Will the DNP be a dying degree???

[psychMDhopefully]

I think most nurse practitioners are smart enough to realize it adds little to nothing to their education.

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[762513]

Here’s a better question, what does the BSN add to a RN that the ADN doesn’t already have enough of? Isn’t the BSN degree creep too?

 

[Mad Jack]

The goal is for it to be the entry level degree for nurse practitioners moving forward. Once that happens it won't matter that it provides no advantage over the masters, it will be the requirement.

 

[762513]

I think most nurse practitioners are smart enough to realize it adds little to nothing to their education.

I understand that it is a barrier to entry to practice, and that’s something we as a profession need to work through. I disagree that it doesn’t add value to the NP role.

 

[psychMDhopefully]

The goal is for it to be the entry level degree for nurse practitioners moving forward. Once that happens it won't matter that it provides no advantage over the masters, it will be the requirement.

Yeah but a lot of schools and students aren't buying it. There are MSN programs that switched over to the DNP, enrollment dropped, then they went back to the MSN. Folks that go into nursing aren't like folks that go into medicine, extra school for no reason won't do well with that population.

 

[Mad Jack]

Yeah but a lot of schools and students aren't buying it. There are MSN programs that switched over to the DNP, enrollment dropped, then they went back to the MSN. Folks that go into nursing aren't like folks that go into medicine, extra school for no reason won't do well with that population.

We shall see. My bet is that most schools will streamline the DNP eventually, similar to DPT and PharmD programs, making it 6 years total to get a DNP and equivalent to the current MSN in length.

 

[pamac]

I actually think that would be a decent expectation to have to streamline it a bit. As it is, it’s a bridge too far for folks that want to make it into practice without that monkey on their back. It’s a fat research project tacked on to a perfectly fine degree. The masters NP can stand alone without it, and not have it have any effect on the MNP being a force for good, both for society and for the professional. I really am fine if it exists, and I understand what it can do for prestige (which is helpful if PAs ever pursue independence... as they are through their new initiative called OTP). CRNAs are doing the doctorate, and PT is doing it too. But I think it’s a mistake to make it the entry level requirement. I like how the NP exists at many schools in several forms.... either as entry level, post masters,or to be opted out of in favor of the masters alone. Schools don’t like the variability in each cohorts class structure because it’s difficult to plan for, but I think that’s the best option for the industry.

I feel like what they just did by requiring programs to find clinical placement for students is going to help refine the pipeline quite a bit. For those who don’t know, the ANCC just made the requirement that going forward, schools won’t be RE accredited if they don’t provide clinical sites for students vs having students have to find their own. Watch for this to make the much maligned distance programs much more difficult to maintain. If there are indeed degree mills, they will find this bites hard into their ability to appeal cross country and haphazardly.

 

[jl lin]

I understand that it is a barrier to entry to practice, and that’s something we as a profession need to work through. I disagree that it doesn’t add value to the NP role.

It seems it ultimately will be the expectation for teaching graduate nursing students and eventually practicing. As stated, if it is made as a pre-requisite, then that is what it will be, perpetrated by the czars of higher learning and such.

The escalation of tuition in all programs has been an outlandish extension of student loans/lending. Today I look at just about all programs in all fields with a high amount of suspicion in terms of milking people dry. "Raising the bar" essentially means schools get a lot richer. An advanced degree alone isn't the soul measure of what raising the bar should mean in terms of excellence in practice. Sigh.

I doubt it will add that much to income, unless one uses it in a business or some leadership capacity, and even then one may be better served with an MBA if the goal is to become better compensated for advancing one's degree. I just feel like institutions of higher learning have taken us all for such a ride. It ticks me off.

 

[jl lin]

We shall see. My bet is that most schools will streamline the DNP eventually, similar to DPT and PharmD programs, making it 6 years total to get a DNP and equivalent to the current MSN in length.

Probably.

 

[jl lin]

I actually think that would be a decent expectation to have to streamline it a bit. As it is, it’s a bridge too far for folks that want to make it into practice without that monkey on their back. It’s a fat research project tacked on to a perfectly fine degree. The masters NP can stand alone without it, and not have it have any effect on the MNP being a force for good, both for society and for the professional. I really am fine if it exists, and I understand what it can do for prestige (which is helpful if PAs ever pursue independence... as they are through their new initiative called OTP). CRNAs are doing the doctorate, and PT is doing it too. But I think it’s a mistake to make it the entry level requirement. I like how the NP exists at many schools in several forms.... either as entry level, post masters,or to be opted out of in favor of the masters alone. Schools don’t like the variability in each cohorts class structure because it’s difficult to plan for, but I think that’s the best option for the industry.

I feel like what they just did by requiring programs to find clinical placement for students is going to help refine the pipeline quite a bit. For those who don’t know, the ANCC just made the requirement that going forward, schools won’t be RE accredited if they don’t provide clinical sites for students vs having students have to find their own. Watch for this to make the much maligned distance programs much more difficult to maintain. If there are indeed degree mills, they will find this bites hard into their ability to appeal cross country and haphazardly.

To me it's insane to be a part of any program "distance," w/o it being part of a valid Brick and Mortar school, which one must attend in some amount/capacity. All schools, B&M, Ivy, whatever, take full advantage of use of the internet and hybrid or online courses. They'd be idiots not to do so. But to be far removed from the actual school is problematic for me.

It's on the student to find out precisely how a particular program of study works, its expectations, costs, lab, campus time, clinical time/sites, etc, just as much as it is on them to know about accreditation.

The only thing worse than paying a boatload for one's education is doing so and not having all of the above in check. Furthermore, to me it is idiotic to attend any program/school in which you cannot easily commute and interact w/ professors and the campus, etc. Programs that are not part of solid, accredited schools/programs, and that are hundreds or thousands of miles away make no sense to me. Just b/c one takes courses online does not mean s/he doesn't need office time w/ professors or to be able to take advantage of the other resources at the particular school.

But again, I moan the relentless hikes in tuition. It's like rust. It never sleeps.

 

[pamac]

I can't think of why it is superior to take time out of my busy schedule to battle traffic, drive to a campus, find parking, walk to my professor's office at the specific time he or she is there, and then talk to them in person... especially when I can accomplish the same thing via email or by telephone. I've managed to handle that approach through my BSN and through NP school without problems. I also can't think of what other resources I would be missing out on. Do people even go to college libraries anymore to access anything?

I hear what you are saying in a general sense regarding degree creep. But If I’m understanding some of the rest of your critique, I have to diverge a bit on several issues. The fact that being able to attend a hybrid program, like the one I did, offered competition to the local NP programs that were not as reputable, supportive, nor focused on my specialty, which is psyche. And like you said, it makes sense for an Np school to offer as much online curriculum as is workable, which I’ve found to be extensive. But the competition offered by the programs that aren’t close by is one bright spot among a sea of university profiteers. And the DNP will being more of this out. Folks like me will always seek out an MSN program to save time and effort, and any program that still offers one will be rewarded by plenty of applicants.

 

[PikminOC]

Yeah but a lot of schools and students aren't buying it. There are MSN programs that switched over to the DNP, enrollment dropped, then they went back to the MSN. Folks that go into nursing aren't like folks that go into medicine, extra school for no reason won't do well with that population.

I dont consider medical school and residency as "extra school for no reason".

 

[MisterKitty]

I dont consider medical school and residency as "extra school for no reason".

Yeah I’m a little alarmed at the mindset of “how can I get the littlest training/education possible and still be able to treat patients”.

 

[762513]

I dont consider medical school and residency as "extra school for no reason".

Yeah I’m a little alarmed at the mindset of “how can I get the littlest training/education possible and still be able to treat patients”.

Having seen PsychMDHopeful a lot on these boards, I think he was comparing the schooling for the DNP vs the MSN, not the NP vs MD. He can speak for himself though.

 

[PikminOC]

Folks that go into nursing aren't like folks that go into medicine, extra school for no reason won't do well with that population. --- PAMAC wrote that

 

[PikminOC]

Yeah I’m a little alarmed at the mindset of “how can I get the littlest training/education possible and still be able to treat patients”.

Easy to think this way when there are the deep pockets of the physician to milk when there's a lawsuit...

 

[pamac]

The context of what was being said was basically that many RNs aren’t interested in spinning their wheels for a DNP that they don’t feel ads value because an MSN/NP gets those folks what they need to have to get out and practice. The writer might have been better off to put a period in instead of a comma. But then two physicians came in and didn’t look at the whole thread in context.

 

[pamac]

Easy to think this way when there are the deep pockets of the physician to milk when there's a lawsuit...

I’m independent. There are no pockets to milk but my own. Maybe you guys would be better off if more more NPs were free from making you guys a bunch of money.

 

[pamac]

And no... it looks like PhsycheMDhopefully said what you are attributing to me. But I get what he was saying.

 

[762513]

And no... it looks like PhsycheMDhopefully said what you are attributing to me. But I get what he was saying.

Sorry that was my bad, I misread who said what, I do know that’s your opinion too though so I think I did a mental switch I edited my post above

 

[PikminOC]

Solved!

 

[pamac]

Solved!

You are the one who seems to have the most trouble following the conversation. “Alarmed” at all the “mindsets” and such. How much sleep do you lose at night worrying about nonphysician providers taking away business? I guess keeping a corner on the market so folks have to wait 3 months for an appointment means job security for you?

 

[PikminOC]

I do not feel that way at all. I see people within one week. I am not in anyway concerned about people taking patients from me, whether they be other physicians, or midlevels. There is more than enough business to go around.

 

[PikminOC]

I do not hire any physicians or midlevels. Many of my physician friends are hospital employees forced to supervise midlevels. They dont make more money, the hospital does. Their compensation remains the same.

 

[pamac]

Its strange that the issue that most disturbed you, of all the stated points, was that the provider dared to expect any respect. Obviously he or she needs some work on delivery, but your biggest beef was that the hierarchy was seen to be compromised. In my mind, sure, ask politely for an office with a view, don’t demand it. But your approach seems like you carry in your mind a template for how people need to fit into their lot in life....with you, of course, occupying the upper echelons. How convenient.... for you.

 

[MisterKitty]

Its strange that the issue that most disturbed you, of all the stated points, was that the provider dared to expect any respect. Obviously he or she needs some work on delivery, but your biggest beef was that the hierarchy was seen to be compromised. In my mind, sure, ask politely for an office with a view, don’t demand it. But your approach seems like you carry in your mind a template for how people need to fit into their lot in life....with you, of course, occupying the upper echelons. How convenient.... for you.

Yeah absolutely physicians are a tier above midlevel providers. It’s asinine to say the two are equal. Seeing the quality of the average medical school student vs midlevel student speaks for itself. Mind blowing that you guys then demand autonomy upon completing some half assed online program while we then begin residency. There is a reason for the difference in level of respect between midlevels and physicians.

 

[MisterKitty]

If you would like to occupy the “upper echelons” then go to medical school. Don’t go to school to be a nurse then stomp your feet saying it’s unfair that you aren’t treated the same as a doctor. No one forced your hand to become ancillary staff

 

[762513]

Its strange that the issue that most disturbed you, of all the stated points, was that the provider dared to expect any respect. Obviously he or she needs some work on delivery, but your biggest beef was that the hierarchy was seen to be compromised. In my mind, sure, ask politely for an office with a view, don’t demand it. But your approach seems like you carry in your mind a template for how people need to fit into their lot in life....with you, of course, occupying the upper echelons. How convenient.... for you.

Don't feed the troll.

 

[pamac]

I’m not stomping my feet, you guys are stomping your feet at the thought of a nonphysician provider being extended courtesy. There’s a nuance there that betrays arrogance in and of itself.

NPs and PAs are providers, not ancillary staff. We don’t demand autonomy, we have it in half of the state’s. It’s working just fine, except I guess for you guys that get bent out of shape when we get an extra office that a provider isn’t using. You lack the self awareness to see the reason the public thinks a lot of physicians are elitist. It’s these kinds of conversations when you veer off in to the real reason you are mad at another provider getting some workspace or a decent paycheck. If our healthcare system changed overnight to one where your university was paid for and you were given a stipend through school, but physicians made $150k, none of you guys would show up because it lacked the big payday you all wanted in the first place. Oh, and the respect. You want to be kings everywhere you go.

 

[pamac]

Every physician I personally know doesn't see this as a zero sum game where everyone has to kiss up to them. There’s enough work to go around, and they act like it.

 

[762513]

Every physician I personally know doesn't see this as a zero sum game where everyone has to kiss up to them. There’s enough work to go around, and they act like it.

Stop taking the bait, mate, or do one better, and report the troll!

 

[NecFasc92]

I’m independent. There are no pockets to milk but my own. Maybe you guys would be better off if more more NPs were free from making you guys a bunch of money.

Question for you: Do you practice medicine?

 

[pamac]

PMHNP.

 

[NecFasc92]

PMHNP.

Doesn't answer my question.

 

[pamac]

Oh ok.... let me set you up to start an existential off topic argument about what NPs practice so you can insist that clinical treatment of illness is in your exclusive domain.

You are a little late for the game if you want to have it out on that subject. Take it up with over 24 state and territory legislatures, as well as the federal government, because they are perfectly fine with what NPs practice.

 

[NecFasc92]

Oh ok.... let me set you up to start an existential off topic argument about what NPs practice so you can insist that clinical treatment of illness is in your exclusive domain.

You are a little late for the game if you want to have it out on that subject. Take it up with over 24 state and territory legislatures, as well as the federal government, because they are perfectly fine with what NPs practice.

It's an extremely simple question. Care to answer it? Also, there's this neat quote feature-- you could give it a go?

 

[pamac]

Essentially I did answer it. My license to prescribe and practice independently is granted by the Board of Nursing. I’m overseen by the Board of Nursing. I practice andvanced practice nursing.

 

[NecFasc92]

Essentially I did answer it. My license to prescribe and practice independently is granted by the Board of Nursing. I’m overseen by the Board of Nursing. I practice andvanced practice nursing.

How is what you do at your job different from a psychiatrist?

 

[pamac]

I guess you are on to something.... maybe the BON should be supervising psychiatrists since their duties are so similar.

 

[pamac]

In all seriousness though, you really should just go shout your frustration at the sky, or take it up with the various state legislative bodies that have allowed NPs independence. Come Monday I’m back out to work doing whatever it is that you want to call what I do with a prescription pad, and am overseen by the BON. All without any kind of agreement tying me to a physician.

 

[NecFasc92]

In all seriousness though, you really should just go shout your frustration at the sky, or take it up with the various state legislative bodies that have allowed NPs independence. Come Monday I’m back out to work doing whatever it is that you want to call what I do with a prescription pad, and am overseen by the BON. All without any kind of agreement tying me to a physician.

Similar duties? Indeed. As you practice medicine without a license, illegally.

No frustration for me. The lack of knowledge is palpable, disgusting, and beyond injust to those who need care. You care not for the patients who see you, only for your self-consumed accomplishment that you rid yourself of your perceived chains. It is sad to see a charlatan practicing medicine without a license. Of which, will clearly be revealed as the gross negligence starts to pile up in congruence with the lawsuits in the near future. I will gladly testify against my 'colleagues' during these cases for their misrepresentation and harm, all so they can line their pockets through their guise, gross negligence, and fake persona. Interestingly, the standard of care is based on medicine and what those who practice medicine would do in each case. Kinda weird 'advanced nursing' would fall under this. Maybe that means those who pass legislation turn a blind eye to this daily illegal activity so that they could make money? *Gasp* at the possibility.

 

[pamac]

Sure....

 

[pamac]

I guess if NPs are lining their pockets, they can get in line behind certain physicians, because I don’t know of many NPs making over $200k, or even near that. On the contrary, how many physicians do you know that make less than $200k?

In any event, don’t worry too much, because nurse practitioners have been independent in quite a few states for decades, and the sky hasn’t fallen. It continues to not fall as more states grant independent practice rights to NPs based on that track record. PAs are starting to push for independence as well. It’s going to be ok. We will be policed. We just won’t have to be shoved into awkward supervisory agreements with physicians. It means they can’t enrich themselves based on the work of nonphysician providers. Someone else will get that money, it just won’t be you guys. Probably won’t be NPs or PAs either. Once California allows independence in the near future, you’ll watch all the dominos fall.

 

[wholeheartedly]

This is a professional forum. Let's treat it that way.

This particular area is designed for PAs and NPs to have discussions relevant to them. Others can participate if professional about it. Just like we don't allow someone from one medical specialty to go into another and start criticizing that field we don't allow it across other health professions either. That said, if someone isn't behaving professionally, please report them and don't engage. Engaging just results in further thread derailment.

This thread was supposed to be about whether or not the DNP degree will remain viable. Any further derailment from that will result in a thread lock and moderator actions against any party derailing things.

 

[deleted480308]

The DNP degree won’t be dead because the nurses are better at politics than physicians. They trick legislators into granting independent practice and continue the facade by adding “doctor” to their degree.

It’s not good for patients but it is what is happening and anyone who speaks up firmly against it will just get railroaded by the hospital because the nurses will scream about how unprofessional the physician is for pointing out they are not trained to the same standard and shouldn’t be independent

 

[762513]

The DNP degree won’t be dead because the nurses are better at politics than physicians. They trick legislators into granting independent practice and continue the facade by adding “doctor” to their degree.

It’s not good for patients but it is what is happening and anyone who speaks up firmly against it will just get railroaded by the hospital because the nurses will scream about how unprofessional the physician is for pointing out they are not trained to the same standard and shouldn’t be independent

The DNP writes a thesis. The physician does not. The final course work for the DNP is very similar to that of the PhD with prelim and final committee defenses; and yes, I’ve seen DNP candidates fail their defenses. Technically, the DNP is more of a doctor in the traditional sense of the word than the physician. Food for thought.

The nurses haven’t tricked anyone. There’s been decades of independent practice for some states and the sky hasn’t fallen. The morgues aren’t full with NP victims. I just wish someone could solidly retort this point, but it’s just ignored, because it’s a rather inconvenient truth.

 

[jl lin]

Honestly, there is more than enough work to go around. I have not seen where a NP trumps a physician, politically speaking or otherwise---unless we are talking about an individual's integrity, depth, and commitment to practice. This is something that occurs in all fields regardless of tiers. Some people just go the extra mile and others don't, period. Having said that, I stand by the position that complex cases need to be fully managed by experienced, reputable physicians. Also, whether NP, PA, or physician, a wise person knows and accepts her/his limitations. Extreme example in order to make my point:, a physician untrained in general surgery doesn't try to perform general surgery.

 

[pamac]

Honestly, there is more than enough work to go around. I have not seen where a NP trumps a physician, politically speaking or otherwise---unless we are talking about an individual's integrity, depth, and commitment to practice. This is something that occurs in all fields regardless of tiers. Some people just go the extra mile and others don't, period. Having said that, I stand by the position that complex cases need to be fully managed by experienced, reputable physicians. Also, whether NP, PA, or physician, a wise person knows and accepts her/his limitations. Extreme example in order to make my point:, a physician untrained in general surgery doesn't try to perform general surgery.

A wise provider refers out. Physicians refer out, as do PAs and NPs. As a psyche NP, I get referrals from physicians every day. I refer out cases to others. I also understand that much psyche management, especially in the early stages, takes place in primary care settings. I’m booked 3 months out, so it’s probably a good thing to try. But I also get patients that come in after primary care management that need a lot of med adjustments to fix some problems that arise from that. But that’s understandable because their primary providers often are trying to use their 8 minutes of actual face time with their patient to do something that I have an hour on intake and 30 minutes in follow up on. That and their primary care provider usually has to address all their physical illness in their brief visits too. You won’t see me criticize them for doing the best they can. But you also won’t see me sit back and take it when a physician downplays my work as an NP simply to imply there needs to be a hierarchy with them at the top of the food chain for hierarchy sake. Do something to reduce the mental health backlog, because I am. If I want to be an independent provider to do that job that someone else isn’t doing, the critics aren’t in the position to tell me that I need to have direct physician supervision to do it, especially when that supervision is merely a formality that serves primarily to line the pockets of a supervising position and increase their control over us for control sake. I don’t need to be the Np squire to the physician knight in order to do my job. We operate independently in halfback of states, and the sky has not fallen, and we haven’t tried to walk into surgery to replace physicians. We practice within our scope.

 

[Jules A]

The DNP degree won’t be dead because the nurses are better at politics than physicians. They trick legislators into granting independent practice and continue the facade by adding “doctor” to their degree.

It’s not good for patients but it is what is happening and anyone who speaks up firmly against it will just get railroaded by the hospital because the nurses will scream about how unprofessional the physician is for pointing out they are not trained to the same standard and shouldn’t be independent

The DNP won't be dead because the institutions that are pushing students to stay enrolled, without any need to practice as a RN-which by the way was the cornerstone of the brief NP educational tract-are making serious money. And nurses think calling themselves "Dr" gives them a seat at the table. Unfortunately there are multiple issues in play here.

As for the physicians lamenting being forced to supervise midlevels I have little sympathy. How about saying no? Or requiring an appropriate fee for your time and liability? Much of the nursing movement, hospital administration's power and CMS over the top requirements would not be so inflated if physicians had been willing to spend the time to push back. It is unfortunate that the barn door on all the above is open and unlikely to shut now.

 

[MidwestPAC]

The DNP writes a thesis. The physician does not. The final course work for the DNP is very similar to that of the PhD with prelim and final committee defenses; and yes, I’ve seen DNP candidates fail their defenses. Technically, the DNP is more of a doctor in the traditional sense of the word than the physician. Food for thought.

The nurses haven’t tricked anyone. There’s been decades of independent practice for some states and the sky hasn’t fallen. The morgues aren’t full with NP victims. I just wish someone could solidly retort this point, but it’s just ignored, because it’s a rather inconvenient truth.

DNP is no where close to a 7 year PhD. You are crazy if you think that! DNP is online and writes papers. PhD is years and years of 50-60 hour weeks of studying/research, etc. Please never compare DNP to PhD again.