The controversy over the Doctorate in Nursing
When you step into your doctor's office, calling your physician by the title of "doctor" seems a logical thing to do. But what if your nurse happens to be a doctor, too?
Nurses who choose to enhance their career with further education can pursue a doctorate in nursing, which gives them the right to be called "doctor." But that can also lead to confusion for patients, and sometimes even for co-workers -- it can be tough to know what to make of a nurse who is actually a doctor, or a doctor who is actually a nurse.
What is a doctorate in nursing?
A doctorate in nursing is the terminal degree of the nursing profession. The doctorate in nursing provides a higher degree of clinical skills and knowledge, as well as enhanced leadership skills. Students who earn the doctorate are considered to be just as prepared and credentialed as others who carry the doctorate designation in health care, such as doctors of pharmacy or doctors of medicine.
There are three doctorate degrees in nursing. The Ph.D. is designed for those who want to teach and conduct research. The Doctor of Nursing Science (DNS) grew from a need for advanced clinical nursing. Over time, the Ph.D. and the DNS seemed to merge, and a third degree was created: The Doctor of Nursing Practice (DNP).
For many decades, leaders in the nursing field have fought for the right to greater autonomy, higher pay and the power to write prescriptions for patients. Many nurses see the doctorate as a way to break into top administration or coveted university positions. However, The New York Times reports that the doctorate hasn't yet proven to bring in higher fees from insurance companies or more prescribing power from state legislatures.
The doctorate in nursing: Why so controversial?
Many physicians are uneasy about the idea of "doctor" being used to describe someone who doesn't hold a medical license. Some argue that blurring the line between nurse and doctor could lead to confusion for patients, as well as questions about who is allowed to do what in terms of health issues. For instance, a nurse who holds a doctorate might seek higher compensation or more prescribing power, something that doctors have long felt should be reserved for themselves.
In an effort to set the record straight, many physicians are pushing to restrict the use of the word "doctor" in a medical context. Some states, such as Arizona and Delaware, already forbid anyone from calling themselves by the title of "doctor" unless they immediately state their profession. For instance, a pharmacist must say "I am a doctor of pharmacy," not simply, "I am a doctor."
Though there is no proof that nurses with doctorates provide better care than nurses who hold master's degrees, some doctors worry that nurses are pushing for a higher degree in order to eventually demand the opportunity for independent practice. That just may happen: According to The New York Times, twenty-three states already allow nurses to practice without physician supervision.
Medscape, "A Bold Step for Nursing: A Practice Doctorate," Medscape Today News, http://www.medscape.com/viewarticle/453247_4
Duke University School of Nursing, "Comparison of DNP and PhD Programs," http://nursing.duke.edu/academics/programs/dnp/dnp-phd-comparison
Nursing Link, "PhD in Nursing Explained," Marijke Durning, http://nursinglink.monster.com/education/articles/189-phd-in-nursing-explained
The New York Times, "When the Nurse Wants to Be Called 'Doctor,'" Gardiner Harris, October 1, 2011, http://www.nytimes.com/2011/10/02/health/policy/02docs.html?pagewanted=all&_r=0
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