[NPInfo] Call me "Dr. Nurse"
Judi Shea-Vaillancourt
jshea-vaillancourt at comcast.net
Mon Apr 28 17:51:02 PDT 2008
As a parent of a child in a 5 yr BS architecture program.....they did not
fall by the wayside......Most programs still require the 5 yr and then 6
mo-1y for the MS
And while other programs have gone the way of making a D the entry- and I
am not on either side of this issue with Nursing as a whole if we are
going to make sweeping assurance we should be clear of the facts
The BS Architecture at Roger Williams(RI) is a 5 yr program at Catholic
university ( DC) at CMU ( Pittsburgh) and at RPI (NY)
You can still enter pharmacy with a 5 yr degree and not get a pharm D
Judi Shea-Vaillancourt MSN FNP
Sib of a 5 yr non pharmD, mother of a Architecture student year 3
-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of David Mittman
Sent: Monday, April 28, 2008 3:51 PM
To: NP Info
Subject: Re: [NPInfo] Call me "Dr. Nurse"
You do not need to graduate college to go to med school. You do need
the required courses. MCATs,etc.
Interesting.
Dave
On Apr 28, 2008, at 3:38 PM, Havens, Shelby wrote:
>
> Gino:
>
> Professions grow and change. I lived in Alabama when I was younger
> and worked as a paralegal at an Alabama law firm for awhile when I
> was in college. I learned something very interesting about the
> history of practicing law in Alabama. Until the 1960's, there was
> only one law school in the entire state (University of Alabama). It
> was assumed that if you graduated from the law school, you were
> automatically eligible for licensure in the state of Alabama, since
> you graduated from the state school. There was no bar examination.
>
> Then Samford University in Birmingham opened a law school, and
> Samford is a private school. So the graduates of BOTH law schools
> had to start sitting for bar exams upon graduation.
>
> Even earlier in the evolution of legal education, graduates were
> required to earn only a bachelor's degree in order to practice law,
> before the Juris Doctor degree became the entry level for practice.
> Even after the Juris Doctor came into being, some colleges allowed
> students to enter law school after only three years of college.
> They weren't required to first earn their bachelors degree in order
> to get into law school.
>
> I was married to an architect in a former life, at a time when a
> "fifth year" bachelors degree was sufficient to become a registered
> architect. Now a masters degree is required and the 5 year
> baccalaureate programs have gone by the wayside.
>
> So I really don't think what is happening with NP education is too
> uncommon. Unfortunately, I don't think that the DNP degree will
> solve all our problems. There may STILL be further developments
> down the road in NP education, and I don't like the situation any
> better than you do. I feel your pain!
>
>
> Best Regards,
>
> Shelby Havens, ARNP
>
>
>
> -----Original Message-----
> From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On
> Behalf Of Gino
> Sent: Monday, April 28, 2008 3:12 PM
> To: npinfo at nurse.net
> 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
>>
>> C 2008 Star Tribune. All rights reserved.
>>
>>
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