Is the DNP a real threat, or a paper tiger?

[Instatewaiter]

You should spend the 8 years because you'll be better educated than a mid-level provider. Most nurses know this. Taurus takes quotes from fringe members of nursing like Mundinger and spouts them as if everyone in nursing believes her words to be gospel. If fact, in most circles, she's thought a fool.

Mundinger is far from a "fringe" member. Not only is she the founder of the DNP degree and one of the most vocal, politcally active nurses but she is also the dean of one of the better respected nursing schools, Columbia.

She is the person who is putting out all of those questonable studies that say that NPs=MDs. Her quotes lead people to believe that DNPs have equivalent training, are equivalent if not better prepared than an MD and take the same exams as MDs need to, to get licensed. She is the face of DNPs, and frankly if you dont like people assuming all NPs feel this way, you and all of your nursing peers should do something about it.

To do nothing, means that you condone what she says. I have heard of no nurse ever go on record and disagree with Mundinger. Police the people who speak for your group! If nurses really disaggree with Mundinger, someone needs to publically go on record and disagree with what she says- not just some passive "she doesn't speak for nurses" on an annoymous internet board.

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[deleted6669]

fyi- mundinger is no longer dean of the school of nursing at columbia. she has been replaced.

 

[Cp22kjer]

fyi- mundinger is no longer dean of the school of nursing at columbia. she has been replaced.

Hmm, I wonder why? Any idea where/what she's doing now?

 

[VassarLiberal]

Confirmed: "Mundinger to step down"

The article doesn't indicate where she's gone. Apparently, she's not running for reelection on the board of Gentiva.

 

[deleted6669]

Hmm, I wonder why? Any idea where/what she's doing now?

experimenting on kittens in a dirty underground lab somewhere to try to turn them into dogs with all the rights and privileges of dogs without having dog parents.....
someday these "kogs" or "dittens" will be able to fill all the roles of dogs and dogs will no longer be needed.....these kogs will be more caring than real dogs because of their cat background so they will have all the purring of a cat with all the growl of a dog.
and they can be gestated in less than half the time once the genetic manipulation is worked out....

 

[VassarLiberal]

experimenting on kittens in a dirty underground lab somewhere to try to turn them into dogs with all the rights and privileges of dogs without having dog parents.....

 

[Charles_Carmichael]

experimenting on kittens in a dirty underground lab somewhere to try to turn them into dogs with all the rights and privileges of dogs without having dog parents.....
someday these "kogs" or "dittens" will be able to fill all the roles of dogs and dogs will no longer be needed.....these kogs will be more caring than real dogs because of their cat background so they will have all the purring of a cat with all the growl of a dog.
and they can be gestated in less than half the time once the genetic manipulation is worked out....

This post is so full of win!

 

[deleted6669]

critics of the kog concept state that kogs should have to undergo a full season of obedience training just like dogs followed by specialty training in water retrieval, tennis ball, or mail man chasing.
mundinger countered by saying " our kogs have prior experience as cats so watching a painting of dogs playing poker for 5 min is more than adequate for the kogs to take the place of dogs in any situation".
the american kennel club has been slow to respond to the kog threat and independent dog breeders are starting a grassroots movement to make sure kogs never get admission privileges to dog shows and other traditionally canine events.
unfortunately a small dog show in tulsa has already stated that they will welcome kogs when they hit the scene due to a shortaage of actual dog entrants to their annual show.
veterinarians refuse to deal with kogs because "they are not even real animals-go ahead, find me one in a textbook". a midlevel vet group calling itself "kogians" are trying to gain the right to take care of kogs in rural medical settings. so far only 12 states will allow this.
religious extremists also are coming out against kogs as "they weren't even on the ark with noah".
more to follow as the situation develops....

 

[VassarLiberal]

critics of the kog concept state that kogs should have to undergo a full season of obedience training just like dogs followed by specialty training in water retrieval, tennis ball, or mail man chasing.

Water retrieval = geriatrics?

 

[TexasFight]

This post is so full of win!

It was as full of win as mundinger is full of evil

 

[deleted6669]

the american kennel club is finally starting to see the trend and wants to oversee kogs and have some say in their breeding and domestication however mundinger claims that even though they can replace dogs they are really cats after all and should be overseen by the editors of cat fancy magazine, which she just happens to be the owner of.
mundinger claims that a new (watered down) obedience school practical exam should clarify once and for all that kogs have a place in the world and should be allowed to fill any dog role.
for whatever reason less than 50% of her hand selected kogs were able to pass this exam which consisted of fetching a single stick once and did not include running an obstacle course, pulling a fireman clear of a burning building, assisting a blind man or detecting drugs on smugglers like the dog exam does.
after these initial failures with kogs that were bred onsite at mundinger's home she is now making kog training available over the internet to animals that weren't even ever cats. rats will be allowed to watch videos and come to her house 1 weekend/yr for 2 yrs for "intensive kog applications training". these direct entry kogs are already flooding the market and even critics of the kog concept say that they prefer the traditional kogs who at least have cat experience to this new breed of younger rat based inexperienced kogs.

 

[deleted6669]

I love it. What is your stance on breeding for specific traits ie "caring"? Would the progeny be spies by default or potentially cost-saving?

or more importantly what if someone crosses a kog back with a real dog?
would it be a dok or just be able to use that title? it would after all be a Dog-based Natural Pet(DNP).

 

[Taurus]

Taurus's posts depend more on hyperbole than reality, something you'd know if you'd been around long enough to have the misfortune of reading his never-ending rants.

You should spend the 8 years because you'll be better educated than a mid-level provider. Most nurses know this. Taurus takes quotes from fringe members of nursing like Mundinger and spouts them as if everyone in nursing believes her words to be gospel. If fact, in most circles, she's thought a fool.

If you read the Time article, it wasn't written by Mundinger. Mundinger has made the kool-aid and many have become drunk with it. There are many NP's out there truly believe that NP = MD based on what people like Mundinger tells them. They like to reference the poorly designed studies that Mundinger wrote. By now fab, you should know I can back up my statements with evidence. People will make up their minds based on the facts. Argue with the facts not me.

In the recently released House health-reform bill, nurse practitioners (and physicians' assistants, another relatively new, but smaller, category of medical professionals who can perform medical procedures and often prescribe medication) are listed alongside doctors as primary-care providers. Nurse practitioners lobbied hard for this legislative language in meetings with White House health officials, including Nancy-Ann DeParle, Obama's health-reform czar. The nurse-practitioners lobby is hoping such federal recognition of the central role the profession can play in a revamped health system will exert pressure on states to ease restrictions. A patchwork of state laws now dictates how much freedom nurse practitioners have, ranging from states like Alabama, where nurse practitioners can work only under the supervision of a physician, to Oregon, where nurse practitioners are permitted to run their own private practices.​

The NP are using their lobbying power to expand their scope. An important solution will be to arm the trial lawyers and insurance companies with information about training differences. If NP's want to play the game, then they should pay more to play and be willing to accept the catastrophic consequences if they lose. That seems fair to me.

 

[VassarLiberal]

The NP are using their lobbying power to expand their scope. An important solution will be to arm the trial lawyers and insurance companies with information about training differences.

Sadly, in quite a few states, there's more precedent than there should be that demonstrates how nursing practice and medicine overlap depending on who is providing the care. The idea of charging NPs with practicing "medicine without a license" is weak, at least, in a legal sense (though certainly true from a training perspective). Still, if an undertrained NP manages a very complicated patient and messes up, they're liable and easy to wring money out of (and maybe get policy changes for the state made)! And it'd be easy to convince the court that their minimal training was a problem (and the lack of supervision, too, especially if they were credentialed as an MD equivalent by the hospital – negligence = cash money). At least, that's what it seems like.

Hmm...Maybe the NP problem is going to be resolved in courts and state legislatures more than by physicians, PAs, and NPs.

 

[Taurus]

Sadly, in quite a few states, there's more precedent than there should be that demonstrates how nursing practice and medicine overlap depending on who is providing the care. The idea of charging NPs with practicing "medicine without a license" is weak, at least, in a legal sense (though certainly true from a training perspective). Still, if an undertrained NP manages a very complicated patient and messes up, they're liable and easy to wring money out of (and maybe get policy changes for the state made)! And it'd be easy to convince the court that their minimal training was a problem (and the lack of supervision, too, especially if they were credentialed as an MD equivalent by the hospital – negligence = cash money). At least, that's what it seems like.

Hmm...Maybe the NP problem is going to be resolved in courts and state legislatures more than by physicians, PAs, and NPs.

Malpractice suits against advanced practice nurses are rising in number and increasing in severity, according to malpractice insurers.

Nurses once were, for the most part, outsiders in the physician-led fight to reduce malpractice insurance rates. Sheltered no more, nurse practitioners are finding their annual malpractice costs tripling, nurse-midwives are facing annual premiums as high as $35,000, and only one company is willing to write policies for nurse anesthetists​

Does it make any sense for the insurance premium of a 16 year old driver be the same or lower than a 50 year old with many years of experience? Likewise, does it make any sense for the malpractice premium of someone who only has 500 hours of clinical training be the same or lower of someone who has received over 17,000 hours? This is a huge money-making opportunity for trial lawyers and insurance companies and we need to encourage it. We just need to arm them with the right information. If NP's want to practice medicine and consider themselves equivalent to MD's, then they will be held to the MD standard of care.

 

[VassarLiberal]

We just need to arm them with the right information. If NP's want to practice medicine and consider themselves equivalent to MD's, then they will be held to the MD standard of care.

Definitely. And, as you said, the lawyers will have a field day. Could be a hell of a thing to see!

 

[zenman]

I was at Rush University this last week and a faculty member who knows says that Mundinger was the only dean that chose to have students take the watered down step 3. No dean of any other DNP program did the same. In fact, development of any DNP exams are 5-10 years away...if anyone cares. Looks like Mundinger was one of a kind.

 

[Auxiliary Nurse]

What I've been hearing in the Nursing World is that if you become a DNP you will be like a Doctor. That's what I've been hearing. I've never heard something like " if you get a DNP you will be a Doctor in Nursing". All I've heard is that if you become a DNP you will be like a Doctor(MD/DO). It is a threat? It is a threat to the patient. Everybody on this forum knows that this is just a soft tittle to permit Nurses to practice medicine independently and completely. My mom and I are very concerned about this. Three weeks ago my grandma had a complicated flu that led into a chest congestion. We took her to the Physician. My mom and I were very sure that she was taken care of by a physician. I even asked her twice: Mom, was she seen by a physician? Some NPs are wonderful but I think that there has to be more rigorous training to let them practice independently. For example: my mother was seeing a doctor. But she never got to see the doctor. She always had to see the NP. My mother said that she didn't like it because the NP prescribed a lot.


P.D: I am so sorry for resurrecting old threads. This is a very interesting forum.

 

[PikminOC]

Uh, over half of states allow NPs to practice independently without MD oversight. What exactly is it they're "never" going to achieve?

I fully expect within our careers DNPs calling themselves "Doctor" and claiming equivalence with MDs will become quite common. MDs will roll their eyes and snicker about them behind their backs and otherwise do nothing about it. The public will, as always, believe that whoever spends longer in the room is providing better care.

Until the (*(^ hits the fan.