New Degree Creates Doctor Nurses

[bushdoc]

I heard this on NPR.
Found it quite interesting.
I searched, but couldn't find it, so thought I'd post it up.

Any thoughts?

http://www.npr.org/templates/story/story.php?storyId=100921215

---

Members don't see this ad.

 

[SpecialmED]

Not saying that this was going in a bad route but I'll go ahead and head it off anyways. The program your speaking of is the degree of Doctorate of Nursing Practice (DNP). When you graduate you are licensed to work as a nurse practitioner. This is similar to the rights of a PA, except the abiltiy to practice independently of a physician.


With that said, in no way does the degree mean that you can refer to yourself as a "doctor" "physician" etc, to do so in a clinical setting would be illegal. Furthermore no self respecting nurse would ever do this, and the curriculum stress the difference of your practice between that of a doctor, including the limitations.

I know that I'll still see threads claiming that "nurses want to be called doctor" and so forth. If someone sees that who have read this could please lay some knowledge on them it would be much to the betterment of the world.

 

[hemoglobincell]

It's really slimy that this degree even exists. What else would you learn by getting a "doctorate" in nursing? You can't always improve your work by getting additional schooling - nurses are technicians, trained to carry out certain tasks. They learn everything they need to know in nursing school. Everything they are learning beyond that is a waste because the system already has physicians to take care of everything else. They do not diagnose and they do not prescribe.

Because there is no need for doctor nurses, the reasons for their existence must be more sinister. By NO means should a doctor nurse ever be allowed to give direct primary care without a physician.

It is really troublesome to read the comments in articles like these. It won't be long before people see their family practice doctor as someone who wasted their time going to medical school to do what the nurse practitioners do. I really hope that the new nurse practitioners and nurse doctors are not the ultimate solution. I have never met a nurse who had what it took (intelligence-wise) to get into medical school.

Why isn't anyone standing up and taking legal action when this sort of thing happens? I remember reading someone's comment (I believe it was Law2Doc), stating that physicians should band together like the lawyers do and sue all the paramedical entities into oblivion. Whenever another field starts getting into the strict field of "practicing law", the lawyers did not hesitate to pull the trigger.

There should only be DOCTORS and NURSES, with clearly-defined, legally-protected roles. The role of doctor has always been vague, limited oftentimes to "well, doctors can diagnose disease and prescribe medication". Now, even that thin amount of territory has been encroached on.

Reading articles like this makes me want to start studying for the USMLE right now. I ABSOLUTELY do not want to end up in any primary care residency. The sucky reimbursements coupled with the new (less educated) competition doesn't sound very appealing. Specialization will be the only buffer (for now) to keep the nurses at bay. I can imagine someday that less than 25% of med school graduates become primary care docs, with the nurses opening practices all over the place without the debt (so, with a leg up).

We need a strong lobby to go to the various state legislatures and press them to define "What is medicine?" legally, and then to stomp out programs like this before they gain too much footing.

 

[neurolddoc]

- nurses are technicians, trained to carry out certain tasks. They learn everything they need to know in nursing school. Everything they are learning beyond that is a waste because the system already has physicians to take care of everything else.

I hope you are not overly attached to the current status of your rectal sphincter. If you walk into your first ICU rotation with that attitude then the nurses will surely ream you a new one.

 

[badasshairday]

I hope you are not overly attached to the current status of your rectal sphincter. If you walk into your first ICU rotation with that attitude then the nurses will surely ream you a new one.

lol.

 

[badasshairday]

Personally, NP's play a role in health care, but what is the need for the new doctorate? Is a DNP receiving any more practice rights than an NP? If not, that what is the point?

 

[meister]

I hope you are not overly attached to the current status of your rectal sphincter. If you walk into your first ICU rotation with that attitude then the nurses will surely ream you a new one.

I'm seconding this. A lot of the nursing staff, and definitely the NPs in the ICU, will simply own your ass not only as a medical student but also as a physician-in-training. The hospital would quite literally be nearly shut down without their help.

That being said, a lot of the DNP movement does stink of ego-stroking envy. And I personally know at least two people who are going to get a DNP solely because they could not get into medical school. That won't really influence my interaction with NPs on a daily basis in the hospital, but politically it definitely does affect my opinion of their profession. At this moment their scope should remain limited and supervised, and the current momentum towards granting unlimited practice and hospital admission privileges is not going to do anything to improve patient care, just the bottom line for hospitals.

Unfortunately for us hospitals care mostly about that last part. I think the writing is already on the wall when it comes to giving DNPs unlimited scope in an outpatient non-surgical setting. They have that de facto already. Until their training is extended and their schooling is more standardized they should not have an expanded scope.

 

[SomeDoc]

There's nothing slimy or wrong with it as some have posted, but that is just my opinion.

This is what happens when medical students shy away from primary care, and when overseeing administrative bureaucracies create tight controls on the number of graduating medical students for decades, leading to the creation of physician shortages.

A DNP may have a tough time competing with an MD/DO practice group in a desirable location. The opposite may the case in a rural area where medical graduates don't want to practice. These professionals have potential to fill in the void created by us in underserved areas.

 

[Cp22kjer]

I read a post a while back linking a few of these new DNP programs to their curriculum which consisted mainly of online training components. This in my opinion is a questionable approach for awarding someone a "Doctorate".

I also believe that legislation is in the works or has been passed stating that DNP's are not to be referred to as "doctor" or "physicain".

Promoting education is a wonderful thing but the ANA or whoever should have just reworked the NP's curriculum if they intend to "parallel" PA's. Now there's just more letters to add..... not to mention a now larger hierarchy of nursing egos. Nurses are essential and I realize this but you've got to question the point of having a DNP and more importantly the education required to be one.

 

[Daemos]

Well a Doctorate in the end is just a dsgree, most countries around the world do not give out a doctorate for finishing medical school, you end up with something like MBBS, MB ChB, etc...which are all bachlors degrees...but they are medical doctors.

I think at least in North America, every profession wants to have a 'doctorate' degree, even if it doesn't mean more training or education over a regular bachlors and is a doctorate just in name sake.

 

[cpants]

Thanks for posting. I put it on to listen, and was surprised to hear that most of the interviewees were in my own home hospital.

Mundinger is such a slimeball. It's obvious that this is a strategy meant to equate the DNP with the MD, at least in the patients' minds. She has made quotes to that effect in the past as well. I love her response to the question about how patients will know the difference between MD's and DNP's. She says because the DNP will say "Hi I'm Dr. Mundinger, I'll be your nurse." Yeah...right.

 

[mlw47]

I think that we should retaliate.

Every med school should start conferring RN or MSN or DNP degrees to their graduates as well. See how they like it when we start to dilute their title.



Forget this DNP crap. It's time for an RN/MSN/PA to MD bridge program. That's the debate we should be having.





Also, it's laughable when the nursing camp says that advanced practice nurses can help with the "MD gap" in primary care. Why would advanced practice nurses want to go into primary care? They'll be under the same financial and work pressures as MDs not to go into primary care! That and there's not 60,000 unemployed advanced practice nurses just sitting around looking for primary care jobs...

 

[niranjan162]

Theres a thread in the gas forums about the NBME making a standardized test. Its basically a watered down version of the USMLE step 3 for nurses.

http://forums.studentdoctor.net/showthread.php?p=7775550#post7775550

Anesthesiology is the forefront of the nursing takeover. CRNA's are trying to get equal practice rights as MDs and DOs. I believe they already have independent practice rights in 14 states.

Nurses will try to take over primary care. They'll do it as a stepping stone to other specialities.

Its all basically white coat envy. The DNP curriculum is a joke. Physicians need to start getting more politically savvy soon, or the profession will go down the tubes.

 

[Forthegood]

Next major division of SDN is the DNP. After all, they are doctors, so they should have a place on the student doctor network. Actually, they could put that under the "Highschool" thread. Because a good number of the prehealth students have more clinical experience than these DNPs have. Especially if they opted for the Online DNP.

 

[stefanlukic]

We've had an equvalent to that title for about 3-4 years now.
The equivalent to that title here is called a High nurse because they have the 7th step of education which is birocratically the same as physicians.
And from my experience those nurses are a lot worse than regular nurses.
I was their anatomy lab teacher for a year (yeah students can do that here) and I was amazed by how compact their curriculum is, but they were still bitching about the volume....
I was their ICU teacher (no one else wanted to take them so they turfed them to a student) and I noticed that they didn't have any idea what I was talking about.
They really had no idea about physiology (acid/base, ventilation, pressure control...). Their whole practice was based on: "See that, do that, don't think about that".
I think that medicine is taking a dangerous road by allowing them more decision making.
They have the arrogance of the worst doctors but they don't even have the knowledge of a 3rd year MS.

 

[midwesterner]

It seems like all this NP licensing came so quickly, and just 10 years ago this was a non-issue. Physicians do need to organize better, and need an organization truly dedicated to fighting for their political/legal rights.