Talk:Doctor of Nursing Practice

message: I suggest that the last two paragraphs under the "Controversy in the United States" section be moved to the nurse practitioner page. While they are accurate for the most part (I could nitpick some of the details of the "Nurse practitioner vs Physician Assistant" paragraph), they do not deal specifically with the DNP -- these issues are broader, and apply to all NP's (both those with doctorates, and those with masters). DoctorEric (talk) 15:52, 20 February 2013 (UTC)
thread_title:  NP Discussion under DNP Article 

message: It seems that time and time again there has been a desire by some to list a comparison of the educational requirements of a physician in contrast to an NP or a DNP.  While in most instances the discussion of one profession's education in the section of another is a bit odd, and indeed all of the previous posts to that effect have been removed because they both 1) had no direct relevance to the DNP and 2) were posted with the sole purpose to further a political based motive and to "show" that DNP education is somehow inadequate by comparing it to physician education.  Such indeed was the post made by Nebrfan at 16:05, 29 January 2011.
Instead of reverting the post, however, I decided to undergo an edit of the post which really took a number of revisions to get it to a more neutral and appropriate level.  I think there is some value to leaving a brief and fair comparison of physician vs DNP education, since the DNP is such a new roll, and to understand something that is new often takes a comparison to something similar but different.  And, hopefully, by having such a comparison we will get beyond the recurrent vandalism of this section by some individuals who feel the need to emphasize the education requirements of an entirely separate, but related, profession.  
syncnotes 04:15, 30 January 2011 (UTC)
thread_title:  New edits to Criticisms Section, 29 January 2011 

message: Here is a complete description of why I removed this entire section, line by line.
“The main reason for implementation of the DNP degree is to achieve full autonomy for nurse practitioners independent of physician collaboration or oversight.[6] “
* This is true. However, the source is a document about Certified Registered Nurse Anesthetists only. It does not, by itself, construct any type of criticism, and as you will see, it is one of the few facts in this section, all of which are not critical of NPs.
“The Pearson Report, an annual report published in the American Journal for Nurse Practitioners, was issued in February 2009 describing how nurse practitioners should approach lobbying their state legislatures to push for full autonomy. In the report, the main justification was an analysis of malpractice claims in the National Practitioner Data Bank to show that NPs have much lower rates of malpractice than MDs or DOs. “
* Note there is no link to the Pearson Report. It is available at http://www.webnp.net/downloads/pearson_report09/ajnp_pearson09.pdf. The specific quote this previous author is evidently referring to is: “NPs must use these malpractice and malfeasance ratios and figures to show legislators that the rationale for physician supervision over NPs is unfounded.” 
“Such an analysis is flawed not only because malpractice suits rarely target NPs and more often target collaborating or supervising physicians, but also because there has been a growing trend among state boards of nursing for under-reporting malpractice claims against NPs.[7]”
* This sentence is based upon a biased interpretation of the Pearson Report’s legitimacy. Further, the Pearson Report does not say anything about malpractice suits “rarely” targeting NPs and more often targeting physicians. Further, reference #7 cited to back up this statement about under-reporting of malpractice in fact claims the OPPOSITE of what this wiki author wrote. To quote the actual source: 
** “Malpractice insurers’ profitability in covering APNs has dropped, perhaps because more nurses are being sued these days.”
** ”APNs should be aware that if they practice with a physician who is under- or uninsured, the nurse might become the deep pocket — the one who is covered for the highest amount and, therefore, is the more attractive to name in a lawsuit.”
"In California, thousands of nurses were discovered to have felony convictions while still retaining an RN license in contradiction of state law.[8]"
* This is true. However, it is a fact about RNs. Yes, NPs need to retain a RN license, but generalizing this fact about RNs to their more well-educated counterparts is a biased and unfounded interpretation. The next sentence is also biased and does not have any facts to back it up:
“Such lax oversight by boards of nursing has lead many to question the ability of boards of nursing to adequately police NP practice.[citation needed]”
* Who are the “many” who are questioning the ability of boards of nursing to adequately police NP practice? There is no source I can find that compares facts to back up this opinionated statement.
"In addition to the criticisms offered against both the expansion of NP scope of practice as well as state boards of nursing, there is little uniformity among DNP programs.[citation needed]"
* Again, this has no factual basis and has no citation.
"There are DNP granting programs offered online[9], and many programs contain few extra clinical training that would seemingly justify the granting of the doctorate level degree.[dubious – discuss][10][11][12]"
* Already marked as dubious, this statement again uses opinion and its sources do not back up the opinion. Sources 10 and 11 simply refer to internet pages that show programs use online training as part of a DNP curriculum.
"In addition to the non-uniformity in training[citation needed] and the overall lack of clinical training[citation needed], 
* Again, no factual basis.
"…recently the Council for the Advancement of Comprehensive Care together with the National Board of Medical Examiners administered a certification exam to recent graduates of Columbia's DNP program."
* Yes, there was such a certification examination. However, from that exam’s website: “The Comprehensive Care exam is not intended to replace the national certification exams that lead to recognition for state licensure as an APRN.” 
"The exam was based on step 3 of the United States Medical Licensing Exam but had fewer questions and fewer complicated scenarios."
* This information can be found nowhere on the examination’s website and thus has no factual basis. However, the website, at http://www.abcc.dnpcert.org/faq.shtml, does state that the exam is based upon an examination for physicians. NPs are NOT physicians. This examination is designed to be an optional certification and it is nonsensical to apply it to NPs as a requirement to prove competence.
"The fail rate of the exam was 50%, lending weight to many of the criticisms of the current model for DNP education.[13]"
* Yes, the fail rate was 50%. This does not “lend weight” to criticisms in any way that is factually based. The local news article cited by this wiki author as #13 simply includes an opinionated interview with one physician and is certainly not a factually-based source.
So that is why this ENTIRE criticism section is being deleted, AGAIN. I will delete it every time it is reposted if done so without changes and I will monitor this site very, very carefully. I am absolutely not opposed in any way to FACTUALLY BASED, UNBIASED sources which can be used to construct a criticism section on this page. Until an author can add this type of criticism this existing section will remain removed. Please feel free to write me if you have any questions about my substantiations as above; I am more than willing to back up my work unlike the authors who made this section in the first place. 
Bryan
Hagenb (talk) 04:09, 8 May 2009 (UTC)
replies: text: Thanks for this detailed rationale. The comments are sourced, and editing them is better than wholesale deletion. Why not try to re-work it? JJL (talk) 04:13, 8 May 2009 (UTC)

text: JJL, my rationale seemed pretty clear as to why this should remain off the page. Please do not undo my edit without substantiating your reasons. The comments are biased and do not belong in a wikipedia article. If there are reliable, peer-reviewed sources that can back up the previous claims, then please cite them and be specific. If you can somehow disprove my rationale as posted above please share that here before reinstating the entire biased criticism section. As it stood before it was removed, it provided an unfair, one-sided, and obviously biased point of view, and should not be left public as-is. Hagenb (talk) 04:29, 8 May 2009 (UTC)

text: The material is sourced. It's better to edit and present both sides--a balanced point of view. You've removed a lot of material. Please try editing it and improving instead. JJL (talk) 12:40, 8 May 2009 (UTC)

text: JJL, by reading my explanation above it is obvious that the material is not sourced and is in fact deceptive. The sources do not represent the writing and thus saying "The material is sourced" is inaccurate. I cannot find a way to edit this in a way that will leave any criticism left because the only criticism consisted of lies and bias. In the same vein, restoring material proven to be biased is no different from vandalizing the page. Thus, I will not restore it and I ask that you refrain as well. I feel I explained that very carefully and in plain language already. However, I will thoroughly research and present a criticism section in the next week or so that will present things accurately - if for nothing else than to prevent this trash from being restored again. Hagenb (talk) 03:25, 9 May 2009 (UTC)
replies: text: What is obvious to you is not necessarily obvious to me, nor to the editor(s) who added the material initially. (For example, in your last point your comments above seem to support the point made, in light of WP:RS.) Are you familiar with WP:CONSENSUS and WP:TRUTH? Editing the material rather than deleting "lies and bias" and replacing it with "accurate" material may not be the most collegial approach--and accusing those who disagree with you of vandalizing the page certainly isn't a helpful approach. JJL (talk) 04:38, 9 May 2009 (UTC)

text: JJL, I feel this is turning personal and I certainly do not intend so. I apologize if this is the impression you have. I simply do not understand how the bias is difficult to see in the original contribution. Regardless, in thinking about this criticism section I came to the realization that a more general critique would be more appropriate in the Nurse Practitioner article, as it seems that the debate is over autonomy and practice limitations of NPs and not specifically DNPs. There certainly are many more resources that would substantiate an even-handed debate when not restricted to the relatively new DNP level of education, as the practice standard now is still at the Masters level. Perhaps leaving this particular article without critique would make more sense. Hagenb (talk) 05:22, 9 May 2009 (UTC)
replies: text: I think you're right that many of these are actually criticisms that are at least equally shared by the master's and DNP degrees, and that makes sense. But there are some that are specific to the degree here and that should be mentioned; I've read several stories like this , for example. JJL (talk) 13:04, 9 May 2009 (UTC)

text: I have carefully researched critique of the DNP and posted what I have written as a subheading instead. What do you think, JJL (and others?) My goal has been to present a more even-handed critique that does not inflate or misinterpret resources, and all those I used are from peer-reviewed, reputable publications. I hope this provides a more accurate basis for further expansion of this section as other users see fit. Hagenb (talk) 07:34, 18 May 2009 (UTC)

text: I'm now reverting the continued unexplained blanking as simple POV vandalism. JJL (talk) 02:06, 22 August 2009 (UTC)
thread_title:  Removal of Criticisms section posted by 128.172.28.45 on 19 March 2009 

message: Added a criticisms section since the DNP programs are off to rocky starts and there is a lot of political tension currently in the medical community. The turf war between NPs and physicians is still ongoing and to ignore it in an article about the DNP degree is pretty ridiculous.128.172.28.45 (talk) 19:04, 19 March 2009 (UTC)
thread_title:  Criticisms section 

message: This page should be marked for NPOV. Clearly, this article was significantly edited by a Caucasian female NP. The tone, inflection and syntax are obvious. ~JB  — Preceding unsigned comment added by 67.81.224.14 (talk) 04:27, 28 May 2013 (UTC)
thread_title:  Bias in tone 

message: An unregistered editor recently removed a section from this article that described "an interdesciplinary controversy over the use of the salutation or title “Doctor” being used within the clinical setting by holders of the DNP."  Although he or she was correct that the only reference in that section is now dead, he or she also indicated in the edit summary that "a google search was unable to find a reputable source for this discussion."  I conducted my own quick Google search and was able to come up with many sources, including ones from The New York Times (2011), HealthcarePOV (2014) (no, I've never heard of it, either!), and Clinical Advisor (behind a paywall).  There are many other sources that indicate that at worst this was an issue in the immediate past that might warrant a brief mention in this article.  If there are laws on the books that specifically address this issue (as claimed in some of these sources and the text deleted from this article) then that should be mentioned, too.  But I'll leave this to others with more time and interest in this topic. ElKevbo (talk) 20:05, 10 May 2016 (UTC)
thread_title:  Title controversy 

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thread_title:  External links modified 

message: New section added. It is specific to the USA DNP and it cited throughout (I think). Would welcome further citations to ensure it is evidence based Imaginarium Monkey (talk) 10:16, 24 March 2022 (UTC)
replies: text: I've edited this section to nudge towards a neutral POV. The article is still fairly poor throughout and US centric. 185.58.164.47 (talk) 09:22, 12 April 2023 (UTC)
thread_title:  New Controversy Section 

message: That is misquoting. The 1-year requirement is after an MSN degree (see the source), which usually takes 7 semesters after a bachelor's degree. In effect, the total requirement is close to 9 semesters after a bachelor's degree, in line with doctorate requirements in other fields. 99.13.228.225 (talk) 00:21, 17 April 2022 (UTC)
thread_title:  The 1-year DNP requirement in the US 

message: Controversy section was very obviously written by a disgruntled person, probably a physician. Firstly, the DNP isn’t a response to the MD/DO. The section assumes that all DNP-educated nurses serve in direct, clinical/bedside roles (i.e. nurse practitioners) when that just isn’t true. DNPs also act as executives, administrators, owners, chief officers, managers, etc., and they do not “tread” on physicians in those capacities. This section also does not share any detail or background on the very real and tangible ways that nursing institutions, accreditors, boards, and individuals are working to improve the image, credibility, and rigor of these degrees. I believe that people deserve a comprehensive view of any given issue so I’d argue that a reasonable effort needs to be made to present, not only the problem, but also what’s being done to solve the problem. In general, this section can explain the flaws that nursing education has to overcome without throwing the entire profession away as cheats and imposters. 76.150.36.106 (talk) 16:54, 9 January 2023 (UTC)
replies: text: I have edited to make tone for neutral. 185.58.164.47 (talk) 09:23, 12 April 2023 (UTC)
thread_title:  Not all DNPs are patient-facing 

message: There is another terminal nursing degree.  Doctor of Nurse Anesthesia Practice (DNAP) 2601:100:4180:1D73:71D1:5C0B:2556:EA3 (talk) 14:47, 23 October 2023 (UTC)
thread_title:  Fourth terminal Nursing degree is not mentioned