jfmDNP

What exactly does “complete an additional three years in practice beyond the 3-year or 4,600 hours transition period” mean? Is it six years total of supervised practice before being eligible to practice independently?

It does not. To be licensed and certified as an MD you must first graduate med school, complete residency and pass the boards. Graduating med school with a diploma without the aforementioned steps does not confer a medical license. Based on your premise, it should be cardiologist Jane Doe, MD, IM-C, ACA-BC so as not to be confused with pulmonologist Jane Doe, MD, IM-C, APCCSD-BC. MD is a degree. DNP is a degree. MDs are physicians. Again, based on your premise their title ought to be Jane Doe, PhyS.

The environment connotes one's area of expertise. John Doe, DNP in the ER treating patients expresses the underlying knowledge that they have acute care qualifications; HR and the hiring manager will have verified this. Adding DNP, AGACNP, APRN to their name can certainly add clarity that John Doe is certified to treat patients in that clinical setting but again, the environment and clinician's scope of practice would already denote that. It never crossed my mind that my PhD wielding anatomy professor may actually have possessed a master's and PhD in English literature with a specialty in modernism in literary thought. The anatomy labs and their lectures connoted their area of expertise.

It's the superfluity that is the issue. I do not think it's a concern of cluelessness per se to simply have DNP, or what have you, after one's name. A person with a masters and DNP in leadership with RN experience in community health without other appropriate credentialing would not be hired as a cardiac ICU provider as that would be a liability issue. You won't find an MD specializing in electrophysiology working at a GI practice doing endoscopic procedures for a similar reason, yet both providers will simply display 'MD' at the end of their names. There is no confusion.

Probably depends on the program. I appreciated the rigor of my doctoral education. The DNP program chair was, and continues to be, very much involved in ensuring a high caliber program. Every student spoke well of them and their dedication towards quality education for the students.

MD, DO, PharmD, DNP, DPT are all degrees with specialties. Typically in the hospital setting you'll see John Doe, MD Cardiology or Jane Doe, DO Orthopedic Surgery. The same could be utilized by NPs/CRNAs/DNPs - John Doe, NP Family Medicine or Jane Doe, DNP Pediatrics (it's a given only FNPs or PNPs work in pediatrics).

Actually I've kept my resume and cover letter to the minimum requirement. In fact I was just offered and accepted a competitive position. The docs et al. who interviewed me made comments of my educational achievements and level of motivation. They simply just needed to read my cover letter, look at my resume and speak with me to know that I was the right fit. So no need to flaunt the entire alphabet after my name. I recently read a post from a resident doctor's page taking a jab at our string of As and Zs after our names. They don't seem to be impressed either. This is what I'm talking about. It borders on titular obsession.

It's certainly acceptable to add PhD after your name and appropriate to add RN to distinguish you from a someone with a PhD in sociology or molecular biology for example who's not an RN as most RNs who get their PhD get a PhD in nursing. As for me, I simply write "jfm, DNP" - plus you can only write so many letters after your name on a lab coat. But mostly, patients know me as the guy who writes RX, interprets their ECGs, does a bit of neuro and MSK exam here and there and tells them to follow up in 2 weeks, with a smile on my face of course.

I think there's some historical context behind it. Perhaps it's due to a time when nurses were seen merely as the doctor's indispensable helper. Now, not so much. Nurses earning doctorates and highly regarded certifications and owning private practices running the show.

Yep. Aren't we taught in APA to be concise?

I can always add my Summer cook off award, CBBQ-RN.

I've heard from many others referring to the acronyms used by nurses after their name as being an alphabet soup, and I agree. It's superfluous. I understand that not all RNs have a BSN and not all APRNs are NPs or CRNAs. But wouldn't it serve to better succinctly clarify our title by limiting it to a single acronym? As with physicians, one can be a pediatrician, rheumatologist or dermatologist and still be John Doe/Jane Doe, MD. It's a given that an NP is an RN/BSN with a minimum masters degree and is also an APRN. And now with the DNP, it's understood than an NP with a DNP is all those other things mentioned with the added educational accomplishment. What's the point with writing Jane Doe, DNP, FNP-BC, AGACNP-C, APRN, MSN, RN (While their colleagues just write Jane Doe, MD or John Doe, PharmD)? Why not just be John Doe/Jane Doe, DNP? I find even adding FNP, PNP, AGACNP, CNM, PMHNP excessive, so I typically shy away from writing it after my name. Any thoughts on this?

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.

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.

I think the consensus model helps provide credibility to our training, but it is not enough in my view. One thing many students struggle with is clinical placements. If it were truly standardized, student A would have equal chance of securing a preceptor from whom they will learn a set of clinical skills as student B, even if both attend different schools in different states. The current scenario, unfortunately, is some students have had to transfer schools due to failure to secure a preceptor. I think if there was government funding at a greater scale for NP education or even financial incentives for institutions to take on students, there may be more preceptors willing to teach. I view myself as adopting holism in my approach. But even that can be subjective. Some doctors will also say they are holistic in their approach by their ability to synthesize and integrate psycho-social aspects of a person with their biomedical state to improve care. I have trained in clinical botanical therapeutics under MDs/NDs and I incorporate evidence-based phytotherapeutics in practice. Would I be more holistic than some? One can argue that no I am not if I don't incorporate vitamin infusion therapy and chiropractic manipulations while addressing past traumas to better manage a patient's chronic insomnia. While legislation will eventually allow IP for the remaining states, it won't confer greater clinical knowledge to the practitioner, only authority to practice what they were taught and trained to do, which differ by educational institutions.