Tuesday, August 02, 2005

A difference of degrees

I was surprised to read in the latest ACNM newsletter, an update on the Doctorate of Nursing Practice degree development. I had never heard of this. I did a little searching around and learned that advance practice nurses have an several degrees available to them:

1. M.S. or M.S.N or M.S.N.P. (Master of Science, Master of Science in Nursing, Master of Science in Nursing Practice): masters degrees and training as a nurse practitioner

2. Ph.D. (Doctorate of Philosophy): doctoral degree, the traditional preparation for research and academic posts

3. DrNP or DNP (Doctor of Nursing Practice also known as the Practice Doctorate in Nursing): "Graduates will be experts in designing, implementing, managing, and evaluating health care delivery systems and will be prepared to lead at the highest clinical and executive ranks."

The first two of these I'm familiar with. Nurse practitioners have their master's degree. Nursing scholars often have a Ph.D. in addition to their master's training.

But what of this "Practice Doctorate?" Case Western Reserve University's web site best explains the reasoning for the DNP:

The Doctor of Nursing Practice degree (DNP) is a practice doctorate, similar in concept to practice doctorates in other professions such as medicine (M.D.), law (J.D.) and dentistry (D.D.M.).

Individuals with practice doctorates are the most highly educated and qualified practitioners in their fields. Instead of focusing primarily on research and teaching, like those with Ph.D.'s within their fields, those with practice doctorates use their education and expertise in leaderships roles on the front lines of their profession.

I have to say I'm having a hard time seeing the vacant niche. What does the DNP offer that nurses couldn't get through Masters training? Aren't nurse practitioners already "the most highly educated and qualified practitioners in their fields?"

If one wants more clinical training than a nurse practitioner, it seems medical school is the appropriate next step. If one wants to enter management and administration, Public Heath programs offer tracks in Health Management and Health Administration.

Admittedly I have a bias against credentialling. I recoil at anyone but a physician referring to herself as "Doctor." This includes a friend with her D.P.H. and another with a Ph.D. I am offended by the listing of credentials in any setting other than the most conservative of professional venues (e.g. business cards).

The DNP looks to this outsider like nursing's attempt to legitimize itself relative to doctoring: "We can be 'doctors' too." And while I'm sympathetic -- nurses get far too little credit for what they do and know -- I think there is nothing wrong with proudly brandishing one's "CNM, M.S.N." credential when the need arises.

If there are nurses out there, especially DNPs, who can shed light on what the DNP degree provides that one can't find elsewhere, I would sincerely like to know. I suspect there must be some "value added." Otherwise Columbia University wouldn't proudly proclaim its status as the FIRST such program in the country. Please also correct any misinformation I put up about the other degree programs. This is a first, and admittedly less-than-expert, take on the matter.

--doulicia B.A., J.D., CD (DONA)


Blogger I am a Milliner's Dream, a woman of many "hats"... said...

Interesting...I'll be curious to see any comments from those in "the know".

I wondered if you were busy at your Aug.7th clients birth these last few days...?


2:04 PM  
Blogger doulicia said...

No birth yet. Sorry I haven't replied to your other messages and posts. Work (non-doula work that is) has been very busy.

Footbath for the Aug. 7 client and her partner tonight (see, I learned something from Birthing with Pride).

2:46 PM  
Blogger Cassie said...

I am a first time blogger and as such decided to search my current area of study, DNP. I appreciate Ddoulicia's comments and perspective. I am self employed and in private practice in a pain/headache practice. I see the DNP not so much a measure of practice validation but rather a terminal degree that will further equip me to care for my patients. It is not unlike the PsyD that many psychologists have attained in lieu of the PhD due to the clinical vs research focus of the training.
Why would I seek a PhD in education, nursing or other fields which will not enhance my diagnostic and treatment skills.

Again, I get what you are saying but there is definite value in what I am learning as I apply the knowledge to the care of my patients.


5:15 PM  
Anonymous Anonymous said...

As a nurse I can say that I think we need to consolidate some of our titles to a fewer number that are more likely to be understood by the public.

About non-physicians calling themselves doctors, I think this represents some favoritism toward medicine. Many other "doctors" worked equally as hard as doctors of medicine and as such deserve to be called doctor. There are many non-physician healthcare professionals that call themselves doctor: dentists (DDS or DMD degree); psychologists (PhD or PsyD or EdD); chiropracters (D.C. degree); and optometrists (O.D. degree) - just to name a few.

Nurses with terminal clinical doctoral degrees deserve to call themselves doctor just as well as physicians with terminal clincal degrees or psychologists or whomever else. Just because medicine was the first to do it doesn't mean that others should be excluded. Many nurses are absolutely expert in thier fields, with knowledge comparable to that of physicians.

"Doctor" isn't owned by medicine; they just want you to think it is.

9:35 PM  
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5:45 AM  

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