Spin off: how do you deal with DNP haters.

syndromal65 · May 29, 2010

Not sure what you meant by all of that but as it stands, the dnp is worthless to anyone short of an educator. Explain how more nursing theory, statisitcs, more statistics, capstone project, management , etc are going to help you care for your patients? I'm not damming you for your choice at all, but I am curious as to what others see in this terminal degree that I and others don't? It would be better accepted if Mundinger hadn't popped off about the equal to doctors thing and if the degree was structured more like PA curriculum with more actual clinical time, not time working on some stupid project, and hard sciences along with advanced patient mgmt. After practicing for many years, i fail to see what this degree will add.

foreverLaur · May 30, 2010

I don't think anyone is anti the DNP in general. I think they are against those that get the DNP with the false belief that it provides them with a great number of clinical hours that will make them equivalent to physicians. Personally, I don't care what degree you get as long as you are getting it for the right reasons. I figure the people that are insulting towards people without just cause are just jealous. Makes life easier :) I have no intention of getting a DNP as it does not contain more clinical/science coursework to make you a better practitioner, but if you are interested in public health, education, business side of things etc, it is a great degree.

sandnnw, BSN, MSN, EMT-B, APRN · May 30, 2010

Syndomal, I was trying to make the point of nursing history and what I've been exposed to in my own past, for improving myself, as well as the profession. For what its worth, I do like to add a bit of my own personal experience on this "blog" for those who, in my opinion, are asking good questions, advice, clarification, etc.

Words like: "worthless, damming, stupid" aren't really helping anyone here. But you are entitled to your opinion and I do applaud your practice for many years. Our situations are very different. I have not practiced for many years as a NP. As a nurse, yes, MANY years with a broad base, that I believe makes me a great NP for my patients (and I think my boss agrees).

As far as my comments regarding my own personal history, I came on board when the BSN was literally taking off in my state, similar to the DNP. The ANA had just PUSHED for the BSN to be standard for all RNs and that was floundering, 1985, I believe. I was in the first BSN class, loaded with theory, research, nursing diagnosis, oh me... So, I was ready for the MSN fluff I keep reading about in the blogs lately. While it's painful, it's necessary to study where we have been and where we are going. I actually welcome the nursing "powers that be" to try and standardize the practice doctorate. Rid us of the DN, DSN, DNSc, ND, etc. PhD or DNP, with standard paths, and options for post-masters certifications, advanced skills or options for administrative vs clinical routes. I believe this is what "they" are trying to do.

Have you read the white papers? They actually are quite well written and make sense. It will evolve. My BSN program did. The kids today are not writing the same 50 page Psych thesis I had to for a undergrad mental health nursing, thank God.

As far as it being worthless, well maybe for you, but there are an ever growing number of new DNPs graduating every semester. For new grad NPs, they have to take this into account, the competition is not easing. I read some folks are taking upwards of 1-1.5 years to get their first job as an NP. All things being equal, those folks who have a DNP might have a "leg up" especially if they have passed the gold standard/BME endorsed, ABCC exam.

As for me, I'm contemplating going back for a post-masters ACNP. I've looked at over 10 schools within driving distance, rank on the graduate USNWR evals, asked my mentors, asked graduates of those programs (including MDs) and am trying to narrow it down to three before visiting the campuses and submit applications. Ironically, EVERY single person I have spoken to has suggested that I go ahead and knock out the DNP. Why would they recommend this???

zenman · May 30, 2010

Not sure what you meant by all of that but as it stands, the dnp is worthless to anyone short of an educator. Explain how more nursing theory, statisitcs, more statistics, capstone project, management , etc are going to help you care for your patients? I'm not damming you for your choice at all, but I am curious as to what others see in this terminal degree that I and others don't? It would be better accepted if Mundinger hadn't popped off about the equal to doctors thing and if the degree was structured more like PA curriculum with more actual clinical time, not time working on some stupid project, and hard sciences along with advanced patient mgmt. After practicing for many years, i fail to see what this degree will add.

I actually think the degree is worthwhile for what it is. Rush University says:

"Building on the established role of the master's prepared nurse, the DNP program provides real world experience in strategic planning, communication to affect change, data management and the application of critical business concepts.

The DNP degree is designed to prepare a leader able to affect change through system redesign and evidence-based decision making in a variety of clinical, organizational and educational systems. Through coursework, clinical practicum and project implementation, the DNP graduate is prepared to influence health care outcomes for diverse populations in a variety of settings."

I needed an elective last quarter and took a DNP course and it was challenging, even with my MBA and business background. So, for what Rush says it's for, I think it's great. Rush doesn't say anything about making you a better clinician. I won't be doing it because I just want to sit across from a patient, but I took advantage of that course and did a mini-business plan for a private practice.

Conqueror+, BSN, RN · Jun 17, 2010

The reason for the negativity falls on a meter that fluctuates between jealousy and ignorance. I think many MDs/DOs feel their territory being threatened by none other than those lowly nurses. You mean the people who had to stand and offer us their chairs when we walked into the room ? They always throw PA education in your face because they CONTROL PA practice. I don't believe you need to justify your choice in degree to anyone, least of all a faceless internet hater. A family friend has her PHD in theatre. Do they call her Dr. on campus? Yep. And so what? If I bust my behind and pass to complete my doctorate of any kind I have the right to be called Dr. if I wish. And it doesn't matter WHY or how anyone feels about it either. Do your thing and know that the people who matter in your life are proud of you. You don't even know me and I'm proud of you. :)

greatgirl123 · Jun 18, 2010

I am in my last semester of the DNP. I have been suprised the negativity in regards to the DNP comes from fellow nurses, NP, and CRNA's. The physicians I come in contact with and work with are very supportive and think the DNP is great! It's really no different than when the pharmacy and physical therapy went from a master's to a doctorate program.

which school do you go to for your DNP

lamazeteacher · Nov 1, 2010

Advanced degree(s) conferred upon anyone, doesn't/don't make them superior to anyone, unless they utilize them thoughtfully and contribute something more than those without them. By more, I mean simply something that isn't done by everyone, that separates the mundane from the special.

I'd hate to think that having a DNP degree meant that a person has finished all the education they may need, that they're "done" with school. Nursing and medicine can never be studied too much, as these fields are constantly changing. Our contributions to the world are a result of all we've done, experienced, and learned. Formal education doesn't make one wiser, as it isn't until theories are utilized, that their real meaning and value become evident. Teaching can be one component in a DNP's career, but nurses just aren't themselves usually, without patient contact.

Unfortunately the history of the careers medical doctors have, is somewhat like a work of fiction. It has a beginning (medical school), an impending crisis (internship and residency), and an end (practising medicine) that can result in premature cessation . Happily ever after, for doctors is a myth. Unless we and they mutually search for more and better answers to our problems, life becomes and stays deadly dull. What I've seen happen most in the past 50 years in which I've been a nurse, that doctors' "beginnings" and "crisis" experiences have been so stringent, that they think they should be able to rest back and make their lives easier, afterward (unless they owe tons of money to a money lender for the education that can become obsolete all too soon).

The difference for nurses, is that practising nursing is not the end, it's the beginning. Our role is one that depends on others, those with whom we work and those who benefit from what we do, as well as great research that keeps our tasks varied. Satisfaction in our work depends on how well we do it, and general agreement that we do it well. Along the way we interface with doctors as members of the healthcare provision team; and we and their patients' outcomes depend on working in synchrony. Orders need to be mutually agreed upon and be effective, otherwise other directions would need to be taken rather than hand wringing and blame games.

The preparation of a physician has been weighed down by much personal abuse, which is then passed down to the next generations, and frustrations taken out on those in the lower echelons. That is just dysfunctional "dog kicking", and impedes professional development while many "life scripts" become intertwined in an adversarial time consuming manner. In some doctors' need for ultimate power, the PA role developed according to their tendency to boss underlings around, who would respect them all the more for their abusive ways, as nurses resisted that role.

Fortunately for us, but unfortunately for the PA, the varied educational backgrounds they started with, if they're not nurses, doesn't provide for a specific school of higher learning, other than perhaps a short trip to health administration. The ultimate goal of the game of oneup(person)/manship, is to win. Nurses checkmated PAs because they attended schools of nursing that set standards for them all along their way; and their opportunities for professional and personal growth within it, flowered. Those outside that network do become resentful unless they accept that infrastructure.

The physician has been off on the tangent of thinking that money spells success in life, as in "he/she with the most and largest toys, wins". What is sadly lacking, if they aren't surgeons is that sense that they accomplished what they set out to do, attained with the patient being involved in the planning of the effort. I believe there was derailment in their sense of accomplishment, when the competition for doing the most successful coronary bypasses at one surgery, was in its heyday. When the death rate for their patients accelerated, skids were put on those endeavors, they had to cut (no pun intended) back on multiples and possibly admit that they were wrong.

Pediatricians and Obstetricians used to proudly declare how many patients they saw in one day, or how many deliveries of babies were attended by them in a month. When the evidence of their own declining health, with accompanying shorter lifespans due to sleep deprivation and anxiety, their aims turned to how much they could play in life and their golf games became more frantic. Now I find more and more physicians referring their patients to ER/EDs if their shorter schedules are filled, with the last patient being seen mid afternoon. They have 2 hour lunches (no patients in the hospitals reaching out to them then), and no hospital rounds to make at the beginning and end of each day (unless they work in teaching hospitals, and actually teach).

Hospitalists have taken over their work with inpatients. They also see the ER/ED patients and have become much like overworked interns and residents, today. They've assumed total responsibility for the most critically ill inpatients, and no staffing plan by them has undergone an "acuity of care study". Please don't get me wrong, as I'm no proponent of that quickly fading development in health care. I believe it isn't working, as patients spend half or whole days waiting to be seen in ER/EDs and not occasionally dying in that process. It did get the personal physicians off the hook for malpractice cases, handily.....

You're probably wondering what my point is, here. The responses in this thread have been fabulous, in that they paint a picture of what needs to be planned for a nurse to become a DNP. That is no easy route, and certainly not an inexpensive one. DNPs will be on the "front lines" in the provision of preventive and frugal care, as well as thoughtfully planned treatment while doctors (please pardon my oversimplification), will continue cutting and dicing, complaining and badgering.

Unless physicians strike out in a different direction from their forebears, they'll continue to find themselves dependent on insurance company direction of specific patient care, the money allowed them; and have many more patients who don't think they're daddy, mommy, and God/Allah, all rolled into one. Certainly the bloom has come off that "rose" greatly.

DNPs haven't the same needs, other than becoming the best provider of their kind of healthcare that they can be, with more and more education and especially experience. With greater skills communicating with people of all ages; and less, to no "handmaiden" ways, nursing has and will be the most versatile and challenging profession of all. There are some things that are greater than monetary rewards.

(Eat your hearts out, docs, PAs, other nurses satisfied with their status quo, and others not willing to go with the flow.....)

AbeFrohman, BSN, RN · Nov 1, 2010

First let me say I am all for the advancement of the nursing profession. I might not always agree with it's direction, but I always want it going up.

Second...Wow... That was the most pompous, pious, and self aggrandizing thing I've ever heard come out of a nurse. I'm so sick of people painting professions with a broad brush. You are no better than the physicians who do the same to nurses. Not all physicians are as you described. As a matter of fact, I know more of the opposite than not. DNPs are also not immune to being money grubbers, weak advocates, uncompassionate, or lazy. When will people understand that work ethic and aptitude are more individual characteristics than those of a particular profession/title?

Oh, and your thoughts on PA creation couldn't be further from the truth. Nursing was offered a midlevel degree and it rudely declined because the ivory tower thought it would be traitorous to learn medicine, until they taught medics to be PAs. Then all of the sudden we snap to and accept becoming NPs. Read the history of Dr. Still, Pediatric NPs, and PAs before you make such ignorant statements.

what physicians do should have no bearing on anything nursing. I find that opposition from physicians has been a minor hurdle in comparison to nursing against it self. Why cannot it decide on one route to be an RN? Why can't standardize education to be an NP? Why can't it have an actually clinical doctorate instead of renaming the same degree over and over again (DNS, DNSc, DNP, etc)? Why can't it have one advanced degree that encompasses all type of care, of all ages, and all settings (inpatient , outpatient, surgical, em, FP, psych, ob/gyn) that is covered by one exam? Why does it have multiple accrediting bodies? Nursing simply must look at a mirror to see it's biggest obstacle.

And you are the reason some doctors are up in arms. That don't care about nursing one way or the other until that hear your anti-physician rhetoric. How you will rise to the top but all the other poor dregs of medicine will be left to burn where there is weeping and gnashing of teeth. Trying to get to the top by stepping on the faces of others is doing nothing but harm.

ominous · Nov 2, 2010

Advanced degree(s) conferred upon anyone, doesn't/don't make them superior to anyone, unless they utilize them thoughtfully and contribute something more than those without them. By more, I mean simply something that isn't done by everyone, that separates the mundane from the special.
I'd hate to think that having a DNP degree meant that a person has finished all the education they may need, that they're "done" with school. Nursing and medicine can never be studied too much, as these fields are constantly changing. Our contributions to the world are a result of all we've done, experienced, and learned. Formal education doesn't make one wiser, as it isn't until theories are utilized, that their real meaning and value become evident. Teaching can be one component in a DNP's career, but nurses just aren't themselves usually, without patient contact.
Unfortunately the history of the careers medical doctors have, is somewhat like a work of fiction. It has a beginning (medical school), an impending crisis (internship and residency), and an end (practising medicine) that can result in premature cessation . Happily ever after, for doctors is a myth. Unless we and they mutually search for more and better answers to our problems, life becomes and stays deadly dull. What I've seen happen most in the past 50 years in which I've been a nurse, that doctors' "beginnings" and "crisis" experiences have been so stringent, that they think they should be able to rest back and make their lives easier, afterward (unless they owe tons of money to a money lender for the education that can become obsolete all too soon).
The difference for nurses, is that practising nursing is not the end, it's the beginning. Our role is one that depends on others, those with whom we work and those who benefit from what we do, as well as great research that keeps our tasks varied. Satisfaction in our work depends on how well we do it, and general agreement that we do it well. Along the way we interface with doctors as members of the healthcare provision team; and we and their patients' outcomes depend on working in synchrony. Orders need to be mutually agreed upon and be effective, otherwise other directions would need to be taken rather than hand wringing and blame games.
The preparation of a physician has been weighed down by much personal abuse, which is then passed down to the next generations, and frustrations taken out on those in the lower echelons. That is just dysfunctional "dog kicking", and impedes professional development while many "life scripts" become intertwined in an adversarial time consuming manner. In some doctors' need for ultimate power, the PA role developed according to their tendency to boss underlings around, who would respect them all the more for their abusive ways, as nurses resisted that role.
Fortunately for us, but unfortunately for the PA, the varied educational backgrounds they started with, if they're not nurses, doesn't provide for a specific school of higher learning, other than perhaps a short trip to health administration. The ultimate goal of the game of oneup(person)/manship, is to win. Nurses checkmated PAs because they attended schools of nursing that set standards for them all along their way; and their opportunities for professional and personal growth within it, flowered. Those outside that network do become resentful unless they accept that infrastructure.
The physician has been off on the tangent of thinking that money spells success in life, as in "he/she with the most and largest toys, wins". What is sadly lacking, if they aren't surgeons is that sense that they accomplished what they set out to do, attained with the patient being involved in the planning of the effort. I believe there was derailment in their sense of accomplishment, when the competition for doing the most successful coronary bypasses at one surgery, was in its heyday. When the death rate for their patients accelerated, skids were put on those endeavors, they had to cut (no pun intended) back on multiples and possibly admit that they were wrong.
Pediatricians and Obstetricians used to proudly declare how many patients they saw in one day, or how many deliveries of babies were attended by them in a month. When the evidence of their own declining health, with accompanying shorter lifespans due to sleep deprivation and anxiety, their aims turned to how much they could play in life and their golf games became more frantic. Now I find more and more physicians referring their patients to ER/EDs if their shorter schedules are filled, with the last patient being seen mid afternoon. They have 2 hour lunches (no patients in the hospitals reaching out to them then), and no hospital rounds to make at the beginning and end of each day (unless they work in teaching hospitals, and actually teach).
Hospitalists have taken over their work with inpatients. They also see the ER/ED patients and have become much like overworked interns and residents, today. They've assumed total responsibility for the most critically ill inpatients, and no staffing plan by them has undergone an "acuity of care study". Please don't get me wrong, as I'm no proponent of that quickly fading development in health care. I believe it isn't working, as patients spend half or whole days waiting to be seen in ER/EDs and not occasionally dying in that process. It did get the personal physicians off the hook for malpractice cases, handily.....
You're probably wondering what my point is, here. The responses in this thread have been fabulous, in that they paint a picture of what needs to be planned for a nurse to become a DNP. That is no easy route, and certainly not an inexpensive one. DNPs will be on the "front lines" in the provision of preventive and frugal care, as well as thoughtfully planned treatment while doctors (please pardon my oversimplification), will continue cutting and dicing, complaining and badgering.
Unless physicians strike out in a different direction from their forebears, they'll continue to find themselves dependent on insurance company direction of specific patient care, the money allowed them; and have many more patients who don't think they're daddy, mommy, and God/Allah, all rolled into one. Certainly the bloom has come off that "rose" greatly.
DNPs haven't the same needs, other than becoming the best provider of their kind of healthcare that they can be, with more and more education and especially experience. With greater skills communicating with people of all ages; and less, to no "handmaiden" ways, nursing has and will be the most versatile and challenging profession of all. There are some things that are greater than monetary rewards.
(Eat your hearts out, docs, PAs, other nurses satisfied with their status quo, and others not willing to go with the flow.....)

Most ridiculous thing I've read here on AN.............

linearthinker, DNP, RN · Nov 4, 2010

I couldn't make heads or tails of it.

MacD · Nov 5, 2010

OOOOkaayyyyyyy???????

Boatswain2PA · Nov 5, 2010

To the OP - nobody hates DNPs....but many people have a problem with Doctorate degree folks trying to pass themselves off as "Doctors" in clinical settings, with the lack of clinical experience DNP programs provide, and with the perceived goal of the NP profession in general.