The 4th National DNP Conference

Lam, believe me it is rigorous!  My BSN to DNP requires so much more than the masters programs I looked into.  After completing my first clinical experience, I could not imagine only having 400 more hours and then letting me go on to practice.  I am grateful that I will have over 1000 hours and wish it was more.  Many of the nurses I work with that are completing their masters degrees told me they don't want to have to do all the extra work and clinical hours that the DNP program requires.  

Kim

First of all, the DNP is not a feel good degree. Second of all, it does not make you a DO or MD. Its a doctoral degree; It is as simple as that. It appears that many NPs feel uncomfortable with the DNP because they believe that is a nurse attempting to be a MD. Many of these NPs are ashamed of there master's degree and wish they were MDs and attack NPs that pursue a doctorate, and this is not necessary. My wife has a DPT (Doctor of Physical Therapy) She has never referred to herself as "Dr" but patients, PT,nurse,  and physician colleagues all have referred to her as "Dr" out of respect to her degree. Now, the purpose of the transition doctorate is definitely appropriate. Soon all new grads will come from DNP programs. Hopefully, this will improve the skill of the new grad. Now, experienced NPs do not require this additional training therefore the focus of the transitional doctorate is different. I plan completing my DNP but not to improve clinical skills but to put myself at parity with other health care providers. Frankly, I have seen job openings (usually administrative) that state that doctoral degree required. Well, I want to be able to apply for that job one day. I'm not pursing a DNP just to toot my horn saying that I am a doctor. The DNP will evolve and have it place in health care. No reason to bash it because every program is not perfect. Personally I don't think that the transition doctorate for the experience NP should be incredibly rigorous however for the entry level NP I believe that the DNP should be much more rigorous the master's level to ensure that it advances the profession.

My recollection is that the DNP was a solution in search of a problem. Before anyone mistakes my comment for a personal attack or professional chauvinism let me clarify. The DNP was implemented by the AACoN. When I spoke to some of the folks working on the DNP (all academics) they all believed that a doctorate level credential was needed, and it had to reflect a research background and emphasize an evidence-based approach. Beyond that there was minimal interest in advanced clinical training. The gist was that the DNP would be a terminal credential for experienced clinicians so further clinical work was not significant. %0d%0a%0d%0aYes, I realize this is a gross over simplification, but my point is that the DNP has become something else. It's a heterogeneous  non-clinical credential of dubious objective value. Heck, there are folks out there going straight from BSN to DNP with no significant independent clinical experience at all. There are folks completing DNPs solely online. %0d%0a%0d%0aWhere does it fit compared to a PhD? There's a lot of variability in across fields and institutions, but generally speaking the demands of most PhD program are substantially more than a DNP. How about a PA? Again, programs vary, but not anywhere near the variability of DNP programs. I had over 55 hours graduate credit, 60%+ with med students in the College of Medicine, and over 2000 hours of clinical time. Oh, and I had to write a thesis too. Does that make me better than a NP or DNP? Heck no. %0d%0a%0d%0aA few years of clinical experience is going to trump your training, whatever it was. That's what most important here.%0d%0a%0d%0aI am not attempting any ad homonym comments, but you can see why the DNP is viewed as fluffy. To complete a DNP and hold oneself out as "Dr So-and-so" is to invite ridicule. The DNP is less rigorous than most PhD programs, some may be less demanding than many PA programs, and it's a long way from MD/DO with a residency. I feel that in creating such a soft credential the AACoN has been self-serving and done a huge dis-service to the NP world. %0d%0a%0d%0aI am not enjoining the PA/NP/DNP one-up-manship of off-hand bitter comments

Wow Thom Gregory.....your really kinda of a butt huh.  Maybe you should seek counseling....maybe from a psych NP with a DNP....really?  Isn't it shameful to be so derogatory towards your own colleagues.  Come on...get a grip.

Well put Debi.

I wonder if Thom also thinks that a doctorate of Chiropractic or a doctor of physical therapy (both entry level degrees and refer to themselves as doctors) are "fluff" degrees?

The title "doctor" is in reference to a degree, Doctor of philosophy, Doctor of science, doctor of medicine, doctor of nursing etc. It is not a clinical title.

We should all be calling MD's, "physicians" when discussing with patients so to not confuse them any more than they are. We refer to Nurse practitioners as such, physician's assistants etc etc.

Can't we all just get along?

The AACN's Essentials of Doctoral Education for Advanced Nursing Practice provides a very nice overview about the degree and the required educational components. To obtain a DNP you must complete over 30 classroom hours of credit, approx 500 clinical hours, and pass a national certification exam.  Quite frankly, this sounds like it would require quite a bit of time and effort.

I have several colleagues that are entered in a DNP program and I haven't heard a single one of them talk about wanting to impress others as one of their reasons for furthering their education. They want to improve their clinical skills and knowledge in order to provide better pt care.

I for one have a great deal of respect for those who are willing to pursue this or any other doctoral degree and I will be more than happy to call them "doctor".

I agree Kim, we just all need to get a long and do what is best for our patients. I do think healthcare is changing and we will see nursing change a lot in the next 10 years, people just have to decide where they fit in.

This conversation is a perfect example of why nurses and nurse practitioners lack the respect of physicians and others.  We are so quick to put each other down.  I am an RN of 15 years currently in school for my DNP.  I enrolled in a DNP program instead of a Master’s program because I was aware at my age (47) that if I didn’t go for the DNP now, I wouldn’t after a Master’s.  When I graduate, I will be a new nurse practitioner.  Do I think I will be a better clinician than a FNP with a Masters degree and years of experience?  Of course not.   Will I be a better practitioner than a new FNP with a Masters Degree?  I really don’t know.  My program requires 1068 hours of clinical time – direct patient time.  Masters programs require 600 - 700 hours.  

Do I expect to be called doctor.  No, not really.  During my last clinical, my masters prepared preceptor (who was great) told her patients that she was a nurse practitioner and they proceeded to call her doctor.  She didn’t correct them.  She said she quit trying too, they just don’t understand the difference.  

What I do expect is to be treated with respect by my fellow nursing colleagues.  We will never be taken seriously if we don’t start standing up for each other.  You never hear physicians talk about each other like this.  You really should be ashamed of yourselves.  I'm glad I work for an organization that respects the role of nurse practitioners.

I sure do use the title "Doctor" in practice with no reserve. My patients know I am a NP and proud of it. If it is so "Fluffy" tell me why it was such a difficult degree to obtain with studying, clinicals and research.

You realize that physicians do not own the title "doctor" right? I earned the title "doctor". :)

Dr. Julie??? You're no friggin' doctor. You're an NP with a fluff doctorate.. Hell doctorate is a misnomer. It's not even at the level of a PhD...

I hope to hell you don't introduce yourself to your patients as "Doctor Julie".

TG

Did you really learn everything you need to know in the MSN program? I think as our roles increase we need to increase our knowledge. The DNP is a clinical doctorate and has made me a better practitioner. Yeah for the DNP degree..

Sincerely,

Dr. Julie

Totally agree with Thom - this is a "feel good" degree - however if you want to earn respect from other healthcare professions%0d%0aand fellow APNs it is through clinical skills and competence,%0d%0anot letters after your name - NP advanced training should take a lesson from PA training,Totally agree with Thom - this is a "feel good" degree - however if you want to earn respect from other healthcare professions%0d%0aand fellow APNs it is through clinical skills and competence,%0d%0anot letters after your name - NP advanced training should take a lesson from PA training

Hey,

If the DNP inflates your ego, go for it..but don't tell me it makes you a better clinician..