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NP Practice Owners

DNP?

Published July 14, 2008 7:51 PM by Joseph Marra

There have been numerous accounts of NP opinions on thecontinuing education and creation of standardized DNP programs. We have allheard of the pros and cons of each camp and must make a decision on whether ornot this is beneficial to our profession.

I for one am in favor of this endeavor for many reasons. Imust first remind you that I own and operate my own practice and would be thelast person many would find continuing on this path. I already have as muchautonomy as any NP can have, and yet now that a doctorate program is availableto solidify my profession, I am forced to act.

I feel it necessary to have the credentials that we alldeserve. It seems to me that those who hold the highest level of education getgrants easier, are asked for their opinions more often, and are generally moreaccepted into research.

Many professions are going to doctorate programs, and seethat this level of education invites respect and credibility. I can think ofmany professions that are not MD/DO, where it is acceptable for the individualto call themselves “Doctor.” A psychologist, chiropractor, and collegeprofessor are just a few.

If you have spent the time and money to obtain this level ofexpertise in your field of study, then I feel you should be permitted to referto yourself as “Doctor” as long as you advise the individual of what you have adoctorate in.

I don’t pretend to be an MD or DO in my daily practice. Infact, I currently have many safeguards to protect me from this. At thereception area I have pamphlets that educate patients: “What is a NursePractitioner?” I also have my office staff simply address me as “Joe” andintroduce the patients to me as “You will be seeing Joe, our nursepractitioner.”

Many patients insist on calling me doctor, and I continuallyhave to correct them. Patients want to give you the respect you deserve, but ifyou don’t own the title, don’t use it!

When I complete my DNP program I will be addressed as “Dr.Marra, our nurse practitioner.” I will have earned the right to use the titleat that point and intend to use it. Many of my physician colleagues often liketo introduce me as doctor and cannot; however, they actually welcome thechange.

But make no mistake I will never portray myself as an MD or DO! I like who I am andwhat I do. NPs do a similar job and have an uphill battle educating andfighting for all that we have. An MD/DO can simply open up shop and go to it. Ienjoy the challenge. The NP profession is on an uphill climb, but we arechanging this daunting task, one patient at a time. Also I have seen manyresearch studies recently that compare MD/DOs with NPs, and the results are eyeopening.

How many times have you seen surveys that ask, “Out of allthese professions who would you trust the most?” Nurses are always the numberone answer! Why would I want to be anyone or anything else? We have the best ofboth worlds.

In my opinion, the DNP should not be mandatory for those whohave been practicing and established for a certain time. I of course am noauthority in this area but feel that a grandfather clause should apply. Thiswould most likely lessen many opposing opinions that current NPs have. I agreewith the notion that those who have been practicing have proven that they canpractice safely and effectively and require no further education to providecare that they have been providing for years.

I also feel that we have to start somewhere, and the bugsshould be worked out by our certifying bodies. We as a profession need to cometo common ground on this issue. A change is inevitable, and input is alwayswelcome, hence the discussion in this forum.

 

Joseph F. Marra CRNP

Urgent Care Center (Owner)

5 comments

I am currently enrolled in a DNP program. I have been in nursing over 20 years in various roles. Most nurses are focusing on the title of doctor and not what the degree will add to the profession of nursing. We must realize that health care has become more complex and for many us our educational preparation was not adequate to meet the complexity we encounter on a daily basis. The DNP adds to your knowledge base and skill in a way that helps you provide better care to your patients and communities. Finally, all other professions are moving to the doctorate has the terminal degree. If we as nursing want to be included in high level decision making processes like policy etc.,  we have to come to the table with the same credentials.  

Karol Ellis, Cardiology - A/GNP, ACNP, Duke University December 10, 2008 12:57 PM
NC

    I have just read a few published comments on the hot topic of DNP. I am presently in a DNP program and I must disagree that a DNP program does not add to clinical practice. It most certainly does. The program does not focus on producing medical physicians nor has any DNP programs that I have researched ever claimed such. A DNP is prepared to approach advanced clinical practice with a scholarly basis. Focus is on development of evidence-based research, its importance and implications to nursing practice in addition to publication of such findings. It is these findings to which NP base their practice knowledge.

    A DNP may not be practical for NP's for a variety of reasons, cost, time, or even lack of initiative. I would advise to those who are so against DNP programs to look closer at the mission.

I don't think I would be so quick to bite the hand that feeds you.

Denise Hite, Orthopedics - CRNP, Cullman Regional Orthopedics and Sports Medicine September 14, 2008 11:11 AM
Cullman AL

I firmly believe in the long term the DNP is necessary for the continued advancement of our profession. At the present time pretty much all clinicians that provide healthcare services for insurance payment have gone to the clinical doctorate. Not too far in the future this will be the norm and insurance companies will expect it. I agree with others that say the current DNP programs offer little to currrently practicing NP's. These transition programs are poorly devised. My hope is the entry level programs will offer more clinical training than the MSN programs of the past. I believe as the DNP programs evolve they will. As a profession I hope we don't get too short sighted in our vision. Just my 2 cents.

William, NP

Ortho, NP

William Beatty July 17, 2008 6:58 AM

When I began my education, I had the choice to do anything I wanted.  I chose to become a nurse with the understanding that I would complete graduate school and become a Nurse practitioner.  I did not chose to become a physician b/c I did not want to attend school for all those years.  If the Doctorate degree is not going to give more clinical expertise, then quite frankly, I do not want it.  I do not need the title of "Dr." to feel fullfilled everyday.  I am quite confident in the care I give to my patients on a daily basis and am quite satisfied with being called Shelley, nurse pracittioner, that is what I went to school to become and what I do everyday.  I am not a physician, nor do I want to be.  I agree with the earlier blog, "If it ain't broke, don't fix it."  In the end, we are going to discourage nurses from obtaining their nurse pracitioner because of the years required to be educated.  Doctorate degrees are great for research and teaching but until I see some proof that it is beneficial to everyday practice, I do not think it should be mandatory.

Shelley, Family Practice - APN July 16, 2008 8:40 PM
Lit tle Rock AR

DNP programs are not clinically based and this does very little to advance our skills as a practitioner. As for "Keeping up with the Jones" a Pharm. D. or PT. D., etc these are true degrees that advance their practice and give professionalism. Most NPs would welcome more clinical enhancements.

It is evident that very little thought has gone into putting together many DNP programs at various universities as they all jump on the money producing wagon. It is clear that before we can make the DNP a standard it needs to be worked into a 3 year clinical doctorate just for NPs and not other nursing disciplines.

The title as it stands is very misleading to the medical world and to our patients. As a med-level practitioner (I dislike the term) a DNP will not change that status with the Federal Government until we do as the DOs and follow their friends the MDs and go to a clinical doctorate followed by a 3 year residency. My question for the Nurse Practitioners is "Are we trying to fix something that is not broken?" just to be doing it!

Roger Mckee, MSN, FNP-BC July 16, 2008 3:50 PM
Phoenix AZ

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