What do you think of this? Needing a PHD for NP?

[Taurus]

I just don't really think there is any substitute for seeing patients and laying hands on them.

I would further add that there is no substitute for seeing patients and having an instructor tell you what you should be looking for and discussing the pathophysiology, diagnostic criteria, management, etc.

That's how medical students and residents are trained. That's why it takes so many years of schooling. Getting an online degree and claiming that you're equivalent to physicians is a joke and a public health risk.

---

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[prairiedog]

Dear Richard and others,

You do not get banned on the SDN forums for espousing controversial opinions, provided you do this with tact and without resorting to inappropriate language, harassment, and other features that can be easily seen in the user terms of service (under FAQ).

You do get banned when your main reason for being here is to incite other users and deliberately bait others, particularly when one does this immediately upon registering. What also gets one banned is registering under an obviously trollish username and assuming that persona.

Now, if your name truly is Richard Head, scan in a birth certificate or another form of personal ID and send it to me. If that's true, then I will reinstate your original account, provided that, of course, you do not resort to trollish behavior and personal attacks. As no one in their right mind with the name "Richard Head" would choose to be called "Dick" I presume this request will not be fulfilled.

You can couch your banning and disappointment in whatever pathetic reasoning you choose (I see you went with both the "the guy who banned me is a coward" and the "you're silencing the truth" arguments this time). In truth, your posts were interesting and seemingly well thought out. A bit confrontational, but that isn't generally a huge problem. I suspect you know this, and are mainly here to draw attention to yourself and argue with people.
We have numerous professional, intelligent, and appropriate discussions on these topics you are referencing all over these forums. We do not censor people who can discuss things like adults. If you wish to return and discuss things as an adult, I suspect no one will have a problem with your existence. Believe me, I have no personal axe to grind in the matter.

So in trying to be consistent how do you not ban Taurus?

 

[Taurus]

So in trying to be consistent how do you not ban Taurus?

Because I don't spew out nonsense like Mr. Head who was here to spread propaganda and false information. Where have we seen that tactic before? Maybe check out the information that the AANA and ANA put out sometime.

Ever heard of evidence-based medicine? I make commentary (what, you want to censor free speech?), but I back up my statements with references so that everyone can see for themselves. I do my best to keep it factual.

I more than welcome any links you can provide that would contradict the information I have gathered.

Clinical training hours
DNP: 1000*
PA: 2400
MD/DO: >12000

*Offered PT & online

Yet, DNP's want to be called "Doctor", be autonomous in all clinical settings (outpt, inpt, ER), be equivalent to PCP's, gain full hospital privileges & pay NBME for cert exam.​

I gather pertinent information from many different sources all around the internet about the DNP and post it here for everyone. If the DNP's are so proud of their new degree, what's the problem with us really scrutinizing it? What is Mundinger et al hiding from the lawmakers, hospitals, the public, etc?

Yes, I know. The truth and facts hurt, especially when they don't support the propaganda put out by your group.

 

[aminoacid]

Here's a bunch of Nurses talking about Online DNP

http://community.advanceweb.com/forums/thread/25727.aspx

Quote:
I am currently enrolled in a DrNp program at Robert Morris University in Pittsburgh. The program requires you to be on campus one week each semester. The rest of the course work is done online.

Quote:
I am currently enrolled in TCU's DNP program that is online. This is their first year. It is $875 an hour and does not require attendence. Hope that helps

Quote:
I am completing a DNP online program this May at UTHSC. It is a great program that has more than a couple of options to choose from. You do have to go to campus 4x a year for a few days to meet requirements (for presentations and the occasional lecture), but residencies and coursework is done from home.

Quote:
I am currently in a blended program. I take courses online, and then attend a 3 day seminar each trimester
​

An online education for a clinical doctorate? Unbelievable. I'm dumbfounded. The worse thing about these posts is that these DNP students seem proud of this educational route.

 

[mig26x]

Here's a bunch of Nurses talking about Online DNP

http://community.advanceweb.com/forums/thread/25727.aspx

Quote:
I am currently enrolled in a DrNp program at Robert Morris University in Pittsburgh. The program requires you to be on campus one week each semester. The rest of the course work is done online.

Quote:
I am currently enrolled in TCU's DNP program that is online. This is their first year. It is $875 an hour and does not require attendence. Hope that helps

Quote:
I am completing a DNP online program this May at UTHSC. It is a great program that has more than a couple of options to choose from. You do have to go to campus 4x a year for a few days to meet requirements (for presentations and the occasional lecture), but residencies and coursework is done from home.

Quote:
I am currently in a blended program. I take courses online, and then attend a 3 day seminar each trimester​

I like the one that says " does not require attendance" and "residency and coursework is done from home". and Mundinger has the balls to say they are equal or better than MD's in preparation!!! I think someone has to educate the public better about the preparation of this joke of a doctorate call DNP.

 

[Therapist4Chnge]

I like the one that says " does not require attendance" and "residency and coursework is done from home". and Mundinger has the balls to say they are equal or better than MD's in preparation!!! I think someone has to educate the public better about the preparation of this joke of a doctorate call DNP.

That is my concern. There just ISN'T an equivalent for being there in person. The more time I spend in the clinical setting, the more I see the value of F2F...as there are subtle nuances to things, particularly when learning it for the first time. I know for psychiatric presentation (what I am most familiar with), there is no substitute for seeing the variety of symptoms a pt may exhibit. People may argue that there isn't a difference in book learning, but I think learning online lacks that immersion feel that can be present in classroom learning, not to mention all of the learning that happens between classes, during breaks, over coffee, attending seminars/brown bags/workshops. "Campus" time is really a big component of learning and shouldn't be minimized.

 

[Justine]

These online courses, do you need an MSN first? That would make more sense, if you're already a practicing ARNP with experience.

In any case, DNPs won't ever take the place of MD/DOs, in my opinion. Maybe in primary care, but I don't think there's any danger in overtaking the profession. Just my $0.02

 

[Jawbone]

These online courses, do you need an MSN first? That would make more sense, if you're already a practicing ARNP with experience.

In any case, DNPs won't ever take the place of MD/DOs, in my opinion. Maybe in primary care, but I don't think there's any danger in overtaking the profession. Just my $0.02

Exactly.

The fact that people are ignoring here is the educational preparation that was performed before the DNP. ~BSN>MSN>DNP. That's 3 different degrees, each with their own set of clinical hours, PLUS the clinical experience gained while working in the process of attaining these degrees.

I'll agree with everyone else that the DNP does not make one an independent practicing physician. I will say that the amount of panic and maniacal browbeating shown by some of the medical students here is dumbfounding.

There is a place for midlevels in healthcare. Mundinger is nuts. That doesn't mean that every midlevel or DNP-aspiring NP needs to be tarred and feathered on SDN.

-----------------------------------------------------------
Quoting Taurus in response to no being banned:
"Because I don't spew out nonsense like Mr. Head who was here to spread propaganda and false information. Where have we seen that tactic before?"

But you do. You constantly prowl this sub-forum, attacking the educational choices of midlevels. You pop in, drop a big steaming load of rhetoric and leave. If you're so concerned about spreading the word about the horrors of midlevels, why would you do it here, on a midlevel forum, among people who don't give a crap about what someone else thinks? Go do it in the med student forum with your fellow future physicians who will apparently be jobless thanks to us disgusting bloodthirsty midlevels. Leave us in peace to discuss our own issues.

 

[mig26x]

Exactly.

The fact that people are ignoring here is the educational preparation that was performed before the DNP. ~BSN>MSN>DNP. That's 3 different degrees, each with their own set of clinical hours, PLUS the clinical experience gained while working in the process of attaining these degrees.

.

so lets make fellowship online! since physicians have the MD plus 3-4 years of residency!!!

 

[Taurus]

There is a place for midlevels in healthcare. Mundinger is nuts. That doesn't mean that every midlevel or DNP-aspiring NP needs to be tarred and feathered on SDN.

Mundinger is the creator and de facto leader of the DNP movement. She is the one who keeps pushing for the power grab. First with the DNP, then with the NBME.

If so many nurses don't agree with her, then it's your responsibility to muzzle her. Why does that concept seem to be lost on so many nurses? As long as she is grabbing for more, the physicians will respond. I am just a small cog. My goal is to expose the DNP. If DNP's are so proud of their degree, why are they embarrassed when I post details like 1000 vs 12000 hours (not including the 5000 hours in medical school) for physicians, that the DNP can be done totally online, etc? Maybe it's because most DNP's know that the degree really is just a sham and nothing more than a blatant power grab?

If the AMA resolutions are any indication, the DNP is being taken seriously at the highest levels. The resolutions are just the tip of the iceberg. The DNP has many weaknesses and the medical groups should exploit them all. In the end, if this goes badly and NP's have more stringent education requirements, increased oversight, more regulations, etc, then at least you'll know who to blame.

Like I said, I respect nurses who don't agree with Mundinger. My posts are intended to get my message out to the people who can make policy changes and the public. Anywhere I can do that, I will. Not only midlevels frequent this forum. As you can see, many med students, residents, and attendings do as well.

 

[Taurus]

The fact that people are ignoring here is the educational preparation that was performed before the DNP. ~BSN>MSN>DNP. That's 3 different degrees, each with their own set of clinical hours, PLUS the clinical experience gained while working in the process of attaining these degrees.

The question is, do DNP's practice medicine or nursing? Let's listen to what practicing NP's have to say:

"As a practicing NP, I have the opinion that a vast majority of the day to day acts I perform in my role fall into the practice of medicine."

"I too think that I practice medicine far more than nursing"

"In my opinion, most NPs practice medicine."​

If NP's do in fact practice medicine -- the question of why we allow BON's to regulate NP's notwithstanding and deferred for now, when do they learn their "medicine"?

During their BSN? No, that's when they learn to become a nurse.
During working as a nurse? No, they're doing nursing not medicine.
During the MSN/DNP? Yes! During their measly 1000 hours of clinical training.

 

[prairiedog]

Mundinger is the creator and de facto leader of the DNP movement. She is the one who keeps pushing for the power grab. First with the DNP, then with the NBME.
Like I said, I respect nurses who don't agree with Mundinger. My posts are intended to get my message out to the people who can make policy changes and the public. Anywhere I can do that, I will. Not only midlevels frequent this forum. As you can see, many med students, residents, and attendings do as well.

You have supported many of your claims with references, can you do the same for Mundinger? In previous postings blasting Mundinger she was creating the DrNP, one would think that the creator and leader of the DNP movement would at least know the initials.

 

[Faebinder]

Hopefully enough lawsuits will come out to expose this DNP issue. We already know the insurance companies are finding it harder to insure them and the nurses are underreporting nurse practice lawsuits. I guess trial lawyers have a new target. Infact, a DNP is much easier target than a primary care physician cause it's easy to get a higher level expert witness.. the physician.

 

[Taurus]

Hopefully enough lawsuits will come out to expose this DNP issue. We already know the insurance companies are finding it harder to insure them and the nurses are underreporting nurse practice lawsuits. I guess trial lawyers have a new target. Infact, a DNP is much easier target than a primary care physician cause it's easy to get a higher level expert witness.. the physician.

Yeah, this is where DNP's should get really nervous. The trial lawyers are licking their chops over this one. Sometimes the deeper pocket belongs to the NP and not the physician.

APNs should be aware that if they practice with a physician who is under- or uninsured, the nurse might become the deep pocket — the one who is covered for the highest amount and, therefore, is the more attractive to name in a lawsuit. Lawyers representing the injured have been known to go after anyone who might have provided care to the patient — anyone whose name is on the chart.

If DNP's are equating themselves with physicians, then they will be held to the same standards as a physician. You can't say on the one hand you're just as good as a physician and then on the other hand say that you should be held to nursing standards. You can't have it both ways. I'm sure that the lawyers won't have any difficulty finding physicians who are willing to testify against DNP's. I would be more than happy to volunteer.

 

[Taurus]

You have supported many of your claims with references, can you do the same for Mundinger? In previous postings blasting Mundinger she was creating the DrNP, one would think that the creator and leader of the DNP movement would at least know the initials.

Uh, ok.

Mary O' Neil Mundinger, Dr.P.H., is the Dean of the Columbia University School of Nursing, which was the first to pioneer the DNP concept.

I'm more interested in the fact that she is director at UnitedHealth.

http://biz.yahoo.com/t/99/3783.html
http://www.nndb.com/people/218/000128831/

We can surmise her motivation for creating the DNP.

 

[mig26x]

so in a DNP's the physician is not at fault of the DNP's mistake?? NICE!!!! give it 2-3 years and lawyers will be breathing down there necks so hard!!!

Will DNP's have shift work or work like physicians without shift (where they work until the job is done)?

 

[straba]

I am a newly graduated ACNP (MS), and first time poster. I agree that the majority of my job in neurosurgery involves the practice of medicine (under the guise of "advanced practice nursing"). I attended a great program, but my training should have included many more clinical hours. DNP programs do add clinical hours to NP training, but I think that an additional 1000 hours is grossly inadequate for a clinical doctorate. Mundiger is way off course! I think that online programs for any practitioner program (MS or DNP) are a big mistake, and only serve to delegitimize the profession.

 

[prairiedog]

Uh, ok.

Mary O' Neil Mundinger, Dr.P.H., is the Dean of the Columbia University School of Nursing, which was the first to pioneer the DNP concept.

I'm more interested in the fact that she is director at UnitedHealth.

http://biz.yahoo.com/t/99/3783.html
http://www.nndb.com/people/218/000128831/

We can surmise her motivation for creating the DNP.

As a participant who tells us you rely on facts I am a bit confused.
May I suggest you actually do something called a "ROL" which would help you with something called facts. Mundinger could be considered an outlier, I suspect many of your peers would also place you in this category. In my 10 second Google search I found http://www.medscape.com/viewarticle/501769, which many would consider a better source than Forbes. I think your credibility would be enhanced if you were able to support your arguments with some balance, even 95% to 5% would be an improvement.

 

[Taurus]

As a participant who tells us you rely on facts I am a bit confused.
May I suggest you actually do something called a "ROL" which would help you with something called facts. Mundinger could be considered an outlier, I suspect many of your peers would also place you in this category. In my 10 second Google search I found http://www.medscape.com/viewarticle/501769, which many would consider a better source than Forbes. I think your credibility would be enhanced if you were able to support your arguments with some balance, even 95% to 5% would be an improvement.

Sorry can't access the link. You're more than welcome to set the record straight.

Frankly, it doesn't matter if a whole committee created the DNP. Mundinger took what was there and has effectively shaped it to advance her agenda. She has become to symbolize the DNP movement.

People on this forum have already read many articles either written by her, with quotes from her, or some organization that she's involved in that's pushing the DNP. You're more than welcome to convince other physicians why Mundinger should not be considered the face of the DNP movement. That will be like arguing that the DNP is just about creating more nurse educators. In one of the first threads on the DNP, an NP tried to make that argument. Of course, that was before Mundinger's famous Forbes article. I haven't heard many make that argument anymore. I wonder why.

 

[prairiedog]

Sorry can't access the link. You're more than welcome to set the record straight.

Frankly, it doesn't matter if a whole committee created the DNP. Mundinger took what was there and has effectively shaped it to advance her agenda. She has become to symbolize the DNP movement.

People on this forum have already read many articles either written by her, with quotes from her, or some organization that she's involved in that's pushing the DNP. You're more than welcome to convince other physicians why Mundinger should not be considered the face of the DNP movement. That will be like arguing that the DNP is just about creating more nurse educators. In one of the first threads on the DNP, an NP tried to make that argument. Of course, that was before Mundinger's famous Forbes article. I haven't heard many make that argument anymore. I wonder why.

Have you been to medscape before? Maybe you need to do the free enrollment? You would have the opportunity to read what others are saying, many of whom agree with your position. Not sure where your last "fact" came from in regards to nurse educators. Sometimes it is easier to pursue an agenda pretending you have the facts versus actually doing the research.

 

[Taurus]

Not sure where your last "fact" came from in regards to nurse educators. Sometimes it is easier to pursue an agenda pretending you have the facts versus actually doing the research.

A walk through memory lane.

http://forums.studentdoctor.net/showthread.php?t=289278

It's amazing how prescient some of those ideas were in that old thread. It's like opening a time capsule. Who at that time would have guessed that the DNP was being taken so seriously at the highest levels at the AMA and medical groups? This is not just some trivial debate.

Here's the response from the ASA to the NBME.

http://www.asahq.org/news/NBME-Letter62708.pdf

 

[Taurus]

better source than Forbes.

Btw, Mundinger is the author of that article.

 

[Sunfire]

Here's the response from the ASA to the NBME.

http://www.asahq.org/news/NBME-Letter62708.pdf

Nicely stated, too.

 

[mig26x]

Here's the response from the ASA to the NBME.

http://www.asahq.org/news/NBME-Letter62708.pdf

I hope this is only the beginning. Medicine has to defend its territory. If nurses wants to practice medicine they should go to med school and apply like everyone else, but this shortcuts call DNP's with online classes and 1 time per semester visit to campus is a freaking joke!!!

 

[Justine]

My understanding of the DNP program (perhaps I'm wrong, this is what professors have told me) is that it does not change the scope of practice that an ARNP already has. Rather, it's meant to enhance the profession. Just like physical therapists were mandated to get a DPT and pharmacists are now PharmDs, this is another trend in the health care system.

And if it's not changing what's already going on, what's the big deal with it?

 

[Taurus]

AMA meeting: Physicians demand greater oversight of doctors of nursing

In response, delegates at the AMA Annual Meeting in June passed a resolution calling on the Association to advocate that professionals in a clinical setting clearly identify their qualifications and degrees to patients. Delegates directed the AMA to develop model state legislation to that effect and to support other state legislative efforts to make it a felony for nonphysician health care professionals to misrepresent themselves as physicians.

The house also adopted policy that DNPs must practice under physician supervision and as part of a coordinated medical team. Delegates voted to oppose the NBME's participation in any DNP exam and directed the AMA to refrain from producing test questions.​

 

[patriots0000000]

yea i dont see what the big deal is anyway with this DNP, isnt it just like DPT kinda. There will always be a place for docs, this wont change anything

 

[desdude]

Yo tired, the "paraprofessionals will decide thier place and the pseudo doctors read MDA can decide theirs.

 

[Jawbone]

My understanding of the DNP program (perhaps I'm wrong, this is what professors have told me) is that it does not change the scope of practice that an ARNP already has. Rather, it's meant to enhance the profession. Just like physical therapists were mandated to get a DPT and pharmacists are now PharmDs, this is another trend in the health care system.

And if it's not changing what's already going on, what's the big deal with it?

Word of advice Justine.... don't even waste energy trying to ask a rational question on this forum. I come here when I start to forget how horrible humans can be (I also go to CNN for the latest on the war)......

 

[oldManDO2009]

Word of advice Justine.... don't even waste energy trying to ask a rational question on this forum. I come here when I start to forget how horrible humans can be (I also go to CNN for the latest on the war)......

lets be clear - DNP's have a stated purpose to take over primary care just like CRNA's would be happy without anesthesiologist. If I told you nurse assistants were going to take over nursing because RN's were over educated then you might have a problem with that assumption. Primary care belongs to physicians who may chose to hire and work with NP's. The DNP is a pointless degree aimed at making inroads in to primary care.

Is there a rational argument for the DNP that is not already covered by the MSN? It can't be more clinical exposure of clinical sciences all lacking in the current degree structure???????

 

[Oculomotor]

I have been talking to friends of mine who are in nursing school and it is rather alarming (for MD/ DO's). The DNP is a subject of discussion with some regularity. I just cannot see how it can be taken seriously because EVERY other clinical doctorate with autonomous/independent practice providers/prescribers of medicine--->DO, MD, OD*, DDS*, DPM*, DMD*.....all have a:
1) Dedicated/Full time
2) Intense
3) 4 year
clinical doctorate degree with an admissions test--> MCAT, DAT, OAT to gain acceptance. I cannot see how 33 credit hours "tacked onto" a Masters program can even remotely compare?

The ONLY way nursing can make this legit is to have a legitimate 4yr clinical doctorate in nursing that starts after a BSN and structured after medical education. Then they can talk......Even then all the degrees I mentioned* (except MD/DO) produce limited license doctors who do not treat systemic disease. The DNP would have to have some kind of residency program to be comparable to the MD/DO practitioners who treat systemic disease and have a full medical license........

 

[mig26x]

Makes sense.

I usually go to allnurses when I start to forget how stupid humans can be . . .

I also go to allnurses to see who really nurses are!!! they REALLY HATE MD's!!!

 

[fab4fan]

Makes sense.

I usually go to allnurses when I start to forget how stupid humans can be . . .

Hmmm. I go there for the same reason. Maybe that's why they banned me.

 

[Therapist4Chnge]

Makes sense.

I usually go to allnurses when I start to forget how stupid humans can be . . .

Let's leave the jabs out of the discussion....as it cheapens the facts and provides an opportunity for people to degrade the conversation and take it off track.

I've actually been meaning to read up on it over there....

 

[Josh L.Ac.]

Word of advice Justine.... don't even waste energy trying to ask a rational question on this forum. I come here when I start to forget how horrible humans can be (I also go to CNN for the latest on the war)......

If you honestly think bickering back and forth on this thread is somehow the pinnacle of how horrible humans can be, you really need to get out more.


Now I know in nursing school we were taught that every member of the health care team was equal, everyone's opinion mattered, and there is no hierarchy...but that's not reality. Just because you can legally practice within your state's scope does not mean that your training actually prepares you to perform those acts. Physicians are angry that nurses with a fraction of their training are claiming to have the ability to perform the physician's role as well as the physicians, and rightful so.

[/ketosis-inspired rant]

 

[core0]

lets be clear - DNP's have a stated purpose to take over primary care just like CRNA's would be happy without anesthesiologist. If I told you nurse assistants were going to take over nursing because RN's were over educated then you might have a problem with that assumption. Primary care belongs to physicians who may chose to hire and work with NP's. The DNP is a pointless degree aimed at making inroads in to primary care.

Is there a rational argument for the DNP that is not already covered by the MSN? It can't be more clinical exposure of clinical sciences all lacking in the current degree structure???????

Here's the dirty little secret. NPs don't want to do primary care any more than physicians do. If you look at the statistics (what few there are), NPs are moving into specialty care in increasing numbers for roughly the same reason that physicians are, the pay is better. The DNP doesn't change that. It actually makes things worse. The data for PAs shows that the higher the debt the more likely a PA is to go into surgery or specialty medicine. Limited data from the NP world suggest the same. Unless the payment for primary care is changed remarkably, there is little incentive for anyone to go into primary care. If the payment is changed then physicians will presumably also flock to primary care which would once again largely nullify any gains by the DNPs.

David Carpenter, PA-C

 

[Justine]

I have been talking to friends of mine who are in nursing school and it is rather alarming (for MD/ DO's). The DNP is a subject of discussion with some regularity. I just cannot see how it can be taken seriously because EVERY other clinical doctorate with autonomous/independent practice providers/prescribers of medicine--->DO, MD, OD*, DDS*, DPM*, DMD*.....all have a:
1) Dedicated/Full time
2) Intense
3) 4 year
clinical doctorate degree with an admissions test--> MCAT, DAT, OAT to gain acceptance. I cannot see how 33 credit hours "tacked onto" a Masters program can even remotely compare?

The ONLY way nursing can make this legit is to have a legitimate 4yr clinical doctorate in nursing that starts after a BSN and structured after medical education. Then they can talk......Even then all the degrees I mentioned* (except MD/DO) produce limited license doctors who do not treat systemic disease. The DNP would have to have some kind of residency program to be comparable to the MD/DO practitioners who treat systemic disease and have a full medical license........

I'm not sure why a full-time curriculum is needed in order to produce a clinical doctorate. Could you please elaborate?

How are you evaluating the DNP programs for "intense"-ness? Do you have any experience with the programs, other than what you've read online on a discussion forum?

Straight through, DNP programs take a minimum of 3 years. This is similar to other doctorate programs such as the DPT (3 years). One group you didn't mention that prescribes medications is the Physician's Assistant program (unless I didn't recognize one of those acronyms, in which case I apologize), which takes three years as well.

Are you arguing that NPs should be phased out of the system entirely? Again, I ask, if you don't have a problem with MSN NPs, then why are you fearful of DNPs who are not changing the scope of their current practice? I believe you mentioned that the hope is that NPs will take over primary care--which you do not agree with (along with myself). Is this concern the only reason why you are opposed to DNPs?

Most the animosity that I've found from nurses towards doctors at allnurses.com were from statements such as this:

"I just don't get the nurses. Why are they questioning my care? I know what's right for my patient--they don't have the education to know what's happening."

RNs don't have the education background that a physician does, but they do know enough to help spot errors in the patient care. And questioning what doesn't feel right helps improve patient safety. Maybe there is nothing wrong with the order, but if I was a patient, I'd rather have more than one person looking out for me.

On a sidenote, none of this post (or my previous ones) were meant with any animosity, but rather to facilitate this discussion, which is a button-pusher for some folks.

 

[Therapist4Chnge]

I'm not sure why a full-time curriculum is needed in order to produce a clinical doctorate. Could you please elaborate?

I believe it has to do with immersion and taking advantage of the full experience, vs. taking classes here and there and just trying to get through it. For example, I've seen degree creep in Education (everyone and their brother going for an MS because they want the letters after their name and a bump in pay) and many/most look for the path of least resistance (typically online/distance learning).

I don't mean to generalize that everyone is trying to do this, but considering there are entire threads/discussions on programs that are completely online and/or the easiest to get into.....it makes me wonder the true motivation of the individuals. A doctorate should really be about mastery and depth of education, as it is the highest terminating degree in each field, but it somehow has turned into finding the easiest/quickest way to cut corners, and that is concerning to me because I think it weakens the perception of everyone who pursues doctoral training.

People often complain that a person shouldn't have to suffer/work through a doctorate, but I'd argue that immersion and a rigorous course of study, combined with in-depth clinical application and application of research learning is essential in any doctoral program...regardless if it is more 'clinical' in nature.

Ultimately, I believe all of the cutting corners diminishes the training, experience, and overall effectiveness of the degree. The path should be about wanting to become the best provider in your area of expertise, but it seems that for many it is about collecting letters, which is not going to garner the respect or acceptance of colleagues. Some may say they don't need the approval of others, but I think it would at last offer an opportunity to hear the criticisms/feedback and evaluate if there is anything that can be done to better address the concerns.

 

[Justine]

I agree that there should more motivation than "just wanting a doctorate behind my name" (though there is nothing wrong with that as long as you have other intentions to provide good quality healthcare).

Unfortunately, I don't think that because a program is part-time or has some components online (which is very rare and actually a hotly-debated topic over in the graduate nurse forum at allnurses.com) means that they do not deserve a program of a clinical doctorate.

Many programs are part-time because unlike MDs/DOs, NPs don't make over $100,000 (generally) and could not pay off student loans quite easily. In fact, in the PhD program, many schools don't offer the tuition and stipend assistance that is almost guaranteed for other programs. Most NPs have families that they need to support.

I'd also like to let it be known how being an NP is really not something RNs do straight out of getting their BSN. That is a very rare occurrence and is highly discouraged. Most programs require at least 2 years of being in the related field before they can apply to graduate school.

Thank you for your response.

 

[Therapist4Chnge]

Unfortunately, I don't think that because a program is part-time or has some components online (which is very rare and actually a hotly-debated topic over in the graduate nurse forum at allnurses.com) means that they do not deserve a program of a clinical doctorate.

It isn't that I mean to discount it because it is a part-time endeavor, it just seems like people often want it both ways of not having it full-time, but also not taking twice as long.....which is where the online classes seem to come in, and are particularly problematic.

I'd also like to let it be known how being an NP is really not something RNs do straight out of getting their BSN. That is a very rare occurrence and is highly discouraged. Most programs require at least 2 years of being in the related field before they can apply to graduate school.

Thank you for your response.

I'd hope that they would get at least a few years of real experience. That is actually a pet peeve of mine about Clinical Psychology programs, that they don't REQUIRE at least a couple years out in the field. Many have to do it to be competitive, but I think the learning is quite different for someone who has some clinical experience, vs those that try and go straight through.

 

[osli]

The holistic nature of examining psych, soc, spiritual, physical, support systems and interaction with environment is what makes nursing so unique, special and completely different than that of medical-model based systems.

I just stumbled upon this thread, and this post by this banned user, and found the above particularly interesting. I can't claim to know a lot about the education model of nursing programs, but the above is taught as a part of a standard history taking in medical school, and is included in any complete SOAP note. To suggest that somehow "NP's" have a monopoly on seeing beyond tissues and chemicals is ludicrous.

BTW, keep up the fight Taurus. I agree 110% with everything you have posted. I appreciate what nurses do, and even what NP's do under doctor supervision. The "cherry picking" that you mentioned earlier hits the nail square on the head. DNP's want essentially the same scope of practice, same Rx rights, and same reimbursement, but don't want the responsibility of actually having to deal with the tough pathologies, don't want the high malpractice, don't want the same rigorous education, and don't want the same oversight. Something stinks.

I hope some combination of AMA action and market correction will curb this craziness. You can't expect to gain the same rewards without the same investments and risks, period. Any attempt to do so is disingenuous.

 

[mig26x]

I think I wouldnt have any problems with DNP practicing by their own if they have to pay the same insurance policy that MD's/DO's have to and also if they are the one's responsible when things go down south and have to go to court and defend their own AS$ instead of now where docs are responsible for their mistakes.

 

[osli]

Would you also be comfortable with them billing at the same rates with only a fraction of the educational time and expense?

 

[mig26x]

Would you also be comfortable with them billing at the same rates with only a fraction of the educational time and expense?

sorry, my post was 100% sarcastic!!! If you read my other post you can see Im 200% against this joke of a diploma giving RN the power to treat patient independently. Online courses? One time per week visit to campus?

 

[prairiedog]

sorry, my post was 100% sarcastic!!! If you read my other post you can see Im 200% against this joke of a diploma giving RN the power to treat patient independently. Online courses? One time per week visit to campus?

Hmmm, you will like this take by a MD on the ability of a NP to practice
http://www.cantonrep.com/index.php?ID=420284&Category=8&subCategoryID=

 

[fab4fan]

I agree that there should more motivation than "just wanting a doctorate behind my name" (though there is nothing wrong with that as long as you have other intentions to provide good quality healthcare).

Unfortunately, I don't think that because a program is part-time or has some components online (which is very rare and actually a hotly-debated topic over in the graduate nurse forum at allnurses.com) means that they do not deserve a program of a clinical doctorate.

Many programs are part-time because unlike MDs/DOs, NPs don't make over $100,000 (generally) and could not pay off student loans quite easily. In fact, in the PhD program, many schools don't offer the tuition and stipend assistance that is almost guaranteed for other programs. Most NPs have families that they need to support.

I'd also like to let it be known how being an NP is really not something RNs do straight out of getting their BSN. That is a very rare occurrence and is highly discouraged. Most programs require at least 2 years of being in the related field before they can apply to graduate school.

Thank you for your response.

I have to disagree with you about your last point. There are more students opting to go through accelerated programs or just doing the bare minimum of clinical time to get into NP programs. It's not like "the old days" when nurses used to work for donkey's years and get a solid clinical foundation before going on to become an NP. Now the philosophy is that "experience doesn't matter." Just search some of the old posts right here on the subject; there's a member here who has posted quite vigorously about how much experience doesn't matter one bit. It scares me to death, personally (pun intended).

A lot of programs are prefacing the experience issue with the word "preferred." There are some specialties like CRNA where you still have to have those 2 years, but think about it--just 2 years of ICU experience and that's it? Does that sound like enough to you? It sure doesn't sound like enough to me. It didn't used to be enough years ago. If someone is going to knock me out, I want that person to have a ton of experience managing airways, anesthesia meds, etc. I don't want some kid that had 2 years of ICU experience and is so green she/he looks like Kermit the Frog.

 

[Justine]

BTW, keep up the fight Taurus. I agree 110% with everything you have posted. I appreciate what nurses do, and even what NP's do under doctor supervision. The "cherry picking" that you mentioned earlier hits the nail square on the head. DNP's want essentially the same scope of practice, same Rx rights, and same reimbursement, but don't want the responsibility of actually having to deal with the tough pathologies, don't want the high malpractice, don't want the same rigorous education, and don't want the same oversight. Something stinks.

Again, the DNP does NOT change the scope of practice for an NP. Just makes the profession more professional, like physical therapists and their DPT and pharmacists with their pharmD. Please read the entire thread. And again, the online program that you spoke of was for people who already had their MSN, along with the fact that it's very hotly contested in the nursing world, in any case.

fab4fan, there are the direct-entry APNI programs, but they are generally ONLY for family nurse practitioner, and not anything else. Do I agree with those? No, not particularly. As for CRNAs, the person has 4 years of a BSN, 2 years of RN experience, and 3 years to get their CRNA. To be fair, clinical components aren't until the 3rd year of your BSN, so figure 7 years of practice. I think that's adequate for minimum competency (key word: minimum). And have you researched getting into CRNA programs? There's no way in hell (or at least on this side of the coast), that you get in with just 2 years experience. They say that, but there're waiting lists longer than a woman's line to go to the bathroom during a ballgame.

 

[Josh L.Ac.]

Again, the DNP does NOT change the scope of practice for an NP. Just makes the profession more professional, like physical therapists and their DPT and pharmacists with their pharmD. Please read the entire thread. And again, the online program that you spoke of was for people who already had their MSN, along with the fact that it's very hotly contested in the nursing world, in any case.

fab4fan, there are the direct-entry APNI programs, but they are generally ONLY for family nurse practitioner, and not anything else. Do I agree with those? No, not particularly. As for CRNAs, the person has 4 years of a BSN, 2 years of RN experience, and 3 years to get their CRNA. To be fair, clinical components aren't until the 3rd year of your BSN, so figure 7 years of practice. I think that's adequate for minimum competency (key word: minimum). And have you researched getting into CRNA programs? There's no way in hell (or at least on this side of the coast), that you get in with just 2 years experience. They say that, but there're waiting lists longer than a woman's line to go to the bathroom during a ballgame.

I personally know of a murse that got admitted into CRNA school with 7-10 months of ICU experience and he started in the ICU right out of the same accelerated BSN program I did. By the time the program started, he did have a year of experience however.

Granted, the Midwest can be considered a wasteland where thoughts are fleeting and hope dies...

 

[Krisss17]

Well, I've read numerous posts on this board and on allnurses and believe me, 90% or more dont see the point of the DNP nor are looking at this to be competitive with an MD/DO.

I had been going back and forth between medicine and becoming an NNP (neonatal nurse practitioner). If this comes to pass where in 2015 a DNP is required, I'm definitely considering just going the MD/DO route. What I don't like about the DNP is that in looking at many of the available DNP programs there really doesn't seem to be anything clinical to do with them. To me, it seems to be more business related and projects etc. I would definitely prefer a stronger clinical base over that. I might as well go for the PhD.

There seems to be a lot of negativity towards nursing and I really think that it needs to be directed to those that are pushing this measure than nurses in general. It is the teamwork of MDs/DOs, RNs, NPs, PAs, RTs, OTs, etc. that work together to bring a patient to a state of health or better health.

Med students need to realize that while they are gaining much valuable knowledge, nurses can offer a different view that is only meant to help the patient. Yes, you will run into some nurses that will make you turn your eyes upward, but you'll also meet a number that want to work towards a better relationship. We all have our purposes and functions, lets not disrespect the others.

 

[dfk]

I have to disagree with you about your last point. There are more students opting to go through accelerated programs or just doing the bare minimum of clinical time to get into NP programs. It's not like "the old days" when nurses used to work for donkey's years and get a solid clinical foundation before going on to become an NP. Now the philosophy is that "experience doesn't matter." Just search some of the old posts right here on the subject; there's a member here who has posted quite vigorously about how much experience doesn't matter one bit. It scares me to death, personally (pun intended).

A lot of programs are prefacing the experience issue with the word "preferred." There are some specialties like CRNA where you still have to have those 2 years, but think about it--just 2 years of ICU experience and that's it? Does that sound like enough to you? It sure doesn't sound like enough to me. It didn't used to be enough years ago. If someone is going to knock me out, I want that person to have a ton of experience managing airways, anesthesia meds, etc. I don't want some kid that had 2 years of ICU experience and is so green she/he looks like Kermit the Frog.

hey fab,
let me break it down for you (in a nutshell of course):
coming out of anesthesia school, the newly minted CRNA (even the senior SRNA) has more hands-on/applicable knowledge of anesthesia than a CA-1 (and some CA-2s from my experience). does this justify being enough? well, i would be biased if i answered that. but, until you have been in either's shoes, you really can't contend to their experiences/education/competencies.
of course, that's your right to whom you feel comfortable with.
as for your 'years ago' comment, i might be a little lost as to what you were referencing to, but CRNAs of yesteryear were not required to have any specified bedside experience, let alone ICU. so, in today's world, the incoming SRNA is much more prepared in critical care than those of long ago.