Nurses, physicians weigh in on new doctoral nurse degree

[Brian]

New Degree Creates Doctor Nurses-And Confusion

All Things Considered, February 22, 2009

No one wants to badmouth Florence Nightingale, but a new degree for nurses is causing bad blood between doctors and their longtime colleagues. The program confers the title of doctor on nurses, but some in the medical profession say only physicians should call themselves "doctor."

Dr. Steven Knope is a family practitioner in Tucson, Ariz. "If you're on an airline," he jokes, "and a poet with a Ph.D. is there and somebody has a heart attack, and they say 'Is there a doctor in the house?'-should the poet stand up?" Knope laughs. "Of course not."

Physicians such as Knope say the title of doctor implies a certain amount of training, hours in medical school that nurses just don't have. Dr. Ted Epperly, president of the American Association of Family Practitioners, says that while doctors place a high value on nurses, sharing the same title could confuse-and even harm-patients.

Full Story and listen to radio show here:

http://www.npr.org/templates/story/story.php?storyId=100921215

[istat]

To some people of the medical establishment, and you know to who I speak. I am a professional military officer who has completed 3 combat tours(as infantry and after injury an NP). I also have a PhD in Military History. And if any one of your want to try to insist that I should not be addressed as Doctor----you are going to have more of a problem then you'll know how to handle. Lose the pompus arrogant attitude. Just because you completed medical school/residency (and it is quite the accomplishment) it does not give you exclusive ownership of the title "Doctor" by fiat. I do realize that this attitude is not found in a majority of physicians. And how do I know this? Because I've had quite a few of them under my command. And the good one's don't worry about title, they're too busy insuring that quality care is being provided regardless of the level of training.. And so you aware, in a patient care unit I am addressed as Colonel.

And just to be clear. If upper level nursing deleated all the fluff course, there would be enough time to get adequate clinical training. And then maybe this problem would not occur. Nursing should have the ability to obtain a doctorate-but not have one mandated.

[BabyLady, BSN, RN]

Sorry, I didn't make myself clear. I wasn't referring to the specialties, I was referring to primary care. We can replace primary care doctors in a New York second. I know b/c I do it every day!

Ok..I think I understand what you are saying.

In my state, a NP works under the supervision of a physician (in private practice) and cannot admit patients to the hospital. They can admit "on paper" in the name of the physician, but they cannot actually treat the individuals while they are in the hospital (making rounds, etc).

Now, the hospitals, in some specialty areas, do hire NP's as direct employees.

[HazeKomp, BSN, RN]

I have to take the stand that professionals who introduce themselves properly to the patients, families and the public minimize any confusion over the word "doctor".

Physician and Nurse are proper. Doctor is a collegiate degree (well) earned.

At the bedside, I introduce myself as a Registered Nurse .... I do NOT give the patient a discertation on my college degrees or clinical certifications!

[BBFRN, BSN, PhD]

Here's the best rebuttal to this guy's arrogant attitude: http://www.design.caltech.edu/erik/Misc/Doctors.html

Thanks for that. I was waiting for someone in academia to chime in. I have been wondering for some time when this would start happening.

Here's the thing- if the AMA is really serious about this, they need to watch how they frame their argument, lest more academics get involved and lobby for exclusive ownership of the doctor title themselves, for those who have doctorates only.

They may have initially picked the fight with DNPs, but I have a feeling they'll end up fighting academia in the end. I'm not so sure that's a fight they can win, as new physicians are turned out by the universities.

This is not to say that I agree with how Mundinger framed her argument. And I do question some of these programs, which are offering the DNP as a clinical doctorate, without showing evidence of providing a rigorous clinical education framework. Academia needs to step up to the plate, and address this as well.

As out health care system continues to focus more on health promotion and illness prevention, APNs are in a prime position to continue to move this focus forward. I believe they should be allowed to specialize in this at the DNP level, as these tenets are at the core of our profession- and they are things that often need to be implemented in the general clinical setting. I hope to see more coursework focused on this at the doctoral level, in DNP programs.

I'm not against DNPs at all. I just question the direction and focus of some DNP programs.

[birdgrrl]

md = medical doctor. mds are not simply doctors, they are medical doctors. possibly another approach to easing their fears.

[Mexarican]

I would not call my professor or someone with a doctorate in ___fill in the blank___ "doctor" in a clinical setting as to me (and the general public) doctor, in a hospital setting, refers to physician. It is misleading to the public, staff and does not seem to serve a true purpose except to ... ???

There are state BONs that already have standards to NOT use the term doctor in the workplace.. or others that require doctor to be addressed something like, Doctor of nursing... as they realize it is confusing.

I hope you never make the mistake of doing this! If I was a doctorate in education and was YOUR professor...I would have lengthy talk with you for the shear lack of respect of discrediting my educational status!!!! Educate yourself...a Doctorate degree is the pinnacle of ones field...IT DOES NOT MEAN "doctor or medicine" It means "Doctor of ....." That assumption is ignorant, arrogant and severly misinformed! A Doctor of whatever deserves they're title EVERYWHERE! not just out on the street. It is hard earned and should be respected! Doctorate refers to expertise in your respective field...Doctor of Medicine is an expert in medicine, a Doctor of Nursing Practice is an expert in nursing practice, a Doctor of Engineering is an expert in engineering science...are you gettin the point?!?! Must school be in session...where you not taught this in school...this concept is basic knowledge...

Mex

[NRSKarenRN, BSN, RN]

:typing

i'm requesting that our passion for the subject discussed not trigger fingerpointing or name calling per our lovely terms of service to minimize moderator intervention.

[rnboysmom]

Go Manny!!!

[CountyRat]

Just because the professional organization says it is so does not make it so until the board of nursing enacts new legal requirements.

Actually, multicollinearity, it does. Could you be confusing licenses and degrees? A license is granted by a state, provincial, or territorial government, and allows the license holder to practice in a field restricted to the general public. A degree is granted by an educational institution, indicates completion of an academic program, but does not confer any legal privilleges, because a university (or whatever) does not have legal authority to extend or restrict any citizen's libery; only government can do that. Doctor of Nursing Practice is a degree, not a license, so conventions regarding its use are a matter of tradition and common opinion, making the opinion of professional societies relevant. Now, whether the state, provincial, or territorial government will grant additional privilleges or authoruty to nurses with DPNs is another story. That will vary from jurisdiction to jurisdiction, just as scope of practice always does.

Lawyers are also trained to the doctoral level; they have earned juris doctor (JD) degrees. However, no one calls a lawyer "doctor." Why not? It is just not our tradition in the Western world, and whether one uses a person's educational accomplishments as a title for them is strictly a matter of tradition and consensus, not a matter of law. On the other hand, in Great Britian, for several centuries it was customary to refer to medical doctors who practiced within surgical specialties as "Mr." (though I understand that this tradition is passing away, and surgeons are called "Dr." now). Why? Tradition. Centuries ago surgery and medicine were seperate fields of practice. "Mr." was an honorific title granted to surgeons out of respect. In our day, "Mr." is no longer an honorific; it is a generic term applied to any adult male. In addition, modern surgeons go to the same medical schools and earn the same degree as doctors who end up in non-surgical practices, so, we call them all "doctor."

Time marches on. In our day, other changes are taking place, for example, nurses earning clinical doctorates. This requires changes in how we refer to them, using "doctor" instead of Ms. or Mr. However, whenever there is social change and progress, there will always be some who are threatened, and who warn of imminent disaster if the changes are not haulted at once! Don't worry too much. Such individuals are generally passed by and left behind by the progress of history. To my nursing colleagues persuing higher education, I say, LEAD ON!

[cruisin_woodward]

In the program I will be attending,(BSN to DNP) we take our "clinical" classes along side the MSN students, with additional research projects assigned. We have 500 clinical hours (same as MSN) in addition, we have 2 years of classes spent with the PhD students, numerous other acedemia. We also have an additional 500 hours of research. We do not have a dissertation, we have an advanced research project that we must defend our findings. It is four years full time, including summers. I think that I will have earned it.

[Multicollinearity, BSN, RN]

Actually, multicollinearity, it does. Could you be confusing licenses and degrees? A license is granted by a state, provincial, or territorial government, and allows the license holder to practice in a field restricted to the general public. A degree is granted by an educational institution, indicates completion of an academic program, but does not confer any legal privilleges, because a university (or whatever) does not have legal authority to extend or restrict any citizen's libery; only government can do that. Doctor of Nursing Practice is a degree, not a license, so conventions regarding its use are a matter of tradition and common opinion, making the opinion of professional societies relevant. Now, whether the state, provincial, or territorial government will grant additional privilleges or authoruty to nurses with DPNs is another story. That will vary from jurisdiction to jurisdiction, just as scope of practice always does.

Here's what I'm talking about. In my state we have a couple MSN-NP programs that have no plans of transitioning to DNP. Our board of nursing has no statement on the issue yet, and all that is required for licensing is an MSN for NP and certain clinical requirements for APN-NP licensure. This is what I was referring to. If a university is still offering an MSN NP degree in a state where the licensing board has not changed its licensing requirements, it doesn't matter what some professional body states (like the 2015 goal). Now eventually accrediting issues will probably catch up to universities that are holding out and not transitioning for NP education. But who knows when that will be. It may or may not coincide with the AACN's goal of 2015 because some universities are not following the AACN's goal.

All of the graduate degree granting universities and colleges are not in lock-step agreement with the AACN's goal. The issue will not be forced until ALL NP degree granting institutions transition to DNP or the board of nursing (licensing) requires the DNP degree.

[bubbabubba]

Last time I checked, Medical School was 4 years-- same as the nurses are putting in for their degree...We call physicians DOCTOR right out of MEdical school....no internship, no advanced training no nothing.......What is the difference? None that I can see.....What do you call the "doctor" who finished last in their Medical School class............"DOCTOR".....old joke but appropriate to make reference to here.