Will DNPs be chosen over MSNs?

TicAL · Apr 20, 2011

You should hear the way some physicians speak about DNPs... suffice it to say that they don't see DNPs as equivalents, lol. I think the newer generation of doctors know what a DNP is, and most of them know that the DNP education and experience is no where near what the MDs is. I think for the DNP students to be taken seriously they'll need to lose the entitlement and embrace that a DNP isn't a backdoor to becoming a doctor. I know that probably isn't a popular opinion but that's the way I see it.

linearthinker, DNP, RN · Apr 21, 2011

You should hear the way some physicians speak about DNPs... suffice it to say that they don't see DNPs as equivalents, lol. I think the newer generation of doctors know what a DNP is, and most of them know that the DNP education and experience is no where near what the MDs is. I think for the DNP students to be taken seriously they'll need to lose the entitlement and embrace that a DNP isn't a backdoor to becoming a doctor. I know that probably isn't a popular opinion but that's the way I see it.

This is interesting. I am acquainted with perhaps 100 DNPs and DNP students, and I don't know a single one who thinks the degrees MD and DNP are equivalent, has an attitude of entitlement (they would not be inclined to work so hard for one thing!) or regards their advanced degree as a backdoor to being a "doctor" (I assume you meant to say physician). I am forced to conclude that this is a strictly anecdotal experience and not representative of my DNP colleagues. I detect a hint of sardnonicism that makes it a bit difficult to heed the authors POV.

JustinTRN · Apr 24, 2011

Technically, years of experience does tend to win out.

However, most positions postings tend to state: BSN preferred and my hospital hires a BSN over an associate degree nurse every time. I think this will be the same in the future of NP practice.

I believe, in the future, the DNP will always be preferred over the MSN. In 20-30 years we will see MSN Nurse Practitioners about as much as we see diploma nurses. They are almost extinct. I was just admitted in a DNP Acute Care Nurse Practitioner program and decide to do that route because I'm younger and allowed to get my MSN along the way to work as an NP while finishing the rest of my doctorate. People are trying to hate the DNP but they might as well get over it because it's mandated and here to stay after 2015. We will see the curriculum of the DNP evolve over time but for now it's what we have in practice.

CCRNDiva, BSN, RN · Apr 24, 2011

The DNP is not mandated, it is a recommendation. The credentialing boards and state boards of nursing are the only agencies that can mandate anything and so far they have yet to require the DNP for entry to practice as a NP.

Furthermore, I work with plenty of diploma nurses (in the ICU of a level II trauma center). They are far from extinct. They may be rare in your area but they are still in practice in significant numbers in many areas of the country.

PMFB-RN, RN · Apr 24, 2011

however, most positions postings tend to state: bsn preferred and my hospital hires a bsn over an associate degree nurse every time. i think this will be the same in the future of np practice.

*** i wonder if that will reeally be the case. those adn vs bsn nurses are being hired by other rns. aren't most np's hired by physicians? in the medical center were i work all crnas & np are hired by physicians, usually heads of departments. the medical field doesn't seem to suffer from the same self image problems that nursing does.

people are trying to hate the dnp but they might as well get over it because it's mandated and here to stay after 2015.

*** uh, no it's not mandated. there will still be plenty of msn np programs after 2015.

eglide87 · Apr 28, 2011

originally posted by llg

i'm old enough to remember when it became a requirement for np's to have master's degrees.

at first people disagreed, saying that the msn

inclusion of research, theory, leadership, etc. was not necessary for an np. those voices died out as the np's without msn's retired and a new generation of np's who all had msn's took over.

my point is that there is a good chance that the same thing will happen with the dnp issue..

no particular comment. just thought it should be posted again.

this could also go the way of the adn vs bsn debate. without a mandate to change to the dnp, we could end up with another dual entry method to become an np. if that were to happen, we could end up having yet another entry level to practice conundrum. where would that put the dnp's? head of the pack or just another np...the only difference will be the letters at the end of their name

PMFB-RN, RN · Apr 28, 2011

I'm old enough to remember when it became a requirement for NP's to have Master's Degrees. At first people disagreed, saying that the MSN inclusion of research, theory, leadership, etc. was not necessary for an NP. Those voices died out as the NP's without MSN's retired and a new generation of NP's who all had MSN's took over. My point is that there is a good chance that the same thing will happen with the DNP issue. quote]
*** Yes, I agree it is very likely to happen with DNP as well. Eventually those with legitimate criticism of DNP as entry to practice will retire and will no longer be around to voice their points. Are you suggesting that those who disagreed with MSN as entry to practice changed their minds because you no longer hear from them?
Another huge difference is that MSN is actually mandated. DNP is a suggestion.

dp1200 · Apr 30, 2011

*** Criticism is healthy. Not every idea that come down the pike is a good one. We have had our share of ridiculous ideas being foisted on us. Scripting, electronic nurse tracking among them. The DNP seems to fit into this category to me. A solution to a problem that doesn't exist.

This is exactly how I see it as well: DNP is a solution to a non-existent problem. There is a wise old phrase from the story of Nixon's Watergate scandal that I like to apply to situations like this: Follow the money.

In the case of DNP as entry to advanced practice nursing, where does following the money lead to? Academia. From the beginning, this move has been pushed by who? The American Association of Colleges of Nursing. Academia wants this because it means they get two more years of tuition and fees out of people who want to be NPs.

This move would make a lot more sense if it were being driven by hospitals, physician practices, or patient advocacy organizations due to an actual clinical deficiency of Masters-prepared NPs. Has anyone seen any indication that MSN-NPs are inadequate to satisfy their scope of practice? Are their patients dissatisfied with their care? If there was a clinical need for mid-level providers to start as DNPs, then academia would not need to be trying to force it, would they?

I think we need to consider this MSN-NP vs. DNP debate from a context that has been missing on these threads so far: the financial condition of our health care system as it stands today, and what will be happening to it over the next few decades. I doubt anyone will argue the point that regardless of what Washington does with the politics, our healthcare system is stretched to the limits and cost-cutting will be the name of the game for the foreseeable future.

As such, we all reasonably expect to see increases in the need for mid-level providers such as NPs and PAs, who can take some of the load off physicians at a lower cost. So why do we need to throw up an obstacle - the DNP - to people who want to practice as NPs if there is no demonstrated clinical justification?

A person willing to invest the time and money into a DNP would rightly expect to get some financial benefit from it, no? I sure would. So if we push the DNP as the mandated entry point for advanced practice nursing, aren't we increasing the cost of healthcare and diminishing the value of NPs as midlevel providers? Is this wise in today's economic climate?

With money being as tight as it is, I would expect MSN-prepared NPs would have somewhat lower expectations in terms of financial compensation than someone who spent the money and effort on a DNP (again, I certainly would). So, doesn't this make an MSN-NP more attractive to a hiring hospital or practice than a DNP, if there is no clinical need to warrant the DNP?

mbuchanan2107 · May 8, 2011

Correct me if I am wrong, but isn't the reason for the big push to have MSN NP's move toward a DNP degree is because many physicians did not think that NP's have the proper knowledge to practice as they are currently? I see your point on the impact this change will have in regards to cost and would think those who holder higher degrees should be compensated properly, just as one should in regards to years of experience. I am in my MSN program currently and have been debating on whether to continue on to obtain my DNP. I did speak with one of my preceptors who gave me some insight concerning the requirement of NP's to become certified. She graduated from her program when it was not required to be certified, but she took the test anyways. Everyone in her class laughed at her for taking the test and thought it was a waste of time. Since then, my preceptor has seen the impact on those NP's that did not become certified and that they are now only able to get certain jobs. I am assuming that may happen in the future, not any time soon, to MSN NP's. It is only an assumption, but one will never know until we see how the DNP will continue to evolve, just as we watch how the healthcare system is evolving.

I also hate to see so many fight about DNP vs. MD vs. PA. If I get my DNP, I would not expect to be called Dr, but would hope that other healthcare providers, including physicians do see that I took the time to become more knowledgeable and get the higher education. We all do need to collaborate and work together and no one person is better than another. We all need to do our job to ensure proper patient care.

PMFB-RN, RN · May 8, 2011

correct me if i am wrong, but isn't the reason for the big push to have msn np's move toward a dnp degree is because many physicians did not think that np's have the proper knowledge to practice as they are currently?

*** that is incorrect. the push for dnp is entirly "nurse" driven. even if it was the case why in the world would we give a rat's behind about what physicians opinions are?

i also hate to see so many fight about dnp vs. md vs. pa.

*** it's not dnp vs anything. a dnp is just an academic degree and doesn not lisence anyone to do anything. like having a bsn doesn't qualify you to be a nurse, your nursing lisence does. it would be correct to say "np vs. md vs. pa.

if i get my dnp, i would not expect to be called dr, but would hope that other healthcare providers, including physicians do see that i took the time to become more knowledgeable and get the higher education.

*** who cares what physicians see about our profession. do you think the physicians spend any time thinking about how nurses view their academic credential?

SoonToBeFNP · May 8, 2011

Hi Student FNP,

I recently finished my MSN/FNP program at Regis College and have been having the same fight with myself of whether or not to pursue the DNP. A few weeks ago I would've said no way am I taking more classes BUT then several colleagues of mine had brought up the issue of not only continuing to advance my education as much as I can, but also job security. If I was in my 40s or 50s I don't think I would be even thinking about going back for my DNP as it is not well recognized at this point and it wouldn't be neccessary for my job...just an added bonus. But since I am young, eventually (10-15 years down the road) I will be competing with NPs who have the same experience but they will have a DNP and myself an MSN. I definiately believe that employers pick people, not degrees, but it can't hurt. Ultimately I've made the choice to continue.

Also a couple of you on this thread had mentioned that you've been quite frustrated with the DNP curriculm as it is supposed to be a clinical doctorate, as opposed to a PhD. Most of the schools that I have researched only have a leadership component but there are schools now starting to change that. My school currently has a few DNP tracks that work with education, health policy, public health, and leadership but they have announced that they will be starting new tracks in the fall for hospitalists and those who which to remain at the bedside. It's not on their website yet, but if talk to their nursing department or look at the website in a few months it should be unveiled. As their programs are designed to only meet one day a month or as an online or hybrid course, it makes it very easy to complete if you are living away from the MA area.

CCRNDiva, BSN, RN · May 8, 2011

Hi Student FNP,
I recently finished my MSN/FNP program at Regis College and have been having the same fight with myself of whether or not to pursue the DNP. A few weeks ago I would've said no way am I taking more classes BUT then several colleagues of mine had brought up the issue of not only continuing to advance my education as much as I can, but also job security. If I was in my 40s or 50s I don't think I would be even thinking about going back for my DNP as it is not well recognized at this point and it wouldn't be neccessary for my job...just an added bonus. But since I am young, eventually (10-15 years down the road) I will be competing with NPs who have the same experience but they will have a DNP and myself an MSN. I definiately believe that employers pick people, not degrees, but it can't hurt. Ultimately I've made the choice to continue.
Also a couple of you on this thread had mentioned that you've been quite frustrated with the DNP curriculm as it is supposed to be a clinical doctorate, as opposed to a PhD. Most of the schools that I have researched only have a leadership component but there are schools now starting to change that. My school currently has a few DNP tracks that work with education, health policy, public health, and leadership but they have announced that they will be starting new tracks in the fall for hospitalists and those who which to remain at the bedside. It's not on their website yet, but if talk to their nursing department or look at the website in a few months it should be unveiled. As their programs are designed to only meet one day a month or as an online or hybrid course, it makes it very easy to complete if you are living away from the MA area.

That's so good to hear:yeah: :yeah: :yeah: :yeah: ! I've been looking for a DNP program with a true clinical focus. Thanks for the update!

Congrats on obtaining your MSN and pursuing your DNP!!