Nurse Practitioner Needed/Not Needed?

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DrCOVID, DNP

462 Posts

Specializes in psych/medical-surgical.
53 minutes ago, FullGlass said:

Finally, I do not find you very credible given that you previously stated becoming an MD is the easy way to make a bunch of money. Good day to yoou.

The fact you keep trying to say this is making me laugh out loud. Have you even read my 3rd and final response to your asinine comments in that other thread?

Instead of focusing on what you think I was trying to say in the past, why exactly would you do an MSN/NP program when you are convinced of this other way and that there is already a great 4 year option? Kinda strange don't you think?

I feel like you are on some other planet. The DNP is a 4 year program like any other doctorate. We go 3 years full time, the three Summer semesters make up what would be the 4th year.

Like where is this change not happening? You are speaking like I'm the one trying to get support to change things LOL... There are no MSN programs at the schools in my city! This is a political/academic movement that is happening. I think you are the lone person out here wanting to keep things where they are because you don't wanna go back to school or learn anything!

FullGlass, BSN, MSN, NP

2 Articles; 1,724 Posts

Specializes in Psychiatric and Mental Health NP (PMHNP).
4 hours ago, adammRN said:

The fact you keep trying to say this is making me laugh out loud. Have you even read my 3rd and final response to your asinine comments in that other thread?

Instead of focusing on what you think I was trying to say in the past, why exactly would you do an MSN/NP program when you are convinced of this other way and that there is already a great 4 year option? Kinda strange don't you think?

I feel like you are on some other planet. The DNP is a 4 year program like any other doctorate. We go 3 years full time, the three Summer semesters make up what would be the 4th year.

Like where is this change not happening? You are speaking like I'm the one trying to get support to change things LOL... There are no MSN programs at the schools in my city! This is a political/academic movement that is happening. I think you are the lone person out here wanting to keep things where they are because you don't wanna go back to school or learn anything!

I am already an NP with an MSN. There are still plenty of MSN NP programs out there.

I am just giving my opinion. I think an MSN with an NP residency would be a better way to go in general. There is a lot of room to improve the current MSN curriculum w/o requiring a DNP. The DNP would still be an option.

My perspective on the DNP is based on what the curriculum for someone like me who already has an MSN. I can do a DNP in one year at many excellent schools given I already have an MSN.

In fact, I do plan to earn a post-master's PMHNP and go on to obtain a DNP in order to teach.

Again, a 2 year MSN and a 1 year residency are much less expensive than 4 years of school. A residency has didactic and clinical components. I fail to see how the DNP is superior to that, since a residency would provide at least 1500 clinical hours, probably more like 1800. I'm saying this because I am sick and tired of escalating higher education costs and requiring more and more education to do the same thing.

Mandating a DNP would also be unfair to experienced NPs with an MSN. There would need to be a provision to grandfather them in.

umbdude, MSN, APRN

1,228 Posts

Specializes in Psych/Mental Health.

DNP is not a solution. Diploma mills have been offering DNPs for a while and they are fully capable to offering BSN-to-DNP programs because they're not accountable for anything to begin with.

IMO, the way to rid diploma mills and other substandard NP programs is to make clinical placement mandatory and increasing clinical hours for accreditation, with the accreditation agency closely monitoring & auditing placement stats of each program. That should cut out a number of programs that never had students' interest first nor will they invest in the clinical placement process. There's already a movement for this, but it needs to be beef'd up.

Another problem is that there are already so many NPs out there who graduated from diploma mills and they don't seem to think that these mills are an issue, thus dividing the community. But I think many will agree with making clinical placement mandatory is a good path forward.

Guest1144461

590 Posts

On 3/2/2020 at 10:30 AM, adammRN said:

The fact you keep trying to say this is making me laugh out loud. Have you even read my 3rd and final response to your asinine comments in that other thread?

Instead of focusing on what you think I was trying to say in the past, why exactly would you do an MSN/NP program when you are convinced of this other way and that there is already a great 4 year option? Kinda strange don't you think?

I feel like you are on some other planet. The DNP is a 4 year program like any other doctorate. We go 3 years full time, the three Summer semesters make up what would be the 4th year.

Like where is this change not happening? You are speaking like I'm the one trying to get support to change things LOL... There are no MSN programs at the schools in my city! This is a political/academic movement that is happening. I think you are the lone person out here wanting to keep things where they are because you don't wanna go back to school or learn anything!

Bro I know this post is old, but you full on drank the Kool-Aid. How about you look at the post-MSN DNP curriculum. It's literally a joke. It's does nothing to substantiate its worth in the clinical setting

I would take my 2.5 year MSN and my year long residency (4000 hours) over a DNP in a heart beat. Like its not even close and not one person in practice cares about it. Not one MD, NP or HR person has every asked me about getting a couple more letter that would add nothing to my skills.

I live in a major city full of academic centers and still no one cares...Also no NP is ever called Dr. in the inpatient setting regardless of the alphabet soup titles.

jfmDNP

18 Posts

Specializes in Cardiology and Family Medicine.

I commend the goal of the DNP in advancing APRN training. But I am of the strong opinion that we need to beef up NP academic training and reevaluate the role of diploma mills in lending credibility to the profession if we want to be a needed and sought after professional by those in the community. Increase clinical hours and clinical content. No nursing theory after theory has ever saved an MI or helped recognize peritonitis. Standardize NP training nationwide! Advocate for fellowships and residencies. And no, this doesn't mean we should just mirror MD/DO training. I'm advocating for expanded clinical training and education mirroring CRNA programs as they are already established, with NP programs simply adopting the same criteria and requirements.

umbdude, MSN, APRN

1,228 Posts

Specializes in Psych/Mental Health.
On 4/10/2020 at 1:15 AM, Numenor said:

How about you look at the post-MSN DNP curriculum. It's literally a joke. It's does nothing to substantiate its worth in the clinical setting

To be fair, the DNP is never about clinical skills and was never sold as such. It's about population health and translating research.

That said, I've looked at many of them and the curriculum is unsettling. I've been considering a post-MSN DNP but I just don't think I can take some of those courses without going insane. The courses teach concepts that many competent NPs can learn by studying a few books. I also find the approach - reading, writing papers, writing more papers relating to projects, and maybe taking an exam here & there - very outdated and not the best way to acquire skills.

Specializes in CVICU, MICU, Burn ICU.
On 4/9/2020 at 10:15 PM, Numenor said:

Bro I know this post is old, but you full on drank the Kool-Aid. How about you look at the post-MSN DNP curriculum. It's literally a joke. It's does nothing to substantiate its worth in the clinical setting

I would take my 2.5 year MSN and my year long residency (4000 hours) over a DNP in a heart beat. Like its not even close and not one person in practice cares about it. Not one MD, NP or HR person has every asked me about getting a couple more letter that would add nothing to my skills.

I live in a major city full of academic centers and still no one cares...Also no NP is ever called Dr. in the inpatient setting regardless of the alphabet soup titles.

I hear this all the time - the DNP curriculum being a joke and all. While there could be improvements made, no doubt, I am not finding my DNP curriculum a joke. There are no "nursing theory" or management courses. It's heavy on research - and some would say too heavy as it's not a PhD program - but I'm doing this degree because I really want to translate research. So I'm fine with my program teaching me how to conduct research, because that's going to absolutely give me an edge in translating it (I am already reaping the benefits of this education and still a year from earning the DNP).

My program, a reputable state institution, holds students accountable for meeting the DNP essentials. This includes gaining new clinical competencies we did not have to gain in our MSN APRN program - though these competencies can (and should) be tailored to our practice specialty.

I have worked with PhDs who did not have a good grasp on how to conduct research. While my DNP program is not going to put me on par with a PhD, who knows what they're doing with design methods and statistical analysis, it is preparing me to be a research and practice leader in my clinical specialty.

Also, and I know this is often not the case, when talking to a potential future employer - an MD - one of the first questions he asked me is if I will have a doctorate. So, the whole "no one cares" about the DNP, just isn't true.

Guest1144461

590 Posts

On 4/15/2020 at 10:17 AM, umbdude said:

To be fair, the DNP is never about clinical skills and was never sold as such. It's about population health and translating research.

That said, I've looked at many of them and the curriculum is unsettling. I've been considering a post-MSN DNP but I just don't think I can take some of those courses without going insane. The courses teach concepts that many competent NPs can learn by studying a few books. I also find the approach - reading, writing papers, writing more papers relating to projects, and maybe taking an exam here & there - very outdated and not the best way to acquire skills.

Not really true. It was labeled from the beginning as a clinical doctorate to distinguish it from DSc or PhDs in nursing. I remember all of this nonsense from its inception.

You got it, total waste of time. A lot of the courses or jumbled up regurgitation of my MSN curriculum. I literally laughed when I took a look.

Guest1144461

590 Posts

On 4/15/2020 at 12:02 PM, WestCoastSunRN said:

I hear this all the time - the DNP curriculum being a joke and all. While there could be improvements made, no doubt, I am not finding my DNP curriculum a joke. There are no "nursing theory" or management courses. It's heavy on research - and some would say too heavy as it's not a PhD program - but I'm doing this degree because I really want to translate research. So I'm fine with my program teaching me how to conduct research, because that's going to absolutely give me an edge in translating it (I am already reaping the benefits of this education and still a year from earning the DNP).

My program, a reputable state institution, holds students accountable for meeting the DNP essentials. This includes gaining new clinical competencies we did not have to gain in our MSN APRN program - though these competencies can (and should) be tailored to our practice specialty.

I have worked with PhDs who did not have a good grasp on how to conduct research. While my DNP program is not going to put me on par with a PhD, who knows what they're doing with design methods and statistical analysis, it is preparing me to be a research and practice leader in my clinical specialty.

Also, and I know this is often not the case, when talking to a potential future employer - an MD - one of the first questions he asked me is if I will have a doctorate. So, the whole "no one cares" about the DNP, just isn't true.

Learning to research is not some esoteric fund of knowledge that requires a doctorate to grasp in any meaningful way. Any standard MSN program provides bio-statistics and literature review/bioinformatics courses to prepare someone to process research for a clinical purposes. Actually conducting research is something completely different and NOT generally applicable to standard clinical practice. What you need to know is how to process information given to you by researchers and apply it to patient care. That's it.

Look, I know you have skin in the game but lets not pretend the average MD or HR rep cares about a doctorate. I had multiple interviews/offers at various jobs, residencies and fellowships and not ONE asked about a doctorate. I am sorry, I do practice as a NP day in and day out and the only thing colleagues care about is your license and if you can prescribe. I am very hesitant to accept your anecdote with any sort of gravity consider the majority of MD literature out there seems rather ignorant on the fact that there even different types of NPs, let alone MSN vs DNP.

In short, get the DNP if you feel like it helps your individual practice. But besides NP organizations making it mandatory (terrible move considering they have bigger issues to fry with the diploma mill online programs and BS curriculum standards), I don't see the DNP being considered solely over an MSN anytime in the future. Experience is all that matters, since new NPs with 600 clinical hours or not that useful in the clinical setting...

Specializes in CVICU, MICU, Burn ICU.
11 minutes ago, Numenor said:

Look, I know you have skin in the game but lets not pretend the average MD or HR rep cares about a doctorate. I had multiple interviews/offers at various jobs, residencies and fellowships and not ONE asked about a doctorate. I am sorry, I do practice as a NP day in and day out and the only thing colleagues care about is your license and if you can prescribe. I am very hesitant to accept your anecdote with any sort of gravity consider the majority of MD literature out there seems rather ignorant on the fact that there even different types of NPs, let alone MSN vs DNP.

Well, trust me, I'm not going to try to convince you I'm truth-telling about my "anecdote" .... also, I am not the one making generalized, sweeping statements about the DNP and APRN practice. I'm not "pretending' anything about what I've asserted. The DNP is a useless degree to you - fine. It's not useless for me and it is for that reason I "have skin in the game".

I am going to take my ball and go home now, because .... frankly, I'm tired, and should have known better to engage in any even slightly serious post. It's been a long day, week... month.

Peace and be well.

Guest1144461

590 Posts

6 minutes ago, WestCoastSunRN said:

Well, trust me, I'm not going to try to convince you I'm truth-telling about my "anecdote" .... also, I am not the one making generalized, sweeping statements about the DNP and APRN practice. I'm not "pretending' anything about what I've asserted. The DNP is a useless degree to you - fine. It's not useless for me and it is for that reason I "have skin in the game".

I am going to take my ball and go home now, because .... frankly, I'm tired, and should have known better to engage in any even slightly serious post. It's been a long day, week... month.

Peace and be well.

Look you can do what you want, but this is the epitome of what wrong with advanced practice nursing. Too focused on fluffed drawn out courses/titles rather than fixing the root of the NP problem which is laughable clinical hours, no program oversight and lack of residencies. We have 600 clinical hours vs a MDs 15000 and NPs are more focused on a nonsensical debate of masters vs doctorate.

Good day.

jfmDNP

18 Posts

Specializes in Cardiology and Family Medicine.

The DNP as a terminal degree is here to stay. While I initially debated on getting mine, in the end I saw value and applicability. Not to mention meeting some of the most talented individuals in the field as a whole and learning directly from them. However, I do believe the profession can build on this and improve the MSN-NP level curriculum. It should mirror the rigor of CRNA programs. We should promote residencies and fellowships. Clinical hours, exposure and experience are fundamental to our training. It can be further formalized and standardized in the academic setting. And even more importantly, we need to reevaluate the value of diploma mills on the profession.

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