[NPInfo] AMA News

Joanne DaCunha JPD at FADavis.com
Wed Jun 11 06:46:28 PDT 2008


I've been following the DNP issue and have been to several conferences discussing the future of it.

This degree was not conceived specially for the NP. It is intended to be the clinical degree for all advanced practice clinical specialties: NP, CNS, CNM, and CRNA. 

>From discussions at national meetings, tenure for the DNP is an institution choice. 

It is considered a terminal clinical degree. The PhD is considered the terminal academic degree.

 

-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf Of Dena
Sent: Wednesday, June 11, 2008 9:10 AM
To: 'NP Info'
Subject: RE: [NPInfo] AMA News

This will probably be true for DNPs who want to go into teaching but that's NOT what this degree is for in the first place!! This is SUPPOSED to be a clinical doctorate for NPs, not for those who are in academia. The whole premise behind the DNP is that it is NOT research focused which is what is needed for tenure in academic institutions. My biggest fear is that, in the quest for tuition moneys from DNP students, programs will (and already are in some cases) admitting and graduating non-NP MSN prepared nurses... in my class we had nurse anesthetists, CNSs, a CNM, and administrators, and some
educators-- all seeking a degree that was developed specifically for clinically-based NPs. This not only bastardizes the program from the very beginning and steers it away from it's main objective but, if DNPs in education find that they can't be tenured because of their lack of pure research, guess what's going to happen?? In the quest for tuition moneys from DNP students, the curriculums will change and become more research
focused-- again steering away from the main purpose. That's exactly what happened with the DNSc degree-- it was originally meant to be the clinical doctorate but, instead, morphed into being almost identical to the PhD and research focused. 

The 2 year bridging DNP programs are much more attractive to those seeking a doctorate than a 4 year PhD program-- and everyone seems to want the fast track... but the curriculum is much different. The DNP will be considered ENTRY-level for NPs-- it is NOT considered a terminal degree. I have already heard thoughts on possibly developing bridging programs for DNPs to PhDs being discussed. For goodness sakes.............
Dena Galler

-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf Of Margienp at aol.com
Sent: Wednesday, June 11, 2008 3:22 AM
To: npinfo at nurse.net
Subject: Re: [NPInfo] AMA News

 
 

I just read that DNP's, can not be tenured . They are considered a second class to the PHD.HMM...
So I want to spend money on a degree for what????
Margie
Again I am tired of academia telling me what to do. Come work in the trenches for a while.
 
In a message dated 6/10/2008 11:22:04 P.M. Eastern Daylight Time, rosemorankelly at gmail.com writes:

This  reply comes from Dr Galler...am I correct?  and thank you.  I do  not wish to take a test administered by MDs...Rose

On Tue, Jun 10,  2008 at 10:15 PM, Dena <galdena at sbcglobal.net> wrote:

> WHAT'S  LEFT TO ARGUE???? The whole purpose of this exam!! The fact 
> that a  non-NP nursing academia type and medical associations are 
> pushing for  it for their own agendas. The fact that this test is for 
> DNP  NPs only and
further
> separates the profession by alienating the MSN  prepared NP. That the 
> bridging NP programs generally don't contain any  clinical components 
> to them so what exactly are we testing???  I already proved my 
> competency in the clinical arena by taking the  ANCC FNP certification 
> exam after my MSN program. That the certifying  bodies stand to make a 
> lot more money off of us by pushing  this additional exam. And the 
> fact that no other EDUCATIONAL DEGREE  needs a certification exam to 
> prove they deserve their doctoral  degrees (PhD, DNSc, etc). No one 
> can HONESTLY believe that if we pass
this
> little new exam that MDs will finally accept us as equal  colleagues. 
> OH
NO!
> They will always find something else to throw in  our faces because 
> they don't WANT us as equal colleagues. I think THAT  little list sums 
> up MY opposition for it. I think we should all band  together and 
> boycott this stupid additional hoop someone has decided  we should jump through.
Nursing
> had had us jumping through additional  hoops for years... and now 
> others
are
> going to tell us to jump  further, higher, and more? Enough is enough. 
> I'm
> %*#@#$* done!
>  Dena Galler
>
> -----Original Message-----
> From:  npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On
Behalf
>  Of brocsanche at aol.com
> Sent: Tuesday, June 10, 2008 6:54 PM
> To:  peg at fhea.com; npinfo at nurse.net
> Subject: Re: [NPInfo] AMA  News
>
> I'm already signed up to take the exam. I personally  think it's a 
> great idea. If we all take the exam and can demonstrate  that we are 
> comparable
to
> physicians (since we pass similar exams)  then what's left to their 
> argument?
>
>
> 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: Margaret A. Fitzgerald, DNP, NP-C, FNP-BC, FAANP,  CSP 
> <pegf at hotmail.com>
> To: NP Info  <npinfo at nurse.net>
> Sent: Tue, 10 Jun 2008 8:08 pm
>  Subject: RE: [NPInfo] AMA News
>
>
>
> OK- Anyone on  list with a DNP planning on taking the exam?
> Dr. Margaret A.  Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP resident, 
> Fitzgerald Health  Education Associates, Inc.
> 5 Flagship Drive
> orth Andover, MA  01845-6154
> 78.794.8366
> FHEA website www.fhea.com
> HEA  on line store www.fhea.biz
> peg at fhea.com
> FNP, Adjunct Faculty,  Family Practice Residency reater Lawrence (MA) 
> Family Health Center,  Inc.
>
>  From: galdena at sbcglobal.net
>  To:  npinfo at nurse.net
>  Subject: RE: [NPInfo] AMA News
>   Date: Tue, 10 Jun 2008 17:24:51 -0700
>
>  I also find it  amusing that MDs are apparently just nervous about 
> the
DNP
>   degree... have they expressed the same sentiments about NPs in the  
> clinical  setting with PhDs or DNSc? Plus do THOSE doctorally  
> prepared NPs have to  take another credentialing exam? Also the  
> latest on the movement by the AMA  to limit the title  "Dr" in a 
> healthcare setting to only MD/DOs,
dentists,
>  and  podiatrists, leaves out doctorally prepared PT/OTs,  
> chiropractors  (understandable given the long history of turf  wars 
> between MD/DOs and  chiropractors), and to psychologists as  well! Now 
> THAT'S not going to
sit
>  well with everyone, is it  <G>?
>  Dena Galler
>
>  -----Original  Message-----
>  From: npinfo-bounces at nurse.net  [mailto:npinfo-bounces at nurse.net] On 
> Behalf  Of AnnMarie  Roetzer
>  Sent: Tuesday, June 10, 2008 5:09 PM
>  To:  NP Info
>  Subject: Re: [NPInfo] AMA News
>
>  I  even find the tone of the initial article condescending. When are
they
>  going to get it... I don't want to provide the same care of  a 
> physician,
I
>  want to provide my own type of care which is a  fusion of medicine 
> and  nursing as well. I provide caring  compassionate well-informed 
> care which is  much  appreciated by my patients. I take the time to 
> make sure that
their
>  needs are met.
>
>   Futhermore, it  is obvious that this NP in the article must not practice
>   independently as they "allow her" full prescriptive authority and 
> when
she
>  is in the office they "feel free" to do hospital rounds or  take a 
> day
off.
>  How condescending!
>
>   I  got into a big argument after interviewing a new nurse the other  
> day  with the nursing supervisor. The nurse works in a jail and  see 
> patients  according to protocols -- the nursing supervisor  said "well 
> its similar
to
>  what you do as an nurse practitioner  and that takes critical 
> thinking" I was  furious I  replied that it is not similar -- and 
> where are my standard
>   protocols. I also heard one of the front desk staff telling a 
> patient
that
> I
>  "work under" Dr. So and So, well needless to say  there was some
education
>  provided that in fact work "in  collaboration with" the physicians -- 
> his  reply, well same  difference you know what I meant.
>
>   My last  question, why are nurse anesthestists having the turf 
> battles
and
>  drama -- they seem to be well-accepted and I never hear  someone say
"well
>  thats just the nurse anesthestist NOT the  doctor." Maybe we should 
> study  their model... seems to working  better.
>
>   Its a shame to see everything that we have  worked for --- just be 
> trashed.
>
>   Ok my rant  is over -- I rarely pipe in on these issues, but I am
steamed
>   now...
>
>   Take care,
>    AnnMarie
>
>  David Mittman <dmittman at comcast.net>  wrote:
>   This is all such BS but the people at Columbia may  by their 
> mistakes  still positively push on the envelope. This  remains to be 
> seen. Where  doesw this place :PAs and NPs who  don't want to play in this?
>  Dave
>   ???
>
>  PROFESSIONAL ISSUES
>
>  Medical  testing board to introduce doctor of nursing  certification
>
>  Physicians are concerned that the move  will lead to 
> scope-of-practice  expansions.
>
>   By Myrle Croasdale, AMNews staff. June 16, 2008.
>
>   Starting this fall, doctor of nursing practice graduates will be  
> able  to take a certification test that proponents say will set a  
> national  standard for DNPs and add to the profession's  credibility.
>
>  The voluntary test, being created by the  National Board of Medical  
> Examiners, is based on the medical  licensing exam. It will be offered  
> at a time of growing momentum  in the DNP movement: About 200 nursing  
> schools are expected to  offer the two-year DNP degree by 2015 -- more  
> than double the  programs available today.
>
>  Discuss on Sermo
>   ???
>
>  The making of "Dr. Nurse"
>  See related  content
>  Test proponents said the DNPs, called "doctor nurses" by  some in the  
> nursing profession, are comparable with primary care  physicians in  
> their diagnostic and disease-management  skills.
>
>  But physicians expressed concerns that DNPs will  use the test as  
> leverage to seek scope-of-practice expansions  that cross into medical  
> practice.
>
>  "Why  would they get a DNP unless they want to do things that are
>   currently not in the nursing scope of practice in most states?"  
> asked  AMA Board of Trustees Secretary William A. Hazel Jr., MD.  "It 
> makes  sense they will want to change their  scope."
>
>  The AMA and the American Academy of Family  Physicians said they  
> support advances in nursing education but  emphasized that nurses  
> should operate as part of a health care  team under physician  
> supervision. Dr. Hazel said there are  important distinctions between  
> DNPs and physicians that the  public should understand.
>
>  "I do not want to be construed  as attacking nurses, but there are  
> concerns," Dr. Hazel said.  "There's a difference in training that  
> should not be  overlooked."
>
>  In April, the nonprofit Council for the  Advancement of Comprehensive  
> Care contracted with the NBME to  create the exam, which is expected  
> to be offered in  November.
>
>  Mary Mundinger, DrPH, speaking for the  council, said the goal is for  
> a national standard that  distinguishes DNPs who have an advanced  
> clinical knowledge from  those who have an emphasis in research,  
> administration or  systems management.
>
>  "While a primary care physician went  to medical school and did  
> residency, a nurse practitioner with a  DNP has achieved many of the  
> same competencies but through  nursing education," said Mundinger, who  
> also is dean of Columbia  University School of Nursing in New York  
> City. "They have the  same skills in identifying a disease state and  
> treating it, but  it's a different hybrid of care."
>
>  Using a similar  test
>
>  Richard Hawkins, MD, NBME vice president for  assessment programs,  
> said the test will be based on Step 3 of  the U.S. Medical Licensing  
> Exam, the last level in the test  series.
>
>  "We're a testing organization, and this fit our  mission," said Dr.
>  Hawkins. The NMBE develops assessments for  health care professionals  
> in general, not just for  physicians.
>
>  Mundinger said about 75 graduates qualify to  take the DNP  
> certification test. Once nursing schools finish  their program  
> expansions, she expects there will be at least  2,000 DNPs graduating  
> each year. Candidates must first complete  a master's-level nurse  
> practitioner degree before they begin a  DNP program.
>
>  Though DNPs have a year of residency as  part of their two-year  
> program, Dr. Hazel said, it is important  to recognize the difference  
> between physicians' and nurses'  residencies.
>
>  Residency, DNP style
>
>   DNPs' residency year entails 1,000 hours, Dr. Hazel said.  Medical  
> residents work 80 hours a week, racking up about 4,000  hours their  
> first year and approximately 12,000 hours over three  years, he added.
>  In addition, patients could easily confuse  these nurses with a  
> licensed physician.
>
>   "Let's make sure they make the distinction between a doctor of
>   nursing and medical doctor," Dr. Hazel said.
>
>  At press  time in early June, the AMA House of Delegates was expected  
> to  consider a resolution to endorse policy that the title "doctor"  
> be  used only by licensed physicians, dentists and podiatrists in  a  
> medical setting. The resolution also sought to have the  title  
> "resident" apply only to individuals enrolled in a  medical, dental or  
> podiatry training  program.
>
>  Another resolution sought to oppose the NBME's  development of the  
> certification test and to urge the  Association to adopt policy that  
> DNPs practice under physician  supervision.
>
>  AAFP President James King, MD, said that  although these nurses pass 
> a  test similar to the one for medical  school graduates, that does 
> not  make 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  the physician work  force shortage, they'll work as part of a 
> team,  not leading that  team," he said.
>
>  Mundinger said the nursing degree and  test do not alter existing  
> scope-of-practice rules, but as DNPs  demonstrate their expertise, she  
> expects that scope to  change.
>
>  "The more nurses prove they can do certain  things, the more likely 
> it  is legislation will follow, but there  is no direct link between  
> certification and what nurses  [legally] can do," Mundinger said.
>
>  Working with  physicians
>
>  Richard Mulder, MD, is a family physician in  Ivanhoe, Minn., who has  
> worked with Dawn Bucher, DNP, since she  was a registered nurse and  
> then a nurse practitioner. He said  her level of expertise as a DNP  
> has eased his  workload.
>
>  On days she works, he feels free to do  hospital rounds or take a  
> coveted day off.
>
>   He is confident that patients will be well taken care of by  Bucher.
>  He and his partner set her prescribing formulary and  have given her  
> unrestricted prescribing  authority.
>
>  Bucher said the biggest impact her DNP degree  has had is how she  
> thinks about patient care. She looks for ways  to better meet  
> patients' needs and coordinate their  care.
>
>  "We're all about patient care," she  said.
>
>  Bucher does not introduce herself as doctor. When  the voluntary DNP  
> certification test is available, she plans to  take it.
>
>
>  ???
>  Discuss on  Sermo
>  Back to top.
>
>
>
>
>   ADDITIONAL INFORMATION:
>
>  The making of "Dr.  Nurse"
>
>  The doctor of nursing practice degree is a  two-year program open 
> only  to those who hold a master's degree  in advanced-practice 
> nursing. New  York's Columbia University  School of Nursing, one of 
> the schools  offering this degree, has  a 40-credit-hour curriculum 
> that includes a  year-long  residency.
>
>  1. Support core courses (19 credit  hours):
>
>  Translation and synthesis of evidence for  optimal outcomes  
> Quantitative research methods
>   Legal and ethical issues
>  Clinical genomics advanced  seminar
>  Practice management
>   Informatics
>  2. Clinical core courses (11 credit  hours):
>
>  Doctor of nursing practice I and  IIv  Didacting and clinical  
> Chronic illness  management.
>  Doctor of nursing practice I and II
>   Didactic and clinical
>  Chronic illness management
>   3. Residency/seminar (10 credit hours)
>
>  Source: Columbia  University School of Nursing
>
>  Back to  top.
>
>
>  Copyright 2008 American Medical  Association. All rights reserved.
>
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