[NPInfo] DNP and R*E*S*P*E*C*T
Carla Anderson
carla_rayne at yahoo.com
Fri Nov 30 20:41:47 PST 2007
I agree. If an NP with a doctoral degree goes in to see a patient, and introduces themself as "Hi, I am Dr. Jones".. and the patient says "what kind of doctor are you? " and you say "well, I am not that kind of doctor, I am a nurse, with an advanced doctoral degree..." I think you lose the patient at "I am not that kind of doctor, I am a nurse.." and then I feel the patient will be left with a feeling of confusion and perhaps unease, that a possible false portrayal is being done intentionally. I even get that feeling myself when someone says "I am a physician, so I tend to do such and such...." and then I say what kind of physician? They say "I am a naturopath"...I have to admit, I get a wierd sense in my stomach sometimes. Like they are saying it to obtain an immediate response of respect, based on the word "doctor" or "physician", and what it implies to society. I do not like it. I do respect Naturopaths, and Chiropractors, but do not feel that the term "Doctor" should
be said loosely across the board for all professions, because these are all different eductations.
I do think people should be recognized for their education, but we dont go around and say "Hi I am Master's Smith" or "You will be seen by Bachelor degree Jones"... Your education is recognized on paper, and in bio's, and different ways, when patients ask about your background.
Stephanie Walker <stephanie2u at optonline.net> wrote:
Judy, I don't know what your last name is, but let's say it's Jones.
Are you calling yourself Dr. Judy Jones? Are you patients saying
their primary care provider is Dr. Jones? (I am looking at your
statement "Many legislators, TV commentators, consumers etc?won't go
to "just a nurse" for advice when they can go to a DOCTOR. This term
connotates authority and knowledge.? But if the Nurse?also had a
Doctorate in their chosen field, then maybe the public will begin to
believe that both professions have expertise."
I don't think the answer is to start calling ourselves Dr. That seems
almost like carrying out a deception. Nor are we RN nurses. We're
nurse practitioners.
I've been an NP for 25 years. I find that many more people know what
an NP is today than did even 10 years ago. But--whether the public
knows about NPs is a completely separate issue from our practice
issues and our legislative issues.
The public perception is irrelevant when we are talking about
funding, money, political power, practice legislation, etc. The
public doesn't have any role, or any power, in these areas. If all
your patients wrote a letter telling your legislator how wonderful
you are, it would not make any difference, unless they threatened to
not vote for him/her the next election and there were enough of them
to change the outcome by so doing. Legislators are not "the public."
They are politicians who are paid off by the AMA and state medical
groups to act in their interests, and willingly do so.
Stephanie Walker, FNP
On Nov 30, 2007, at 2:53 PM, jabphd83 at aol.com wrote:
>
> Stephanie, I agree that $$$$? speaks volumnes and the?AMA has lots
> more money than the ANA, yet there are MANY more RNs than MDs in
> the US.? MDs join their national and state associations and support
> them so that they can lobby the issues that may come up that could
> eat into the MDs pocket, such as NP and PA practice.?? RNs need to
> learn that they will never get far on legislative issues unless we
> support our organizations to lobby for our needs.
>
> The doctorate in nursing will help?negate the AMA's argument that?
> MDs are better educated and trained than NPs. We do not need to get
> this degree to impress anyone.? We need a doctoral degree as a
> terminal degree to help?equal the health care playing field.? Many
> legislators, TV commentators, consumers etc?won't go to "just a
> nurse" for advice when they can go to a DOCTOR. This term
> connotates authority and knowledge.? But if the Nurse?also had a
> Doctorate in their chosen field, then maybe the public will begin
> to believe that both professions have expertise.
>
> Stephanie, I am not trying to change your mind.? I only want to
> provide "food for thought".? NP recognition and equality?may not
> happen in?my lifetime, but it is up to all of us to help change the
> environment for the next generation of NPs.? It is sad to realize
> that many people still do not consider nursing a profession, but
> merely a trade.? We have a long way to go to be seen as equal along
> side professions such as medicine, law, engineering etc.
> Judy
>
> -----Original Message-----
> From: Stephanie Walker
> To: NP Info
> Sent: Fri, 30 Nov 2007 1:40 pm
> Subject: Re: [NPInfo] DNP and R*E*S*P*E*C*T
>
>
> I don't agree that politicians/legislators will be impressed if
> NP's go to them and tell them them now have an additional degree. I
> think this is naive in light of the fact that all legislation
> depends on deal-making. NP's are very small potatoes in this game.?
> ?
> If and when a practice act is opened, the state medical association
> will be lobbying to restrict NPs even more, so opening a practice
> act is extremely risky. The AMA's agenda, which is what its state
> affiliates are carrying out to the best of their ability, with mega
> lobbying bucks, was all set out this past year and probably can be
> found on their website: in a few words: crush PA's and NP's.?
> ?
> What impresses legislators is money, not intellectual arguments : )
> The state medical associations have bought off the legislators and
> the legislators look to the medical association for advice whenever
> healthcare related legislation comes up. When the legislators ask
> their state medical association contact what they think of NP's,
> they'll get the AMA's party line. When NPs visit them to lobby,
> they will repeat the AMA's party line and pretend not to understand
> what the NPs are telling them about all their education and what
> they can do. This was my experience, anyway.?
> ?
> Stephanie Walker, FNP?
> ?
> On Nov 29, 2007, at 9:18 PM, jabphd83 at aol.com wrote:?
> ?
>> ?
>> ?
>> Sue, I agree with you.? If our state makes us collaborate, we
>> don't > have independent practice.? I also live and work in a
>> state with > collaborative practice.? But, when your state nursing
>> organization > opens your Nurse Practice Act and lobbies for
>> expanded practice, > the medical lobby will be there shouting that
>> NPs don't have the > education or training for independent
>> practice...... and the > majority of your state legislators will
>> believe them for many > reasons including the belief that a
>> masters degree does not equal > an MD (which is a clinical
>> doctorate).?
>> ?
>> Years ago the MDs were fighting with the DOs saying that the DO
>> was > inferior to the MD.? It took years of education of the
>> public and > legislators? to convince them that although the
>> curriculum had > differences and the degree conferred had
>> different letters, their > education and training as health care
>> providers was equally > acceptable and was, after all, a doctoral
>> degree.? Even today, > there are segments of the population who
>> will only go to an MD > versus a DO.?
>> ?
>> Your physician colleagues will get use to the DNP degree, just as
>> > the MDs got use to the DOs.?
>> I do agree that as a profession, we need to come up with a
>> clinical > doctorate "name" and stick to it to avoid more confusion.?
>> Thanks for the discussion.?
>> Judy?
>> ?
>> -----Original Message-----?
>> From: suernfnp at iwon.com ?
>> To: npinfo at nurse.net?
>> Sent: Thu, 29 Nov 2007 7:17 pm?
>> Subject: [NPInfo] DNP and R*E*S*P*E*C*T?
>> ?
>> ?
>> ?
>> ?
>> Judy, the reason I am not ready to attend my former college's DNP
>> > degree program?
>> is because I am not convinced in any way that this degree will >
>> level the?
>> playing field between professions. From speaking with DOs and MDs
>> > where I work,?
>> I would earn great respect from them if I had a PhD in any field.
>> > They would not?
>> understand what a DNP or DNS or DrNP is. As a NP I still am >
>> required to?
>> collaborate with a physican, so the playing field will not be
>> level > in my state,?
>> no matter what degree I hold, until I can practice independently.?
>> ?
>> Sue D in Detroit, MI - The home of Aretha and R*E*S*P*E*C*T?
>> ?
>> ?
>> ?
>> ?
>> --- On Thu 11/29, < jabphd83 at aol.com > wrote:?
>> From: [mailto: jabphd83 at aol.com]?
>> To: npinfo at nurse.net?
>> Date: Thu, 29 Nov 2007 14:29:42 -0500?
>> Subject: Re: [NPInfo] Mary Mundinger?
>> ?
>> Dave:??You talk about an "end degree" for the other professions, >
>> but not so in?
>> nursing.? A Pharm.D. is a clinical doctorate.? An MD is a clinical
>> > doctorate.?A?
>> PsyD. is a clinical doctorate.? ?A DNP, DrNP or DNS are clinical >
>> doctorates.???
>> If anyone in these professions want to do serious research and?
>> have > major?grant?
>> funding, they will need a Ph.D.? That is why you may see MDs and >
>> PharmDs with a?
>> PhD as part of their credentials.? Academically speaking, a PhD is
>> > the terminal?
>> degree in all professions.? Many professionals do not need this >
>> degree to?
>> practice clinically or to be clinical faculty, but to do
>> scientific > research and?
>> receive major NIH grants and lead teams in national clinical
>> trials > or to be?
>> tenured in a research intense university, the Ph.D. is the way to
>> go.?
>>
Academically,the Ph.D. is the end degree for all >
>> professions,? including?
>> nursing.?
Nursing came late to this conclusion and 25 - 30
>> > +?yrs ago,?
>> nurses obtained doctorates in other disciplines?
>> until?the profession?concluded that along with a shared body of >
>> knowledge from?
>> many disciplines, ?nursing had a unique body of knowledge that >
>> would support a?
>> PhD in nursing.? Because nursing is a practice discipline with a?
>> solid?theoretical base, many nurses opted for a theoretically
>> based > education?
>> with? clinical application?versus?theoretical development and
>> basic > science?
>> research.? ?That is why?nursing first went with a clinical >
>> doctorate such as a?
>> DNS, ND and then DNP.? These clinical doctorates are evolving, but?
>> > they are all?
>> clinical doctorates that emphasize?clinical application built on a
>> > strong?
>> theoretical ?base.
What we are seeing is the evolution of a
>> > profession,?
>> with all it's growing pains, and sometimes false starts.? But >
>> nursing is moving?
>> forward and we are setting ourselves up to compete with other >
>> professions -?
>> practice and basic science alike.
If we want to compete
>> for > health care?
>> dollars? and withstand the criticism of our "lack of training an!?
>> d?
>> education" from other health professionals, we must have similar >
>> educational?
>> endpoints ( ie: a clinical doctorate like MDs or PharmDs or PsyDs)
>> > or we will?
>> continue to be seen as second?class providers by congress, health
>> > insurers,?
>> other professionals, and consumers.
I realize that you are
>> > a PA and may?
>> not have the?knowledge of nursing's history, but it is a history >
>> worth noting.??
>> PAs are a much younger profession than nursing and the lessons >
>> learned by?
>> nursing, good and bad, may be something PAs should take note.??>
>>
Both?
>> professions know we are "good" and how well we do our jobs.? But
>> we > have to get?
>> this message to the legislators, big business, insurers and the >
>> consumers.? To?
>> do this, we must "prove" we have the knowledge and credentials to
>> > do what we say?
>> we do as independent professionals.? In today's world a doctorate
>> > is the?
>> academic credential that these groups "first" look?for before they
>> > actually see?
>> what you can do. The academic credential is the?
>> proverbial "foot in the door" to gain entry and then the?>
>> opportunity to prove?
>> we?deserve equal standing with other health care providers. >
>>
I am a?
>> practicing NP who is politically active, a faculty member, and a >
>> researcher.? I?
>> have also continually gone back to school to get the expertise and/
>> > or credential?
>> I needed to move forward in my profession and reach my goals.? At
>> > times I have?
>> gone back to school "kicking and screaming" because I thought my
>> 25 > yrs of?
>> experience as an NP "should count for something".? However, I must
>> > admit that I?
>> always learned something in school and it always opened up new >
>> avenues to?
>> explore.
Individual NPs and PAs may decide they do not need
>> > a doctorate?
>> to reach their individual goals or?enhance their practice and that
>> > is OK.? But,?
>> as a profession, nursing needs to compete on equal footing with >
>> other members of?
>> the health care team and to be viewed as equals by all the >
>> stakeholders, we need?
>> the academic credentials.??The clinical?
>> doctorate contributes to nursings' ability to compete?on an equal
>> > playing?
>> field.
Judy
-----?
>> ?
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Carla R. Anderson, FNP-C
Healing Presence Family Practice, PC
carla_rayne at yahoo.com
503 819 9726
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