DNP Curricula

[Status Sciaticus]

clearly

by and large


You again missed my point, and I'm not sure if you're willfully ignoring what I'm saying or if you're just a bit oblivious to the world of inpatient care. RNs have judgment too, and MDs rely on them to to exercise it to help assess the efficacy of the treatment plan.

Guys and gals, we're all on the same team here. Simmer the fck down about this issue. RNs are our friends (many exceptions, of course), and NPs mostly aren't out to get err jerrbs, and frankly if you're worried about patient confusion let me assuage you with the simple truth that patients will confuse a mop handle for a physician if a scrub top is draped over it.

pot kettle black

What exactly is your point?
And you are talking about RNs while I was talking about DNPs/ future DNPs in my first argument.

If you read previously the ANA may want this but it is not going to happen. They originally said all programs will be translated to DNP programs by 2015. But look here at this
http://admissions.nursing.ufl.edu/files/2011/06/MSN_Exit_Option_Extto2020.pdf
It's not happening by 2015, because significant progression was not achieved.
As for the reimbursement, I agree with you. Nurse practitioners will never be physicians is my point, unless they go to med school of course

I wasnt aware of the delay to 2025. I am just saying that this whole issue came about when the DNPs that were demanding to be called doctor in the hospital environment hit the headlines.

I think RU brings up a good point though. Just as allnurses would engage in hyperbole, exaggeration, and overly generalized statements, so too will SDN - and frankly I think you're guilty of it multiple times in this thread. I would argue that nurses are also responsible for the health of the patient. Try telling a critical care nurse otherwise, while she's titrating vasoactive drips to effectiveness in a fresh surgical patient while monitoring for complications. The roles of the physician and the nurse are very different, but the responsibility for the health of the patient is, from what I can tell, a shared responsibility.

I agree with you that they are different professions. Its the need that some nurses and DNPs have to justify and compare their roles and responsibilities to physicians that leads to heated debates like this.

If their roles are by and large different from physicians, then why demand to be called doctor? why say that they can provide better care than physicians? See where I am getting at?

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[deleted307836]

What exactly is your point?
And you are talking about RNs while I was talking about DNPs/ future DNPs in my first argument.

Uh, you were clearly talking about "nurses" and "RNs" in the post RU just responded to.

I agree with you that they are different professions. Its the need that some nurses and DNPs have to justify and compare their roles and responsibilities to physicians that leads to heated debates like this.

If their roles are by and large different from physicians, then why demand to be called doctor? why say that they can provide better care than physicians? See where I am getting at?

And again you're purposefully redirecting the point. This is not what you were just posting about...

 

[RogueUnicorn]

What exactly is your point?
And you are talking about RNs while I was talking about DNPs/ future DNPs in my first argument.



I wasnt aware of the delay to 2025. I am just saying that this whole issue came about when the DNPs that were demanding to be called doctor in the hospital environment hit the headlines.



I agree with you that they are different professions. Its the need that some nurses and DNPs have to justify and compare their roles and responsibilities to physicians that leads to heated debates like this.

If their roles are by and large different from physicians, then why demand to be called doctor? why say that they can provide better care than physicians? See where I am getting at?

bro. bro.

 

[Status Sciaticus]

Uh, you were clearly talking about "nurses" and "RNs" in the post RU just responded to.




And again you're purposefully redirecting the point. This is not what you were just posting about...

Look at my first and second posts. They say DNPs. The RN comment was on my third post which was a response to RNs being brought into the topic by someone else, not me.

I already asked you what point are you talking about.... this is my second time asking.

bro. bro.

No comment to the post above?

 

[deleted307836]

Look at my first and second posts. They say DNPs. The RN comment was on my third post which was a response to RNs being brought into the topic by someone else, not me.

But RU was clearly responding to that third post so I don't see how that's relevant.

I already asked you what point are you talking about.... this is my second time asking.

No you didn't. I was responding to the aspects of your posts that I found hypocritical and incorrect.

No comment to the post above?

After this exchange,

bro. bro.

is really all that needs to be said.

 

[sliceofbread136]

Oh look it's this thread again...

 

[acceptmeplease]

I think getting butt hurt over the title doctor is interesting... Some of my nursing instructors had DNPs, but in clinical were referred to by their first names. Why? Because they didn't want to be mistaken for a physician.

Is being called "doctor" only a problem in clinical settings?

I've met quite a few nurses who can run circles around some of the doctors with whom we work. Does that mean they are smarter/know more about the human body? No. It simply means they have pattern recognition in relation to clinical practice down. They never operate outside of their scope of practice, but I'd be willing to bet their orders would be similar or as pertinent/safe as a physician if they had privileges to give them.

The idea that nurses are simply given orders and are supposed to unquestionably follow them is funny, gandalf. Ever been to a patient-advocacy meeting where standards of care, core measures, etc. are discussed? I've never seen a physician there. Isn't the physician responsible for creating orders which adhere to SOC and core measures? Yes. But pt/ot/nursing staff/nutrition/any other department is responsible for creating the CPOE order sets that physicians use in my hospital.

I think it is frightening how easy it is to get into NP school. CRNAs may be whiny about equality, but at least their entrance requirements are more difficult.

 

[BSNtoMD]

I think getting butt hurt over the title doctor is interesting... Some of my nursing instructors had DNPs, but in clinical were referred to by their first names. Why? Because they didn't want to be mistaken for a physician.

Is being called "doctor" only a problem in clinical settings?

I've met quite a few nurses who can run circles around some of the doctors with whom we work. Does that mean they are smarter/know more about the human body? No. It simply means they have pattern recognition in relation to clinical practice down. They never operate outside of their scope of practice, but I'd be willing to bet their orders would be similar or as pertinent/safe as a physician if they had privileges to give them.

The idea that nurses are simply given orders and are supposed to unquestionably follow them is funny, gandalf. Ever been to a patient-advocacy meeting where standards of care, core measures, etc. are discussed? I've never seen a physician there. Isn't the physician responsible for creating orders which adhere to SOC and core measures? Yes. But pt/ot/nursing staff/nutrition/any other department is responsible for creating the CPOE order sets that physicians use in my hospital.

I think it is frightening how easy it is to get into NP school. CRNAs may be whiny about equality, but at least their entrance requirements are more difficult.

+1
Unfortunately many of the traditional students on SDN and in the general population do not know much about the interdisciplinary professions of healthcare. I don't blame them for being uneducated about the subject, it's how the system was designed. More collaboration via nursing and medical schools is needed. There is a medical educator at one of the health systems in my area working to bridge this gap by having medical students and nursing students in the simulation lab working together in their specific roles. Respect is needed both ways.

 

[Pose]

I'm going to chime in and say that when I worked as an ED tech, about 25% of the new grads went back to school within a year. Every one citing that they want to be the ones giving orders. But the worst scenario was the boatload of the nursing student techs who went on to FNP programs after graduating nursing school. They used an advanced degree program as a backup to getting a nursing job. It's tough for them to get jobs these days, but still it calls into question the integrity of the graduate program.

 

[mvenus929]

I THOROUGHLY researched the NP route prior to making my decision towards physician. When I began looking at this site a while ago I was surprised at the lack of knowledge regarding nursing and the oppositional opinions towards nursing. On the other hand many nurses are uneducated about physicians and their training. I really hope to bridge this gap. They are COMPLETELY different professions in health care that need each other in order to provide the best care. Love thy nurse Love thy physician

I'm going to agree with this. My dad and the wife of one of my classmates are both nurses, and they have both mentioned on multiple times how shocked they were to realize just how much goes into training of physicians. My dad has further commented that he has a newfound respect for the docs he works with because of it.

Nurses (RNs and NPs alike) are part of an overall team to take care of a patient's care. We should not be breeding contempt for the other profession (I admit, it's really hard sometimes when you have a bad nurse or a bad doc).

 

[Mt Kilimanjaro]

I THOROUGHLY researched the NP route prior to making my decision towards physician. When I began looking at this site a while ago I was surprised at the lack of knowledge regarding nursing and the oppositional opinions towards nursing. On the other hand many nurses are uneducated about physicians and their training. I really hope to bridge this gap. They are COMPLETELY different professions in health care that need each other in order to provide the best care. Love thy nurse Love thy physician

If you're talking about a run-of-the-mill RN, of course they have different roles.

But in many states NPs can function as primary care providers just like MDs can, so the professions are no longer completely different in that case. I think the PA role makes much more sense overall, as there is no confusion about the PA's role and clinical relationship to physicians.

 

[Mt Kilimanjaro]

I'll toss this in here for posterity.

The poor doctor is outnumbered and outgunned. I'm not sure if all NPs are this militant, but some of their assertions about managing complex patients and clinical knowledge are concerning.

http://thedianerehmshow.org/shows/2013-03-26/role-nurse-practitioners

 

[whatbout2morrow]

Personally, I don't have a problem with it as long as it's made clear who the professional is. "Hi, I'm Dr. So and So and I'll be your pharmacist/nurse practitioner/physical therapist/doctor/what-have-you...

This right here.

I know of plenty of patients asking to see a "real doctor" (ie MD/DO) before settling on seeing an NP or PA. As long as there's no confusion on whether someone is an MD/DO or not, I don't think there's any problem. I can't imagine that DNPs would get away with representing themselves as medical doctors for long if they are doing so, I'm sure there are laws against that.

 

[Status Sciaticus]

This right here.

I know of plenty of patients asking to see a "real doctor" (ie MD/DO) before settling on seeing an NP or PA. As long as there's no confusion on whether someone is an MD/DO or not, I don't think there's any problem. I can't imagine that DNPs would get away with representing themselves as medical doctors for long if they are doing so, I'm sure there are laws against that.

Thats precisely the point. The AMA has argued that to say "Im Dr. So and So" is initially confusing to the patient because the word 'doctor' is understood by patients to mean MD/DO. Its made even more confusing since NPs/DNPs wear white lab coats like doctors as well.

There are only a few laws and only in certain states that require NPs/DNPs to disclose that they are not a physician or say that they are a doctor of nursing and not a doctor of medicine.

 

[Ashley1989]

Isn't all this solved by the fact that most hospitals require that any healthcare provider wear a badge front and center with their picture stating their name and a full list of their credentials?

BUT ANYWAYS

Come to think of it, I have a huge bone to pick with a NP who my mom went to see the other day. The NP CHANGED my moms blood pressure medication even though she's seen numerous doctors for her high blood pressure who keep her on this same medication, and also prescribed her diabetic medication even though she is not diabetic. Now, this NP may have reasons to prescribe her the diabetic medication whatever but I'm PISSED that she said all the doctors were were wrong about her BP meds and switched her medication. Heart disease is a huge problem in my family and I don't want some lady swooping in and messing with my moms meds. Ugh. *end rant*

 

[Arbor Vitae]

If yawlz not treating your nurse(s) properly, your going to have an abysmal time in med school, residency, and where ever you end up. Plain and simple.

i treat them nicely then treat them to dinner

 

[Status Sciaticus]

Isn't all this solved by the fact that most hospitals require that any healthcare provider wear a badge front and center with their picture stating their name and a full list of their credentials?

BUT ANYWAYS

Come to think of it, I have a huge bone to pick with a NP who my mom went to see the other day. The NP CHANGED my moms blood pressure medication even though she's seen numerous doctors for her high blood pressure who keep her on this same medication, and also prescribed her diabetic medication even though she is not diabetic. Now, this NP may have reasons to prescribe her the diabetic medication whatever but I'm PISSED that she said all the doctors were were wrong about her BP meds and switched her medication. Heart disease is a huge problem in my family and I don't want some lady swooping in and messing with my moms meds. Ugh. *end rant*

Most patients don't pay attention to the initials on your badge. Most think that anyone in a lab coat is a physician.

Sorry to hear about your mom. Although that NP has some nerve to say all her prior physicians who have a lot more training than her are wrong.

 

[RogueUnicorn]

Isn't all this solved by the fact that most hospitals require that any healthcare provider wear a badge front and center with their picture stating their name and a full list of their credentials?

BUT ANYWAYS

Come to think of it, I have a huge bone to pick with a NP who my mom went to see the other day. The NP CHANGED my moms blood pressure medication even though she's seen numerous doctors for her high blood pressure who keep her on this same medication, and also prescribed her diabetic medication even though she is not diabetic. Now, this NP may have reasons to prescribe her the diabetic medication whatever but I'm PISSED that she said all the doctors were were wrong about her BP meds and switched her medication. Heart disease is a huge problem in my family and I don't want some lady swooping in and messing with my moms meds. Ugh. *end rant*

Doesn't mean she's wrong

 

[Ashley1989]

Doesn't mean she's wrong

Doesn't mean she has the right to say four different doctors were wrong and that if she didn't take this medicine and get her blood pressure under control that she will die relatively soon.

Just sayin

 

[Status Sciaticus]

Doesn't mean she's wrong

Doesnt mean she's right.

When it comes down to it, I would trust the person with more experience than a person with less.
Its several physicians vs. 1 NP claiming they are all wrong... You think the real reason is that all the physicians are wrong or she wants to sound credible or superior in the eyes of the patient?

 

[RogueUnicorn]

Doesn't mean she has the right to say four different doctors were wrong and that if she didn't take this medicine and get her blood pressure under control that she will die relatively soon.

Just sayin

Again, doesn't mean she's wrong

Doesnt mean she's right.

When it comes down to it, I would trust the person with more experience than a person with less.
Its several physicians vs. 1 NP claiming they are all wrong... You think the real reason is that all the physicians are wrong or she wants to sound credible or superior in the eyes of the patient?

One should never blindly trust experience, it can also make you less likely to adapt. Do I think that the NP is more likely to be right here? No, but it's not an insignificant possibility.

Additionally, lay off the psychoanalysis, your proclivity to assign motives to people you've never met is disturbing to say the least.

 

[Status Sciaticus]

Again, doesn't mean she's wrong

One should never blindly trust experience, it can also make you less likely to adapt. Do I think that the NP is more likely to be right here? No, but it's not an insignificant possibility.

Additionally, lay off the psychoanalysis, your proclivity to assign motives to people you've never met is disturbing to say the least.

So because I question why an NP might be throwing out claims of physicians being wrong, it means I am disturbed or psychoanalyzing?

Please...

 

[Straw Hat]

I remember an article or news story about physicians overprescribing certain BP medications because they would get an extra cut from pharma. A pt would come in and have a borderline or even normal BP that could easily be treated with lifestyle modifications and the first thing done is slap them on medication. Obviously this isn't what every single doctor does but the point is it doesn't matter if you're an MD or NP. There will always be great healthcare providers and bad ones on both sides.

I feel like there's no point in debating over whether that NP is right or wrong because we don't have the full story. Maybe during her first visit with a busy physician he saw the typical high BP pt and assumed his usual prescription treatment would suffice. Then when she went to a new doc he saw what was previously prescribed and reasoned the same. Perhaps there really was a better drug to treat her. Maybe the NP took more time to evaluate the patient and found that better drug. Or perhaps the NP is overstepping and trying to prove they're just as smart as a physician and it's putting the pt at risk.

That insulin could've been prescribed to counteract any hyperglycemic side effects of the prescribed medication or maybe she was unknowingly diabetic (tons of people come into the ER not knowing they're diabetic for months then you check their blood glucose and it's in the thousands) - who knows, maybe mom didn't tell son/daughter all the facts so they wouldn't be worried. Or the NP is just nuts and randomly prescribed insulin.

Point is, you can play what if all day but it seems like the real underlying problem is premeds and probably some physicians feel very threatened by NPs. The fact is NPs/DNPs/whatever are going to be around and continue to fill in the huge gap in primary care (and anywhere else you can find much needed healthcare) so you might want to get used to working with other professionals or your job will get a lot harder. Heck if you can't respect NPs then you might not respect nurses in general and boy if you ever let them find that out you're going to hate coming to work (they are your eyes and ears, sometimes even the voice of reason).

The whole goal of both professions is to help people and improve their health right? To me that should mean learning how to work together and respect each other. Hopefully one day I'll get into medical school but I would love to see less debate about NPs and their "inferiority" and more about teamwork and how we can help people and make things better. I'd love to see an integrated system everywhere where nursing and medical students can see what the heck each profession consists of. This reminds me again of another article where a medical school provided a shadowing class (like 1 credit hour) for students to shadow professional nurses and they came away with a newfound respect and understanding of what nurses do. I know I've fallen off the path here and we were mainly talking about NP/DNP but it all boils down to nursing in general.

I do agree though that some nursing and master/NP/DNP classes can be fluffy (professional development and management classes) but those are there for nurses who end up in management positions, policy and protocol development, and other community leadership positions).

Also, I'd be interested in hearing what the family history is / any other diagnoses and what the medication was and what it was switched to. That might help make this debate a little more sane.