[NPInfo] DNP Credentials

Wed Jun 11 22:14:04 PDT 2008

Gosh...I am sooo happy you lurk and chime in as necessary...I want you to
enlighten mundinger...Rose

On Wed, Jun 11, 2008 at 10:47 PM, <nursinglaw at aol.com> wrote:

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> As many of you know, I lurk on the list serve.? I have read this dialogue
> with interest and I understand and appreciate both sides of this
> discussion.? I just don't understand the purpose of the examination for the
> DNP.? If it is intended to become a certification tool, the examiners will
> need to conduct a role delineation study, develop competencies, develop test
> questions based upon those competencies to prove that the exam is
> psychometrically sound and legally defensible for certification purposes.?
> If the purpose of taking the test is show that DNP practice is comparable to
> medical practice, I have concerns.? I believe that nurses can and will
> master the content and the test, but there is something lacking when one
> profession has to "prove" its validity to another profession.? Have we
> looked introspectively and thought hard about why some nurses need to prove
> comparability.? I think docs and nurses are like apples and oranges-- both
> have comparable values, provide servic!
>  es but do so from a different perspective (which I personally like).? Some
> have used the term mini-docs to describe nurse practitioners.? Of all of the
> terms that have been used to label NP practice, I find this the most
> offensive.? Why?? Because nurses only need self-validation.? We should not
> look externally to prove the value of the profession.? If I need a nurse
> practitioner, I don't go to a doc.
>
> What are the benefits of taking a medical exam to prove DNP competencies??
> I am not sure, but I can tell you that it reinforces the notion that NP/DNP
> need to be regulated jointly or by boards of medicine.? It gives validity to
> arguments made by the AMA and MDs across the country that NPs practice
> medicine, not nursing.
>
> I have been working on nurse practitioner scope and regulatory issues for
> over twenty years and I am saddened that we still have to have these
> discussions.? Why can't we relish in the fact that NPs and DNPs are and will
> be nurses with expansive, extensive clinical expertise who can provide
> excellent primary care, case management, etc.? How does comparing the NP or
> DNP with MD's improve access and quality of care?? The reality is that NP
> and DNP?have and continue to fill primary care needs; and we don't have
> enough doctors to address all of the health needs of the American public.
>
> Either we want comprehensive care or we don't.? The present system has not
> worked well, even with?NPs?filling the gaps.? Can?we afford to
> retain?MD?hierarchy within the health care system?? No.? We need to think
> about and support the nurse components of advanced nursing practice.? When
> doctors ask us about whether we intend to?become primary care providers and
> use MDs for specialized complex care, ask them?whether they can articulate
> more and better alternatives for?providing the public with access.? Docs
> can't have it both ways if they really want health reform.? There just are
> not enough docs to provide primary care and the fractured method of patient
> management by insurance companies (and not health care professionals)
> doesn't work well.? Evidence-based practices clearly reflect the benefits of
> utilization of NPs as well as other ANPs as hospitalists and clinicians.?
> Why should nurses apologize for being good at what you do?? When we?are
> approached about not being doctors!
>  , we need to?stand up and clearly and articulately pronounce the wonders
> of NP/DNP practice.? And, we need to?stop docs and others from making the
> comparisons.? The services and care provided by NPs?is wonderful.? You save
> lives,? You care for your patients excellently and you don't have to be
> doctors or prove your competence to continue this practice.? The?health care
> system is responding to?economic and other variables and they need you
> considerably more than they profess.
>
> Until we change OUR mindset, we cannot change the health care system. We
> need to quit trying to change the regulatory and education system just to
> prove NP competence to docs.? If NPs are considered competent by nursing
> standards, then NPs are competent and don't need additional validation.
>
> For those who don't know me, I am not a nurse, just an ANP?lover, supporter
> and advocate. (Also some say I am a ANP wannabe)
>
> Winifred Carson-Smith, Esq.
> CarsonCompany, LLC
> www.CarsonCo.net
> nursinglaw at aol.com
> 202-232-5193
> 202-232-5194(fax)
>
>
> -----Original Message-----
> From: David Carpenter <coloradopa at gmail.com>
> To: NP Info <npinfo at nurse.net>
> Sent: Tue, 10 Jun 2008 11:44 pm
> Subject: Re: [NPInfo] DNP Credentials
>
>
>
> Actually the real question should be, is a test designed to measure
> primarily inpatient management after a physicians first year the best test
> to measure NP practice which is primarily outpatient (according to the
> press
> release)? The other part is that they are only administering half of the
> test. There is a practical escalating question portion of the test that
> they
> chose not to do. Its really a lose lose proposition. If the NPs do well
> then
> its because they only took what is considered the easiest of the step tests
> by the med students and residents. If they do poorly its because they don't
> have the knowledge of the physician (even though the test is not targeted
> at
> the areas that Mundinger claims are the domain of DNPs).
>
> As far as MDs administering the test, that isn't really true. The National
> board of medical examiners along with the State boards of medical examiners
> sponsor the step tests.The NBME is also in the business of developing and
> administering tests related to medical practice. They are considered one of
> the pre-eminent research groups regarding test taking and consult with a
> number of non physician groups including veterinarians, medical assistants
> and Public health. For a fee they are happy to work with any group that
> wished to develop certification standards. Their board is largely physician
> oriented as is their mission but as with any independent agency you will
> find a number of non physicians and lay members.
>
> David Carpenter, PA-C
>
> On Tue, Jun 10, 2008 at 11:19 PM, Rose Moran-Kelly <
> rosemorankelly at gmail.com>
> wrote:
>
> > But Meg...  Do you think we should take a test that the MDs administer??
> > Rose
> >
> > On Tue, Jun 10, 2008 at 10:07 PM, Meg <enigma462003 at yahoo.com> wrote:
> >
> > > This is only my opinion but I believe we are witnessing history in the
> > > making (literally) with the launching of the DNP programs...this is one
> > of
> > > the biggest events to encompass nursing and its move forward in a
> > century.
> > > This is a step our profession must take, with or without backing of
> > everyone
> > > involved, including Advanced Practice...many will be able to be
> > > "grandfathered" under present law...many will go on to become prepared
> at
> > > the doctorate level...this is how a profession evolves. With primary
> care
> > in
> > > dire need of professionals to care for the aging population and
> increased
> > > need for primary care in this country this is the perfect opportunity
> for
> > > nurses to actually move into this role since more and more physicians
> > will
> > > be in the "specialist" role in the future. We need to take this
> > > opportunity. Meg Helgert FNP
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