Credential creep -- do you really NEED that doctorate

Discussion in 'General Distance Learning Discussions' started by PsychPhD, Sep 8, 2009.

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  1. PsychPhD

    PsychPhD New Member

    It's not about respect for nurses

    I have never said nursing was easy or intended to insinuate that nursing was not a noble and crucial healthcare profession.

    I have worked alongside nurses for years ... starting as a unit aide during my undergraduate studies, then as an ambulance EMT, then as a mental health worker on a psych unit, now as a psychologist associated with a state hospital, a community hospital, and an assisted living facility.

    I have seen the best and the worst of many health care professions (including my own). I've also been working in the field during the climb of nursing from nursing school > BSN > "nurse specialist" (MSN) > nurse practitioner > now DNP.

    Unfortunate, as I would be interested in hearing a nurse's perspective.

    I'm sorry but I do not see how having a "history of being a patient advocate" qualifies anyone for the responsibility to select from thousands of medications to treat illness/disease. This has always been the focus on my concern -- the elevation of nursing to independent practice has been less about enhanced/expanded training and education and more about a concerted (and stunningly) effective PR and lobbying campaign.

    Which I noted in a previous post. Nursing's roots go back as far as the dawn of humanity. Midwifery in the earliest incarnation however wasn't truly a nursing activity as it didn't involve acquiring an education in how to make childbirth as uncomplicated as possible. It was about a mother helping another through a process with which she had personal experience.

    Again, I am not saying that this was not a valuable or compassionate role. But let's not over romanticize the roots of nursing. Medicine started in a similar fashion, where people who discovered certain natural substances had healing properties then shared that knowledge with others. (Study the philosophies of Oriental, Native American or Indian medicine.)

    Finally ... I want to say one more time so there is no confusion:
    This is not about belittling or criticizing the role or contribution of nurses.

    My concern has always been about taking short cuts to advanced degrees (and presumably expanded clinical authority) with less than adequate training. And, if you go back to the beginning, I was including audiology, physical therapy, pharmacy, etc. in that category as well.

    One last thing:
    Yes, I am a psychologist.
    Yes, my profession is seeking expanded clinical authority (i.e. prescription privileges).
    The core of my research on other professions was undertaken to understand why there is such a resistance to an already doctorally trained profession being allowed limited authority to prescribe medications we already monitor and are asked to evaluate currently and how adding an additional two years to our education is being seen as insufficient when compared to other professions which have been able to secure prescription privileges.

    My worry is that it has been about the lobbying, not the qualifications.
    I know some will declare this a self-serving undertaking, but I would think we should ALL be concerned with being asked to receive our healthcare from someone with less than optimal training. (Believe me, most of us have been already given a prescription by an NP/PA).
     
  2. cookderosa

    cookderosa Resident Chef

    Don't know where others are getting their information but ...

    AAS program (Hudson Valley Community College)
    FIRST TERM
    BIOL 205 Microbiology 4
    BIOL 270 Anatomy & Physiology I 4
    ENGL 101 Composition I 3
    NURS 095 Orientation* 0
    NURS 101 Nursing I 4
    Term Total 15
    SECOND TERM
    BIOL 271 Anatomy & Physiology II 4
    ENGL 102 Composition II 3
    NURS 102 Nursing II 6
    PSYC 205 Dev. Psychology 3
    Term Total 16
    THIRD TERM
    NURS 201 Nursing III 10
    PSYC 210 Abnormal Psych. 3
    Social Sci. Elect. 3
    Term Total 16
    FOURTH TERM
    NURS 202 Nursing IV 10
    Humanities Elect. 3
    Term Total 13

    Total Credits Required 60 >>>>>>



    BIOL 205** Microbiology 4
    BIOL 270** Anatomy & Physiology I 4
    BIOL 271** Anatomy & Physiology II 4
    ENGL 101 English Composition I 3
    ENGL 102 English Composition II 3
    NURS 101** Nursing I 4
    NURS 102** Nursing II 6
    NURS 201** Nursing III 10
    NURS 202** Nursing IV 10
    PSYC 205 Developmental Psychology 3
    PSYC 210 Abnormal Psychology 3
    Social Science Elective 3
    Humanities Elective 3
    Total Credits Required 60

    Because I don't have the time or energy to explain the science (and in this case social science) prereq sequence AGAIN, I'll simply point out that this exact sequence can't be completed in under 3.5 years at that exact college, and if the student comes in from high school without having earned C or better in both biology and chemistry it will be 4. That assumes the student tests in on the COMPASS/ASSET test at 100 level. English and math minimums will also be required to begin the prereq sequence.
     
    Last edited by a moderator: Sep 13, 2009
  3. PsychPhD

    PsychPhD New Member

    If you won't invest the time, why join the conversation?

    From the HVCC nursing program website:
    Admissions to Hudson Valley Community College is open to students who have earned a high school diploma or high school equivalency diploma (GED). The charts below list specific courses that are required for admission and to ensure success in the individual program choice. Students who are interested in pursuing programs for which they are not currently prepared should consult with the Admissions Office for extended options that will provide necessary preparation.

    Nursing program requirements:
    Nursing (A.A.S.) NUR (0622) (Full-time) day
    Math I, algebra or 1 unit of equivalent academic math, biology and chemistry w/labs (75 or above for Regents or 85 or above for non-Regents in each course)

    These are all high school courses. ("Regents" are the end-of-year exams required to graduate high school in NYS). Also not seeing any specific English or social science requirements other than one might have in a standard HS curriculum.

    I'm sorry, are you actually suggesting that classes one takes in high school should count as program content in an AAS program and not represent the minimum pre-requisites to begin such a program?

    They are meant to be demonstrate one can handle college level work.

    ". . .if the student comes in from high school without having earned C or better in both biology and chemistry it will be 4."
    I would hope someone who couldn't handle HS sciences is required to demonstrate basic competence in the sciences before being permitted to advance to college level work. But suggesting that remediation is required if one wasn't successful in HS doesn't undermine the argument that the academic requirements for an AAS-RN are still pretty light. If one meets the minimum qualifications for admission at HVCC, one can complete the nursing AAS in two years.

    [I'll ignore the reminder that you stand practically zero chance of getting into an MD or PhD program with a C grade in any core course.]

    Sorry, Jennifer, I know from your sig line that you have earned a couple of Associate degrees but they are not the same -- practically or philosophically -- as a four-year degree. Trying to insinuate that they are is self-serving and disingenous. (You seem to not want to acknowledge this, but I actually do my homework before making public statements.)

    Community colleges absolutely provide a valuable service to society by providing training/education for many trades/professions which do not necessarily require a four-year degree (or preparing one to move on to a Bachelor's program).

    However, of all of the health professions mentioned in this thread -- medicine, mental health, physical therapy, pharmacy, nursing -- ONLY nursing allows one to begin full professional practice (RN) at the Associate degree level. The others provide qualification at the "Assistant" level (PTA, pharmacy tech, etc.). Following this structure, the CNA (Certified Nursing Assistant) should be what is earned at the AAS level, the RN coming at the BSN level. Instead, the CNA is a 100 hours certificate program.
     
  4. Jeremy

    Jeremy New Member

    An interesting topic for health care proffesionals is expansion of scope of practice. MD/DO are the only two with unlimited scope of practice. All others are constantly evolving.
    DPM now can do surgery in soft tissues to the hip, use to be foot ankle only
    OD are getting minor surgical rights and in one state use of lasers
    Anesthesiology assistants- recognized in more states
    PSYD or PHD- Rx rghts
    PT- Direct access to patients (one sate requires a DPT for this that I know of)
    NP- Removal of bariers to practice and function incolaberation not supervision
    CNMT- now have an advanced level education
    x-ray- two different advanced practice tracts R.A. and RPA

    So aside form do you need a doctorate degree, all of the listed advancedments above are taking over roles once held by MD/DO. Do you need to have more people doing tis work.

    One of the issues I have read about with psych seeking rx abilities is that it will be turning back from what you are trained well in, therapy and just start medical management which we have physician, psychiatric NPs and CNS (some states), and PA-C (who have psych residencies they can go to) who can already do that.

    Back to the DNP since that is the only advanced degree I know about. It does increase clinical hours for students which is needed. If you look at a BSN to DNP it will be different than a current NP gong back for a DNP.

    Here is one example. This has about double the clinical hours required for MSN prepared NPs.

    http://nursingandhealth.asu.edu/files/programs/graduate/dnp/pos/fulltime/family.pdf


    And a CNA is not a proffesional nurse, LPN/LVN would be the entry level. The CNA is more of a supportave personel
    This is seen in other health care areas;
    CNA to LPN to RN
    pt aid to PTA to PT (same with occupational therapy)
    dietary manager to DTR to RD
    Medical assistant to PA-C to MD
    Speech pathology is now having aids and assistants

    .
     
  5. jek2839

    jek2839 New Member


    LOL!
    You clearly have no idea of what it takes to become an RN!!

    The high school science and math courses are PREREQUISITE coursework for admission into the nursing program. A nursing student will STILL have to take Chemistry, Microbiology, Pharmacology, Anatomy & Physiology (Pathophysiology), and Algebra.

    Why do you think that nursing school is so competitive to gain admission? One must have a high GPA in the science coursework, past experience, and a variety of other factors to gain entry into a ADN program.

    Would you like to become a prospective nursing student and find out, just how hard it is to become an RN?
     
  6. John Bear

    John Bear Senior Member

    A brief 'time out'

    Each time I see the forum heading, "Credential Creep," I have my morning smile as certain people come to mind who fit that description.
     
    Last edited by a moderator: Sep 13, 2009
  7. jek2839

    jek2839 New Member

    PsychPhD,
    I agree with the self-serving.:D Just kidding!

    If your profession truly wants prescribing authority, be prepared to "lobby and fight" for that authority.
     
  8. jek2839

    jek2839 New Member


    WOW!! I was thinking the same thing
     
  9. Ian Anderson

    Ian Anderson Active Member

     
  10. jek2839

    jek2839 New Member

     
  11. Ted Heiks

    Ted Heiks Moderator and Distinguished Senior Member Staff Member

    Am I a credential creep? :confused: :eek:
     
  12. cookderosa

    cookderosa Resident Chef

    I don't want to join this conversation- just pointing out your misunderstanding.
    I'm only following for the entertainment value.
     
  13. Ted Heiks

    Ted Heiks Moderator and Distinguished Senior Member Staff Member

    :confused:
     
  14. PsychPhD

    PsychPhD New Member

    Didn't just learn to read

    And you clearly have no idea what I have an idea about ... nor the fact that I have taught both HS science and college psychology for 15+ years (along with working IN the health field!)

    Well, yeah ...
    The HS prereqs were pretty clear in the HVCC program curriculum.
    Don't know where you see the required CC level chemistry, pharmacology, and Algebra though.
    I see a semester of microbiology and a year of A&P.

    Jennifer (only in it for the entertainment value) seems to have independently added course work not included anywhere in the program.

    I simply cut-and-pasted directly from: https://www.hvcc.edu/catalog/programs/hsc/nur.html

    It is pretty straightforward in its structure as a two year program.

    1) I don't see where you conclude it is competitive to get into nursing school -- especially since there are three separate entry points -- nursing school (diploma), community college (AAS), four-year college (BSN).

    2) A high GPA is necessary? The HVCC materials are pretty clear that a 75 (2.5 GPA) is necessary on the Regents level (college prep) classes. Sorry, but that does not strike me as a particularly rigorous qualification.

    3) Why don't I become a nurse? Hello? Already have a BA, MSEd, and PhD. I also already took the pre-med undergraduate courses. (This is how I ended up tutoring the BSN tranistion program students.) If I wanted to, I already have the college prereqs to be 3/4-way to a BSN. I'd just need the nursing specific courses.

    (And Jeremy, I know full well CNAs are not professional nurses. But they have assumed many of the nursing duties now that nurses have "moved on up" the health care hierarchy).

    Look, I posed a question asking -- starting with the DBA, then expanding to the DNP, DAud, DPT, DPharm -- if such degree elevation was really necessary in the sponsoring discipline.

    It has become very obvious that a few people are highly invested in ignoring contradictory information in order to preserve their self-justification biases regarding the value/rigor of their career choices as nurses.

    For the last time: I respect and honor the work of the nursing profession. However, I believe they have 1) abandoned their core philosophy and values in the pursuit of becoming "doctor-nurses; and 2) did so by skipping over several educational steps required of others with similar clinical authority.

    Which jek, I have pointed out several times has been a remarkable accomplishment by the nursing profession based upon their "lobbying and fighting". It seems peculiar, therefore, that long term doctorally prepared psychologists proposing even MORE extensive education are having their efforts squelched in large part because of the success seen by the expanding scopes of practice by lesser educated nurses.
     
  15. jek2839

    jek2839 New Member

    :)............Bump.................:eek:


    Southwestern Michigan College: ADN-RN
    http://www.swmich.edu/pc/curriculum/09_10/4035RN0910.pdf

    Ivy Tech State College: ADN-RN
    https://wwwapps.ivytech.edu/cgi-bin/curr/gpprogram_list.cgi#

    Macomb Community College: ADN-RN
    http://www.macomb.edu/Current+Students/Educational+Offerings/Associate+Degrees/Program+Descriptions/Nursing.htm



    Physician Assistant certificate programs

    Red Rocks Community College:
    http://www.rrcc.edu/pa/

    University of Washington (Medex):
    http://www.washington.edu/medicine/som/depts/medex/applicants/programinformation.htm

    Anne Arundel Community College:
    http://www.aacc.edu/physassist/




    http://findarticles.com/p/articles/mi_qa3958/is_200011/ai_n8914483/



    :eek:..........Bump...........:)
     
  16. jek2839

    jek2839 New Member

    Ivy Tech State College: ADN-RN
    https://wwwapps.ivytech.edu/cgi-bin/curr/gpprogram_list.cgi#


    APHY 101 Anatomy and Physiology I 3
    APHY 102 Anatomy and Physiology II 3
    ENGL 111 English Composition 3 IVYT 1XX Life Skills Elective 1
    PSYC 101 Introduction to Psychology 3 Select 1 of the following courses. COMM 101 Fundamentals of Public Speaking 3 COMM 102 Introduction to Interpersonal Communication 3 Select 1 of the following courses. ENGL 112 Exposition and Persuasion 3 ENGL 211 Technical Writing 3 Select 1 of the following courses. MATH 117 The Art of Geometry 3 MATH 118 Concepts in Mathematics 3 Select 2 of the following courses. APHY 201 Advanced Human Physiology 4 BIOL 201 General Microbiology I 4 BIOL 211 Microbiology I 3 CHEM 101 Introductory Chemistry I 3 CHEM 111 Chemistry I 4 PHYS 101 Physics I 4 Select 1 of the following courses. PSYC 201 Lifespan Development 3 PSYC 205 Abnormal Psychology 3 SOCI 111 Introduction to Sociology 3 SOCI 164 Multicultural Studies 3 General Education: 31 - 33 Professional-Technical NRSG 100 Fundamentals of Nursing 3 x NRSG 101 Fundamentals of Nursing Lab 1 NRSG 102 Medical Surgical Nursing I 2 NRSG 103 Medical Surgical Nursing Lab I 2 NRSG 105 Medical-Surgical Nursing I Clinical 2 NRSG 106 Pharmacology for Nursing 3 NRSG 110 Medical Surgical Nursing II 3 NRSG 111 Medical Surgical Nursing II Clinical 2 NRSG 112 Maternal Child Nursing 3 NRSG 113 Maternal-Child Nursing Clinical 2 NRSG 114 Health Care Concepts in Nursing 1 ^ NRSG 200 Complex Medical-Surgical Nursing for the ASN 3 NRSG 201 Complex Medical Surgical Nursing for the ASN Clinical 4 NRSG 202 Nursing Care of the Complex Family 2 NRSG 203 Nursing Care of the Complex Family Clinical 2 NRSG 204 Psychiatric Nursing 2 NRSG 205 Psychiatric Nursing Clinical 1 Professional-Technical: 38 Total: 69 - 71
     
    Last edited by a moderator: Sep 15, 2009
  17. jek2839

    jek2839 New Member

    I had to clean it up a little.


    Ivy Tech State College: ADN-RN
    https://wwwapps.ivytech.edu/cgi-bin/curr/gpprogram_list.cgi#


    [FONT=&quot]APHY 101 - Anatomy and Physiology I
    APHY 102 - Anatomy and Physiology II
    ENGL 111 - English Composition [/FONT]

    [FONT=&quot]IVYT 1XX - Life Skills Elective
    PSYC 101 - Introduction to Psychology

    Select 1 of the following courses.
    [/FONT]

    [FONT=&quot]COMM 101 - Fundamentals of Public Speaking [/FONT]
    [FONT=&quot]COMM 102 - Introduction to Interpersonal Communication

    Select 1 of the following courses.
    [/FONT]

    [FONT=&quot]ENGL 112 - Exposition and Persuasion [/FONT]
    [FONT=&quot]ENGL 211 - Technical Writing

    Select 1 of the following courses.
    [/FONT]

    [FONT=&quot]MATH 117 - The Art of Geometry [/FONT]
    [FONT=&quot]MATH 118 - Concepts in Mathematics

    Select 2 of the following courses.
    [/FONT]

    [FONT=&quot]APHY 201 - Advanced Human Physiology [/FONT]
    [FONT=&quot]BIOL 201 - General Microbiology I [/FONT]
    [FONT=&quot]BIOL 211 - Microbiology I [/FONT]
    [FONT=&quot]CHEM 101 - Introductory Chemistry I [/FONT]
    [FONT=&quot]CHEM 111 - Chemistry I
    PHYS 101 - Physics I

    Select 1 of the following courses.
    [/FONT]

    [FONT=&quot]PSYC 201- Lifespan Development [/FONT]
    [FONT=&quot]PSYC 205 - Abnormal Psychology [/FONT]
    [FONT=&quot]SOCI 111 - Introduction to Sociology [/FONT]
    [FONT=&quot]SOCI 164 - Multicultural Studies
    General Education: 31 - 33 Professional-Technical [/FONT]

    [FONT=&quot]


    NRSG 100 - Fundamentals of Nursing [/FONT]

    [FONT=&quot]NRSG 101 - Fundamentals of Nursing Lab [/FONT]
    [FONT=&quot]NRSG 102 - Medical Surgical Nursing I [/FONT]
    [FONT=&quot]NRSG 103- Medical Surgical Nursing Lab I [/FONT]
    [FONT=&quot]NRSG 105 - Medical-Surgical Nursing I Clinical [/FONT]
    [FONT=&quot]NRSG 106 - Pharmacology for Nursing [/FONT]
    [FONT=&quot]NRSG 110 - Medical Surgical Nursing II [/FONT]
    [FONT=&quot]NRSG 111- Medical Surgical Nursing II Clinical [/FONT]
    [FONT=&quot]NRSG 112 - Maternal Child Nursing [/FONT]
    [FONT=&quot]NRSG 113 - Maternal-Child Nursing Clinical [/FONT]
    [FONT=&quot]NRSG 114 - Health Care Concepts in Nursing [/FONT]
    [FONT=&quot]NRSG 200 - Complex Medical-Surgical Nursing for the ASN
    NRSG 201 - Complex Medical Surgical Nursing for the ASN Clinical
    NRSG 202 - Nursing Care of the Complex Family [/FONT]

    [FONT=&quot]NRSG 203 Nursing Care of the Complex Family Clinical
    NRSG 204 Psychiatric Nursing [/FONT]

    [FONT=&quot]NRSG 205 Psychiatric Nursing Clinical 1 [/FONT]
    [FONT=&quot]Professional Technical: 38 [/FONT][FONT=&quot]

    Total: 69 - 71
    [/FONT]
     
    Last edited by a moderator: Sep 15, 2009
  18. cookderosa

    cookderosa Resident Chef

    >>


    LOL! I love it, I see I'm not the only one being entertained :)
     
  19. cookderosa

    cookderosa Resident Chef

    Jennifer (only in it for the entertainment value) seems to have independently added course work not included anywhere in the program.>>

    How are you still confused?
     
  20. jek2839

    jek2839 New Member





    :mad:.......ouch......:rolleyes:.....bump....I'm okay........



    Cookderosa,

    LOL! 20 plus years of guiding young nurses and spoon feeding, young physicians and now this. :confused:

    I hope it's okay to have a little fun.



    .........Bang.........Honey, why isn't the dog barking and what was that noise?.......Honey, the dog ran away when he heard the neighbors car, back fire..........Sure.........If he keeps "shooting" at all of the neighbors dog's, he is going to be joining, Michael Vick........:)
     

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