[NPInfo] AMA News/ HOW A FEW SCREWED SO MANY!!!!!!

[brocsanche at aol.com]

I have HOPE.  Things can change. I've been in the medical field long enough to see MD's except DO's. I'm hoping that in my lifetime DNP's will also be excepted. It would be helpful that our own profession and peers would be more accepting.  Already, there are too many programs and people jumping on this bandwagon to put the cat back in the bag. We can succeed! Si Se Puede! (Yes we can!) 


Broc Enrique Ramón de Peña Sánchez
DNP, NEA-BC, PMH-CNS-BC, PMHNP-BC, FNP-BC, FNP-C
9331 East Lake Highlands Drive
Dallas, Texas 75218-2723
Work Email: Broc.Sanchez at va.gov
Cell (972) 859-9934
Home (214) 328-8378
Home Email: ExecPsySvs at aol.com



-----Original Message-----
From: Smith, Melissa <SmithMS at umkc.edu>
To: NP Info <npinfo at nurse.net>
Sent: Tue, 10 Jun 2008 8:48 pm
Subject: RE: [NPInfo] AMA News/ HOW A FEW SCREWED SO MANY!!!!!!



Agree with you Dave.  What has occurred was never the intention of the DNP 
egree.  A doctor was talking with me about this today as a friend of his in PA 
s furious and out for bear.  I explained what the degree meant, how it was not 
eveloped to tick off the AMA, that the NP does in fact have 7-8 years to get 
his degree (BSN, MSN, then DNP) and it is to make the NP stronger in certain 
reas.  He stated he couldn't think the NP would want to be in an adverse 
elationship with the doctors we have worked with.  He suggested we band 
ogether and make Columbia and Muninger hush.  Which isn't such a bad idea.  (He 
n fact has a PA and NP in his office and treats them with respect and 
ppreciates their knowledge).
elissa 
-----Original Message-----
rom: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf Of 
fnp at cox.net
ent: Tuesday, June 10, 2008 9:15 AM
o: NP Info
ubject: Re: [NPInfo] AMA News/ HOW A FEW SCREWED SO MANY!!!!!!
Sounds fantastic! Those who have been behind the "movement" should be very proud 
f themselves, especially the "Ivory Tower" crowd. 
They have now undone almost 50 years of progress in Nursing by allowing the 
hysicians to gain further control over the practice of nursing. What it appears 
ike is that DNP grads will be able to be tested to the standards of physicians, 
ut still be at a level that offers no further income, no other benefits, with a 
reat deal of negatives. 
Way to go, because you have just begun the down fall of NPs, and possibly  most 
f nursing, and we soon can wear white caps, come under physician control, and 
atch the rest of the hard worked for benefits just get sucked down the drain. 
hose that pushed for this should be very proud because this is an explanatory 
ew beginning. So, for those that pushed this, stand up, ID yourselves, and we 
hould all remember what was done by a small few to change a great deal of 
rogress. 
Bedpans anyone???
---- David Mittman <dmittman at comcast.net> wrote: 
=============
his is all such BS but the people at Columbia may by their mistakes  
till positively push on the envelope. This remains to be seen. Where  
oesw this place :PAs and NPs who don't want to play in this?
ave

PROFESSIONAL ISSUES
Medical testing board to introduce doctor of nursing certification
Physicians are concerned that the move will lead to scope-of-practice  
xpansions.
By Myrle Croasdale, AMNews staff. June 16, 2008.
Starting this fall, doctor of nursing practice graduates will be able  
o take a certification test that proponents say will set a national  
tandard for DNPs and add to the profession's credibility.
The voluntary test, being created by the National Board of Medical  
xaminers, is based on the medical licensing exam. It will be offered  
t a time of growing momentum in the DNP movement: About 200 nursing  
chools are expected to offer the two-year DNP degree by 2015 -- more  
han double the programs available today.
Discuss on Sermo

The making of "Dr. Nurse"
ee related content
est proponents said the DNPs, called "doctor nurses" by some in the  
ursing profession, are comparable with primary care physicians in  
heir diagnostic and disease-management skills.
But physicians expressed concerns that DNPs will use the test as  
everage to seek scope-of-practice expansions that cross into medical  
ractice.
"Why would they get a DNP unless they want to do things that are  
urrently not in the nursing scope of practice in most states?" asked  
MA Board of Trustees Secretary William A. Hazel Jr., MD. "It makes  
ense they will want to change their scope."
The AMA and the American Academy of Family Physicians said they  
upport advances in nursing education but emphasized that nurses  
hould operate as part of a health care team under physician  
upervision. Dr. Hazel said there are important distinctions between  
NPs and physicians that the public should understand.
"I do not want to be construed as attacking nurses, but there are  
oncerns," Dr. Hazel said. "There's a difference in training that  
hould not be overlooked."
In April, the nonprofit Council for the Advancement of Comprehensive  
are contracted with the NBME to create the exam, which is expected  
o be offered in November.
Mary Mundinger, DrPH, speaking for the council, said the goal is for  
 national standard that distinguishes DNPs who have an advanced  
linical knowledge from those who have an emphasis in research,  
dministration or systems management.
"While a primary care physician went to medical school and did  
esidency, a nurse practitioner with a DNP has achieved many of the  
ame competencies but through nursing education," said Mundinger, who  
lso is dean of Columbia University School of Nursing in New York  
ity. "They have the same skills in identifying a disease state and  
reating it, but it's a different hybrid of care."
Using a similar test
Richard Hawkins, MD, NBME vice president for assessment programs,  
aid the test will be based on Step 3 of the U.S. Medical Licensing  
xam, the last level in the test series.
"We're a testing organization, and this fit our mission," said Dr.  
awkins. The NMBE develops assessments for health care professionals  
n general, not just for physicians.
Mundinger said about 75 graduates qualify to take the DNP  
ertification test. Once nursing schools finish their program  
xpansions, she expects there will be at least 2,000 DNPs graduating  
ach year. Candidates must first complete a master's-level nurse  
ractitioner degree before they begin a DNP program.
Though DNPs have a year of residency as part of their two-year  
rogram, Dr. Hazel said, it is important to recognize the difference  
etween physicians' and nurses' residencies.
Residency, DNP style
DNPs' residency year entails 1,000 hours, Dr. Hazel said. Medical  
esidents work 80 hours a week, racking up about 4,000 hours their  
irst year and approximately 12,000 hours over three years, he added.  
n addition, patients could easily confuse these nurses with a  
icensed physician.
"Let's make sure they make the distinction between a doctor of  
ursing and medical doctor," Dr. Hazel said.
At press time in early June, the AMA House of Delegates was expected  
o consider a resolution to endorse policy that the title "doctor" be  
sed only by licensed physicians, dentists and podiatrists in a  
edical setting. The resolution also sought to have the title  
resident" apply only to individuals enrolled in a medical, dental or  
odiatry training program.
Another resolution sought to oppose the NBME's development of the  
ertification test and to urge the Association to adopt policy that  
NPs practice under physician supervision.
AAFP President James King, MD, said that although these nurses pass a  
est similar to the one for medical school graduates, that does not  
ake them physicians.
"I don't think they can replace family physicians," Dr. King said.
"If they are sincere in saying they are going to contribute to easing  
he physician work force shortage, they'll work as part of a team,  
ot leading that team," he said.
Mundinger said the nursing degree and test do not alter existing  
cope-of-practice rules, but as DNPs demonstrate their expertise, she  
xpects that scope to change.
"The more nurses prove they can do certain things, the more likely it  
s legislation will follow, but there is no direct link between  
ertification and what nurses [legally] can do," Mundinger said.
Working with physicians
Richard Mulder, MD, is a family physician in Ivanhoe, Minn., who has  
orked with Dawn Bucher, DNP, since she was a registered nurse and  
hen a nurse practitioner. He said her level of expertise as a DNP  
as eased his workload.
On days she works, he feels free to do hospital rounds or take a  
oveted day off.
He is confident that patients will be well taken care of by Bucher.  
e and his partner set her prescribing formulary and have given her  
nrestricted prescribing authority.
Bucher said the biggest impact her DNP degree has had is how she  
hinks about patient care. She looks for ways to better meet  
atients' needs and coordinate their care.
"We're all about patient care," she said.
Bucher does not introduce herself as doctor. When the voluntary DNP  
ertification test is available, she plans to take it.


 Discuss on Sermo
ack to top.


 ADDITIONAL INFORMATION:
The making of "Dr. Nurse"
The doctor of nursing practice degree is a two-year program open only  
o those who hold a master's degree in advanced-practice nursing. New  
ork's Columbia University School of Nursing, one of the schools  
ffering this degree, has a 40-credit-hour curriculum that includes a  
ear-long residency.
1. Support core courses (19 credit hours):
Translation and synthesis of evidence for optimal outcomes
uantitative research methods
egal and ethical issues
linical genomics advanced seminar
ractice management
nformatics
. Clinical core courses (11 credit hours):
Doctor of nursing practice I and IIv
idacting and clinical
hronic illness management.
octor of nursing practice I and II
idactic and clinical
hronic illness management
. Residency/seminar (10 credit hours)
Source: Columbia University School of Nursing
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