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. . . . .?

[nursetim, NP]

I remember when it was supposed to be, now it has been subverted into another piece of evidence that nursing has a humongous inferiority complex.

[Laboratorian]

I was at the clinic today for a checkup and the doctor introduced herself.....

"Hi, I'm Dr. Happyface, nurse practitioner."

I told her about the debate going on online & in her opinion she went to school and earned a doctorate so she is a doctor.

[jilljw]

If the DNP could pass all the USMLE Steps and oral boards. With additional residency time. I would welcome them to be called DNP in clinic. Not doctor. It is deceiving your patients who are not educated on the difference. After all we are there to serve their best interest not our own. I feel that those who call themselves "doctor" in a clinical setting have buyers remorse. This is too bad. I am happy being an ANP and fitting into the medicine model. We fill an important role. Having a DNP or PhD is a personal achievement. You should not have to feel like you are less of a practitioner by not carrying the title. My husband got his DsC of Emergency Medicine through the Army's Baylor program. He would never think of being called doctor in a clinical setting. He goes by his first name. That is it. His terminal degree is a personal achievement and more importantly gave him more practical skills he can use to benefit patients. Why not be proud of our profession as an ANP?

[jilljw]

PAs get a 4-6 week rotation through psych. FNPs get a full semester of psych didatic which builds on our previous didatic psych and clinical psych rotations in our RN education. That is one reason it is difficult comparing apples to apples. Many RNs have worked for years in ICUs, ER, cardiology etc before going to NP school.

Look at the job postings. I can't find even one ad for a psych PA but many for psych NPs.

Now that being said. With the psych education of the two groups. Do you really think either one is prepared to manage psych patients? I don't.

A pysch NP receives much more education and training, sorry core0. What you surmise is simply not true.

The same goes for ortho, ER or any other specialty. You MUST have additional training that is provided on the job, period (for both PA and NP).

I agree that PA's get less psych rotations than an NP going into psych. However, NPs likely do not get even close to the amount of ER time that a PA gets, both didactically and clinically. My husband had to do 200 hours of ER pt. time outside of a 8 week ER rotation in PA school. This was time spent on weekends and at night outside his other rotations. He also has countless trauma courses he has completed in the military. On top of that he did a 18 month DsC in Emergency medicine. Not too many NP's I know with that experience.

[nomadcrna, DNP, CRNA, NP]

And?

My point is that NO pa or np is qualified to solo an ER right out of school. This includes your husband. I also was in the army (doing anesthesia). I worked with the army trained PAs. Army had a great program but they still could not function in the ER alone without additional training.

My point was the additional training is needed to specialize. Many of us have had "countless trauma courses" in the military and civilian world. I'm not sure exactly what that has to do with the discussion on basic PA and NP education and being ready to function in a specialty.

This is not a PA vs NP discussion.

I've said it before and will repeat myself. Functionally, there is no difference in PAs and NPs. There are good and bad in both professions.

I'm sorry your ANP program was not as good as you would have liked. There are many other great programs.

[nursetim, NP]

I worked with a DNP briefly who intro himself as "doctor Whojewhatit", the scheduling people would refer to all of us as Dr. Whoever, PA, NP, or MD, made no difference. I got tired of correcting people every visit. I got to where I would only correct them if I thought they were , or likely to be seriously confused.What does a DNP do for you? Does it mean more money? No Does it confer admitting privileges? Does it get you a great deal more clinical time? Not any more. I intend to use the "Dr." title outside of clinic. That and it keeps my wife happy and as the saying goes "happy wife, happy life."

[LookingAhead]

A small point: there are clinically-focused DNP programs that include significant clinical components, including U Texas-Houston, U Tennessee-Memphis, and Columbia.

[jilljw]

Just stating that the educations are not the same. Psych NP is going to get more training than a PA is in psych. Most PA's get way more training in ER than NP. Of course, we all need more training after school. That is why MD/DO has residency. He didn't solo an ER until after 6 yrs. of practice. I am not making this an NP vs PA thing. Just stating there are differences in the education. To assume they are the same is not true.

** side note- I doubt civilian courses have same level trauma courses as military. Live tissue labs. They cannot afford it!

[nomadcrna, DNP, CRNA, NP]

I've done both military and civilian and yes, many civilian programs have tissue labs.

I did the goat labs in the Army. Two of them.

Interesting but not a big deal in regards to actually learning anything.

I found the static tissue labs a much better learning experience.

Again, I'm sorry your Adult NP program was lacking. Many FNP and ACNP programs are very good. There are ER NP programs such as Vanderbilts FNP/ACNP program that are outstanding.

So you see you can't throw such a broad loop when all you have to go on is your husband's PA program and your adult NP program.

So it would be accurate to say that your husbands PA program was much better and more involved than YOUR NP program.

No offense intended to PAs but actually they cannot "solo" an ER. They have to have physician backup.

I've know many that could but unfortunately the laws will not allow it.

[PMFB-RN, RN]

so it would be accurate to say that your husbands pa program was much better and more involved than your np program.

*** nursing has further demonstrated it's own lack of self esteem and identity issues buy recommending the dnp for entry into advanced practice. sure it isn't required yet but most of the msn np programs in my region have gone away and all of the public msn np programs have gone away and have dnp in their place. many pa programs are one to two years shorter than dnp programs and dramatical cheaper. i know several nurses who intended to become nps who have now changed to pa for that very reason. i don't know for sure but i suspect many other nurses are making the same decision.

no offense intended to pas but actually they cannot "solo" an er. they have to have physician backup.

i've know many that could but unfortunately the laws will not allow it.

*** what is "solo"? solo must be something different than a pa being the only provider in the er, the only provider in the whole hospital with no physician on call. here in wisconsin pas can and are the only provider in the er and often in the hospital, particularly at night. it seems pretty solo to me. in my job as critical care transport nurse we regularly pick up patients from small hospital ers where the only provider in the hospital is a pa. one er pa told me that his physician supervision consisted of a physician reviewing a percentage of his charts.

[jilljw]

I've done both military and civilian and yes, many civilian programs have tissue labs.

I did the goat labs in the Army. Two of them.

Interesting but not a big deal in regards to actually learning anything.

I found the static tissue labs a much better learning experience.

Again, I'm sorry your Adult NP program was lacking. Many FNP and ACNP programs are very good. There are ER NP programs such as Vanderbilts FNP/ACNP program that are outstanding.

So you see you can't throw such a broad loop when all you have to go on is your husband's PA program and your adult NP program.

So it would be accurate to say that your husbands PA program was much better and more involved than YOUR NP program.

No offense intended to PAs but actually they cannot "solo" an ER. They have to have physician backup.

I've know many that could but unfortunately the laws will not allow it.

They also solo in Washington state. My husband has done it as a side job at rural ER. Yes, they need to be able to reach a SP by phone. So do NP's.

Additionally, compare Vanderbilts FNP/ACNP to say my husbands basic MPAS (IPAP). They do much more ER training. Additionally, you cannot compare any NP program to his additional Baylor US Army ER DSc program. They are not the same caliber.

[jilljw]

The tissue labs on civilian side do not have the financial means to support a live tissue lab for trauma. Sure they might do one every now and then, but you are not doing annual training. That would cost way too much. You need a barn with animals or procure them. Vets are suppose to be on site. I am not talking about an animal under anesthetics. Like porcine labs, which still cost a lot of money. I am talking about animals that are fully awake. You induce mass trauma and then manage it. I doubt there are many schools that do that.