[NPInfo] Call me "Dr. Nurse"

[Shelby Havens]

Dear Lisa:
 
I don't think the letters "DNP" will ever appear behind my name, either. You and I will probably be the last two remaining NPs on the planet without that degree! 
 
 
Peace,
 
Shelby
 > From: meyerlm at chartermi.net> To: npinfo at nurse.net> Subject: Re: [NPInfo] Call me "Dr. Nurse"> Date: Mon, 28 Apr 2008 18:09:27 -0500> > Gino,> If you are not already a MSN prepared NP, you should start in a DNP program. > The program is only a little longer than the previous 2 year master's > degree. It is those of us who already have a MSN that will have to take a > "bridge" program to get our DNP's. Don't quote me on this, but I think I > read somewhere that if you are starting from a BSN, your DNP program is 3 > years long plus some sort of residency/practicum. Others out there with > more info? And the way things are looking, I wouldn't waste my time with an > MSN program at this point--I would just do the DNP. As someone who already > has an MSN though, I don't think I'll be going back for mine.> > Lisa> > ----- Original Message ----- > From: "Gino" <wellperfused at aol.com>> To: <npinfo at nurse.net>> Sent: Monday, April 28, 2008 2:11 PM> Subject: Re: [NPInfo] Call me "Dr. Nurse"> > > > Hello All,> > I posed a few weeks ago as someone who will be starting NP school in the > fall. I continue to feel uneasy about entering the profession right now but > my question to the list is, will any of this change despite the outcry by > the current NP community? Is the DNP requirement and the tide of change that > will accompany it something we are stuck with? I I would hope that the > powers that be would actually consider the concerns of those practicing but > from what I've read, I don't remain optimistic. Sadly, I'm resigning myself > to the thought of another 2 years (and ~$25K more) of education after my 3 > year NP program. Had I been aware of this two years ago, I wonder if my > career path would be different.> > Cheers,> Gino Paolucci> Rhode Island> > > > > > > > -----Original Message-----> From: Havens, Shelby <havens.shelby at mail.dc.state.fl.us>> To: NP Info <npinfo at nurse.net>> Sent: Mon, 28 Apr 2008 11:10 am> Subject: RE: [NPInfo] Call me "Dr. Nurse"> > > > > > > > > > > > Dear Lisa:> > Sometimes I think about working as a barista at Starbucks. I would have > autonomy> there and could brew up an espresso all on my own, without a protocol and a> supervising physician. But being an NP pays better!> > There are some DNP online programs that have minimal residency requirements, > and> they wouldn't involve much travel. But I agree with you that we don't need > more> leadership, theory, and health policy courses. The title of "doctor" won't > mean> much for us as a profession unless our scope of practice expands with the > title.> I don't think the DNP will help us much politically.> > I work in a psychiatric unit with a mental health counselor who has a > doctoral> degree in Divinity. She insists on being called "Dr.", even though the > degree> that qualifies her to practice mental health counseling is her master's in> Psychology. The added doctoral degree, although in a somewhat related field,> doesn't increase her scope of practice. Spiritual counseling doesn't do much > in> the treatment of bipolar disorder or schizophrenia. Some of our co-workers > roll> their eyes when she introduces herself as "Dr."> > I fear that it might be the same for us in some settings. An NP with a DNP> degree will not have better suturing skills than you. Where I work, an NP > can> suture superficial wounds (not several layers) that are not on the face, > hands,> or genital areas. I suspect that in the future, the DNP prepared nurse> practitioners who will come along after us will not be permitted to have the> same suturing privileges as our physicians, who can suture facial wounds,> lacerations of the hands, and (occasionally) genitals.> > I do believe that the MSN degree will become a thing of the past, because so> many people are pushing for the DNP as the entry level for NP practice. > Those of> us who are masters prepared may be seen as "lowly" among nurse practitioners> someday, but to the public and others it won't much matter. Just think of> bedside RN skills. Do you care if your nurse has a diploma, a two-year > degree,> or a BSN when you are in the hospital? I just want a nurse who can provide > good> care.> > Best Regards,> > Shelby Havens, ARNP, MSN> > > > -----Original Message-----> From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf > Of> Lisa Meyer> Sent: Monday, April 28, 2008 10:34 AM> To: NP Info> Subject: Re: [NPInfo] Call me "Dr. Nurse"> > Bethany and list--> > You are not alone! I totally agree that we are already being made to look> like idiots over this. I have no desire in my role to devise elaborate> programs/projects, or to get involved just too much with the "health care> system". I WANT, and my rural community needs, me to suture wounds and> treat the sick. More theory, leadership, and health care systems won't help> me to do this, and the public (who was just starting to catch on) will have> no bloody idea that I am capable of doing that. Even if us lowly master's> prepared people are "grandfathered in", is the public, after reading> articles like the one below, going to be suspicious of a clinician who is> not a physician, who is not a doctor-nurse suturing their wounds? Talk> about making the whole damn thing complicated. And I know I will get flames> on this list from those who have already forked over the $25,000 for their> DNP, but I will work down at the local greenhouse watering the plants before> I will travel the 6 hours by car to the nearest DNP program.> > Lisa> > > ----- Original Message ----- > From: "Bethany Hartrum" <hartrumb at charter.net>> To: "'NP Info'" <npinfo at nurse.net>> Sent: Sunday, April 27, 2008 9:08 PM> Subject: RE: [NPInfo] Call me "Dr. Nurse"> > > > Who are we kidding??? This is so typical of nursing to introduce another> > title and level of nursing that will not benefit the majority of us in> > primary care, working in rural health care. This degree may be> > appropriate for large university type settings for faculty of nurse> > practitioner programs, or large tertiary care settings for clinical> > ladders. But to confuse the public and collaborating health care partners> > with the title "Doctor", defeats the movement for us to be viewed as a> > "health care provider" We should stick to the title "NP" just like> > physicians use "MD" or "DO". Or maybe NP-D. But call ourselves NP's. I> > predict that this degree will not put out any higher salaries that are> > comparable to the physicians we work for and with. Will it change the> > reimbursement? Unless you are independent and have your own business, the> > degree will not make one difference in the community I live in. The> > curriculum's that I have reviewed, look like a dressed up master's> > curricu!> > lum. And who is going to teach in these program's? If you want to be a> > Doctor of health care, go to med school. I strongly oppose the title> > "Doctor Nurse". That is ridiculous and will make us look like fools.> >> > -----Original Message-----> > From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf> > Of David Mittman> > Sent: Sunday, April 27, 2008 8:12 PM> > To: NPinfo> > Subject: [NPInfo] Call me "Dr. Nurse"> >> > > >> > A doctor and a nurse, all in one package> >> > By CHEN MAY YEE, Star Tribune> > April 26, 2008> >> > Anne Boisclair-Fahey is used to patients doing a double take when she> > introduces herself.> >> > She begins by carefully explaining she's a nurse practitioner, then> > adds "You can call me Dr. Anne."> >> > Get ready to meet a new kind of hybrid at your local clinic: the> > doctor nurse. They sport name tags with the letters DNP for doctorate> > of nursing practice.> >> > Seen as one answer to the looming shortage in physicians, doctor> > nurses take the nurse practitioner concept to yet another level.> > Doctor nurses are trained in finance, health policy and systems know-> > how in addition to core clinical expertise. They can do a lot of what> > many doctors no longer have time to do in an increasingly complex> > health care environment.> >> > While doctor nurses are still a rare breed nationally, that's about> > to change dramatically. The first class of 24 doctor nurses graduated> > in December from the University of Minnesota's School of Nursing, one> > of a handful of schools at the forefront of this trend. All have> > returned to their jobs or new positions, some with expanded roles and> > pay.> >> > Now more than 90 nursing schools have introduced DNP programs and 200> > more are about to start. Beginning next year, the University of> > Minnesota is converting its entire master's of nursing practice> > program into a doctoral course, meaning any nurse practitioner who> > passes board exams will be a doctor nurse.> >> > "They are designed to work in collaboration with physicians," said> > Connie Delaney, dean of the School of Nursing, "so that very> > expensive physicians and specialists can spend their time on other> > things."> >> > But some physician groups worry that the increasingly fuzzy> > demarcation between doctors and nurses may be confusing for patients> > at best, and unsafe at worst.> >> > A looming void> >> > Experts are forecasting a shortage of physicians in the country by> > 2020 because the population has grown even as enrollments in medical> > schools have remained flat.> >> > What's more, 36 percent of active physicians are older than 55 and> > most will retire by 2020, said Edward Salsberg, director of workforce> > studies for the Association of American Medical Colleges. A new> > generation of physicians is less willing to work the long hours> > usually associated with the profession.> >> > The shortage is already showing up in primary care, which includes> > family medicine, pediatrics and internal medicine. This year, U.S.> > medical graduates filled just 1,156 of 2,387 residency positions> > nationally in family medicine; the rest were filled by foreign> > medical graduates. Primary care doctors are paid far less than> > specialists.> >> > Against this backdrop, nurse practitioners are "a phenomenal> > alternative," Delaney said.> >> > There is a parallel movement in dentistry. Dentists are in short> > supply in rural areas of Minnesota, and there is a proposal moving> > through the Legislature to allow dental hygienists to drill and> > extract teeth, and prescribe medication without a dentist on site.> > The Minnesota Dental Association opposes the proposal, saying it> > jeopardizes safety.> >> > Some doctors object> >> > For years, physicians have resisted the notion of a doctor nurse.> >> > The American Academy of Family Physicians, for example, wants it made> > clear to patients that nurses with an advanced degree are not the> > same as doctors who have been to medical school.> >> > "With four years of medical school and three years of residency> > training, physicians' understanding of complex medical issues and> > clinical expertise is unequalled," said the academy's president,> > James King.> >> > Macaran Baird, head of the Department of Family Medicine and> > Community Health at the University of Minnesota, says he's not> > worried about that. He points out that turf battles are not uncommon> > in the hierarchical world of health care.> >> > However, he noted, there's no guarantee that doctor nurses will go> > into primary care unless the gap between payments in primary care and> > specialty care narrows.> >> > Otherwise, he said, "we have the same risk of them going where the> > money is."> >> > Projects show potential> >> > For some nurses, the new title is a validation of what they've been> > doing for years.> >> > Registered nurses, or RNs, are those with a bachelor's degree in> > nursing. Nurse practitioners have a master's in nursing practice and> > can see patients and prescribe drugs, just like doctors.> >> > According to Delaney, there is already an 80 percent overlap between> > what nurse practitioners do and what primary care physicians do. The> > remaining 20 percent includes minor surgeries such as appendectomies> > or vasectomies. Nurse practitioners may also specialize in fields> > such as family practice, psychiatry, pediatrics, gerontology or> > midwifery.> >> > Doctor nurses extend that nurse practitioner role even further with> > training positioning them for leadership roles in health> > organizations or teaching.> >> > The three-semester program costs $14,500 for Minnesota residents and> > $23,500 for nonresidents. Most of the work is Web-based, with> > students coming to campus for several intensive weekends of work. So> > many nurse practitioners in the first class were able to add the> > doctor nurse credential while continuing to work part time.> >> > Their student projects showed the scope and promise of combining a> > nurse practitioner's clinical skills with a doctor nurse's new> > awareness of health care systems. One student developed and> > implemented a standard screening for asthma patients during clinic> > visits, to ensure proper follow-up care. Another devised a plan to> > institute regular bathroom breaks at school for kids who wet their> > pants because of medical problems.> >> > Karalee LaBreche, a psychiatric nurse practitioner for Ramsey County> > who was in the first class of doctor nurses, looked for ways to get> > emergency medication to those who needed it, including going to their> > homes. As a result, fewer patients showed up at the emergency room, a> > very expensive option.> >> > The project won her an award from the International Society of> > Psychiatric-Mental Health Nurses.> >> > More pay, promotions> >> > For some, the new doctor of nursing practice degree has opened doors.> >> > Six graduates have since been offered new positions or promotions,> > and a few have gotten modest salary increases, said Sandra Edwardson,> > director of the U's DNP program.> >> > For Nicole Lynch, a psychiatric nurse practitioner at Abbott> > Northwestern Hospital in Minneapolis, the added training as a doctor> > nurse brought expansion of her role beyond outpatient care to> > inpatient care, too. For Boisclair-Fahey, who specializes in> > pediatric urology, it meant a 3 percent raise and an invitation to> > sit on a major board.> >> > The proliferation of titles has caused some confusion.> >> > Lynch explained her title to a child patient, who quickly twisted it> > around to "Nurse Doctor Lynch."> >> > Most of the time though, she said, they just stick to "Miss Nicole."> >> > Chen May Yee • 612-673-7434> >> > © 2008 Star Tribune. All rights reserved.> >> > > >> > _______________________________________________> > NPInfo mailing list> > NPInfo at nurse.net> > http://lists.nurse.net/mailman/listinfo/npinfo> > *****************************> >> >> > _______________________________________________> > NPInfo mailing list> > NPInfo at nurse.net> > http://lists.nurse.net/mailman/listinfo/npinfo> > *****************************> >> > _______________________________________________> NPInfo mailing list> NPInfo at nurse.net> http://lists.nurse.net/mailman/listinfo/npinfo> *****************************> > _______________________________________________> NPInfo mailing list> NPInfo at nurse.net> http://lists.nurse.net/mailman/listinfo/npinfo> *****************************> > > > > > _______________________________________________> NPInfo mailing list> NPInfo at nurse.net> http://lists.nurse.net/mailman/listinfo/npinfo> ***************************** > > _______________________________________________> NPInfo mailing list> NPInfo at nurse.net> http://lists.nurse.net/mailman/listinfo/npinfo> *****************************
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