Actually, a lot of medical students/pre-med students as well.
I've been googling the subject DNP vs. MD and find little from nurses, but a slew of pure hatred for nurses and the DNP.
What gives? I understand the idea- the fear that the DNP will start to deprive the MD from practice, rather than work with the MD.
I found the threads interesting as at no point did any of the med students, not once, show concern that the quality of care provided might be lacking with a DNP.
The med students have this idea that from year 1 of undergrad through completion of a DNP program there are only 600-700 hours required in clinic, and that a DNP takes 2 years or less presuming one already has a BSN.
They also seem to rage in regards to nurses being able to work, and thus get paid, while attending school.
They call the DNP's "Dr. Fakey McNursey", and worse.
Where's the respect? What about the patients?
Why all the hostility? Why do MD's feel they're being pushed away? Is there a history of these new DNP's not providing quality care, or working with MD's? Is it just an ego issue? And why do so many existing NP's dislike the idea of the DNP (beyond what I've read- that additional education isn't apparently needed, some claim)?
I found another site, a blog, written by a nurse who is in med school now and trying to become a physician. She, of course, is excessively hostile to anyone making comments, and usually responds to nurses with "why not just go to med school? It's a waste!" and the like.
I have seen a lot of negativity from MSN students that are at the same university as me. I am a graduate teaching assistant, and I have even seen the negativity from faculty. Oh, and even PhD students. As far as physicians, I have gotten a lot of grief from surgeons....and CRNAs. "Why would you want to do that?" "So, when you are done do I have to call you 'doctor'", "The universities just want more money", "Why don't you just go to medical school" etc. It has gotten to the point that I only explain that I am in the DNP program vs MSN program if I am questioned as to why it is taking me so long to complete it. I have a cousin in chiropractic school in Chicago, where apparently they are able to work as primary care providers, and she has had nothing positive to say about NPs in general, nevertheless the DNP program. She is very upset that my clinical doctorate is "watered down" compared to hers. I tried to explain, that my doctorate is very different than hers. Not necessarily watered down. I have also gotten rude remarks made by PAs. I have not visited the SDN. I have seen enough negativity on this site to last me. Regardless of whether or not this becomes entry level, I think we should all embrace education. More education can not be a bad thing. It is the one thing that can never be taken away from you. My choice to get my DNP was a personal choice. Period.
It is a personal choice and it should remain so. I should be able to decide, for myself, if I want to do clinical work or research. I'm all for more education, but why not add more sciences and clinicals before you throw in more research (especially for what is supposed to be a clinical doctorate).
Also, education for the sake of education is asinine. Is there a study that shows a DNP has improved outcomes over an MSN NP?
I have no problem with DNPs. I just dislike the direction that some organizations are taking nursing.
I don't think there's much hostility between current attendings and NPs/DNPs because, honestly, they probably don't care. However, I think there'll be increased awareness of encroachment and more political involvement by those who are currently junior residents, med students, and premeds. Especially after the last set of articles where NPs were quoted saying they were equivalent to physicians, I think a lot of people in the medical fields, especially in academia, are starting to finally pay attention.
Second, I've not encountered hostility toward NPs and other advanced practice nurses in my career (I'm a psych CNS) from actual physicians -- it appears lots of people are hearing a lot of trash talk on SDN (I don't waste my time on SDN, so I don't know what actually gets said there). Keep in mind these are students, and their perspective is not necessarily a) realistic or b) representative of the larger physician community. Look at the attitudes of many of the student posters here (or even the wanna-be-students, with no real-life experience whatsoever) that are seriously incongruent with (and even offensive to!) many of the experienced nurses here. The practicing physicians I've known over the years have all embraced the idea of advanced practice nurses and been v. gracious and welcoming toward us (of course, I realize it may simply be that physicians who feel otherwise don't communicate that to me ... :)).
Third, I think much of the hostility toward the DNP is directly related to that kook Mundinger at NYU and her personal crusade to let the world know that she considers the graduates of NYU's DNP program to be at least the equal of primary care physicians, if not superior to them. IMHO, the articles she's written and interviews she's given on this have done a lot of harm, esp. since she's not been able to back up her talk with any hard evidence (the one effort to have NYU's DNP grads take a watered down version of the most basic step of the USMLE was an, ummm, disappointment, to say the least. )
"Why do MDs feel they're being pushed away"??? How about, because they're being told that people with a fraction of their education can do their job as well as they can, and should get paid the same amount and get the same respect they do?? I know that it's only small percentage of people are making that claim (and many of them, here, seem to be students!) but they are the ones getting attention from the medical community. You know how we feel when CNAs or MAs say that they know as much as the nurses do and do almost the same job nurses do? I'm sure physicians feel the same way when they hear some people claiming that advanced practice nurses know as much and should be considered the equal of physicians.
There are a lot of us, not just physicians, who don't really see the point of or need for doctoral-level preparation for advanced practice nurses, and have issues with some of the hype being put out there.
I think this is one of the best, most level headed responses on the subject.
Many physicians find it a slap in the face when the most vocal and ostensible leaders in nursing act like physician training is overkill. Mundinger is the obvious example (I hear she is retiring from Columbia). Most on SDN and many students/residents on this site, come to vent. When a resident is working very long training hours and hears someone with much less training is claiming to be able to do the same job, it becomes frustrating especially since it is usually the DNP students and not the experienced nurses. The knee jerk reaction comes off as anti-nurse... which most are not.
I know all the doctors/residents (and even most of the older the med students) know that good nurses are worth their weight in gold and have probably been saved on more than one occasion by an experienced nurse. The nurses are also the ones who guide the new interns and keep them from doing too much stupid. They also occasionally are the ones paging at 3am about a diet order (you know who you are). All in all I think much of the "anti-nurse" sentiment is just frustration at the system, incredulity that people would claim equality with half the training and jealousy that others didn't have to make the same kind of time and life sacrifices to get some autonomy.
Specializes in Family Practice; Emergency Medicine.
I have to also throw my hand in on this one.....yes.....there are alot of students who seem to have lived the experience of medicine and nursing and are a bit too overzealous with their take on reality here.......I have been an NP fora bout 7 years ....a nurse for about 10.....I personally am on the fence about what should and shouldn't be in health care for NPs at the moment....however, I will make it clear....while I feel capable and good at handling most common acute and chronic medical problems.......allopathic and osteopathic physicians sure put a hell of alot more time into the books and with patients.....bottom line......I'm fine with the nearly independent practice I am doing now with a nice experienced physician to collaborate with if need be.......
Personally, I strongly doubt that "fear" is a significant motivator where "hostility" toward the DNP is concerned, at least among current and future nurses who don't like the idea. If you think about it, you can hardly blame master's-level NPs in particular for being offended -- not by current or future DNPs, but by the mandatory-DNP lobby (AACN et al). In a different forum, one poster said that she had "never once read anything that says DNPs are more clinically competent than Masters Level NPs"; she has apparently never seen the AACN's own comments on the issue. Said comments imply rather clearly that the AACN folks don't seem to feel that master's-level APNs are adequately prepared to deal with the demands of a 21st-century health care system. I'm sure that will come as a fascinating bit of news to the thousands of MSN-degreed APNs out there on the front lines who have been very ably navigating and practicing in that very same 21st-century health care system for quite some time now! Does it seem the least bit appropriate for a group of ivory-tower academic types (who quite probably have an agenda of their own) to be questioning the competence and capabilities of MSN APNs whose skills and acumen have been more than amply demonstrated time and time again? I hardly think so -- it seems to me that the AACN folks owe the many fine MSN-prepared APNs out there an apology!
From my own perspective, I don't see anything wrong with any nurse wanting to earn a DNP; if that's your goal, then good for you and best of luck. Where I have a problem, on both personal and objective levels, is the idea that the DNP should be forced upon would-be APNs as the mandatory entry-level credential for advanced practice. Selfishly, I don't like it because I have no desire to do high-falutin' research; my goal is to provide primary-care services as an NP, plain and simple. If I wanted to get involved with research, I'd pursue a PhD, because that's what a PhD is for! Moreover, I also have no desire to spend eons on school, not to mention large wads of extra cash, just to become a mid-level practitioner. If I wanted to spend four years and take on a boatload of debt to do grad-level education in health care, I'd go to med school and make it pay off!
On a macro level, one must consider the probable impact of making the DNP mandatory for all APNs, particularly in light of the projected need for both bedside nurses and APNs in the years ahead. Unlike most other health-care fields, nurses have other options; they can practice in a variety of other roles (and earn decent money) simply with their RN licenses, whereas in the other fields, students have no choice but to earn the grad-level degree if they want to enter the field at all. Indeed, many (if not most) nurses pursue their APN credentials part-time while working as RNs, an option not available in the other fields. In all likelihood, then, many nurses who might wish to become APNs may well choose not to pursue graduate nursing study at all if changes are made that would require them to either (a) quit working and go through school full-time for four years all over again; or (b) spend eight long, difficult years (instead of the current 3-4 years) studying part-time while trying (in many cases out of need) to hold down a full-time nursing job (can you say "perfect recipe for burnout," kids?). Large numbers of APNs could thereby be lost just when our health-care system will need them most, simply because some academic body (AACN) arbitrarily decided that APNs need twice as much training as they currently receive -- and never mind the fact that a large body of evidence, compiled over many years, indicates that MSN-prepared APNs are excellent, well-qualified providers of care in their practice roles!
It is also useful to draw a distinction between graduate training in nursing and other health-care disciplines, including medicine. Keep in mind that all nurses enter their graduate study with an extensive background in their field, whereas would-be PTs, OTs, audiologists, physicians, etc. do not. Nurses who wish to undertake study at the grad level already hold undergrad credentials and have received training that qualify them to practice within the scope of their field, whereas students in these other fields may hold degrees in any discipline (but none of them have current training or credentials in the field they will be studying in grad school). As such, nurses are unique in that, unlike any other health-care field, they have a considerable head start in their professional training as they enter graduate study; they are not starting from scratch like students in these other fields. It therefore makes little sense to require NPs to go through four years of full-time graduate study when they have already, at a bare minimum, received two years of training in their discipline as undergrads. Even physicians receive "only" four years of formal medical education in order to be deemed qualified to hold the MD or DO degree, and considering that NPs have a much narrower scope of practice than physicians (comparable to PAs -- who, lest we forget, earn master's degrees!), it seems plainly inappropriate and unnecessary to put APNs through a curriculum as long as medical school -- especially given their aforementioned head start on med students!
Again, the problem isn't that some nurses want to go on and earn a DNP -- the problem is the prospect of all APNs being forced to do so whether they wish to or not. It seems to me that it's much like the long-standing "ADN vs. BSN" argument. Many ADN RNs are perfectly happy being pure bedside nurses and feel neither the need nor the desire to earn a BSN, and there's nothing wrong with that; others, meanwhile, may aspire to upward mobility or obtaining broader knowledge of their field and thus opt to earn a BSN. Similarly, many current and prospective APNs would be perfectly happy to provide hands-on patient care in their advanced roles, while others might aspire to greater knowledge and/or different roles and choose to pursue the DNP. (Once again, it should be well noted here that there is a large body of evidence that shows master's-prepared APNs are already doing outstanding work -- while there is NO evidence to suggest that DNPs provide better care than MSNs.) And that, to my own view, is as it should be. If you want more, at either the undergrad or grad levels, that's wonderful; if not, however, there's obviously no need for "more" to be forced down your throat by the AACN or anyone else.
Until and unless AACN and its allies in the "DNP 2015" push can conclusively prove such a need to force the DNP on everyone who wants to pursue a career in advanced-practice nursing, they need to back off. AACN seriously needs to reconsider the potential repercussions of making the DNP mandatory and respond accordingly before they end up harming our health-care system with their shortsightedness.
Just checked this thread due to notification- someone responded after 2-3 weeks!
Anyway, I'm not allowed to- I believe I had it in my OP, but when my thread was moved to this forum, I was told, in private, that mentioning the place is discouraged. I see other members using the initials though.
I don't want to stir up any problems. It's not hard to find, and one of many.
It got me thinking though- as someone who wants to eventually become a NP, and looking at having to go down the DNP road for that goal, there seem to be a lot of up and coming med students very much against it. I'm not sure if I've pointed out that this same/particular group cites the CRNA program as a failure.
Either way, I was curious if anyone has personally encountered problems being a DNP, or being in a DNP program, and what those might be!
It is also useful to draw a distinction between graduate training in nursing and other health-care disciplines, including medicine. Keep in mind that all nurses enter their graduate study with an extensive background in their field, whereas would-be PTs, OTs, audiologists, physicians, etc. do not. Nurses who wish to undertake study at the grad level already hold undergrad credentials and have received training that qualify them to practice within the scope of their field, whereas students in these other fields may hold degrees in any discipline (but none of them have current training or credentials in the field they will be studying in grad school). As such, nurses are unique in that, unlike any other health-care field, they have a considerable head start in their professional training as they enter graduate study; they are not starting from scratch like students in these other fields.
(I agree with most every point you make -- except that I need to point out that it's not accurate to say that "all nurses" enter grad school with an "extensive background" in nursing. With the abundance of "direct-entry MSN" programs out there in recent years, many advanced practice nurses did enter graduate study without any background at all in nursing. People are accepted into those programs with a BA/BS in another area and little or no background in healthcare, certainly no experience as an RN. Other people go straight into grad school as soon as they finish their basic, initial nursing education, with little or no nursing experience beyond their student clinicals.)
It got me thinking though- as someone who wants to eventually become a NP, and looking at having to go down the DNP road for that goal, there seem to be a lot of up and coming med students very much against it. I'm not sure if I've pointed out that this same/particular group cites the CRNA program as a failure.
Either way, I was curious if anyone has personally encountered problems being a DNP, or being in a DNP program, and what those might be!
:)
This is what I mentioned before. The current med students, residents, junior attendings, and even premeds, are becoming more and more politically active against any potential encroachment. This is largely been, IMO, due to increased awareness of midlevels (ie. the many NP/DNP articles in the recent months where NPs/DNPs have been quoted saying either that they're equivalent to physicians or, in some cases, that they're better than physicians). I can't imagine a physician at any level of training taking those types of comments lightly. Either way, I think within the next few years, this entire debate will become even more heated than it already is and will likely spill out from anonymous forums into the courts.
I am a practicing APN credentialled in five hospitals in central IL and personally have contact with MDs, residents, med students, etc and I just don't see this trend at all.
I am also politically active in my state's APN organization as well as two national organizations. Again, I'm just not seeing that most mid-levels want/need compete with MDs.
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zenman
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Please point me to this blog.