NPs practicing as DRs

[SkiBumNP]

This has been a heated discussion between some of my friends and I, so I thought I would bring it to the forum.

Should people who are going through a DNP programs and taking the SAME test we all took for our MSN - NP for national certification think their education 'doctorate" is a clinical doctorate?

Until there is a national standard and an elevation of the test (think along the USMLE) then I think anyone who thinks their DNP is a clinical doctorate is a joke.

your thoughts. . . . .?

[PMFB-RN, RN]

Lots of fluff in the MSN programs too, but the fluff does not take place of the hard core stuff. I think they do that because it keeps it nursing. I had no idea that CRNA's had fluff too. Makes me feel a lil better. And I agree, why not make the programs DNP as is if that is truly the case. I looked at a program around me for the DNP (just in case they make me get it) and its essentially the same classes in the MSN program but just with higher numbers ie NUR 700 instead of NUR 500. IDK. I think it has a lot to do with politics and $$$. No offense to anyone :)

*** The DNP CRNA program at my hospital did not add a single hour of clinical or anestesia related class whent they changed to DNP. Students first do a year of DNP classes and projects then enter the EXACT same CRNA education the previous MSN students recieved. Of course the whole program is much more expensive that it was as an MSN program and a year longer. In addition to the more expensive tution the extra year adds $200K to the cost of becoming a CRNA ( figuring a years lost income based on what my friend made his first year as a CRNA). My friend barrowed $60K a year to support his family and himself while he was in CRNA school. So now instead of a school that cost him $35K plus $120K for living expence for a total of $155K we now have a cost of $470K ($90K for DNP, $180K for living expence, $200K in lost wages).

Hmmm........

$155K

vs

$470K

for the exact same anestesia education and for a job that pays no more than those with an MSN get paid. How is this a benifit? CRNAs have been an safe, effective and econonmical alternative to MDAs. The relitivly lower cost of anestesia services provided by CRNAs has allowed high qualiety anestesia to be provided in settings like rural and inner city hospitals that other wise would not be available. What is the motivation for the DNP again?

[msn10]

or the exact same anestesia education and for a job that pays no more than those with an MSN get paid. How is this a benifit? CRNAs have been an safe, effective and econonmical alternative to MDAs. The relitivly lower cost of anestesia services provided by CRNAs has allowed high qualiety anestesia to be provided in settings like rural and inner city hospitals that other wise would not be available. What is the motivation for the DNP again?

Yeah, to be honest, I don't know if there is a great deal of financial benefit for the NP. I would think that if someone wanted a terminal degree in their field then they would just get a PhD. I know that people think that the schools make more money for housing a DNP, but really, the start up cost for the university was Astronomical. Again, the CRNA program was even more than the cost of starting and running other DNP programs so it has been scrapped. If the university does not have successful programs as in your example, then that is a lot of money wasted for both the student and the university.

NP's were not getting the same credits as other masters programs. But at the end of the day, nurses always had more course work than other majors like business majors or history for example. Our clinical and lab classes never really counted in all of our hours. I am not necessarily a proponent of a DNP, but I had to get one for work. I can't teach without a DNP or PhD. I liked the DNP route better because it is not a 'publish or perish' mentality. Again, it is all about the program.

[Tinabeanrn]

PMFB-RN question, question for you. Your friend had to get a DNP from the hospital you guys work at? They don't offer a MSN/CRNA? (Unsure of the proper terms). I thought the deadline for CRNA's was 2020. Are they not being for lack of a better term "grandfathered" in?

And I have the same question as you, what is the exact purpose outside of it being a terminal degree. Why make the master degree RN gets a DNP? Unless you want to teach like MSN10. That I completely understand. I still think it should be a choice. Especially if there is no value added to managing patients. Just saying.. I support those who want to get it, more power to them. I just dont see why they are pushing so hard to make it the end all be all. At my school they have started a DNP program which you have to be an experienced NP to get into. The instructor that is starting the program says that they are keeping the MSN/FNP program and have no plans on changing that unless forced. But several schools in my area only offer DNP now. And the MSN programs are getting flooded with applicants so they can avoid getting there DNP later on. My instructor says that forcing the DNP is going to close college programs that do not offer Doctorates and only offer Masters degrees... Seems a bit ridiculous to me.

[msn10]

my instructor says that forcing the dnp is going to close college programs that do not offer doctorates and only offer masters degrees... seems a bit ridiculous to me.

i think your instructor is absolutely right. i work at a very large university/hospital organization and we have the resources to go dnp, but most do not. ironically, we still have our msn programs as well.

pmfb

fwiw the hospital where i work has a dnp crna program in association with a state university. one of the main clinical instructors tells me that the qualiety of applicants has dropped dramaticaly since they went to dnp.

as a fellow wisconsinite, i know the program you are talking about and that is too bad. on of our large hospitals in the north has about half of their crna's from that program (masters graduates) and they are phenomenal. hate to see what is going to happen if that organization looses their good reputation for competent graduates.

[nursegirl2001]

Ok I absolutely loved this post !!!!!!!!!! How soooooo very true !!!!

[nomadcrna, DNP, CRNA, NP]

Yep, and what he says is the truth, I'm sure.

I don't know of any CRNA programs that are "full of fluff". Personally I think that is a load of bull.

Because one student did his thesis on med errors, really? So you extrapolate that to "CRNA programs are full of fluff"? WOW.

I did my research project on epidural vs intercostal blocks for postop pain management in the open chole (shows how long ago I went to school). Does that mean anything? Not really.

*** If that were REALLY the motivation behind the push for DNP and entry to advanced practice then why don't we simply award the DNP to those completeing the over long current programs? If the issue is that NPs & CRNAs are working too hard to only recive a masters (and I don't buy that) then why not simply award them a DNP for the programs as is? This would still allow the schools to charge the crazy high tution they got for doctorate credits but save the students a year or more?

I can't speak for NP programs as I am not really familiar with what the requirements are, however CRNA programs are already full of fluff. My roomate who graduated last August spent 3 months doing his thesis on the subject of medical errors. A worthy topic for sure but not directly related to becoming a competent CRNA. It's silly to take a program already too heavy on fluff and add yet more fluff while in the process dramaticaly increasing the cost and time burden on students.

Is there some evidence that graduates of MSN programs are not competent practioners?

FWIW the hospital where I work has a DNP CRNA program in association with a state university. One of the main clinical instructors tells me that the qualiety of applicants has dropped dramaticaly since they went to DNP. There are four other non DNP CRNA programs in the area that are attracting the highest qualiety students according to him.

[nomadcrna, DNP, CRNA, NP]

I hope they teach the DNP students how to spell. :)

*** The DNP CRNA program at my hospital did not add a single hour of clinical or anestesia related class whent they changed to DNP. Students first do a year of DNP classes and projects then enter the EXACT same CRNA education the previous MSN students recieved. Of course the whole program is much more expensive that it was as an MSN program and a year longer. In addition to the more expensive tution the extra year adds $200K to the cost of becoming a CRNA ( figuring a years lost income based on what my friend made his first year as a CRNA). My friend barrowed $60K a year to support his family and himself while he was in CRNA school. So now instead of a school that cost him $35K plus $120K for living expence for a total of $155K we now have a cost of $470K ($90K for DNP, $180K for living expence, $200K in lost wages).

Hmmm........

$155K

vs

$470K

for the exact same anestesia education and for a job that pays no more than those with an MSN get paid. How is this a benifit? CRNAs have been an safe, effective and econonmical alternative to MDAs. The relitivly lower cost of anestesia services provided by CRNAs has allowed high qualiety anestesia to be provided in settings like rural and inner city hospitals that other wise would not be available. What is the motivation for the DNP again?

[nursegirl2001]

I love this statement because it is soooo true !! We need to also write state legislatures and oppose this mandatory DNP hooey!! We already lag as a profession and the mandatory DNP issue will just further forfeit already compromised patient care and disparity. America is such a title conscious country that it's sickening. We need to forget about our egos and focus on professional unity and quality patient care! Excellent post !!!!

[Tinabeanrn]

Amen Nursegirl2001. It is just causing division and more confusion. Too many tracts to be able to the exact same thing clinically. I.E direct entry MSN (just learned about this today on here), MSN/NP, BSN to DNP, MSN to DNP, RN to MSN or RN to DNP. Seriously? A ton of tracts to do the exact same job when you graduate. That's what makes us lack as a profession.

[nursegirl2001]

Tinabeanrn:

Well said !!!!!!!!!!!!!!!!!!!!!!!!!!1

[PMFB-RN, RN]

Yeah, to be honest, I don't know if there is a great deal of financial benefit for the NP. I would think that if someone wanted a terminal degree in their field then they would just get a PhD. I know that people think that the schools make more money for housing a DNP, but really, the start up cost for the university was Astronomical. Again, the CRNA program was even more than the cost of starting and running other DNP programs so it has been scrapped. If the university does not have successful programs as in your example, then that is a lot of money wasted for both the student and the university.

NP's were not getting the same credits as other masters programs. But at the end of the day, nurses always had more course work than other majors like business majors or history for example. Our clinical and lab classes never really counted in all of our hours. I am not necessarily a proponent of a DNP, but I had to get one for work. I can't teach without a DNP or PhD. I liked the DNP route better because it is not a 'publish or perish' mentality. Again, it is all about the program.

*** Don't get me wrong, a DNP as a terminal degree seems like a great idea. I am opposed to the DNP as entry to advanced practice.

[PMFB-RN, RN]

yep, and what he says is the truth, i'm sure.

i don't know of any crna programs that are "full of fluff". personally i think that is a load of bull.

*** i can speak for three programs here in the upper midwest based on my close personal friends / roommates who have attending them. i have observed what they are studying. the fluff opinion is shared by them.

because one student did his thesis on med errors, really? so you extrapolate that to "crna programs are full of fluff"? wow.

*** oh don't be silly. nobody said that. that was simply one example. if you would like more i can provide them.