DNP credentials- notices discrepancy

[Diane McGinnis, DNP, FNP]

Hi DNP persons,

I was looking at the speakers list for the upcoming conference and noticed that each speaker listed their credentials differently, for the most part.

So I went looking and found this article by Mary C. Smolenski, FNP, NP-C, EdD
Directed of the American Nurse Credentialing Center (ANCC), 2003.

Why I'm posting this as a discussion is that I noticed many put BOTH DNP and MSN or MN in their list of credentials. If we as a group do not value the DNP as our HIGHEST nursing degree and feel we need to add the MSN to it for clarification purposes or otherwise....how can we expect OTHERS to respect our degree? In my case I put the MSN, because I am a DNP candidate, but have not yet been awarded the degree.

Interested in your opinions,
Diane McGinnis, DNP(c), MSN, RN, APN-FNP

p.s. I debated whether to put this under practice issues or professional growth...but decided it really is a "practice" of how we list our credentials or "postnomials"

[Catherine Bishop, DNP, NP, AOCNP]

Diane,
I think you have a valid point. The public does not know what DNP stands for, and often times will not ask. However, most understand what the MSN is. The second reason is probably more out of habit than anything else. I have a queston for you. You have listed both RN and APN and FNP. Some may argue that using RN once you have attained APN education is redundant. One must be an RN in order to be an NP so there is not a need to use the RN credential. Also, listing APN-FNP may be viewed as redundant. APN is an umbrella term only to be used by NPs, CNSs, CRNA and CNMs. I think identifying one's role is important, such as FNP. or perhaps just NP. Again the public does not understand the initials APN. I list on my lab coat: C. Bishop, DNP, N.P.
What do you think? How about others?

[Sue Doyle, DNP]

I use DNP, APN.
APN is a state requirement, and I chose to put my highest academic degree.

[Diane McGinnis, DNP, FNP]

I debated about putting the RN in the credentials, I did not use it when I registered for this forum for the same reason you stated, it's implied because a person can not be an APN without being an RN.

I concluded that in my state, NV, I am granted an RN license, and an APN-FNP certificate to practice at a higher level of RN practice, so I am not licensed as an APN. NV uses the term APN. Other states use CRNP, APRN, ARNP and so on, so it is important to use the correct credential granted from your particular state. If you practice is more than one state, the choice would become even more difficult!

The Consensus article (found on this community in another place) mentions a nationwide goal of using the credential, APRN, only for the four roles identified in the document: CRNA, CNM, CNS, and CNP. In the last paragraph of page 8 it is stated that as a minimum, the professional should use the APRN in their legal signature and include the role (one of the 4 above). It then states the "individual" may add their specialty title (FNP, ACNP, PNP, etc.) as part of the legal signature. Of course the two different certifying agencies for NP's have different ways for the NP's to show they are certified (FNP-BC vs NP-C), so another part of the alphabet soup! Standardizing this discrepancy could also lead to a clearer understanding of the roles of NP's.

Since the goal is to standardize the credential to APRN across ALL states, many states will need to open their nurse practice acts, to change the terminology, so it becomes a "protected" title, like "nurse" and "physician" are in most states. I do not feel the FNP is redundant, because it shows my population focus. If I said ACNP it might change the way you view my post, or if I said CNM you might find a different context for my posts.

I do think it is important for us, as pioneers, to make some media waves, and help the "public" understand what the DNP title means. To do so we should have a standardized, "elevator" speech that can be given to someone in the 20 seconds it takes for the elevator to travel from one floor to the next. Does anyone have any quick "word tracks" they use to describe their degree?

One of the issues I have always noticed with nursing is that often "we" as nurses do not know what other types of nurses do. So I feel it is important for DNP's to create, as a group, a unified statement of who we are, and if possible include what we do, all in 20 seconds! I have met, in the last month, at least 3 RN's who did not realize my scope of practice included prescribing, and ordering and interpreting xrays and labs! This might mean we are not marketing our degree enough. Let's start with what multilevel marketing guru's call our "warm market". Those are our acquaintances, family and friends. I usually include anyone who is a "nurse" as my friend until proven otherwise. So if you can follow all this, I am calling on all of you to start marketing the DNP, and APRN roles to fellow RN's so they can better understand, with the hope that once we practice selling ourselves to a "safe" market, we can then go out and "cold call" those outside of our profession to sell our degree to them.

I think many may understand in theory what "MSN" stands for in terms of changing the intials to words (Master of Science, Nursing), but I am not sure others know what that "means" as it pertains to a scope of practice.

Another point mentioned somewhere by someone as I was researching this issue is that the credentials should all be listed without periods between them, FNP vs F.N.P.

Hoping to hear more personal opinions, please keep the dialogue going.

Diane DNP (c), MSN, RN, APN-FNP

[Catherine Bishop, DNP, NP, AOCNP]

Diane,
You are obviously passionate about the DNP and our obligation to us and the pubic in promoting this hard earned degree. I absolutely agree. One of the problems with nursing in general is the lack of standardization. Evidenced by the differing state designation of identifying initials, ie., CRNP, APRN, ARNP, etc. As you have alluded to the APRN regulatory model may help to streamline and standardize this group so that, perhaps we can begin to help the public understand our role and how it differs from the role of the RN. Here is an excerpt from an article in Medscape
"The new APRN Regulatory Model sets forth requirements for future APRN licensure, certification, education, and accreditation of APRN education programs. Under this regulatory model, 4 APRN roles are recognized: certified registered nurse anesthetist (CRNA), certified nurse-midwife (CNM), clinical nurse specialist (CNS), and certified nurse practitioner (CNP). These four roles are given the title Advanced Practice Registered Nurse (APRN), which is protected and can legally only be used by individuals licensed in 1 of these 4 roles. Under the new model, all APRNs will be educated in 1 of these 4 roles in addition to at least 1 of 6 population foci: individual across the lifespan/family, adult-gerontology, pediatrics, neonatal, women's health/gender-related, or psych/mental health. Nurse practitioners (NPs) will be licensed solely by the state board of nursing as an APRN, CNP and in one population. This will be the designation on one's license and what individuals will be required to use as the legal credential (for example, Jane Smith, APRN, CNP). The individual has the option and may indicate the population-focus as well.
I am licensed in the state of VA, and hold both an RN and FNP license. I pay for each separately. I am certified by both the American Academy of Nurse Practitioners as an NP-C and the Oncology Nursing Society as an Advanced Oncology Certified Nurse Practitioner (AOCNP). My DNP diploma has not arrived yet, but when it does in a couple of weeks I will indeed display this and hope that it will stir questions from my patients. I have already begun to tell patients that I have completed this degree. As well, I have purchased new lab coats with C. Bishop, DNP, N.P. (By the way I choose to replicate the way my physician partner has his initials done on documents and lab coat—which is M.D.) In my practice I display all of these licenses and certifications except the RN--as you state, it is implied. As a matter of attempting to differentiate myself from the role of the RN and that of an NP, I do not use the initials RN. I am always happy to explain to patients and anyone else who may inquire what the differences are in the two roles. As far as a quickie on the DNP, I simply say "I have a doctoral degree in nursing.” If I need to expound or if one is interested in a further explanation, I refer to the PhD and draw the differences between the DNP and PhD and how they complement one another.
Clearly we have a way to go in order to have the public and healthcare in general understand the initials and the degree of the DNP. Keeping it simple, I believe is best. Emphasizing it is the highest degree an advanced practice nurse can earn in the clinical setting is key.

[Valerie Fuller, DNP, ACNP, FNP]

Hi Diane,

I share this same pet peeve but as a profession I think we've only contributed to the confusion with credentials. The AANP grants different credentials than ANCC and many states use different designations, some use APRN, others APN, etc.

I like the suggestions by Mary Smolenski but the titles could get pretty lengthy. She suggests listing degrees (highest to lowest), state license, ANCC credentials, other nursing or nationally recognized credentials, fellowships and other awards! My own could be DNP, APRN, FNP-BC, ACNP-BC, RNFA - it's alphabet soup and only applicable if you are ANCC certified!

Nursing is also one of the only professions that uses (c) while a person is working on a degree. Medicine doesn't use MD (c) nor do you see law students using JD (c) - perhaps we shouldn't do it either.

Valerie

[Diane McGinnis, DNP, FNP]

I was told the (c) came from PhD which almost all other professions do use.

Link to wikipedia ( I know not "scholarly" but has a summary none-the-less


Our school carried it over to the DNP degree....as if "the PhD's are doctoral students, so our the DNP's".

In my case I have defended my project, and finished my term, but my school doesn't grant degree's but a couple times a year. So I am waiting for the paper, but I am really a DNP.

I agree with your comment on Mary Smolenski's suggestions....lots of letters that mean nothing to the public, and probably not anything to nurses who haven't persued lifetime learning. So who are we trying to impress? My plan is to use DNP, APN, NP-C, though I am hoping that AANP and ANCC standardize there credentials. I like the new way ANCC is including the focus of practice in the certification.

Diane

Diane

[Jonathon Brown]

I agree with Mary's article:  Highest nursing degree, then licensure title (RN or NP Licence not both), followed by certification(s).  I also hold a 2nd graduate degree outside of Nursing so I include this after my highest nursing degree:  MSN, MBA, RN, NEA-BC, FACHE.  When I earn my DNP I will drop the MSN and add the DNP.

 

I personally believe lots of nurses are starting to know what the DNP is as there is much in the nursing literatire about it.

[Angela Armstrong]

Diane

I agree I am in a DNP program and I would drop my MSN once I obtain my DNP. I also see the same with the ARNP and RN why list both. I am certified in Dermatology and Family and I use only my DCNP since this is the speciality that I work in.

Angela

[Melissa W. Moreno]

good point!
forget the alphabet soup--only problem is that not all DNP's are NP's but may be APNs-with Masters degree--sticky sticky area-and I have a bone of contention with that- since someone may obtain a DNP and not be able to practice with the same authority and boundaries but will have the same title...this makes the water murky...

Melissa DNPc,MSN, FNP,BSN, AAS, CURN,CRC...lol

[Catherine Bishop, DNP, NP, AOCNP]

Hi Melissa,
I believe keeping things simple is the best way for the public to understand our roles. APNs are limited to NPs, CNSs, CNM or CRNA. Anyone else with a DNP should identify their role, which may be an RN.
Many schools only admit NPs. This may have been the original idea behind the DNP. As you know the DNP was intended to be a practice doctorate for patient-centered, direct care-giver APNs. It is now open to many.

M. Jones, DNP, NP
M. Jones, DNP, RN

[Susan Corey, M.N., PMHCNS-BC]

Hi, Diane,

Excellent point as we all move forward and try NOT to confuse the consumer.  It was my understanding that the highest degree is the one cited after your name.  I am in a DNP program so my highest degree is my Masters in Nursing (Pitt's Masters degree).  Afterwards, we are to indicate our advanced practice which used to be APRN but is now for me PMHCNS-BC, ie Psychiatric-Mental health Clinical Nurse Specialist-Board Certified.  There is yet another designation which will hopefully be in place after the consensus model is implemented, but I haven't heard that APRN's are using it yet.

It is a very important issue and speaks to our identity and the way in which we wish the public to know us.

Susan