Will doctoral requirements change the scope of advanced practice?

[RNMAN2010, CRNA]

i currently work in an sicu divided into provider "teams" of residents and acnps, each guided by an attending. the acnps are a permanent group on our unit and a blessing to the bedside nurse; as surgical and anesthesia residents come and go along their journey learning icu patient management (and causing minor headaches). our advance practice nurses really do just about anything an intensivist can, with some limitations set by our hospital (lumbar puncture). i know advance practice is not like this everywhere. will things change with the doctoral requirements? is that the big idea? what about other practitioners: nps, fnps, crnas, midwives. i will be starting a crna program next year with a masters requirement, i don't plan on getting a doctorate (not in nursing anyway) if it won't change my practice.

[zenman]

It's not going to change my practice at all nor will it increase my salary. It will keep your university financially stable and increase your debt load if you go that route.

[Corey Narry, MSN, RN, NP]

Scope of practice will not change just because of a doctoral degree. The publicity behind the DNP from some nursing camps have increased confusion, triggered turf wars, and have cast doubts as to it being necessary given how the degree evolved to its current state. Scope of practice for any advance practice nurse is determined by the individual states through the Boards of Nursing and in some states, with some oversight from the Boards of Medicine. It would take each state board to pass legislation to change scope of practice and so far, there is no significant activity within states that is pointing to that direction in terms of the DNP. There is a Consensus Model that is now being proposed for implementation by 2015 and the NCSBN (the national association of Boards of Nursing) is on board with it. It, however, has no provision to increase the current limits in scope for NP's and makes no mention of the DNP.

[Corey Narry, MSN, RN, NP]

i currently work in an sicu divided into provider "teams" of residents and acnps, each guided by an attending. the acnps are a permanent group on our unit and a blessing to the bedside nurse; as surgical and anesthesia residents come and go along their journey learning icu patient management (and causing minor headaches). our advance practice nurses really do just about anything an intensivist can, with some limitations set by our hospital (lumbar puncture). i know advance practice is not like this everywhere.

there is nothing written in legislation in each state preventing acnp's from functioning in this manner. while this practice arrangement is largely seen in big cities and major metro areas, ignorance of what acnp's are capable of accomplishing and contributing to icu management continues to be the biggest hindrance to why you don't see this arrangement as often. there has been published data on positive outcomes when acnp's are added to the provider teams in icu's.