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?

[Moogie]

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.

You are absolutely correct about entry-to-practice. It is unbelievable that the nursing profession has waffled on this issue for over thirty years. I got my ADN thirty years ago and went into an RN to BSN program a year and a half after graduation, in part for career mobility but in part because, at that time, the BSN as minimum level for entry to practice seemed imminent. I just hope that nursing gets its act together so that thirty years from now we're not still debating this issue.

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.

Since you do have experience as an LPN and have a good idea about what you want to do with your career, why not go into a DEMSN program instead of the accelerated BSN? Indeed those programs are pricey and not prevalent in all areas of the country yet but the DEMSN route could shave several years off your educational goals. Or---if you really want to become a PA, I believe most programs only require a bachelor's degree, not a degree in nursing. I mean, if your heart is in becoming a PA, why bother with the extra cost and hassle involved with getting a nursing degree?

ETA: Just realized this is an old thread. Would be interesting to see what the OP decided to do.

[foreverLaur]

Since you do have experience as an LPN and have a good idea about what you want to do with your career, why not go into a DEMSN program instead of the accelerated BSN? Indeed those programs are pricey and not prevalent in all areas of the country yet but the DEMSN route could shave several years off your educational goals. Or---if you really want to become a PA, I believe most programs only require a bachelor's degree, not a degree in nursing. I mean, if your heart is in becoming a PA, why bother with the extra cost and hassle involved with getting a nursing degree?

For a number of reasons. For one, I am not entirely sure if I will be at a point in my life where PA school is a feasible option when I am ready to go back. It is a huge time commitment - you basically have to put your life on hold for 2-2.5 years.

Secondly, I don't have any experience as a LPN. I completed the program as a vocational program my last two years of high school, but never pursued anything with it after that. The PA schools I am looking at requiring at least 2,000 hours of direct patient car experience and I believe RN is a great way to do that.

If the PA route doesn't work out for me, nursing is a fantastic career. I have no desire to be a NP, after further thought. There are a lot of things I disagree with and ultimately, I think I would end up hating it.

[springing]

I disagree. While experience as a RN is valuable, it is not training and practice as an advanced practice nurse. Residency is years of experience that is 100% correlated to a doctors work as an attending physician. You can be a fantastic RN, but that does not always correlate into being a NP. The two are different fields.

Secondly, while a broad medical education is not always directly applicable, it is valuable to have a solid knowledge of the workings of the entire human body, especially if you choose to go into something like family medicine.

Heck, even PAs have more clinical experience in schools than NPs. The PA profession was founded on being a second medical career and most PA students do have substantial valuable experience. Sure there are those that get in without none but there are always a lot of direct entry NPs where you can get through with none either. For example, Cornell has over 2,000 required clinical hours (assuming 40 hrs/week) plus 800 hours of elective clinicals which you can use to specialize just like NPs and heck, not even all NP programs give you 800 clinical hours and PAs get that to specialize PLUS 2,000 more in a broad medical education. How can you even compare?

Nurse practitioners are advanced practice NURSES, not mini-doctors. To say that NURSES shouldn't require NURSING experience is strange. What physicians assistants receive is immaterial. They are physician assistants, not advanced practice nurses. Bedside experience is always a plus, always. It teaches you how to manage your time, how to manage a wide and sometimes overwhelming slate of patients, how to manage paperwork, how to recognize emergencies, signs and symptoms. Registered nursing develops your instincts. Nurse practitioner programs hone those instincts into usable skills.

If you want to be a doctor, go to med school. If you want to be a physician assistant, go to a PA program. If you want to be an advanced practice nurse...practice nursing.