NP's calling themselves MD's

TiredMD · May 17, 2008

First of all, the PA that came into your room DID NOT introduce themselves at all...they just assumed that someone else had introduced them properly. To me, that is not only unethical, but unprofessional.

Even worse, I think, because I'm pretty sure the PA heard the RN introduce him and chose not to contradict her statement.

Don't blame all PA's for what one did.

I didn't. That's why I said I was talking about a small minority.

Try researching a few colleges and add the hours up and see how long it takes....then you'll be quite enlightened to how long these programs take and what goes into them.

I think you were guessing that I know nothing about this. But actually I've spent a fair amount of time looking at this very subject.

Here's the facts:

1) At the present time, there is no national consensus on what should constitute the DNP degree, but in general the recommendation from major nursing organizations is that it include approximately 1000hrs of clinical experience. Contrast this to the average of 2400 clinical hours for PA programs, and approximately 12,000 clinical hours for Internal Medicine & Family Practice residency programs (and that doesn't count clinical hours in medical school).

2) The DNP is available in online format, and can be done part-time as well. For example, here's a program that requires 9 credits a semester of classroom work. That's 2-3 classes/semester.

3) The average Doctorate in Nursing, in constrast, is a 3-5 year full-time program. The PhD in nursing has a variable length, but requires not only graduate level course work but also a doctoral dissertation. The DNP, in contrast, is 2-3 years, potentially part-time and online, and has no research/dissertation requirement.

To summarize: Substantially less classroom and research requirements than the traditional nursing doctoral programs, and approximately 1/2 to 1/3 the clinical hours of the PA curriculum. This degree devalues the true nursing doctoral degrees, and seems to serve no purpose beyond the traditional NP programs except to confer the title of "Doctor".

justme1972 · May 17, 2008

1) At the present time, there is no national consensus on what should constitute the DNP degree, but in general the recommendation from major nursing organizations is that it include approximately 1000hrs of clinical experience. Contrast this to the average of 2400 clinical hours for PA programs, and approximately 12,000 clinical hours for Internal Medicine & Family Practice residency programs (and that doesn't count clinical hours in medical school).
We aren't comparing a DNP program to an MD program.
You said that a DNP program required FAR LESS hours than a PhD program in any other field...I am here to tell you that isn't true.
2) The DNP is available in online format, and can be done part-time as well. For example, here's a program that requires 9 credits a semester of classroom work. That's 2-3 classes/semester.
It is not available as an online program at every school, and you must secure a perceptor that is either another DNP level NP or a physician to work under in order to obtain your clinical hours. ONLY the classroom component is available online...you still have to do your clinical hours.
9 credits a semester hour is considered FULL-TIME for ANY graduate program in ANY discipline. Don't compare it to an undergraduate degree, because they are simply not the same. The hours are not the same.
3) The average Doctorate in Nursing, in constrast, is a 3-5 year full-time program. The PhD in nursing has a variable length, but requires not only graduate level course work but also a doctoral dissertation. The DNP, in contrast, is 2-3 years, potentially part-time and online, and has no research/dissertation requirement.
Other than a for-profit college aka University of Phoenix (who by the way, doesn't require a dissertation for ANY of their doctorate-level programs), I would like for you to find and post a DNP program that is LESS than 3 years and does not require a research/dissertation requirement.
The dissertation requirement is PER COLLEGE and not decided by the program. You show me a college that doesn't require a dissertation for a DNP program and I'll show you a college that doesn't require it for any of their other doctorate-level programs either.
FIND ONE and post their curriculum that is NOT a for-profit institution.
To summarize: Substantially less classroom and research requirements than the traditional nursing doctoral programs, and approximately 1/2 to 1/3 the clinical hours of the PA curriculum. This degree devalues the true nursing doctoral degrees, and seems to serve no purpose beyond the traditional NP programs except to confer the title of "Doctor".
The only people that seems to think that the DNP program devalues nursing appears to be drastically uninformed of the DNP process

However, considering you are most likely a medical school student, I can understand where you feel threatened.

justme1972 · May 17, 2008

By the way-I should have my NP finished by 2010, I hope (if I have any brain cells left that is). I will NOT introduce myself as "Dr. Smith your doctor" to any patient I care for. I WILL introduce myself as "Susie Smith your Nurse Practitioner". Why can't people just be content to be who they are????

If you only have your Master's degree, you shouldn't introduce yourself as "Dr. Smith".

You also won't find an NP-PhD programs, they are DNP-NP programs.

Not all nurses with an RN that have PhD are Nurse Practitioners.

I also don't believe in allowing physicians to have exclusive use of the title in a healthcare setting.

TiredMD · May 17, 2008

However, considering you are most likely a medical school student, I can understand where you feel threatened.

:) I wouldn't be so ridiculous as to call myself a doctor unless I had the degree to back it up.

You know, you really ought to google these topics before you issue challenges like "Name one DNP program that is less than 3 years" or "ALL DNP programs require a dissertation."

Here's what comes up on the first page of google when I put in "DNP Curriculum".

University of Tennessee - 2 years, requires "Residency Practicum" rather than dissertation

Case Western - 2 years, requires dissertation or "DNP Project"

University of Arizona - 2.5 years, including an entire semester devoted to oral and written exams

Minnesota State University - 2 years

There's no real need for me to go on.

And you're right, we're not comparing the DNP to the MD degree, though perhaps we ought to be given that both confer independent practice rights to the holder.

But how about comparing it to the PA degree? A PA-C gets 2400 clinical practice hours during their education, and is not licensed to practice independently. A DNP will have approximately 1000 clinical practice hours, but is licensed to practice independently. Doesn't that strike you as odd?

Larry77, RN · May 17, 2008

I think you're mostly wrong about this, but I'll leave the issue to core0, who knows far more about it than I.

I enjoyed this statement...when I tell someone they are mostly wrong I have the courtesy to state how they are wrong.

I know about this topic because I have checked into it d/t my interest in the field. The entry requirements for both NP programs and PA programs do vary but I was stating the most common from both my personal experience and from friends who are already PA's and NP's.

Good day

core0 · May 17, 2008

Where I'm from PA's do not have a master's degree it is similar to the 28 month program she mentioned. It takes an associates degree to get in, some I've met were even RN's when they started the program.
An MA is usually a 1 year program with no prereq's whereas a Nursing assistant is a few weeks.
A NP actually is a master's level trained provider and has many more years of schooling than a PA so please don't confuse that....thanks.

The reason that the particular PA program does not grant a masters is that that PA school is competency based. There is a set of competencies that are based on clinical practice that all PA students have to learn. They can be found here:

http://www.arc-pa.org/Standards/3rdeditionwithPDchangesandregionals4.24.08a.pdf

The instruction is considered at the graduate level but can be given in any facility that meets the standards of accreditation. This allows PA programs to exist in underserved areas where a masters program is not possible. That being said the vast majority of PA programs are masters programs. If you had done any research you would also know that there are a fair number of NPs in practice without any degree. They seem to be doing a good job of providing patient care without a masters.

As far as NPs having many more years of schooling, this fundamentally misrepresents the educational model of the PA. Like medical school, the PA educational model is not based on the traditional semester system. Full time as a PA student does not mean taking 18 hours of classes per semester. It means 30-45 hours of classwork every week. The last report showed an average of 1350 hours of didactic work and more than 2350 clinical hours for 120 surveyed PA programs. This compares favorably with medical school ~3000 didactic hours and 4000 clinical hours. Here is a comparison from Wisconsin (which has a number of issues specific to Wisconsin NPs):

http://www.wapa.org/pdfs/NP-PA%20Comparison%20Chart%20Revised%20Twice.pdf

Now if you are saying that NP programs take longer to cover less material, yes you would be correct:D.

The difference in educational models is due to the difference is roles. PAs are trained as medical and surgical generalists who always work in collaboration with physicians and are trained to work in any area of medicine and surgery. NPs are trained to work in specific area of advanced practice nursing either independently or in collaboration with a physician (depending on the state). Not stating that either is better or worse, just a different way of educating.

To the OP. Pretty much every state requires a PA to identify themselves as a PA and wear a nametag that states their title. A non-doctorally prepared NP would similarly be open to misrepresenting themselves as a physician. There is a long thread on the use of the DNP title in the NP section.

David Carpenter, PA-C

pagandeva2000, LPN · May 18, 2008

Funny that you mention this...one of the (MANY) reasons why we didn't get Magnet was because they felt that our Nurse Practitioners were aligning themselves more with the physicians than with nurses. Some of them are more demanding of nurses than the actual MDs themselves with senseless orders, disrespect and such.

PMHNP10 · May 18, 2008

hmmmm

PMHNP10 · May 18, 2008

I'm an advanced practice nurse in a large nephrology practice. I see dialysis patients 3-4 times per month and the MD sees them once per month. The patients know that I'm not a physician nor have I ever identified myself as such. However, many of my patients, especially my male veterans, do call me "doc." They KNOW I'm not a physician but it is a term of respect. When I'm out in public and run into patients, they frequently greet me by my first name or the title "doc."
There is nothing wrong with this. I am not misrepresenting myself as a physician. I guess I don't see the problem here.

maybe I'm being picky, but once I become a NP I don't particularly look forward to being called a "doc". I am a nurse first and foremost and in some way I'd like to be respectfully identified as one throughout my career; this is where I got my start and will allow me to become a great wholistic healthcare provider

Unfortunately, being called a "prac" comes to close to being called a quack and it's just not as catchy a title as doc either

we need a catchy, short title for NPs..."god" maybe? (lowercase used intentionally; hopefully I won't be struck with lighning in the next couple minutes)

TX_ICU_RN · May 18, 2008

I am about to start my Post-Master's Certification for my Acute Care NP. I spent several years working as a PNP and then took some time off to raise a family. During this time, I spent a lot of time soul-searching on where I wanted my career to go when I re-entered nursing. I started my PhD in nursing and completed 15 hours before deciding that I wanted to stay in clinical practice. I am now working in an adult ICU as a RN to get the experience necessary to become an ACNP. After I become an ACNP in the summer of 2010, I will begin a DNP program.

We can talk about the difference in program clinical hours all day long, but there is one thing that people tend to forget about. By the time I receive my DNP, I will have approximately 20,000 clinical hours between work and school. I would never expect or want to perform cardiac surgery, but there are many things my years of nursing bring to the table. I will PROUDLY use the title of Dr. when I receive my DNP because I will have completed approximately 120 hours of post-bacc coursework for that degree.

wooh, BSN, RN · May 18, 2008

IEven better, now a handful of Ivory Tower nursing school instructors manufacture a "doctorate" degree that is substantially shorter and has fewer requirements than any real PhD in other field, all so you can change how you introduce yourself. No doubt there will soon be many more DNPs than nursing PhDs, since the PhD is so much longer and harder to actually get . . .
I guess the problem of people trying to inflate their own self-esteem by misleading others happens in every field. I know it happens in medicine. Every year there is some medical student who gets caught introducing themselves as "Doctor". Or an intern who refers to himself as "Resident". Of course, in medicine we crush these people. Utterly and completely.

Wow, did you get a DNS to know how much easier it is to get than a PhD? I'd be interested to hear how someone that has both would compare the two. Do you even have a PhD? Usually I somewhat enjoy your posts, but you're talking of things you know NOTHING of now. Do you object to PhDs calling themselves your precious doctor title? They have been using it longer than medical doctors. If anyone gives up the name, I'd vote for the MDs. You earn a doctorate, in anything, you have the right to be proud of it. And the right to call yourself a doctor. And be called a doctor. Just as much as any MD.

MikeyJ, RN · May 18, 2008

If you only have your Master's degree, you shouldn't introduce yourself as "Dr. Smith".
You also won't find an NP-PhD programs, they are DNP-NP programs.
Not all nurses with an RN that have PhD are Nurse Practitioners.
I also don't believe in allowing physicians to have exclusive use of the title in a healthcare setting.

As someone in the nursing field as well, I must admit you are highly mistaken on many things you have posted about the DNP.

And MD/DO should 100% absolutely be the ONLY health professional in a hospital setting be called doctor.

It angers me that DNP's think they should be called "doctor" in the hospital setting -- they are NOT a doctor. A DNP and an MD/DO have totally different educational/training requirements. I dare you to find a fresh DNP graduate and compare them to a fresh MD/DO out of residency -- the DNP is likely to be no where near the MD/DO in managing diseases and diagnosing. I respect those who pursue their DNP and think they are integral practitioners to the health care field, but it is wrong for them to think they should be called doctor because they took a few extra credits in school and completed a "residency" (a DNP residency is a joke).

Furthermore, there are Ph.D.'s walking around my hospital that work in the translation department. Should staff refer to them as "doctors" when around patients? Absolutely not. The term doctor should be used when referring to an MD/DO -- this is not to stroke the ego of a physician, but rather to not confuse the patients who their doctor is.

And in regards to the DNP -- you can get your DNP ONLINE in a 2 year span. 4 years of BSN + 2 or 3 year DNP = 6 or 7 years. MD/DO takes 4 years undergrad, 4 years INTENSE medical school, and 3 - 7+ years of intense residency. MD/DO = 11 - 15+ years of education. There is a huge difference in the two and they should be treated that way.

Sorry to get defensive. But as someone in the nursing field, it bothers me to no end when nurses feel this need to be considered an equal to an MD/DO. We are all equal in terms of a person and should all be treated the same and work together, but there is and should be a clear distinguishing line between the two.