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Thursday, September 25, 2014

PhD or DNP?

I've been thinking about this topic for a long time.  It's one where I get the most questions from students about which doctoral degree to do in their future career path.

The short answer comes with questions: What do you want to do with your doctoral degree?  Do you want to design and conduct research?  Do you want to focus on applying and testing evidence in clinical practice?  Your answer to that question will determine your educational program choice.

Let's start with why you would choose a PhD. Around the world, everyone knows what a PhD is as a degree.  Doesn't matter where you got it from, with a PhD after your name people will recognize you spent a lot of time in school and must have passed some higher standard of educational preparation.  Outside the United States, except for maybe Canada, no one knows what a DNP degree is or what you can do with it.  It will take decades before that happens.  If you think you want a career with an internationally recognized credential, then you should choose a PhD.

Another reason to choose a PhD is because you want intensive preparation in how to design and conduct research or policy analyses.  You see problems with patient care stemming from different sources and you want to know how to fix them through data analysis, intervention design, or rigorous translation studies. A PhD will prepare you to do that and over your career, you will see a difference made in many lives.

A DNP program that promises to train you in research in 3 years or less is selling you a bag of goods. A DNP program should prepare you to critically evaluate and synthesize research evidence so you can translate that into organizational quality improvement, leadership initiatives, and evidence-based policies.

Another factor to consider about the DNP is that it is a degree that is still figuring out what it wants to be.  Starting in 2015, it will become a standard degree preparation program for nurse practitioners.  This came about because people recognized NPs took a lot of credits, enough to qualify for a clinical doctorate degree.  In the case of some curricula, they also wanted to offer more clinical training time. There is no consensus on whether or not a DNP will be required for nursing education, administration, or informatics.  Those, for now, will remain two year masters degrees.

The DNP is also a solution for the faculty shortage (though vociferously denied by some that it is that) since most people seeking DNP degrees are people who really like clinical practice and want to keep a hand in it.  The DNP allows practitioners who want to teach and practice to do that more easily than a PhD degree does.

So this is my two cents on the subject. When choosing a doctoral program, choose the one that fits your career goals best.  Both are significant time and resource commitments so choosing the right program early will save you a lot of hassle in the long run.

Tuesday, August 5, 2014

Reports from the Job Search Frontiers for US New Grads

About this time of year emails start coming in from students about those who have gotten jobs after passing NCLEX-RN.  In the past few years, reports have shown anywhere from 5 to 8 months to get a job right out of school.  Students who moved out of their home training area were more likely to have a job in 5 months or less.

Here's what I'm hearing from former students since graduation season:

  • Most students have a job within 5 months of passing NCLEX with interviews often coming before the exam is taken.  This is a big change and may reflect what's going on with the implementation of the Affordable Care Act (a.k.a. Obamacare).
  • New York, Philadephia, Boston, and San Francisco remain the toughest job markets for inexperienced nurses.
  • Jobs are readily available in the US South, Midwest, and Southwest. Most students who have gotten a job in 3 months or less have moved to one of those areas of the country. Message: You might need to move to get that first job.
  • Willingness to move may mean you're more likely to get a job in an ICU or specialty area of choice.
  • Rural areas remain a great place to get your initial experience and get a job quickly.
I'm also hearing that hospitals are considering applicants as "experienced" after working 15 months. These nurses have often moved into specialty areas of choice in a shorter period of time.

Based on what I'm hearing, the US nursing job market is improving!