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DNP Answers

Camaraderie Among MSN NPs and DNP NPs

Published August 3, 2012 9:45 AM by Catherine Nichols

Q: A colleague asked, "Why would you ever go back for your doctorate?" with the implication that she thought it a bad idea. It got me thinking: are DNPs supported by our NP colleagues and healthcare in general? What would foster better camaraderie between NPs with a DNP and those without?

A: This question creates an environment of dichotomy and dualism among APRNs. The DNP and NP are not in separate, opposing “camps” as this question indicates. NPs, together with certified registered nurse anesthetists, clinical nurse specialists and certified nurse midwives, are the four complementary specialty APRN roles of our profession. According to the American Academy of Colleges of Nursing (AACN), these specialty focused nursing roles will be phased out and replaced with the terminal nursing degree, the DNP, as of 2015. The master’s degree in nursing will still be offered for a generalist role. Not all current APRNs will be required to obtain their DNP degree. This will depend on personal choice, and likely based on years of future practice projected. The current APRNs who decline the DNP will be “grandfathered” into the new APRN required DNP (AACN).

The purpose of this degree is not to create yet another nursing degree option, as has been the history in our profession with the DNS, PhD, DrNP, ND, etc. This disjointing of degrees has only served to divide our profession and cause dissention. The DNP is designed not only to unify our profession, but to bring our practice as APRNs, in all the various specialties, to parity with our collegial partners in health care who already require doctorates. The DNP has also been developed for the purpose of meeting the challenges set forth by the IOM in their reports, “Crossing the Quality Chasm” (2001) and “The Future of Nursing Practice” (2010). A wonderful resource to answer all of your DNP questions about this degree, what is, and what will be required is the AACN website FAQs on the DNP. You can find information on both requirements for education, along with rationale and resources for our advanced nursing degree. This is an excellent site and will clear up any confusion. And read past posts from the DNP Answers blog to see how other contributors have responded to similar questions.

Making the decision to pursue a DNP is a major life decision and should not be entered into lightly or with preconceived notions. Researching the degree and all that it encompasses will provide you with a knowledgeable and factual base to make this life changing decision.

Editor's note: Here at the DNP Answers blog we take your questions about the DNP and answer them as best we can. This question is answered by blogger Catherine Nichols, MSN, ANP-BC, a DNP student and adult nurse practitioner. Comment below to discuss this topic, or send new questions to jford@advanceweb.com.

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2 comments

Well, I'm going to speak for the silent majority who are afraid to go against the grain or rock the boat:

Unless the individual wants a DNP and wants to be employed at the University level and/or wants to do research; thinking of making it a mandatory requirement in the future is wrought with problems and a monumental mistake for the following reasons:

*the amount of money spent in obtaining a DNP will never be recooped - MD's are taking 30 years to pay back their student loans and their salaries are not as they were in the past along with being placed in a higher tax bracket based upon their gross income; burdens their payback ability. If you want to become Dr", go to Medical School: becoming a specialist in the area of your research will not make you a better practitioner overall.

*the Medical community will really cause you quite a bit of grief with the title in front of our names even though it will have DNP on paper after the printed name.

*pushing for this is just another example of "NURSING" having an inferiority complex and wanting to justify their existence: accept the fact that we do a GREAT job and provide a GREAT SERVICE to the community and go to bed at night feeling good about that. I LOVE WHAT I DO!

This will never fly; Nursing can't even get RN licensure on the same page - how many years has it been and still no progress. The DNP should be a voluntary, individual choice and not a mandated choice.

The DNP is not the BE ALL/END ALL of our profession.

The DNP does not move "our profession forward". It just satisfies ego(s). You want a DNP, that's fine, but don't make it a requirement, it should be an optional choice. Do MD's require all their clan to go for a fellowship? This is for one's own optional personal and professional growth. This mandate will go the way of the EDSEL FORD of the 50's. This is truly the most ridiculous idea the powers that be could ever dream up! You have bought into the propaganda, because you are part of it; and according to "Cognative Dissonance Theory", as proven by Millikin in the 50's, You always justify anything you have paid a price for or expendend energies towards. The greatest majority of the supporters of making the DNP a mandatory requirement are those who already obtained their DNP and need to justify their decision to obtain it, spend the money for it and expended the rigouorus energy needed to obtain it. Just as "Cognative Dissonance Theory" has proven. I have not exhausted any type of resource, nor expense to justify nor influence my decision making, so I can look at things quite objectively.

Doctors have a guaranteed job waiting for them upon graduation, NP's do not. New graduates are having a heck of a time obtaining their first NP position and still have to work as a BSN to stay gainfully employed in order to pay their normal expenses let alone paying back their advanced degree. I, myself back in 1998 did not obtain a job as an NP until 5 months of very aggressive searching and the only job I was offered was in a dialysis center. I never worked a day in dialysis, but was given the job despite 2 other NP applicants with dialysis/ESRD experience applying for the job. Why did I get the job? I was offered this position because I was offered a under-market salary; I had an excellent Medical/Internal Medicine background as a BSN and because the Navy had this program for transitioning retirees which paid the employer $5,000 kick-back incentive if they hired the Vet. So, my employer paid me below market value and obtained a kick-back to hire me as well.

NP's are thriving as a result of a "Perfect Storm" scenario!

Lets review the facts:

IN THE BEGINNING, if it wasn't for money, insurance companies would not have given the NP the right time of day. It was their cost savings that allowed us to progress to where we are today.

a. First DRG's came along for cost savings

b. Physicians practice CYA Medicine because of the litiginous nature of this country, thus ordering all tests whether appropriate or inappropriate

c. As a result, reimbursement dropped and then reimbursement to the MD dropped, following suite.

d. Insurance companies initially wouldn't give the NP the right time of day, but one genius realized that if they reimburse NP's at a reduced rate over the MD, WOW, what a cost savings there would be. As a result, insurance companies have become our best friend. This led to continual decrease in reimbursement of the physician.

As a result,, MD's left the Primary Care/Internal Medicine specialties:

The physicians did it to themselves. Primary Care/Internal Med docs are not adequately reimbursed by their standards and point of view, so there are less and less MD's going into these specialities. Someone has to fill the void; NP's to the rescue. If it wasn't for that, NP's would still be trying to get in the front door. As Gordon Gecko said in "WALL STREET": GREED IS GOOD! Greed by MD's put us on the map and we are definitely here to stay! GO GREEN.

The new mandate for DNP as the only way to become an NP after 2015 will break the Universities back. Now that it will require 4yrs vs 2 yrs and alot of money and time on the part of the RN applicant, compounded with the lack of to miniscule payback on the other end; this program will go the way of the dinasauer. If I have to expend all that time and money for virtually no difference at the end of the day, I'll go to Medical School, and any rational thinking applicant will see this as wwll. This is not ROCKET SCIENCE to be able to figure this out.

As a result, access to care will get worse because of lack of providers because of the decisions of the "Powers That Be". This was really thought out well - lol

A DNP will not make the NP any better as a Clinician. We already outshine the MD community in patient approval and outcomes. So, now you are "beating a dead horse" and expect more people to want to ride this non-productive creature.

Then there is the "PUSH-BACK" from the Medical Community, that has deeper pockets than the NP Community.

DNP: "Doctor of Nursing Practice." Excuse me, no matter what you say or might think, "WE PRACTICE MEDICINE" with a Nursing DNA in our heritage.

When we order a medication, the bottle says Dr/MD, not NP, no matter how often you tell the pharmacist the we are NP's and not MD's. The DNP will not change anyones peception of us no matter how hard you try to justify our existence.

Michael Mahler, Pain Management - Nurse Practitioner, Walter Reed National Military Medical Center February 18, 2013 9:15 AM
Bethesda MD

This is all a crock of professional/political hooey drummed by mainstream society to feel like they are so much better than others 'less educated' in the profession of healing arts. I do not have the money nor the time to pursue the DNP and I resent this profession trying to push this on those of us who have worked hard to become NPs !!!!!!!!

nursegirl2001, RN, BSN, MHA, NP student August 7, 2012 4:32 PM
Wichita KS

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