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 Provided by Clinician 1
There has been a plethora of information, opinions, and “hype” about Nurse Practitioners obtaining the DNP, or Doctorate of Nursing Practice degree. It will be the “terminal” degree for all NPs by 2015, and the degree can be obtained by all advanced practice nurses, whether they are CRNAs, Clinical Nurse Specialists, Certified Nurse Midwives, or Nurse Practitioners. From the opinion pieces I’ve seen and heard (by blogs, online, news media, etc.), this is one of the KEY issues that “big medicine” has with us...that, my word, we NURSES will be called DOCTOR! Never mind that college professors, psychologists, physical therapists, audiologists, etc., have also used the term. No matter that many states have laws that state we must also identify our NP titles in any verbal or written communication, and we must state that we are NOT “Medical Doctors.” I think we ALL know WHO we are...and so do patients. So what if doctorally-prepared NPs want to be called “Doctor?” They should be...they earned the title.
However, I admit...personally, I have very mixed emotions regarding the DNP degree.
What bothers me the most is the lack of consistency between university programs. I’ve looked at the curriculums for several colleges...BIG difference in their programs. How would I know what constitutes a “great” DNP program? We as a collective cannot even agree about “entry-level” nursing degrees (thus, the diploma, associate, and bachelor’s degrees)...and now here comes academia, stating that all NP terminal degrees should be the DNP.
I agree, the typical Masters program for NPs has more credits than the average Masters program (compared to education, etc.). Other fields of study (pharmacy, etc.) all have doctorates as terminal degrees. So, why NOT us, too? We certainly deserve recognition for what we bring to the table.
However, a rarely-mentioned point is that we have seen studies pointing out our value, as Masters-prepared NPs, and similar or better outcomes than doctorate-prepared physicians. So those studies are not valid? Our cost-effectiveness notwithstanding...I have no doubt that many DNP programs are rigorous, and well-prepare NPs for clinical practice. However, are there any studies showing that DNP-prepared NPs are better than MSN-prepared NPs? Or, oooohhh, would that kind of study step on too many toes? Um, yeah. MINE and many others’.
Another thing that NO ONE has addressed (to my knowledge) is insurance reimbursement. Currently, Medicare reimbursement requires an NP to be board-certified...which requires the Master’s degree. Other insurances have followed suit. Who is to say that, at some point, that insurers will ONLY reimburse DNP-prepared NPs, and NOT pay Masters-prepared NPs in a few years? Will we spite ourselves by condoning this DNP?
What I have seen so far is that most of these programs NOW are mostly post-Masters programs that assume candidates already have their Master’s degree. I would “assume” that, by 2015, these programs will be modified for the NP student who enters as a non-Masters candidate, and have different requirements than those of us who already HAVE the MSN or MS degree. Hopefully, in their quest for “advanced” practice, the programs ensure that graduating DNPs continue to focus on the clinical skills, as well as the “DNP” things they now promote.
Explain to me, as a working NP in private practice, exactly HOW I will benefit in spending $30,000 to $50,000 (rough estimate) to do EXACTLY what I do now, in my current position...which I happen to LOVE. My collaborating physician, as wonderful as he is, will NOT (guaranteed) pay me more money simply because I have the DNP vs. an MSN.
Personally, I have two boys to help raise and put through college. I have no extra time or money to work toward the DNP degree at this point in my life. I have no desire to call myself “Doctor,” even if I would somehow have a windfall of cash and time and pursue this degree. I would continue to identify myself as “Kim Spering, the Nurse Practitioner.”
And, quite honestly, I want to keep doing EXACTLY what I do now. My “terminal” degree does not make a difference to me. Hopefully, that fact will not hurt me down the road...as academia has made their choice for all of us.
 Kim Spering is a family nurse practitioner who currently works at Brndjar Medical Associates, P.C., a family practice in Emmaus, PA. Her past experience includes the fields of medical/surgical ICU, open heart/trauma ICU, labor and delivery, nursing education, nursing supervision, and as a nurse practitioner in both family practice and OB/GYN settings. She currently serves as a NP preceptor for her graduate school alma mater, DeSales University, as well as for local baccalaureate programs. She is passionate about patient education and helping patients understand that they are ultimately responsible for their own health. She also firmly believes that the public needs to be educated on the value of NPs and PAs in meeting the health care needs of the next decade and beyond. In her free time, Kim enjoys family vacations with her optometrist husband, Mark, and her two sons, Matthew and Connor.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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