I work with a very smart, well-experienced ER/ICU nurse who has been working for a couple years on gaining entry to a nurse anesthetist (CRNA) program. She's considering abandoning it all, however, because all the programs she's applying for have changed to Doctorate programs. This is to be in line with the requirement that all CRNA programs become Doctorate level by 2015.
What this means, she said, is that the CRNA programs will still take three years to complete, just like when they were Master programs; however, 30 more credit hours will be crammed in, and the degree will cost $30,000 more. That's not chump change, especially when tuition is already $60,000 or more, and you already have to sign an affidavit swearing not to work and live off of loans. The total cost is already upwards of $100-150,000. And, like with the bachelor's versus the associate's for regular nursing, you're not going to get paid any more.
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What this means, she said, is that the CRNA programs will still take three years to complete, just like when they were Master programs; however, 30 more credit hours will be crammed in, and the degree will cost $30,000 more. That's not chump change, especially when tuition is already $60,000 or more, and you already have to sign an affidavit swearing not to work and live off of loans. The total cost is already upwards of $100-150,000. And, like with the bachelor's versus the associate's for regular nursing, you're not going to get paid any more.
The selling point of the CRNA, especially in this day and age of healthcare reform, is that they cost less to train and operate than an anesthesiologist. One anesthesiologist MD can supervise an OR suite with several CRNAs for a fraction of the cost of several anesthesiologists. Outcomes consistently have been proven to be the same. So why would schools want to make it harder to become a CRNA? This nurse I know can't be the only well-equipped RN who is seriously reconsidering her plans to become a CRNA because she now has to become a Doctor of Nursing Practice.
The same story is happening with nurse practitioners. Their selling point is equivalent general care at a cheaper cost than a physician. However, nurse practitioner programs must start churning out doctors by 2015, and many programs are jumping on the bandwagon now to get a larger market share of the students.
What's the deal? The American Association of Colleges of Nursing is the lobby for bachelor and graduate nursing colleges. They seem to be a machine for nursing academia. Years ago they established an academic doctorate for nursing, the PhD in nursing. They've been fighting for a practice-oriented doctorate as well. In recent years they've adopted position papers, plans of attack, and outlines for academic change to force a transition to doctorate-level education.
It seems they've won.
It seems they've won.
What gives? Here's what I think is happening. Academic nursing is fighting for its own existence and respect, regardless of what it does to real nurses and nursing practice. This has been going on since the 1970s. Academic nursing rejected the idea that we're just "handmaidens to the doctor," that we're just a technical trade or service trade, rather than professionals. Independent nursing faculty and schools were created to replace the doctors who used to train us. As good as this backlash is, some of the results have been nothing short of ridiculous. Nurses can't diagnose things like pneumonia; therefore "nursing diagnoses" like "impaired respiratory exchange" were invented so we could diagnose alongside doctors. Hospital nursing schools were abolished despite a nursing shortage. Associate-level nursing programs have been under attack for decades, despite supplying (and preparing well) the gross majority of America's RNs. It's been suggested that all bedside nurses should have Master's degrees, a suggestion which could destroy American healthcare overnight. And an entire academic subculture of "nursing science" and publication was created, some of it worthwhile, some just serving to support the academic establishment.
The worst of it right now is that academic lobbyists like the AACN, as well as nursing theorists, professional faculty, policymakers, and others who don't necessarily work in any professional clinical setting, are pushing for higher and higher educational requirements so we can appear to compete with medical doctors and so cush academic jobs can still exist. Practical jobs like the CRNA and the NP, which could really help the economy and really help people, are being elevated beyond practicality so the academics can feel better about our industry.
This same AACN laments the current nursing shortage. I don't think they get it. But lobbyists seldom do.