN, ASN]

I'm not familiar with this area as I just a baby nursing student. However I do have previous degrees and experience in healthcare. Sometimes you just don't "get credit for" advancing your education - you just learn things independently that make you a better practitioner. I have seen that in only my first semester of nursing school. Had I not gone above and beyond my text/lecture when studying I would have never gotten a 4.0 this semester. Furthermore, graduate programs tend to teach you the bare basics and you have to fill in the gaps (at least that's how my MPH was). Are there CNE courses available on these areas you feel deficient? (Patho, pharm, diff Dx)?

[PG2018]

There is CME and independent learning. I don't presently want or need a doctorate, but I wanted yo know if I chose to pursue doctoral study could I do in a manner of personal interest. There are a few PhD programs I could enter (experiment am psychology and neurobiology), but they aren't for a professional's schedule. Also, I don't want to derail my present earning power with academics.

[CCuser]

If the DNP focused on all that boring clinical stuff - I wouldn't be interested.

I love what it offers. Anyone can learn body systems. It's all memorization. We learn EKG interpretation in ADN school.

I love the research focus and the broader community focus. To learn how to implement the latest research into practice, and then how to apply it - is great stuff to be a part of.

If I wanted all the specifics of pathophys and disease processes I would of gone to PA school. Nursing is first and foremost a holistic practice, and I hope we NEVER move away from that essence because of "science". There's so much more to a persons overall state of health other than what's going on medically with a specific disease. And nurses fill that gap. Thank goodness. The medically focused providers and caregivers are a dime a dozen. Keep nursing unique.

[PatMac10,RN, RN]

I agree with many Elk Park's comments. I'm not sure if a dramatic reformation of nursing (both graduate and undergraduate) is the true answer to some the issue some have raised. Though improvements can always be made, I'm not sure the definition of of a terminal nursing clinical would mean a heavy core science curriculum.

Our profession, from its roots, has been a technical one. Meaning that we were trained to have practical thinking and skills to complete our jobs. However, as time passed, our training had a metamorphosis/evolution to a blend of education and training Academically, Technically, and Clinically. This all has resulted in the modern professional nurses we see today.

With all of that (I hope I didn't come off to "teachers" Haha), by nature nursing has multiple facets, both clinically and non-clinically. So our education is a very blended one. It is certainly very inclusive of scientific and clinical coursework, but not solely or primarily scientific/clinical.

Biomedical Science Masters Program - Wake Forest University Graduate School of Arts and Sciences Is this program more like what your looking for. It's not a nursing program, but seems to be what your describing.

Sent from the iPhone of PatMac10, RN

[PG2018]

If you think the diagnosis and treatment of illness is all memorization then you're not doing it right. There are countless giants in business. I'm quite the opposite of you. I don't see why a course or degree is necessary to integrate new research into practice trends. Having said that, what about integrating research is holistic?

If the DNP focused on all that boring clinical stuff - I wouldn't be interested.

I love what it offers. Anyone can learn body systems. It's all memorization. We learn EKG interpretation in ADN school.

I love the research focus and the broader community focus. To learn how to implement the latest research into practice, and then how to apply it - is great stuff to be a part of.

If I wanted all the specifics of pathophys and disease processes I would of gone to PA school. Nursing is first and foremost a holistic practice, and I hope we NEVER move away from that essence because of "science". There's so much more to a persons overall state of health other than what's going on medically with a specific disease. And nurses fill that gap. Thank goodness. The medically focused providers and caregivers are a dime a dozen. Keep nursing unique.

[Jules A, MSN]

And you're not going to find what you're looking for in a nursing doctorate. I say that as neither a criticism of you nor a criticism of nursing education. You will need to look elsewhere.

Which I personally think is a shame if in fact the goal is to narrow the gap between nursing and physician education. While I truly love my career I also feel as if our pharmacology and clinical skills at the masters level are bare minimum and it would be amazing and likely increase our credibility if we fostered more actual clinicians rather than "nursing researchers".

[Jules A, MSN]

OP, I'm with you. The rigorous coursework is completely lacking. I'm enrolled in a MSN program right now at a well regarded university and it's a complete joke. It's nothing but useless fluff. Where's the real coursework? When I do actually get to finish a course and say "wow I really learned something valuable" ???

My ideal DNP program would have separate courses (with their associated pharmacology) in:

1. Cardiology (with teaching how to read a 12 lead)

2. Radiology (extensive teaching on reading xrays and CTs/MRIs)

3. Pulmonology

4. Renal

5. Surgery (optional--pick one: general, ortho, etc)

6. Elective (OB-GYn, peds, pain, primary care, etc.)

In addition, I would say add an advanced differential diagnosis course, a course dedicated to the prescribing of controlled substances (since some jurisdictions have a problem with this), a pain management course and an advanced psych course dealing with chemical dependency, and a specific course on when and how to make proper referrals.

I realize this starts to sound similar to medical school but unfortunately, those pushing the DNP are stating that "Dr. Nurse" is equivalent to "Dr. Doctor". So advanced practice nurses need to have some of that material if they are to fill the primary care void.

I feel like the bottom line with the DNP is that it is a back handed way to get more academics, not improve practice. It is an academic wolf in clinical sheep's clothing. That doesn't make it a bad degree, but certainly not what is needed. But, no one will listen because it makes sense. To the powers that be, sensibility and practicality are for fools. Ivory towers for the elite

Please send the application package for this program to my home address. I'd consider this even if it didn't increase my income and that is saying something, lol. That there are so few NP programs with an addictions course is disgraceful. Even at my well respected, brick and mortar pysch-np program it was an elective. Does that make any sense at all?

Consider adding a business course to address the number of NPs taking whatever crumb is tossed in their general direction because they are pursuing their dreams, it isn't all about money and "who else would do it if I don't?".

So before anyone wastes their time worrying about my disdain or lack there of for my peers I will address it up front. :) I have a love:hate relationship with NPs and in my experience I have found them to largely be either amazing or lukewarm and I am tired of having to constantly prove my worth due to those who have no business sense and minimal clinical skills.

[CCuser]

There are many different careers that carry the title Dr. This does not mean they need to think like a medical doctor. The same with nursing. The DNP is a Doctor of Nursing Practice, not a Dr of Medical Practice. We have too many providers now all prescription happy and focused on pharmacology and disease management. The role of nursing is geared more toward wellness, prevention and healing - not curing.

That's the difference. We need less science and more spirit. We need less chemicals and more caring and nurturing. The future of nursing lies in our ability to see the difference between curing and healing, and focus on the most optimum outcome for the patient. And sometimes - more often than not - that involves less med management and fewer diagnostic studies. The future of nursing will only change when we have the courage to claim our place in the healthcare profession as total care providers, body mind and soul. The very foundation it was built upon.

I'm sorry but I think most APRN set themselves up for frustration when they continue to beat the same drum of competing with a medical doctor or a PA. We are not the same.

And if you haven't grasped that this far into your education, then maybe perhaps your the one that is "doing it wrong".

[elkpark]

Which I personally think is a shame if in fact the goal is to narrow the gap between nursing and physician education.

What if that's not the goal? (Who said it is the goal?) Again, is there some evidence that the current generations of advanced practice nurses (excluding the occasional, individual "bad apple" to be found in any profession) are providing substandard, inferior, unsafe care, that would justify the need to dramatically revamp advanced practice education in nursing?

While I will happily agree that there are too many low-quality graduate programs "out there" in nursing, the diploma mills that have sprung up like mushrooms after a spring rain, and would love to see a much smaller number of programs that were all of good quality (and I feel the same way about prelicensure nursing programs, for that matter -- far too many of them, and far too many poor quality programs), IMO, that is a different discussion than completely reworking the basic educational model.

There is always going to be "more" to know. I know any number of physicians, experts in their field, who feel frustrated about how much more there is to know, and how much better a job they could do if only they knew everything. But it ain't going to happen. People who feel they want/need further knowledge and education are free and welcome to seek that out. But there is always a tension between "nice to know" and "need to know." As with prelicensure nursing programs, the goal of the advanced practice educational program is to get you "in the door" and started practicing (at a novice, entry level), not to turn out a finished, perfect mature clinician. It is the responsibility of each individual nurse to continue to grow and develop professionally throughout our careers.