NACIQI - DETC - 5 Years and Scope Expanded for Professional Doctorates

Re: Re: Am I missing something?

Fair point, but if nurse educators/managers/executives/researchers didn't need doctorates yesterday to fill those positions, why do they need them tomorrow?

It seems that as a culture we have decided that everyone needs a college degree -- regardless of the fact that not everyone has the skills or motivation to acquire one. Now we are including advanced degrees into the "everyone should have one" mix?

How long before the development of the "super-doctorate" to again restore an accomplishment hierarchy?

 

Re: Re: Re: Re: Re: RENP

Thanks RobbCD,

The reason why the EdD degree is such a hit with nurses is because nurses are naturally trained to be patient educators and its an easy fit for us. But, now that the DNP has been introduced a lot of nurses that are not ready to retire are being encouraged to add the DNP degree to the EdD or PhD that they have already earned.

Regards,

 

Re: Re: Re: Am I missing something?

Definition of a profession.

"A disciplined group of individuals who adhere to high ethical standards and uphold themselves to, and are accepted by, the public as possessing special knowledge and skills in a widely recognised, organised body of learning derived from education and training at a high level, and who are prepared to exercise this knowledge and these skills in the interest of others.

Inherent in this definition is the concept that the responsibility for the welfare, health and safety of the community shall take precedence over other considerations." http://www.accc.gov.au/content/index.phtml/itemId/277772/fromItemId/6193

Nursing is a profession and the organizations that govern the nursing profession have seen fit that a doctorate degree be required for certain areas of practice within the profession whether you like it or not. Perhaps it falls under the natural evolution of a profession.

See: http://www.aanp.org/Practice+Policy+and+Legislation/Education:+Doctor+of+Nursing+Practice.htm

 

Not nearly as clear as you suggest

First of all, there is no need to devolve to personal attacks. This is not about whether "I like it or not." It started as a a comment that should DETC be empowered to oversee doctoral programs and morphed into a discussion of whether every profession needs doctoral level training.

Your point about the utility about a nursing doctorate is muddied by the AACN's own policy statement. They aren't focusing on the doctorate as a research, academic, or administrative credential -- they focus on a clinical practice degree (ND, DSN, DNSc).

I do give nursing credit ... it took a very straightforward technical skill-based credential (LPN) and in short order had it evolve to a higher ranking technical credential (RN), then academic (BSN), to advanced academic/practice (MSN).

You may have a point about having oversight and education of direct care nurses requiring advanced academic credentials.

What does seem to stretch credibility is the utility of a "doctor-nurse" as part of the direct care team. Ultimately, what more does the doctor-nurse bring to the table, other than confusing the nature of providing? Part of the AACN's argument is that MSN/APNs are not getting enough training so they should progress to doctoral level study. Again, hats off to nursing -- how did the "profession" establish APNs at the Master's level while not providing adequate training in the first place?

I also am curious how you'd feel if a few years down the line when CNAs and paramedics start defining themselves as discrete "professions" and demand advanced practice professional parity. Nursing began as a subordinate assistive profession to complement medicine. What is the justification for creating a parallel training modality to medicine? Already APNs are assuming many of the duties and responsibilities as physicians. Is the goal to establish DSNs with equal scopes of practice?

And, back to the original topic, even if you could make a valid argument for doctor-nurses is DETC the best agency to oversee the growth of such training programs?

 

Re: Not nearly as clear as you suggest

Firstly, I apologize if you feel you are being personally attacked. I feel as though you are attacking the nursing profession puting it at a level of air conditoning technician and so forth.

I like how you say, "Nursing began as a subordinate assistive profession to complement medicine."

In fact, it can be argued that nursing is the oldest profession still in existence and the practice of medicine came many millenium after nursing.

Whether or not a DETC accredited institution is the one to oversee a doctoral nursing training program, I admit, I have no idea. There are certainly many RA accredited doctoral programs in nursing!

 

Still unanswered ...

Actually, that is from DETC's list. I maintain my point that DETC does not seem an appropriate oversight body for advanced academic endeavors.

No, that is not a slap against photographers, truckers, or HVAC technicians. But the reality is that not every profession requires advanced academic study and credentialing. That is not a judgment as to the inherent worth of such professions, but acknowledgment that we all have different skills and talents and academia is but one such skill set.

C'mon do you really want to go there? Do I have to mention the "second oldest profession"? Will they be asking for doctorates next?

What about teaching? Or of course, motherhood?

Wouldn't both of these pre-date nursing? And if you want to go back millenia, you lose the research, ethics, and organized body of knowledge requisite for a profession.

What hasn't been addressed is what value is added with DNPs becoming integral participants in healthcare providing? Are we eventually going to evolve to the point where no one works in support roles?

Not everyone gets to be a general/admiral in the military.

 

Re: Re: Not nearly as clear as you suggest

Delta,

The progression of the nursing profession to the doctoral level appears to be on par with a similar augmentation of credentials for other allied medical professions such as Physical Therapy, Occupational Therapy and Audiology. In these respective fields the doctorate is increasingly becoming the norm which enhances practitioners status both as perceived by patients as well as colleagues. In fact, Physician Assistants, who at one point were only required to hold an associates degree are increasingly moving towards master degree training and it would not be surprising if a doctorate in this profession will be offered in the near future. Nurse practitioners have already established independent practices as have Physical Therapists, without the need for a medical doctors referral. By holding the title of "doctor" will only add to their credibility and independence while offering the public viable options to obtain approriate medical care.

In regard to the issue of whether there is an unnecessary expansion of doctorates in a number of professions the same can be claimed regarding the Psychology profession! This field is inundated with Ph.Ds and Psy.Ds even though research has clearly demonstated the same level of positive treatment outcomes when psychotherapy is conducted by clinicians with masters degrees. Health insurance companies recognize this fact resulting in their prefering master level clinicians to provide therapeutic interventions due to their cheaper costs. In addition, it needs to be stated that many doctoral programs in Psychology, particularly Psy.Ds, are not research oriented but clinical in nature and actually appear to be over inflated master degree programs that provide their graduates with an opportunity to obtain a doctorate as well as filling the coffers of a number of universities with big bucks that derive from these very expensive degree programs.

 

BTW, California Coast University will be making application for doctoral programs in Psychology, business and other undisclosed programs with DETC in early January. They expect to initiate these programs by the end of January 07.

 

Nice try ...

Status does not equate with value or necessity. No one has yet pointed to any evidence that elevating credentials in these professions does anything beyond add prestige to the holders of the advanced credentials!

What kind of backward logic is this? A "profession" was created with WOEFULLY inadequate training so now let's "fix" the problem by elevating them to a higher, but nevertheless unnecessary, level?

Again, unanswered .. which is more important prestige or patient care? Just how many primary care practitioners are needed?

The research is far from conclusive, though, yes, it does suggest therapy can be successful with a variety of practitioners. However, there remains a big difference between the "worried well" and the seriously mentally ill. (Also erroneous is your inference that psychologists only perform therapy.)

And the field is hardly "inundated" with PhD/PsyD .. the proliferation has been with Master's level practitioners. Ironically, it is a deevolutionary process. Nursing seeks to advance its prestige and standing to be equal with physicians. Despite the APAs resolution that a psychologist should have a doctorate, the profession seems bent on obliterating the distinction.

This is a total red herring. Of course insurance companies want to pay less. There is absolutely no validation that spending less provides better or even equal services. All that can be said is that they provide cheaper services!

And did a PsyD pee on your corn flakes, simon? You seem to have a real jones on for dissing them in every post you make.

 

Re: Re: Am I missing something?

I was not aware that paint-by-number qualified as artistic work. ;-)

 

Simon

The California Bureau Private Postsecondary and Vocational Education (BPPVE) Web Site reveals the following California Coast University (Non PhD) Doctorate Degrees are approved and registered programs with the BPPVE:

DOCTOR OF BUSINESS ADMINISTRATION
DOCTOR OF EDUCATION
DOCTOR OF PSYCHOLOGY


https://app.dca.ca.gov/bppve/school-search/view-voc-names.asp?schlname=california+coast&Submit=%5B+Search+%5D


Perhaps these programs are the doctorates CCU is making application to the DETC for.

 

Re: Nice try ...

For various reasons the nursing profession has decided to offer a terminal doctoral degree in nursing. This isn't going to happen but is happening so you can argue on the merits of it until you are blue in the face!

The following universities are currently accepting students into Doctor of Nursing Practice (DNP or DrNP) programs.

Case Western Reserve University (OH)


Columbia University (NY)


Drexel University (PA)
A hybrid program combining the professional practice doctorate and the academic research doctorate.

Fairleigh Dickinson University (NJ)

Medical College of Georgia

Oakland University (MI)

Purdue University (IN)


Rush University (IL)


Tri-College University Nursing Consortium (ND)


University of Arizona

University of Colorado at Denver and Health Sciences Center

University of Florida


University of Kentucky

University of Maryland

University of Massachusetts Amherst


University of Medicine and Dentistry of New Jersey

University of Minnesota

University of Pittsburgh (PA)

University of South Alabama


University of South Carolina

University of South Florida


University of Tennessee Health Science Center

University of Texas Health Science Center at Houston

University of Washington


Waynesburg College (PA)


In addition to those mentioned above, more than 190 additional DNP programs are now under development at nursing schools nationwide. AACN will update this list as new DNP programs open and begin accepting students.

http://www.aacn.nche.edu/DNP/DNPProgramList.htm


"Nursing seeks to advance its prestige and standing to be equal with physicians" quoted by PsychPHD.

Where and when has the nursing profession made that statement??

 

Answers aren't given ...

As no one has provided any information as what the impetus for the nursing doctorate is, that is my extrapolated conclusion based upon avaiable information.

Still asking ... what is the importance/value of a DNP?

"Just because we can" really doesn't seem ample justification.

 

Re: Answers aren't given ...

I like Columbia University's statement about the DNP.

"Built on evidence derived from over 10 years of increasing independence and scientific inquiry, including a randomized trial published in The Journal of the American Medical Association, Columbia University School of Nursing faculty developed the DrNP degree to educate nurses for the highest level of clinical expertise, including sophisticated diagnostic and treatment competencies.

The degree builds upon advanced practice at the master's degree level and prepares graduates for fully accountable professional roles in several nursing specialties. The program is comprised of 30 credits of science underpinning practice, a year of full-time residency, and the completion of a scholarly portfolio of complex case studies, scholarly papers and published articles."

In any case, a different thread can be started to discuss the practicalities of doctoral fields.

We will just have to wait and see IF a DETC accredited institution decides to offer a doctoral program in the first place.

 

Re: Re: Re: Am I missing something?

It's called credentials creep, which is just a fancy way of saying two things. For starters, as the old geezers already in the field keep requiring bigger and better pieces of paper of the newbies wanting to get in the field, newbies will go get doctorates in fields where the doctorate wasn't required before. Moreover, as long as many fields have continuing education requirements, those in the field will probably use all those additional classes taken over the years to apply them towards bigger and better pieces of paper, rather than simply letting them lie around as loose credits.

 

DNP

Well since this thread has been derailed I may as well give my experiences. I finished up 2 certificate NP programs, the first in primary care, second in woman's health and I am now completing a family nurse practitioner.

There is so much to learn in health care that I am a stong fan of the DNP concept. Currently NP programs do not haev enough clinical hours and are all designed as a generalist. With teh DNP it will allow students to gain more clinical experience, and have a solid foundation in advanced practice nursing and even choose an area of specilty. I have essentially completed 3 programs and I am much better prepared than when I graduated. Could I have done this with just on the job training yes but at a greater learning curve. If you have someone managing your heart failure, peripheral vascular disease, pregnancy, or epilepsy the more training they have the better.
Jeremy

 

Looks like those are the doctoral programs that CCU used to offer in their pre-accreditation days. On the other hand, there was some report on another board that CCU might try to resurrect its old doctoral programs by late 2006. We shall see.

 

Thanks, but still ...

Jeremy,

Thank you for providing your perspective.

However, I am still left wondering why a parallel training model needs to be established.

OK, it is nice that a DNP would provide you greater depth of training than an MSN/APN.

But if top-level advanced independent practice was your goal, why didn't you just go to medical school and became a family practice physician?

What about a DNP is better, or even different, from an MD?

I'm also seriously puzzled by a profession that you can enter from now four different levels of independent practice? (Nursing school - RN; Undergrad - BSN; Graduate school - MSN, DPN)

You can't do that in medicine or psychology or any other health profession.

What is a nurse?

 

Re: Nice try ...

Psy: Status does not equate with value or necessity. No one has yet pointed to any evidence that elevating credentials in these professions does anything beyond add prestige to the holders of the advanced credentials!

SIMON: So provide us with the references that support your statements above and present any evidence that demonstrates that 'elevating credentials does not result in"anything beyond add(ed) prestige"!

psych: What kind of backward logic is this? A "profession" was created with WOEFULLY inadequate training so now let's "fix" the problem by elevating them to a higher, but nevertheless unnecessary, level?

SIMON: Do not substitute your lack of understanding of complex issues with hostile editoralizing. You are shooting from the hip as usual and making hostile and demeaning comments about other professions without knowing what you are talking about. In fact, Physician Assistants occupy an essential place as providers of medical care contrary to your depiction of this "profession" in such condescending terms. Due to the exponential growth of medical information and technologies there is need for higher levels of education to enable Physician Assistants to maintain high standards of performance that keeps pace with the burgeoning levels of medical knowledge and state of the art treatment interventions.

psych: Again, unanswered .. which is more important prestige or patient care? Just how many primary care practitioners are needed?

SIMON: Fair question. In the same light why are more Psychologists needed when considering the fact that there are overwhelming numbers of mental health professionals from myriad mental health disciplines who are flooding the marketplace?

psych: The research is far from conclusive, though, yes, it does suggest therapy can be successful with a variety of practitioners. However, there remains a big difference between the "worried well" and the seriously mentally ill. (Also erroneous is your inference that psychologists only perform therapy.)

SIMON: Then present ANY substantive studies that demonstrates Psychologists are able to provide more effective clinical treatment outcomes than master level clinicians! Moreover, your point distinguishing the 'worried well" from the "seriously mentally ill" is tangential and not relevant to this discussion. Moreover, your hostility and arrogance is resulting in cognitive distortions. In fact I did not infer "that Psychologists only perform therapy" but was focusing solely on one function that they perform.

psyc: And the field is hardly "inundated" with PhD/PsyD .. the proliferation has been with Master's level practitioners. Ironically, it is a deevolutionary process. Nursing seeks to advance its prestige and standing to be equal with physicians. Despite the APAs resolution that a psychologist should have a doctorate, the profession seems bent on obliterating the distinction.

SIMON: The field of Psychology is most certainly "inundated" with doctoral level practitioners many of whom cannot even conduct doctoral level research ( I am primarily refering to Psy.Ds). In fact many of their job tasks can be performed by master level clinicians including testing and assessment. So prior to making your usual hostile and condescending comments about other professions examine your own with the same level of critically detached "logic" (and hostility).

psy: This is a total red herring. Of course insurance companies want to pay less. There is absolutely no validation that spending less provides better or even equal services. All that can be said is that they provide cheaper services!

SIMON; Red herring! Then provide any substantive studies that demonstrate that Psychologists provide more efficacious interventions leading to better outcomes. We are waiting!

psy: And did a PsyD pee on your corn flakes, simon? You seem to have a real jones on for dissing them in every post you make.

SIMON: Once again you are projecting. You have been making hostile and denigrating comments throughout this thread regarding the Nursing and Physician Assistant professions and then without one iota of insight speak of my "dissing them (Psychologists) in every post"! Unbelievable.