[NPInfo] Re: WSJ Article

[Diana Galler]

Okay-- to set the record straight-- in my A&P class at the community college level we did not each have our own cadaver-- I think we had one cadaver for the school but when it was lab time, we all paraded into the room to exam and take our turn poking at the smelly thing. I remember that by the time we got our turn, many layers had already been dissected which I thought was pretty cool-- we got to get an in depth look without having to do all the work!
   
  I attended community college in San Diego back in the mid-80's-- not sure if the school district was richer than most so we could get a cadaver or if there was simply an influx of dead bodies laying around just begging to be used. <G>
  Dena Galler 

Lisa Meyer <meyerlm at chartermi.net> wrote:
  Dena and group--

First, do you know how extremly unusual it is to have a cadaver experience 
at a community college? I took my A&P in a research-based university 
pre-med program and we had kitty cats--never saw a cadaver. Medicals 
schools DO require undergraduate anatomy as well as med school anatomy on 
cadavers. My NP program did not require anatomy beyond our undergraduate 
course.

My NP program did not cover 12 lead interp, as "most of you already know 
this". I never had 12 lead interp in my undergraduate training, nor was I 
ever expected as an RN to read 12-leads. I had basic instruction on rhythm 
strips in my ACLS courses.

As for suturing, I never had the opportunity to place a stitch in my NP 
program, but we did get a 4 hour workshop with a pig hock. My current role 
as a part time ED NP requires me to suture (sometimes complex wounds) 1-4 
times per shift.

I had no idea when I was in my NP program, exactly what areas in would end 
up working in during my career. I had no idea that I would end up in an ED 
or working in mental health as I also do part time. I really think that our 
clinical education needs a more standardized, broader range. Because NP 
students often have to find their own clinical experiences, it is possible 
for an NP student to choose their hours between a couple of "favorites" or 
whatever is available. This wouldn't be terrible if we knew that the NP 
would only end up practicing in these specialties.

Our NP programs are not turning out equivalent, well-rounded students in 
many cases, and a DNP with more clinical content could help to solve some of 
that problem--but it won't as it stands. As for repitition, how many 
statistics, research utilization, and management classes does one need?

Lisa

----- Original Message ----- 
From: "Dena" 
To: "'NP Info'" 
Sent: Thursday, April 03, 2008 8:15 AM
Subject: RE: [NPInfo] Re: WSJ Article


> Marilyn--
> A couple of questions about your wish list.
>
> Shouldn't anatomy with a cadaver be done as an undergraduate? Is there a 
> reason that someone in a DNP program would need to learn that stuff all 
> over again? I had my cadaver experience at the community college level-- 
> and certainly wouldn’t have wanted to have repeated it now in my DNP 
> program! How many anatomy classes do you think someone needs?
>
> In my MSN NP program we had a whole day of EKGs (although I missed that 
> day )-- being nurses already, most of us had some experience with 
> reading them. How long do you think an EKG class should be-- a whole 
> semester?
>
> Beyond basic suturing? Certainly not something everyone needs to know (how 
> many people actually do ANY suturing in their clinic practices?) and don’t 
> you think advanced suturing (and more intense EKG experience) could come 
> in the one year residency if someone is interested in an ED, plastics, or 
> other specialty area where that knowledge is necessary?
>
> "MS" as in Multiple Sclerosis or M/S as in musculoskeletal? Again, for 
> those interested, an ortho or sports medicine rotation during the 
> residency could cover all of this.
>
> The reason the NP programs are being expanded in length is that "those in 
> power above" now realize that they can’t teach everything we need to know 
> in 2 years. And with this added 1-2 yrs to the already 2+ yrs of the 
> current MSN program, we have enough hours of education that it becomes 
> equivalent to other health care "doctoral" programs (PT, PharmD, etc), 
> therefore we certainly deserve our "Dr" title as well for an extended 
> program. This is the whole rationale behind the DNP degree. You just can’t 
> cram any more clinical content into the MSN NP programs-- you can only 
> cram so much into 2 years.
> Dena Galler
>
>
> -----Original Message-----
> From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf 
> Of Marilyn Dean
> Sent: Thursday, April 03, 2008 5:12 AM
> To: NP Info
> Subject: RE: [NPInfo] Re: WSJ Article
>
> Hi Dena,
> First I need to say that I believe that the DNP is here to stay and I 
> believe it can be a positive change for Nurse Practitioners and those we 
> care for.
> I agree there is less to teach the MSN NP clinically, but programs that 
> are going to use the DNP for entry level need to look at the clinical 
> content. Many of us have complained of lack of several things in our 
> programs.
> Here would be my clinical wish list. I'm sure many could add to this. For 
> the MSN NP, optional opportunities for electives in clinical areas where 
> the NP feels weak would make the program more attractive and practical.
> A dedicated class to EKG interp.
> More procedures (even simple ones like lesion removal).
> Suturing beyond basic.
> More emphasis on MS evaluation.
> Anatomy class with a cadaver.
> Anyone care to add to these?
> Marilyn Dean
>
> -----Original Message-----
> From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net]On
> Behalf Of Dena
> Sent: Wednesday, April 02, 2008 10:18 PM
> To: 'NP Info'
> Subject: RE: [NPInfo] Re: WSJ Article
>
>
> The 18-24 mos MSN to DNP bridging programs don't typically have any 
> clinical components as we received our clinical experience in our MSN-NP 
> programs. What else could they teach us about clinical stuff-- especially 
> for those of us who have many years of clinical experience already behind 
> us? The new 3-4 year DNP NP programs (which will replace the 2 yr MSN NP 
> programs) will, of course, contain all the clinical experience that we 
> received in our MSN programs PLUS the additional "doctoral" level courses. 
> To say that the DNP is the "clinical" doctorate simply means it isn't 
> research based-- most DNP programs require a Capstone project (not a 
> research dissertation) based on evidence based practice to solve a 
> clinical problem and borrows from research already done by others. This 
> separates the DNP from the more research heavy DNSc and PhD. It was 
> explained to me that DNPs take the PhD and DNSc dissertations down from 
> their high shelves, blow off the dust, and actually put that re!
> search into clinical practice. It's basically that simple. The DNP does 
> NOT teach the MSN prepared NP ANYTHING clinical at all. Again, what could 
> they teach us???
> Dena Galler
>
> -----Original Message-----
> From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf 
> Of Marilyn Dean
> Sent: Wednesday, April 02, 2008 6:18 PM
> To: NP Info
> Subject: RE: [NPInfo] Re: WSJ Article
>
> Review the program format for the DNP and see what you think about 
> clinical
> content. I have looked at one well known program and found it lacking in
> additional clinical content. I was disappointed.
> Marilyn Dean
>
> -----Original Message-----
> From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net]On
> Behalf Of David Mittman
> Sent: Wednesday, April 02, 2008 1:26 PM
> To: NP Info
> Subject: Re: [NPInfo] Re: WSJ Article
>
>
> Tracey: I comment vocally and forcefully all the time on how the PA
> profession is not forwarding itself.
> As everyone knows, I am not an NP, so I comment as a professional
> colleague or cousin and as someone who has been involved in medical
> politics for many years.
> Reading the article, three things struck me. At the same time the
> Medical Society of the State of NY is attacking the scope of practice
> of PAs, do we really need the "we are as good as doctors" spin this
> DNP article espouses? It is the NPs of NY State and elsewhere (as the
> WALL STREET JOURNAL is read nationally) who will get the push back on
> these comments and I am not sure if they are said with the discretion
> the times may dictate .
> Secondly, the assertion that DNPs (see chart) are only NPs who go on
> for further education. That is just not true. As it is not just NPs,
> one can not generalize about the graduates "being equivalent to
> family physicians". I doubt a DNP midwife can practice primary care.
> Lastly there is an underlying notion to ME that Master's prepared NPs
> are less than DNPs. There are three levels of nurse talked about in
> the article and chart. The reader comes away thinking these DNP
> graduates will get more clinical training and that is also just not
> the case. There I no studies I know of that show that the DNP is
> clinically superior to any other NP in clinical practice. That
> article strongly suggests that.
> I would be very bothered by that assertion.
> OK, mini rant off now.
> Dave
>
>
> On Apr 2, 2008, at 2:01 PM, Tracy Klein wrote:
>
>> The section of this article that disturbed me was the phrase:
>> "equivalent to family physicians". I would assume (and may still
>> assume, I suppose) that this was a misquote. Unfortunately, I've
>> read the same language several times from this particular
>> spokesperson. While it may be expeditious to assert that the DNP in
>> New York is "more better" in order to gain regulatory autonomy, it
>> does not do the rest of the profession any favors to compare them,
>> once again, to a physician standard as the superior standard and to
>> their practicing peers as the inferior standard.
>>
>> As a disclaimer, I favor the DNP, but I care about how we talk
>> about it and the terminology we use.
>>
>> Tracy Klein, WHCNP,FNP
>> Portland, Oregon
>>
>> npinfo-request at nurse.net wrote:
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>>
>> Today's Topics:
>>
>> 1. MRSA Dr Phil Style (Priscilla Merrill)
>> 2. WSJ Health Blog: "Dr. Nurse" (SGrtWhite at aol.com)
>> 3. Re: WSJ Health Blog: "Dr. Nurse" (David Mittman)
>> 4. Re: WSJ Health Blog: "Dr. Nurse" ... comment (Nbalkon at aol.com)
>> 5. Re: WSJ Health Blog: "Dr. Nurse" (Thiem)
>> 6. Re: WSJ Health Blog: "Dr. Nurse" (David Mittman)
>> 7. Re: WSJ Health Blog: "Dr. Nurse" (Kate Hammill)
>> 8. Wall Street Journal DNP article (David Mittman)
>>
>>
>> ----------------------------------------------------------------------
>>
>> Message: 1
>> Date: Wed, 2 Apr 2008 06:45:36 -0400
>> From: "Priscilla Merrill"
>>
>> Subject: [NPInfo] MRSA Dr Phil Style
>> To: "'NP Clinical'" , "'NP Info'"
>>
>> Message-ID: <00ec01c894ae$af456480$6700a8c0 at Priscilla>
>> Content-Type: text/plain; charset="windows-1250"
>>
>> Did any of you see Dr. Phil yesterday? It was on MRSA/ ãSuperbugä
>> I think he did a good job overall presenting most of the key points.
>> Have any of you seen, heard of or used the uv light ãCleanse Wandä?
>> Fascinating!
>> HYPERLINK "HYPERLINK http://www.cleanselight.com
>> http://www.cleanselight.com" HYPERLINK www.cleanselight.com
>> www.cleanselight.com (I see they sold out quickly after his show )
>> He carried a diluted spray bottle of Lysol wherever he goes (Dr.
>> Sears, no
>> Phil)
>> A little hype perhaps but food for thought.
>> We donât seem to have the MRSA problem as severely here in NH as
>> others.
>> Too darn cold for those bugs! Iâm finally seeing patches of grass
>> through
>> the snow!
>>
>> HYPERLINK http://drphil.com/shows/show/1048/
>> http://drphil.com/shows/show/1048/
>>
>> Priscilla Merrill FNP
>>
>>
>>
>> No virus found in this outgoing message.
>> Checked by AVG.
>> Version: 7.5.519 / Virus Database: 269.22.4/1355 - Release Date:
>> 4/1/2008
>> 5:37 PM
>>
>>
>> ------------------------------
>>
>> Message: 2
>> Date: Wed, 2 Apr 2008 10:09:42 EDT
>> From: SGrtWhite at aol.com
>> Subject: [NPInfo] WSJ Health Blog: "Dr. Nurse"
>> To: npinfo at nurse.net
>> Message-ID:
>> Content-Type: text/plain; charset="UTF-8"
>>
>> _http://blogs.wsj.com/health/2008/04/02/say-hello-to-dr-nurse/?
>> mod=WSJBlog_
>> (http://blogs.wsj.com/health/2008/04/02/say-hello-to-dr-nurse/?
>> mod=WSJBlog)
>>
>> An article in today's WSJ Health Blog about doctorate degrees and
>> nurse
>> practitioners. Gotta love the physician comment:
>>
>> "Also, since these nurses with a doctorate can use ‰¥þDr.‰¥ÿ some
>> physicians
>> worry that patients could become confused. ‰¥þNurses with an
>> advanced degree are
>> not the same as doctors who have been to medical school,‰¥ÿ says
>> Roger Moore,
>> incoming president of the American Society of Anesthesiologists."
>>
>> See? Our goal is to try and "confuse" patients into thinking that
>> we are
>> physicians. Please!
>>
>> Stephen
>>
>>
>>
>> **************Create a Home Theater Like the Pros. Watch the video
>> on AOL
>> Home.
>> (http://home.aol.com/diy/home-improvement-eric-stromer?
>> video=15&ncid=aolhom00030000000001)
>>
>>
>> ------------------------------
>>
>> Message: 3
>> Date: Wed, 2 Apr 2008 10:26:47 -0400
>> From: David Mittman
>> Subject: Re: [NPInfo] WSJ Health Blog: "Dr. Nurse"
>> To: NP Info
>> Message-ID:
>> Content-Type: text/plain; charset=WINDOWS-1252; delsp=yes;
>> format=flowed
>>
>> When you are a physician you feel that you are captain of the ship
>> (and in many ways you are).
>> Others come along that SAY that they can do what you do........
>> They say that you do not need to go to medical school to be a good
>> clinician...............
>> And now some of these people want to be referred to as "Doctor".
>> I fully understand how physicians would at a minimum feel that
>> patients will be confused (and they will be) and at a maximum, how
>> there will soon be no difference between others who did not do it
>> "the right way" as they did which to them is the ONLY way one can
>> do it.
>> I can nfullkyfullky see how threatening this is to docs generally.
>> That being said if you have a doctorate in a clinical area, you
>> earned it and should use it.
>> Dave
>>
>> On Apr 2, 2008, at 10:09 AM, SGrtWhite at aol.com wrote:
>>
>>> _http://blogs.wsj.com/health/2008/04/02/say-hello-to-dr-nurse/?
>>> mod=WSJBlog_
>>> (http://blogs.wsj.com/health/2008/04/02/say-hello-to-dr-nurse/?
>>> mod=WSJBlog)
>>>
>>> An article in today's WSJ Health Blog about doctorate degrees and
>>> nurse
>>> practitioners. Gotta love the physician comment:
>>>
>>> "Also, since these nurses with a doctorate can use ãDr.ä some
>>> physicians
>>> worry that patients could become confused. ãNurses with an advanced
>>> degree are
>>> not the same as doctors who have been to medical school,ä says
>>> Roger Moore,
>>> incoming president of the American Society of Anesthesiologists."
>>>
>>> See? Our goal is to try and "confuse" patients into thinking that
>>> we are
>>> physicians. Please!
>>>
>>> Stephen
>>>
>>>
>>>
>>> **************Create a Home Theater Like the Pros. Watch the video
>>> on AOL
>>> Home.
>>> (http://home.aol.com/diy/home-improvement-eric-stromer?
>>> video=15&ncid=aolhom00030000000001)
>>> _______________________________________________
>>> NPInfo mailing list
>>> NPInfo at nurse.net
>>> http://lists.nurse.net/mailman/listinfo/npinfo
>>> *****************************
>>
>>
>>
>>
>> ------------------------------
>>
>> Message: 4
>> Date: Wed, 2 Apr 2008 10:37:28 EDT
>> From: Nbalkon at aol.com
>> Subject: Re: [NPInfo] WSJ Health Blog: "Dr. Nurse" ... comment
>> To: npinfo at nurse.net
>> Message-ID:
>> Content-Type: text/plain; charset="UTF-8"
>>
>> Good Day....
>>
>> Am responding to the quote below...
>>
>> My name tag clearly states Nancy Balkon, PhD, NP
>>
>> It has been "the physicians" who have called me "Dr".... and the
>> patients
>> who are often interested to know that nurses earn advanced
>> degrees.... yes,
>> EVEN doctorates!
>>
>> Sighhh.... the "medical school"/ "medical education" argument is
>> soooooo old
>> and over-rated! Medical school is FOUR years post baccalaureate
>> education.... with.... "internship"/"residency" thereafter....
>>
>> Comparing this to APRN education [didactic & clinical]...and...
>> years in
>> practice..... isn't worth the bother....
>>
>> WHAT is impt. is that we, as health professionals, should
>> "celebrate" and
>> "respect" the uniqueness of one another, collaborate
>> professionally, and work
>> together toward a common goal... improving health care in this
>> country! This
>> is the most profitable expenditure of the energy wasted on turf
>> battles!
>>
>> "Also, since these nurses with a doctorate can use ‰¥þDr.‰¥ÿ some
>> physicians
>> worry that patients could become confused. ‰¥þNurses with an
>> advanced degree
>> are
>> not the same as doctors who have been to medical school,‰¥ÿ says
>> Roger Moore,
>> incoming president of the American Society of Anesthesiologists."
>>
>> _http://blogs.wsj.com/health/2008/04/02/say-hello-to-dr-nurse/?
>> mod=WSJBlog_
>> (http://blogs.wsj.com/health/2008/04/02/say-hello-to-dr-nurse/?
>> mod=WSJBlog)
>>
>> Nancy Balkon, PhD, ANP-C, APRN-CS, NPP
>> Southern New York State Representative -- AANP
>> Clinical Associate Professor, Stony Brook University School of Nursing
>>
>>
>>
>> **************Create a Home Theater Like the Pros. Watch the video
>> on AOL
>> Home.
>> (http://home.aol.com/diy/home-improvement-eric-stromer?
>> video=15&ncid=aolhom00030000000001)
>>
>>
>> ------------------------------
>>
>> Message: 5
>> Date: Wed, 2 Apr 2008 07:38:41 -0700 (PDT)
>> From: Thiem
>> Subject: Re: [NPInfo] WSJ Health Blog: "Dr. Nurse"
>> To: NP Info
>> Message-ID: <690808.75384.qm at web65615.mail.ac4.yahoo.com>
>> Content-Type: text/plain; charset=iso-8859-1
>>
>> In Missouri this restricted use of "Dr" has been suggested in
>> legislation by the physician groups. Our (nurses) suggestion is
>> that anyone who uses "Dr" must also identify what type of doctorate
>> they hold. This would include all professions and would distribute
>> the responsibility of disclosure evenly.
>>
>> Laura
>>
>> SGrtWhite at aol.com wrote: _http://blogs.wsj.com/health/2008/04/02/
>> say-hello-to-dr-nurse/?mod=WSJBlog_
>> (http://blogs.wsj.com/health/2008/04/02/say-hello-to-dr-nurse/?
>> mod=WSJBlog)
>>
>> An article in today's WSJ Health Blog about doctorate degrees and
>> nurse
>> practitioners. Gotta love the physician comment:
>>
>> "Also, since these nurses with a doctorate can use ‰¥þDr.‰¥ÿ some
>> physicians
>> worry that patients could become confused. ‰¥þNurses with an
>> advanced degree are
>> not the same as doctors who have been to medical school,‰¥ÿ says
>> Roger Moore,
>> incoming president of the American Society of Anesthesiologists."
>>
>> See? Our goal is to try and "confuse" patients into thinking that
>> we are
>> physicians. Please!
>>
>> Stephen
>>
>>
>>
>> **************Create a Home Theater Like the Pros. Watch the video
>> on AOL
>> Home.
>> (http://home.aol.com/diy/home-improvement-eric-stromer?
>> video=15&ncid=aolhom00030000000001)
>> _______________________________________________
>> NPInfo mailing list
>> NPInfo at nurse.net
>> http://lists.nurse.net/mailman/listinfo/npinfo
>> *****************************
>>
>>
>>
>> ------------------------------
>>
>> Message: 6
>> Date: Wed, 2 Apr 2008 11:13:56 -0400
>> From: David Mittman
>> Subject: Re: [NPInfo] WSJ Health Blog: "Dr. Nurse"
>> To: NP Info
>> Message-ID:
>> Content-Type: text/plain; charset=WINDOWS-1252; delsp=yes;
>> format=flowed
>>
>> Many states already have this law (prohibiting the use of the term
>> "doctor" in a medical setting). It will be interesting to see how
>> this all plays out.
>> Years ago, there were no other doctorates that did what physicians
>> did, so no one opposed.
>> Now there are. The mistake that will take years to correct, is that
>> society made physician and doctor a word with the same meaning.
>> Generally still holds. When one screams "Is there a doctor in the
>> house?" in a public place they are not asking for a PharmD.
>> And to deny that it will confuse patients is to deny reality. AGAIN
>> that still is no excuse for prohibiting us using it, only that we
>> should be sensative to that confusion and possibly address it.
>> Dave
>> On Apr 2, 2008, at 10:38 AM, Thiem wrote:
>>
>>> In Missouri this restricted use of "Dr" has been suggested in
>>> legislation by the physician groups. Our (nurses) suggestion is

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