I’m A Doctor-Nurse

Summary

Mary Lou Heater, a Doctor of Nursing Practice (DNP), discusses her role as a Clinical Nurse Specialist (CNS) in psychiatry, the nuances of her professional title, and the varying perceptions of her expertise in the healthcare field.

Abstract

Mary Lou Heater introduces herself as a doctor-nurse, clarifying that she holds a doctorate in psychiatric nursing rather than a medical degree. In Texas, nursing professionals with a DNP can use the title 'doctor.' The DNP is the highest level of practice-based nursing education. Heater, who has been an advanced practice nurse since 2000, specializes as a CNS rather than a nurse practitioner, midwife, nurse anesthetist, or clinical nurse specialist. Advanced Nursing Practice extends nursing's scope, contributing to nursing knowledge and professional advancement. Despite her extensive education and versatile roles, including professor, provider, therapist, consultant, researcher, and administrator, her scope of practice is limited by state regulations, and she is often mistaken for a nurse practitioner. Heater prefers to be addressed by her first name to avoid communication barriers with patients, although she is academically qualified to be called 'doctor.' She reflects on the societal acceptance of the 'doctor' title for other professionals and the controversy surrounding titles, as seen with Dr. Jill Biden. Heater emphasizes that her title does not define her, and she values the mutual learning experience with her patients, who come from diverse backgrounds.

Opinions

Mary Lou Heater believes that the title 'doctor' should not cause confusion among patients, as it is used by various doctorally prepared professionals without mix-up.
She feels that the healthcare agency she works for underestimates patients' ability to understand her role by avoiding the title 'doctor.'
Heater values the educational and experiential aspects of her profession over the title itself, emphasizing that she is more than just her credentials.
She acknowledges the diversity of her patients, recognizing that each individual, regardless of their background, has something valuable to offer.
Heater subtly critiques the societal attitudes towards professional titles, especially when considering

Is that confusing?

It slides off my tongue so easily now. “My name is Mary Lou Heater, I’m your doctor. I have a doctorate in psychiatric nursing, so I’m a doctor nurse, not a medical doctor.”

In Texas, you are “allowed” to call yourself doctor if you identify as a nurse.

The Doctor of Nursing Practice degree (DNP,) is a clinical, terminal degree in nursing. The is no higher level of education available for practice-based training in nursing.

I earned a DNP in 2011, but have practiced as an advanced practice nurse (APRN) in psychiatry since 2000. Confounding the issue perhaps is that I’m not a nurse practitioner. There are four different APRN credentials: midwife, nurse anesthetist, nurse practitioner, and clinical nurse specialist (CNS).

Advanced Nursing Practice is a field of nursing that extends and expands the boundaries of nursing’s scope of practice, contributes to nursing knowledge, and promotes the advancement of the profession (RNABC Policy Statement, 2001). ANP is characterized by the integration and application of a broad range of theoretical and evidence-based knowledge that occurs as part of graduate nursing education.

I am a CNS, which was the first nursing advanced degree (masters) ever awarded, and it was in psychiatric nursing to boot. Specialty trained, I can practice as a professor (mentor, preceptor), provider/prescriber, therapist, consultant, researcher, or an administrator. And I have worked in all those roles in my career.

But the scope of practice varies by state. Regardless, folks still call me an NP, if not doctor, go figure.

Preferring to be called by my first name, I tell my patients I find titles a barrier to communication. This works out well because the agency I work for thinks it would be too confusing to my patients if I were to be addressed as doctor.

I think that’s selling people short.

Psychologists, astrophysicists, dentists, veterinarians, and other doctorally prepared professionals are addressed as doctor and folks don’t confuse them with their primary care physician or psychiatrist.

But then remember the comments about Dr. Jill Biden.

The title of doctor does not confer magical powers.

I am not my title, any more than my patients are their diagnosis. I happen to be a human being educated, experienced, and credentialed to care for the mentally ill. I am trained in diagnostics, pharmacology, and psychotherapy. I attended nursing school.

A medical doctor is a human being educated in medicine and earns a professional degree as a surgeon or physician. She/he attend medical school.

My patients are human beings that may be skilled or unskilled, technically certified or advanced degrees, grade school dropouts, or high school grads, but they always have something to teach me.

Out of respect, cultural norms, or habit some folks call me Dr. Heater or Dr. Mary Lou but as the old saying goes — just don’t call me late to dinner.