nursemark29

Dr. Tammy, I was looking at your educational accomplishments, and I am quite impressed. I am an Excelsior College graduate also. I'll be in University of Phoenix's MSN/FNP program as of November 11th of this year. Just some thoughts. My problem with the DNP is that even though it is a new degree, there were no surveys given to current advanced practice nurses asking for their opinions on the DNP degree. There could have been some type of research done to help back the AACN's position of why this degree is needed. The complete and utter lack of hard data dumbfounded me when I read the white paper. I agree that there are cheaper schools, especially with distance education; however, the point I was making is that universities are seriously jacking up their prices due to the degree being called "doctoral" instead of "master's". I have nothing against anyone who wants to get the DNP. I just don't like the idea of students being forced into it and the universities overcharging for it. I have friends who are currently completing the post-masters DNP program. My post was based on what they said... basically, there is no way they were able to complete it in 1 year. I have to commend you for getting it done in 16 months... that's almost unheard of. The issue I take is the universities telling the students that it's "only one more year" as a way to push the DNP degree to increase their revenue stream. I only want to know one thing if you will oblige me. Was what you learned in the DNP degree program useful to you as a practicing nurse practitioner? More specifically, did it help you be a better nurse practitioner? I look forward to your response. Mark

Guinea, Wow! There were quite a few words in your post that put words in my mouth. First, I respect physicians and what they've gone through to get where they are. Second, the study I was talking about was published in JAMA, not just nursing journals. Where did I say anywhere that physicians were fools? Implying that I lack common sense is a personal attack. You don't even know me, or my educational background. I am well aware that the study has flaws, and in my opinion, most studies do. But I felt this study made a very valid point about master's prepared NP's. I don't believe a DNP should be a degree that is forced upon the nursing community as a whole, especially when there are studies showing the effectiveness of master's level education for nurse practitioner preparation. For the record, I work with physicians all the time. I am unimpressed with many of them. I've caught many of their mistakes as a registered nurse, including some that could have been deadly for the patient. I've been talked down to by them when it was not warranted. I've seen them throw temper tantrums like little children when they don't get their way. I've seen them demean people that are beneath them in the medical hierarchy, or should I say caste system? I've seen them try to blame nurses for their mistakes instead of owning the mistakes like they should have. To be honest, your post is reminiscent of how a physician would reply to the study I cited. For being the most educated "professionals" in the medical food chain, I've seen many examples of them being less than a professional. Again, I never called physicians "fools". I never demeaned their education. One more thought... what do they call the medical student who graduated last in his class... that's right..."Doctor".

I question whether or not requiring the DNP movement will cut down the number of advanced practice nurses and drive up salaries. Why? There are quite a few P.A. programs out there, and they have no intention of going to a doctorate degree. When we see positions posted, they usually ask for an NP or a PA. There are still some bachelor degree PA programs and even some associate degree programs. Because all PA programs are standardized in their curriculum regardless of the degree conferred, the medical community understands these programs are academically rigorous and have trained the graduates in what they need to know. Nursing has become so focused on degrees that they fail to understand what the P.A. community already knows... standardize the curriculum regardless of the degree and you will have quality providers. Furthermore, if you can pay a P.A. less than a "doctorally" prepared nurse practitioner, you will choose the P.A. I have so many NP friends, and they all say the same thing, MOST physician groups and hospitals are notoriously cheap. If NP's overprice themselves due to having a "doctoral" degree, the P.A.'s will be more than happy to fill those positions. Many physicians also like PA's because they are trained in the same allopathic model that they were trained in, but the NP model can vary significantly from school to school. Even the DNP can vary (i.e. DrNP versus DNP). The DNP is overpriced, overinflated, and unnecessary. The MSN nurse practitioner model isn't broken and clearly works, so why is nursing trying to "fix" it? PA's are here to stay and will remain in competition with the NP's. Remember, most physicians and hospitals are more concerned with scope of practice than they are with the degree the provider holds. (i.e. Case in point, I work with PA's that hold associate and bachelor's degrees in physician assisting, and they make as much as, if not more than, the master's level prepared NP's in the group.) Just my two cents...

Reasons why I choose not to drink the Kool-Aid offered by the AACN and the Universities who are sponsoring the DNP degree: 1. There have been studies conducted showing that MSN prepared nurse practitioners perform as well as, if not better than, physicians in diagnosing and managing medical illness and diseases in patients. Where is the empirical or statistical data showing that a DNP will improve the care rendered by NP's? I have read the AACN's white paper on the DNP degree, and foundit to contain mainly conjecture and opinion as to why the degree is necessary. 2. Yes, it will cost quite a bit more to become an NP via the DNP route. The current MSN/FNP programs are between 47 to 50 credits. The average DNP program is between 73 and 85 credits. At Arizona State University, the cost is $847 per credit hour. At 48 credits under the old MSN/FNP program at ASU, the cost for the degree was $40,656, not including books and other fees. The current DNP/FNP program is 85 credits, making the total program $71,995. That's a mere difference of $31,339. 3. Let's look at the University of Minnesota. The current rate for their MSN program is only $614 per credit hour. Under their old MSN/FNP program at 48 credits, the total cost was $29,472. The current DNP/FNP program is 82 credits with a per credit hour cost of $877.89 (and that's in-state tuition), the total cost is $71,986.98. That's a difference of $42,514.98. (Yes, the university does charge the full rate of $877.89 per credit for all 82 credits of the BSN-DNP program, because the credits are now DOCTORAL level, remember?) 4. Student loans need to be payed back. These horrible harbingers of indentured servitude take years to escape from and eat away quite a bit of your post tax income. So if you are a nurse practitioner and want to work in an underserved area, and you have $72,000 of loans hanging over your head (not including possible undergraduate loans), a meager income of say $75,000 - $80,000 a year to start will not exactly inspire an NP to work in an underserved area. (Perhaps if those loans are forgiven to work in a medically underserved area, then yes it would, but not every NP will get this deal.) 5. It takes an average of 2.5 years to complete an MSN/FNP program at 48 credits. The universities are telling us it only takes about a year to a year and a half longer to complete a DNP beyond the MSN level. So if it takes 2.5 years to complete 48 hours, do they really expect us to believe we can complete 37 credit hours in only 1 to 1.5 years? I don't see it happening. Try 4 - 5 years total, unless the student doesn't have to work. In closing, it is my opinion that the DNP is nothing more than a way for the universities to take in huge amounts of revenue. I have found no evidence to support the DNP as being necessary to provide increased quality of patient care. It does not increase scope of practice. It does not dramatically increase salary offers. What does it do to help the profession? In my humble opinion, not much. Just my opinion...

So here's the deal. I don't see our profession as being so malicious as to tell someone who has graduated an MSN level nurse practitioner program that they started before the year 2015, "Oh well. It's 2015 now. You need to get a DNP degree, or else we won't let you get licensed as a nurse practitioner." I'm absolutely certain that they will grandfather those people who were accepted into an MSN level N.P. program before the year 2015 so they can take their boards and practice for what they were trained to do. I will be done with my program in late 2013 or early 2014. Even if I were done in 2015, I would not worry, as I am certain I could easily present my case to the certifying body and would be granted an exception. As others have also stated, I do not know of even one certifying body that states a DNP will be required to be certified as a nurse practitioner. So for those of you that are worried, just concentrate on school and getting through it... that will be challenging enough. You will be a nurse practitioner when you are done.