NP Education Idea

Specialties NP

Published

Specializes in Skepticism, Anti Quackery.

So I was sitting around thinking and reading a lot of the online debates about MSN versus DNP education. The whole independent practice debate where some NP's say they are "just as good" as Docs. The NP versus PA debates on various forums. So I thought of an idea.... just an idea, nobody chew my head off LOL. It seems that a lot of people agree online programs/diploma mills are hurting the profession correct? I also see most people say that getting their DNP did not change anything clinically, with some even saying it was pointless. So here is an idea I propose..... thoughts.......

Make the MSN an "entry level" degree for NP practice. Leave the curriculum currently how it is. However, NP's with an MSN would have to work under the dreaded word "supervision" or a collaborative agreement.

The NP's that want to work independently would have the option to get their DNP. However, make the DNP tougher with more clinical classes. Heck you could even make it equivalent to MD programs, kinda how DO's did and develop Step 1 USMLE type of tests for licensure. Add in things like gross anatomy, histology, more extensive radiology classes etc. Who knows even make it where graduates from these programs could one day apply to the same residencies as MD/DO's. If NP's want to be taken seriously, especially ones with a DNP then why not?

That is one idea.... the other would be certification changes and increasing the amount of one year NP fellowships....but I'll make a separate post for those LOL........

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Specializes in Nephrology, Cardiology, ER, ICU.

Thinking about your idea.  Here are my thoughts:

1. What about those APRNs who have an MSN and have been practicing very safely for years? I've been in practice for >17 years and practice in an independent state - IL. The physicians I work with are respectful and collegial. 

2. Will there be a pay increase if you have a DNP? (My personal opinion is that its not worth it if there is no increase in pay)

3. You are never going to convince the AMA that an APRN = MD. And again, my opinion here, an APRN doesn't = MD. They are two different education paths. 

 

Food for thought though

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Specializes in Skepticism, Anti Quackery.
traumaRUs said:

Thinking about your idea.  Here are my thoughts:

1. What about those APRNs who have an MSN and have been practicing very safely for years? I've been in practice for >17 years and practice in an independent state - IL. The physicians I work with are respectful and collegial. 

2. Will there be a pay increase if you have a DNP? (My personal opinion is that its not worth it if there is no increase in pay)

3. You are never going to convince the AMA that an APRN = MD. And again, my opinion here, an APRN doesn't = MD. They are two different education paths. 

 

Food for thought though

Great questions..... 

1. I think that these NP's would have to be "grandfathered" in and in order for this to work you would have to say any NP's who graduate January 2025 of later these rules would apply to for example.

2. Yes, there would have to be a pay difference since they would be two different career paths so to speak. 

3. I agree, let me be clear that I do not think an APRN is equivalent to an MD. However, a DNP educational track could be created that is eventually equivalent is my point. The same thing occurred with DO's and could one day happen with DNP's if there are major changes to the current curriculum and process. 

So eventually the goal would be to have the MSN be the dreaded "midlevel" provider that is "supervised" and the DNP is the terminal degree that is independent and more equivalent to an MD. Two different tracks for NP education. Again, just an idea I was thinking about one day........

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Specializes in Psychiatry.

Let me pop that bubble:

Anyone who wanted to do the DNP route would just go the MD route. With those difficult classes added, nursing school could not make as much money as they do on the fluff DNP programs that don't require lab space, so they'd charge more. The loans would equal medical school.

 

And....MORE clinics would hire the MSN prepared ones. Why? They can pay them less and know they can never leave and open their own practice. What benefit does a bean counter have hiring the better trained one demanding higher pay when they can have one who does "just as good" for less pay and can never leave?

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Specializes in Psychiatric and Mental Health NP (PMHNP).

Some food for thought here.  However, IMHO, unless the DNP becomes a clinical degree with additional clinical education and training, it really is not worth it.  

I actually think the MSN is fine, but we need NP residencies.  A 1 year mandatory NP residency would rectify most issues regarding NP education and training.

Doctors have done a great job of policing their medical schools in this country.  NPs need to do the same and stop accrediting crappy, mostly for-profit NP schools!

I believe that in the long run primary care is going to be delivered almost exclusively by NPs and PAs, because primary care is no longer an economically viable specialization for medical students.  And NPs and PAs can handle the vast majority of primary care issues just fine.  I actually believe some primary care issues can also be handled by RNs, like getting vaccinations and simple issues like popping a blister, etc.  

There are also certain specialties like Women's Health and Psych that NPs, CNMs, etc., can certainly handle well.  

One of the reasons MDs are generally of higher quality is that it is HARD to get into medical school.  When NP schools admit pretty much anyone with a pulse, there clearly is going to be a lower standard among NPs.  

Now that I have been an NP for a few years, there are times when I am ashamed to be an NP, based on the behavior of some of my NP colleagues.  

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Specializes in Psychiatry.
FullGlass said:

Some food for thought here.  However, IMHO, unless the DNP becomes a clinical degree with additional clinical education and training, it really is not worth it.  

I actually think the MSN is fine, but we need NP residencies.  A 1 year mandatory NP residency would rectify most issues regarding NP education and training.

Doctors have done a great job of policing their medical schools in this country.  NPs need to do the same and stop accrediting crappy, mostly for-profit NP schools!

I believe that in the long run primary care is going to be delivered almost exclusively by NPs and PAs, because primary care is no longer an economically viable specialization for medical students.  And NPs and PAs can handle the vast majority of primary care issues just fine.  I actually believe some primary care issues can also be handled by RNs, like getting vaccinations and simple issues like popping a blister, etc.  

There are also certain specialties like Women's Health and Psych that NPs, CNMs, etc., can certainly handle well.  

One of the reasons MDs are generally of higher quality is that it is HARD to get into medical school.  When NP schools admit pretty much anyone with a pulse, there clearly is going to be a lower standard among NPs.  

Now that I have been an NP for a few years, there are times when I am ashamed to be an NP, based on the behavior of some of my NP colleagues.  

Well we do agree on this. Close the for profit programs and beef up admissions standards! 

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