AMA Doesn't Like That Pesky DNP Exam, Either

Hello everyone! Your comments are enlightening, but my comments almost always get hammered. I will make them anyway in hopes that one or two colleagues will change their opinion and join my bandwagon.

Healthcare is a dynamic entity, and it is in crisis. We need to adapt our practice to the changes that are inevitable. The reality is family practice physicians cannot keep up with the pace of the demand, nor can they or do they take the time with the patient that clinical nurses do in private practice. Currently I have a diploma in nursing, BSN, MPA (Public Administration), PhD (Community and Human Resources), MSN, and have two more years of education than my board certified Cardiologist husband. I am looking for a DNP program that has a very strong Family Nurse Practitioner component, but frankly most of the DNP Family Nurse Practitioner programs I have seen do not offer a strong in-depth emphasis on clinical diagnosis, health assessment, anatomy and physiology, and pharmacology that I want. I see a lot of "fluff" classes that are usually offered in many MSN programs, such as leadership, how to function as an advance practice nurse, etc. (nothing that would educate me to be a better clinician), and I also see a vast difference from program to program. Compare, for instance, the University of Southern Indiana and the University of San Francisco DNP programs. The former has few classes that would help a practitioner in the direct care of a patient; whereas, the latter seems to focus on that aspect of the DNP. In addition, admission requirements are different from program to program; i.e. some require a GRE and some do not. Perhaps all of the Universities that offer accredited DNP programs should get together and standardize each of the advance practice entities (CNS, NP, Nurse Midwives, and Nurse Anesthetists), and sever itself from being under the sometimes oppressive jurisdiction of the MDs. Pharm Ds, Chiropractors, PT doctorates, and so forth, do not have any responsibility to the MD in how they practice, so why should nursing be required in many states to have "collaborative" agreements with MDs? That assumes that nurses are only assistants to the physicians even though the educational preparation of the DNP is more than double what is required of a PA.  In my opinion, if we are going to have a DNP at all, the DNP programs should have a heavy emphasis on the clinical aspects of nursing, and stay away from all the nonsensical fluff courses. In addition to evidence-based nursing practice, the DNP should delve deeply into the holistic aspect of direct care. That is what we do best. That is where the family practice physician fails the patient. MDs should all specialize and move over to let the DNPs be the first healthcare practitioner seen- a gate-keeper so to speak-not to keep patients out, but to care for the less serious issues, and triage the remainder to the MDs. Nurses get to the bottom of patient issues because they are much better at looking at the body as a whole entity and not a pile of body parts. They also are better at taking histories and doing complete physical examinations. Let us get into the 21st century of healthcare practice, and escape the archaic paternalism and oftentimes suffocating auspices of the MD. My challenge to DNP programs is to collaborate among yourselves to focus on clinical aspects and let the PhD perform the administrative and research functions of nursing practice. Let us not fragment the DNP, but unite it by having a clear idea of what constitutes a DNP, just like the MDs and other doctorate prepared practitioners do.

As a family psychiatric nurse practitioner I chose to relocate to Iowa in order to practice independently, and can do so without a collaborative aggreement or any type of oversight or coordination with a physician. Because well funded opposition by medical associations including the Scope of Practice Partnership (SOPP) actively target and lobby against ARNP scope of practice expansion,  independent practice could  be taken away at any time. In order to continue the legitimization process of advanced practice nursing in the healthcare culture, terminal degrees such as the DNP are a necessity for those nursing professionals who wish to continue their education.  

You all just don't get it..... knowledge is power, knowledge comes from education, if we want to complete we need a terminal degree that matches the level of education required in other disciplines.  As a RN for 16 years, ARNP for 13 years and now in a DNP program, there is no "fluff" involved!  This program is hands down the most intense educational experience I have ever had!  And it has already changed the way I practice.  I am proud of the care I have given my patients, but also proud of what I will bring to them as a DNP.  You can't often judge a book by its cover.  Beware of DNP programs if you are not already a leader and possess a yearning to reach the top of your profession.  Yes, my program is that good!

WOW! Not a lot of positive comments about the DNP degree. I am currently a student in a DNP program and quite frankly we ALL have a lot to learn. I didn't learn everything in my Master's program (though it is a great program), but seriously everyone we still have a lot to learn. I work full-time in Family Practice and am enjoying learning new and updated information. I am concerned that so many NP's are opposed to the DNP degree-Why? It is needed as clinical practice is getting more complex. Change is inevitable.

Love the site! Also appreciate it's clarity and organization...so many Facebook pages can become cluttered too fast.

Thank you for the free invite to join! I wil be back soon.

Sincerely,

SB, FNP

I also don't believe that the current DNP programs are preparing us more clinically from what I've seen of the programs. I am not prepared to shell out any more than the 83,000 that I owe now for ANY more theory or research. I want the real meat of clinical information. How to better care for my patients with proven data and to become recognized as a primary care provider in the insurance arenas! Till then, I'm sitting back and waiting.

I have two degrees, one in a bachelor's of science in Physiology and my Bachelor's of Science in Nursing. I attended a BSN accelerated option class and was essentially prepared clinically no better than an ADN. The only real difference was preparation in research etiquette (a term I coined) instead of just teaching us the up to date science done in advanced scientific and health fields, nursing "theory" which isn't a theory at all as few if any are actually based on scientific measurements and tested hypothesis. The exception being Imogene King's theory which is based on open systems theory and tailored to include nursing interventions. %0d%0a%0d%0aI was hoping to pursue a DNP and go into practice, but I have researched the programs and have been disappointed. In the syllabi between a MSN NP and a DNP programs there is a lack of any clinical or scientific training advancements. Instead the DNP classload relates to nursing leadership, more nursing "theory" and research interpretation and etiquette. %0d%0a%0d%0aWhere is the education in advanced psycology, sociology, anatomy, radiology, and more scientific and clinical information to solidify a DNP justification. If a DNP is better prepared than an NP there should be an emphasis on collecting knowledge that is present already, then should a DNP wish to contribute he/she has a knowledge base to truly know what needs contribution.  %0d%0a%0d%0aI still intend on getting my NP, but I have already researched much of the missing scientific information and am constructing my own basic science protocol to better understand my patient's conditions so I can educate them and intervene as a DNP should.%0d%0a%0d%0aThank you for reading.

I do not understand why nursing as a profession feels the need to promote the DNP. Being a NP student, I have found several classes that have not changed since I recieved in my ADN class so many years ago. Theory is the same, research was the same, the advanced pathophysiology was the same. I feel that the advanced practice nurses at the master's level need more clinical and not fluff. The powers that be say that the DNP will provide the clinical side of the house. Then why do I need to pick a program for acute care? Will the DNP provide me with that knowledge? Is there a DNP specialty program as there at the Master's level? It does not seem so. I am not saying that it is not important but I personally, and my patients as well, would rather be clinically proficient and give appropriate treatment than to theorize how they are doing at the Master's level....wait the bachelors.....I mean Associates... If the standard for advanced practice has been the Master's level then we as nurses should treat it as such. Preparing me for clinical practice by having me take a theory class because the school wants you (the student) to understand why they teach from xyz theory is a waste of time, effort and money. This plays into the hands of the DNP by telling me as a Master's level advance practice nurse that will be board certified in my specialty, that my sleepless nites, sacrifices and hardwork really did not prepare me for the work I hope for. That I will have to return to school to get my DNP in order to practice as a NP because i am not clinically prepared (because I do not have my DNP) to take care of patients and been seen as a colleague in the higher education sector. I believe that many more would go into advanced practice if the program you enter provides you with the clinic tools needed instead of fluff. Just my opinion. Thanks for reading.

Butch

As a Doctor of Nursing, I really don't get the whole DNP thing.  Frankly, I think it is just another device for the nursing profession to divide ourselves up into the good and the not-so-good. I learned more about advanced practice nursing in my doctoral program than I did in my Masters program.  Furthermore, I believe the so called "Doctor of Nursing Practice" is nothing more than a fancy masters degree, not an educational level higher than a masters, which is what a DOCTORAL education should be.  I will not be going back to school anytime soon  to "promote" my doctorate into a "mastorate".

If we allow ourselves to be 'measured' by medicine we may be opening the door to be regulated by medicine. Since most DNP programs are currently revamped PhD programs that are not true clinical practice doctorate programs it would be difficult to really measure more advanced clinical knowledge when to curriculums do not address this. I think it is misdirected to take such an exam as it actually represents nothing tangible to advanced practice. We are not doctors, why would we want to be measured by medicine? What does it prove? 50% passed this exam....does not make a clear statement, except that 50% DID NOT pass. If a specific exam were desgined to assess NP practice at the DNP level (no different than MSN level really based on curriculum and practice) that would be more valid. Oh wait....we do have such an exam it is called the board certification exam! Over kill will get us nowhere. Many DNP programs seem to be preparing NP executives not clinical advanced NPs. We need to take a step back and really look at the validity of the measure and its meaning which at this point...there is no real meaning that can be derived.