[Jeffrey]

Hi Avery,

Where I work, it’s a mixed bag in terms of responses to the fact that I am studying to earn my DNP. Where I work, most nurses return to school to pursue a Doctorate of Nurse Anesthesia Practice (DNAP) or Certified Registered Nurse Anesthetist (CRNA), not other DNP degrees. Many senior staff nurses are frustrated when new graduate bachelor’s trained nurses barely practice for a year or two, only to return to school to pursue a graduate degree in nursing. While I agree that some experience should be required to become a DNP, everyone has a different reason to become a nurse. Everyone has unique professional goals, which should be respected. Some discouragement from my nursing colleagues has come when they question why I, as an ICU nurse, would want to work in a less acute environment. Some nurses look at returning to school as giving up and as a sign of weakness or inability to handle high-stress environments for their entire professional nursing career.

I am pursuing my DNP in a Family Nurse Practitioner educational track, so my experience has been different from those pursuing a CRNA education. I have worked in my Medical Intensive Care Unit (MICU) for about nine and a half years. So, my coworkers are sad that I will eventually leave rather than discourage me from pursuing an advanced degree. I believe my experience differs from most because I work in an academic medical center, where staff are used to people leaving to pursue higher education. Like many others, many of the medical and ancillary staff I work with also support my pursuit of an advanced practice degree. While some people have questioned why I did not attend medical school, most are encouraging. I have some older family friends who are physicians. They are more supportive of my becoming a nurse practitioner and even have said that if they had better understood the nurse practitioner role when they were younger, they would have probably chosen differently.

[Jeffrey]

Hi Avery,

The issue of compensation for DNPs is one that often discourages bachelors-trained nurses from pursuing an advanced practice nursing degree. One coworker completed her DNP degree; however, she still works bedside because she can make more money working four to five days a week than she could as an APRN. Similar to many other professions with doctoral terminal degrees, payment does not necessarily correspond to the amount of education required for that position. However, one of the most significant differences is that APRNs with a DNP are more competitive and may find more opportunities in leadership positions.

Another issue related to compensation is independent practice. In states with restricted and reduced practice, APRNs are paid less than in states with full or independent practice. Currently, in California, APRNs have reduced practice authority; however, starting in 2026, they will finally be able to practice independently. Under the current practice standards, nurse practitioners work under the supervision of a physician who is compensated much more, even though the physician may not see patients. Full practice authority will allow facilities to spend much less because physician oversight will no longer be required by law, so nurse practitioners will have more bargaining power when negotiating salary.

[Jeffrey]

Hello Susan,

I am a DNP student in Southern California in an FNP program. I agree with Ryan that restricting professionals other than Medical Doctors (MDs) from using the title “doctor” is frustrating. There are many professions besides nursing, with doctoral programs that are the terminal degrees of those professions. All of these professions deserve to be identified according to their educational level. The American Medical Association (AMA) states, “Patients deserve care led by physicians-the most highly educated, trained and skilled care professionals” (AMA successfully fights scope of practice expansions that threaten patient safety, 2023). It seems a little egotistical for the medical profession to say they are better than everyone else. Ultimately, the patient should come first, not the title you wear on your badge. Even as a bedside nurse, many patients misidentify me as a doctor. I explain that my role is different, however, because I do not want to be labeled as a physician. At my institution, the word doctor, or even MD, is not used to identify a physician; their badges say, physician.

This issue is mainstream and is even present in pop culture. In the movie, The Hangover is a dentist. When he says he is a doctor, he is corrected by his friends and a hospital physician. While he may not be a medical doctor, he is still trained as a dentist, with a doctorate with the title Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DDM), so why is it incorrect for him to identify himself as a doctor?

Reference:

AMA successfully fights scope of practice expansions that threaten patient safety. (2023, May 15). Retrieved July 14, 2023, from AMA: https://www.ama-assn.org/practice-management/scope-practice/ama-successfully-fights-scope-practice-expansions-threaten

• This reply was modified 11 months, 4 weeks ago by Jeffrey.

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