Where is the DNP at in terms of being required?

[foreverLaur]

I heard that the DNP was going to be required for all nurse practitioners by 2015. However, I don't know how factual that is. When my aunt was in nursing school, they said the exact same thing about all RNs being required to have bachelor degrees, but that obviously STILL hasn't happened and that was 30 some years ago.

I am graduating in March with my BA and planning to enter a 2nd degree accelerated BSN program. My plan is to become a Physician Assistant, but PAs aren't used at all in the area where I am from. If I end up staying here or plans change, I may consider an NP program because I still have a lot of prerequisites left for PA and it might not be feasible depending on where my life is. Anyways - I have done a lot of thinking and I would be happier with PA, but if the cards fell in such a way that I ended up going NP, I would not regret the decision and I would be happy with my career.

My question, however, is when (if ever) will a DNP be required? If a DNP becomes standard, I will, with 100% certainty, NOT become a nurse practitioner. I have looked at several DNP programs and they are A JOKE. They are a combination of a M.Ed, MBA, and MPH. Where is the science? Where is the clinical hands on patient care experience? Even the AMA things it is a such.

The Board Chair of the American Medical Association even said:

"We have the deepest respect for nurses, and the AMA wholeheartedly believes that each member of the health care team plays a critical role in ensuring patients get the best possible care. But it's an undeniable fact that a nurse with a graduate degree does not have the same education and training as a physician who has completed medical school and residency training, and it's misleading for nurses to introduce themselves to patients as a doctor, (Make Room for Dr. Nurse, April 2). While standards for the Doctor of Nursing Practice (DNP) are presently being devised, nursing organizations currently recommend DNP students complete just 1,000 hours of "practical experience" after obtaining a Bachelor's degree. Physicians complete more than 12 times that amount during their graduate education. In addition to the two years of clinical rotations physicians fulfill during their four years of medical school, they also complete three or more years of full-time medical residency training.

The DNP program with the one-year residency training mentioned in the article is far from the norm. While one DNP graduate may complete a two-year program including a one-year residency, another can complete the program entirely online and without any patient care experience."

Yikes!! If I get a doctorate degree, I expect to have a lot of hardcore science and at least a few thousand hours of full-time patient care experience. I expect a lot of hands-on learning. Yet in every DNP program I have seen, there is NONE! If I am going to spend that much time in school to get a doctorate degree, I might as well go to medical school. I don't want to go to medical school. I want to get a masters degree and be an excellent mid-level practitioner who provides the highest level of care to my patients. A practice doctorate degree for nurses is a joke.... it doesn't make nurses even close to be equivalent to doctors. They will always and forever be mid-level practitioners. So, what is the point of a doctorate?

I wouldn't be so against the DNP if it was modeled somewhat after the MD/DO or even PA programs that are taught more on the medical model and use science, hands-on learning, and patient care experience. But they don't. Check out the curriculum for the DNP program at Case Western: http://fpb.case.edu/DNP/curriculum.shtm

I'm not against nurses or nurse practitioners. I highly respect the nursing profession and health care wouldn't function without them. I am just against the nurse practitioner program being a doctorate level degree. Is this going to happen? When will it happen? What is the purpose if it doesn't make us better care providers to patients? How do people in favor of the DNP react to the AMA being a against it?

[foreverLaur]

I'm starting at Kent State's accelerated BSN program soon. I have absolutely no problem with nursing. I just don't agree with the push for DNP = MD/DO.

[just_cause, BSN, RN]

....Also, PAs are trained using the old-school medical model. Not the way more holistic and patient-friendly nursing model. I think most of us on this site agree the nursing model is far superior and personally fulfilling ;-)

:trout:

I think you are making a lot of assumptions and that statement not only seems far fetched with a side of bias, but also insulting to both professions and to the intelligence of the people reading this thread.... Obviously deserving of a trout slap IMHO. :)

[BBFRN, BSN, PhD]

Don't let one article by one person (Mundinger) cloud your view of what nurses intend to do. She doesn't speak for the entire profession. I don't know any nurses with doctoral degrees who want to be anything other than nurses.

We like our model, and we have more freedom with our model- it's more interdisciplinary. And, we're proud to be nurses.

And don't worry about theory & research being 'fluff.' You'll learn more middle range theories at the grad level, as opposed to the grand theories you learn about in undergrad. They tend to make a bit more sense, even if they do extend from the grand theories. All professions have their own theories used to define their domain, and you'll take these courses as a part of the core curriculum in any professional grad program.

Once you're at the doctoral level in your education (if you so choose to go that far), you may feel differently about whether these courses are fluff or not. You may even develop a love for them. In fact, comparing those courses at the doctoral level to your experiences with them in undergrad, may be comparing apples to oranges.

[just_cause, BSN, RN]

I agree - but at the same time Mundinger is not just 'one person' she is the visionary and pioneer of the DNP and carries a bit more clout.

v/r

[BBFRN, BSN, PhD]

I agree - but at the same time Mundinger is not just 'one person' she is the visionary and pioneer of the DNP and carries a bit more clout.

v/r

True- but between what she envisions, and what will be the end result remains to be seen. Some of that has to do with her way of presenting her vision in that article. Admittedly, she seems to have clarified a bit in later articles, but the one mentioned, is always the one that is brought up to make the DNP vs MD argument.

My personal opinion as a PhD student, is that MDs don't own the title of Dr., so they can get over it.

[traumaRUs, MSN, APRN]

Personally, I think Mundinger has her own agenda which is to get the DNP to equal MD/DO. Never gonna happen and it shouldn't happen. Nurses are NOT physicians. If I had wanted to be a physician, I would have gone to medical school, not nursing school.

The DNP is a doctorate-level of education, which does not equate with being a physician. If we go that route, then a Pharm-D is a physician, a PhD is a physician, etc..

Mundinger, IMHO has done nothing to further a collaborative working environment with physicians and in fact has gotten more physicians on the bandwagon of "nurses can't call themselves doctor."

[BBFRN, BSN, PhD]

ITA, Trauma.

[Goldenatom]

If you read the DNP white paper (http://www.nursingworld.org/DocumentVault/GOVA/State/WhitePaper.aspx) you'll have a lot of your questions answered. We had someone from the AAN (can't remember the woman's name, but she was a FAAN) come talk to our class about it yesterday. The DNP is in no way designed to replace or equal MDs. In many ways it is a reconnection that many master's nursing programs have credit requirements equivalent to doctorate programs. No one freaks out because pharmacists have doctorate degrees. They aren't trying to be medical doctors and the same thing goes for the DNP degrees. Getting a NP master's degree today shouldn't be substantially different from earning a DNP and getting certified as an NP in the future.

[AtomicWoman]

I take anything the AMA says about NPs with a LARGE grain of salt. Many (obviously not all) physicians feel threatened by NPs and think NPs are going to take income away from them. They rant and rave about how NPs aren't doctors, didn't go to medical school, etc. Which is correct. And that's why NPs are considered a mid-level provider and why they work in collaboration with physicians except in a very few states. Frankly, I look at the DNP the same way pharmacists look at the PharmD and physical therapists look at the DPT. It's the most advanced clinical degree you can have in the field, not an attempt to take the place of doctors. I'll be kind of happy when the MSN/NP option goes away, and you can go straight from your BSN to DNP. But for now, a lot of programs are building DNP programs on the assumption that the students already have an MSN/NP. That will change over time, if the DNP is more universally adopted.

[foreverLaur]

The DNP program involves a vast majority of curriculum revolving around leadership, research, education, business, etc. What about those of us who are only purely interested in the clinical practice and don't care about that stuff? We're stuck spending at least an extra year in school learning about things that aren't beneficial to our chosen career path when we coudl be using that extra year to become better at treating patients.

Why can't the DNP program be more advanced science classes? Going further indepth with the chosen specialty? Another few thousand clinical hours? IMO, that would be A LOT more beneficial and I would be in total favor of the DNP if it included things like that. (advanced pathophysiology? advanced pharmacology? more indepth clinical medicine courses?)

None of the doctors who are anti-DNP feel that the program is taking over their jobs. They just fear of patient safety.

A quote from Dr. Mary Mundinger:

"DNPs are the ideal candidates to fill the primary-care void and deliver a new, more comprehensive brand of care that starts with but goes well beyond conventional medical practice. In addition to expert diagnosis and treatment, DNP training places an emphasis on preventive care, risk reduction and promoting good health practices. These clinicians are peerless prevention specialists and coordinators of complex care. In other words, as a patient, you get the medical knowledge of a physician, with the added skills of a nursing professional."

I interpret that to mean that the DNP program will produce nurses that are equal knowledge to that of a physician (MD/DO) and then are even better then a physician (MD/DO) because they are nurses. Part of what NPs can do is fantastic and can definitely help fill the primary care shortage. But claiming that a NP has the medical knowledge of a physician? Cmon...

[Winnie04]

Hi ForeverLaur,

I agree with your post. I was disappointed when I looked into the curriculum for various DNP programs. The courses seem more geared towards management/leadership and healthcare from a systems perspective rather than strictly clinical practice.

On a related note, at a DNP info session that I attended recently, the director of the program mentioned Mary Mundinger's role in the push for the DNP, and said she had heard or read somewhere that Mundinger's NP students at Columbia School of Nursing had somehow been able to take the Medical Board Exams (that MD's take) and passed them. Has anyone else heard that? Interesting.

Anyway, back to the subject of this thread (not sure if this has already been said): I asked this same DNP director about the status of the DNP (ie. will it be mandated?) and she said that it will depend on each state and whether or not the state changes its practice act to require the DNP for NP's. The AACN, although they are recommending that this change take place by 2015, does not have the authority to mandate it.

It's pretty hard to find reliable (printed) info on its status, isn't it? It seems like it's still very much up in the air.

[Goldenatom]

We're still in very much of a transition phase for DNP programs. For example, at University of Maryland, the DNP program is currently designed for nurses that already have advanced practice degrees. In the next next few years the MS programs will be phased out and the DNP will become the degree of choice for advanced practice nurse (at U of M at least).