Anne, the skills that you mention can be obtained from a Business Administration or Healthcare Management doctorate and should not require the title of DNP.  Systems change is a hot topic in management and really is not of clinical practice origin at all.  I would argue that clinical expertise at the doctoral level should also include a greater depth of understanding of the science of medicine.  As someone who was a student in a CRNA program taught mainly by physicians, pharmacologists and chemists (I left after the first semester) I can tell you that I learned more about Pharmacology and Physiology in my first semester than I had ever learned during both my Bachelors and my Masters degrees in Nursing.  My point is this:  If you are going to offer a degree program with a clinical title (i.e. Doctorate of NURSING PRACITICE) you should focus the coursework on clinical areas not on management, administration, education or research. 

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M. Ojeda, ARNP, MSN, MPH, NP-C

I must disagree with this generalized statement regarding the clinical basis of DNP programs.  I recently graduated from the DNP program at Columbia University.  By stating that a 3 year residency would legitimize the DNP degree is ridiculous.  I think that the public and health care professionals should understand each DNP program before they make any statements.  First, the selection of candidates that were admitted into the program at Columbia University was discriminatory.  All of my fellow classmates were established leaders in their respected clinical practices.  All of the students were very experienced in their fields and had numerous years of clinical experience.  Would we expect an Advanced Practice Nurse to enter a similar residency as a medical student?  Medical students enter residency with minimal bedside experience, few clinical skills and limited prescribing experience. 

The DNP Portfolio, required to graduate, was based on 10 clinical case studies that were defended by evidence based practice.  These cases were presented in a scholarly manner with an emphasis on the prescribed medical regimen.    

As a solution to this dilemma of "how advanced is the DNP clinically?" the ABCC developed a certification exam based on the content and format of the USMLE Step 3 Examination.  The USMLE step 3 is the exam medical residents take when graduating.  This new exam will provide the DNP with Certification status upon successful completion.  I think this should distinguish the DNP as both a Medical and Nursing Clinician. There will no question about the abilities of a certified DNP!  I plan on taking this examination in November.

For clarification, the PA profession uses the Masters degree as its preffered standard, though a few certificate and bachelor degree programs are still kicking around, the majority and are Masters. There is one Clinical doctoral degree for PAs offered only to Army PAs, the DScPA degree.

Anesthesia Assistants/Associates are a completely different profession and have nothing to do with PAs.

I think it is truthfully disgusting and a disgrace that nurses repeatedly continue to belittle eachother!  The eating of the young never ends, does it?  No wonder there is a shortage!!!  There is no keeping up with the Jones's, simply advancing our degrees to a doctoral level, something to be very proud of and to support.  The PT's and the pharmacists celebrate their peers who go on to advanced degrees, and nurses???

 The DNP is a fantastic, CLINICAL degree, that furthers our profession and our professionalism.  In comparison to the PhD, the skills that a DNP program has to offer are completley relevent to clinical practice.  The title is not misleading, it is a doctoral level education.  Did your professors confuse you as well?  Look into various programs, the degree certainly does advance our skills.  There are specialty courses and clinical work, and an end of the program project related to a publishable practice changing product.  Good stuff for our profession.

 Try to see the good in an advanced degree, and try supporting your peers and your profession. 

I also agree with you.   If I am going to go back to school I want a program that will give me more clinical skills.  I don't need any more theory!!! I would welcome a 3 year residency program to improve and provide new skills and knowledge to provide for the veterans I serve.

Kim!

If you want only clinical education and you haven't gotten that in your practice setting, go to medical school. If you want to further your clinical education with evidenced based practice that treats the whole person, their family, and their community, get your DNP degree. There is nothing clinically that you can't get from a book, research articles, or nursing practice. The reason MDs need residency is because they do not have near the clinical exposure that nurses get throughout there education.

 

I highly encourage anyone who has not  read the August 11 AMA News to read the article on Let's keep real meaning of "doctor".  It is very offensive and deserves our attention.  I will be glad to scan article for anyone who cannot find online.  www.amednews.com  to send a response go to www.amednews.com/letters.  Thanks eveyone.  Shannon Whitten NP

"We are already experts in our clinical fields, but we need that extra piece to understand and interpret research and actually integrate research into our clinical practices. We need skills to interpret and design new research that will advance our profession. Who else will do this? We will be the leaders and educators in our  practices and communities."

Is there any argument that the PhD is paramount in preparing nurse researchers, leaders and educators. I am fortunate that my masters program prepared NPs to understand, interpret and integrate research into clinical practice. Like many of my NP colleagues, I feel NP programs would be enriched by expanded clinical training such as PA students receive in their clinical rotations. The technical doctorate level nurse has been recreated many times and the PhD remains the terminal degree in our field.

Laura Triola MSN FNP ARNP-BC

 

Troy,

Thank you so much for the great response and insight into the DNP program.  I am a FNP, run my own practice with my husband (an MD).  I see patients daily and am the practice administrator.  I also love teaching and do that per diem.  I want to pursue my DNP program and am finding it a little difficult to make a choice.  I've been looking at the George Washington University program.  It's online with a short visit required, like most programs I've seen, and the tuition is very reasonable.

I have always wanted to pursue my doctorate degree, but like many, wanted to focus more on the clinical practice and community issues versus pure research.  Your words are encouraging, as this is exactly how I feel about pursuing my DNP.  I just want to make sure I make the right choice in the university.  May I ask which university you attended that gave you such a great experience?

Also, if anyone out there wants to contact me about their great experience with their program, please do so.  This is a very serious decision for me and I want to make the most informed decision that I can.  My email is:  trezi35@aol.com.

Thank you!  Theresa

 

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Theresa I. Klausner, MS, FNP-BC
Board Certified Nurse Practitioner
Certified Health Coach - Take Shape for Life

Well said! Thank you!

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Theresa I. Klausner, MS, FNP-BC
Board Certified Nurse Practitioner
Certified Health Coach - Take Shape for Life

Some people keep mentioning the lack of financial increase with the DNP.  First, an increase in salary is dependent on your place of employment.  I know the veterans administration does recognize a doctoral degree and you enter a different pay grade after recieving your doctorate.  Perhaps, not all places of employment are the same.  But most importantly, should financial gain be the only justification for increasing your knowledge?  I don't think so. 

Thanks Troy for you words of encouragement and confidence in the DNP role. It is very dishearting to hear nurses speak about thier own profession as some have in this blog.  I am in my first semester of a DNP program and have already found that it challenges me as a NP to be more effective in my practice.  It promotes evidence based pracitice and challenges me as the NP to improve or even develop new and more efficent pracitice guidelines. Why is it the nursing profession can not get away from "eatting thier own". 

 

Thank you for your support. It is very strange how nurses "eat their own." It probably emanates from either a misunderstanding of the profession or perhaps some might be interested in pursuing further study but it would have to meeting their specific criteria. Nothing wrong with that but condemning those who choose the DNP program is disingenuous.

Troy