- Email: [email protected]
Is the Doctorate of Nursing Practice a Degree or a Role?
POINT
counter-point
Donna M. Emanuele
Donna M. Emanuele, DNP, MN, FNP-BC, RN, is assistant professor of nursing in the College of Graduate Nursing at Western University of Health Sciences in Pomona, CA. She earned her DNP from Touro University Nevada in 2009 and serves as the health policy chair for the California Association for Nurse Practitioners.
David G. O’Dell
David G. O’Dell, DNP, ARNP, FNP-BC, is the graduate program director in the College of Nursing at South University–West Palm Beach campus. His clinical focus is neurology with a special interest in neurocognitive degenerative disorders. He is one of the founders and principal members of Doctors of Nursing Practice, LLC, whose Web site, online community, and resources are part of his responsibilities and enjoyment.
Is the Doctorate of Nursing Practice a Degree or a Role? Early on at a recent training, the physician sitting next to me suddenly looked up, perplexed. The demographic information we were completing included the question, “What is your role?” “What’s my role?” he asked aloud. The fact that it was free text wasn’t helping. Luckily for him, he was sitting next to a nurse. We tend to be helpful and we know something about roles. Time was an issue, so I forwent the lecture and gave him the bottom line: “You’re a physician.” It seems to me that at least some of the brouhaha around nurses using the title “doctor” is rooted in physicians’ own role confusion, as represented in the near universal use of the title to describe the physician role (ie, “I’m the doctor”). As the number of people with a doctorate of nursing practice (DNP) degree increases and DNPs become more of a force in health care, are we setting the stage for some role confusion of our own? What do you think? Contact Section Editor Donald Gardenier at [email protected] if you would like to comment on this matter or you have an idea for a future column.
Online Poll: What is your view on this topic? Go to www.npjournal.org to vote. 644
The Journal for Nurse Practitioners - JNP
Volume 7, Issue 8, September 2011
Support
for
Support
for
the DNP as a Degree
the DNP as a Role
Donna M. Emanuele
David G. O’Dell
he DNP degree is a step forward for nursing to provide the necessary education to respond to the changing demands of the nation’s health care system. The DNP has ignited lively discussions that fuel both animosity and support. Overall, the DNP has gained favor across a wide audience of stakeholders and skeptics alike, forming alliances to transform health care and improve outcomes through translational research. The DNP has emerged as a model in which nurses contribute value through application, integration, engagement, and teaching. According to the American Association of Colleges of Nursing (AACN), the practice doctorate “builds upon the generalist foundation acquired through a baccalaureate or advanced generalist master’s in nursing,” providing preparation for specialized nursing practice to perform in direct and indirect roles across the health care environment. We should not posture academic or professional indifference over the DNP as a role versus degree. As DNPs, our role is to bring to a wide variety of leadership positions the highest level of scientific knowledge and practice expertise that prepares us to influence change and empower others’ abilities. The goal is to make a critical difference in the decision-making practices of our profession for the betterment of patient care. The DNP offers an opportunity to supply the health care workforce with nursing practice doctorates, to meet growing demands, and to maintain organizational effectiveness and care delivery on all levels of nursing practice. To suggest otherwise limits the intent of this terminal degree and inhibits the scholarly contributions from other domains of advanced nursing practice. Therefore, I argue that the practice doctorate is an academic degree, not a role. The DNP serves as a bridge between research-science and research-practice, enabling nurses to translate evidence to improve quality outcomes within all realms of practice through leadership in both the clinical and academic areas of our profession.
T
T
www.npjournal.org
he intent of the AACN’s “Essentials for Doctoral Education” is to produce competent advanced practice nurses. Most see this as addressing advanced practice as defined by the Licensure, Accreditation, Certification & Education (LACE) model and supported by multiple professional nursing organizations. However, non-APNs are earning DNPs. Does this dilute the degree, or does the diversity of those earning DNPs strengthen its impact? This conversation will likely continue for many years. The foundational question, however, is not so much who earns the degree as what impact are they having on our profession. If a nurse of any stripe can demonstrate an application of the depth of education and talents to improving outcomes, perhaps the discussion will shift from who should earn a DNP to the overarching expectation of all those who earn DNPs. As more DNP graduates begin to implement the broadened knowledge and capabilities of the degree into their practice, the shift in quality and outcomes will be the “proof in the pudding.” This return on investment has yet to be seen, but as the DNP community grows, health care delivery systems, patient care, policy, education, and research will all improve. Advanced practice nurses, in particular, have the educational and moral imperative to improve and enhance outcomes. This is the foundation of a terminal degree, particularly a professional practice degree. The need for DNP-prepared nurses is growing exponentially to keep pace with the rapidly changing needs of our patients. At the same time, nursing must accept increasing responsibility for the paradigm shift in health care delivery. DNP-prepared nurses will increasingly bring a skill set that we clearly need. Does that make the DNP a role? Maybe. I say that the challenge molds the response and that DNPprepared nurses will rise to the occasion. Exciting times are ahead.
1555-4155/09/$ see front matter © 2011 American College of Nurse Practitioners doi:10.1016/j.nurpra.2011.07.019
The Journal for Nurse Practitioners - JNP
645
counter-point
Donna M. Emanuele
Donna M. Emanuele, DNP, MN, FNP-BC, RN, is assistant professor of nursing in the College of Graduate Nursing at Western University of Health Sciences in Pomona, CA. She earned her DNP from Touro University Nevada in 2009 and serves as the health policy chair for the California Association for Nurse Practitioners.
David G. O’Dell
David G. O’Dell, DNP, ARNP, FNP-BC, is the graduate program director in the College of Nursing at South University–West Palm Beach campus. His clinical focus is neurology with a special interest in neurocognitive degenerative disorders. He is one of the founders and principal members of Doctors of Nursing Practice, LLC, whose Web site, online community, and resources are part of his responsibilities and enjoyment.
Is the Doctorate of Nursing Practice a Degree or a Role? Early on at a recent training, the physician sitting next to me suddenly looked up, perplexed. The demographic information we were completing included the question, “What is your role?” “What’s my role?” he asked aloud. The fact that it was free text wasn’t helping. Luckily for him, he was sitting next to a nurse. We tend to be helpful and we know something about roles. Time was an issue, so I forwent the lecture and gave him the bottom line: “You’re a physician.” It seems to me that at least some of the brouhaha around nurses using the title “doctor” is rooted in physicians’ own role confusion, as represented in the near universal use of the title to describe the physician role (ie, “I’m the doctor”). As the number of people with a doctorate of nursing practice (DNP) degree increases and DNPs become more of a force in health care, are we setting the stage for some role confusion of our own? What do you think? Contact Section Editor Donald Gardenier at [email protected] if you would like to comment on this matter or you have an idea for a future column.
Online Poll: What is your view on this topic? Go to www.npjournal.org to vote. 644
The Journal for Nurse Practitioners - JNP
Volume 7, Issue 8, September 2011
Support
for
Support
for
the DNP as a Degree
the DNP as a Role
Donna M. Emanuele
David G. O’Dell
he DNP degree is a step forward for nursing to provide the necessary education to respond to the changing demands of the nation’s health care system. The DNP has ignited lively discussions that fuel both animosity and support. Overall, the DNP has gained favor across a wide audience of stakeholders and skeptics alike, forming alliances to transform health care and improve outcomes through translational research. The DNP has emerged as a model in which nurses contribute value through application, integration, engagement, and teaching. According to the American Association of Colleges of Nursing (AACN), the practice doctorate “builds upon the generalist foundation acquired through a baccalaureate or advanced generalist master’s in nursing,” providing preparation for specialized nursing practice to perform in direct and indirect roles across the health care environment. We should not posture academic or professional indifference over the DNP as a role versus degree. As DNPs, our role is to bring to a wide variety of leadership positions the highest level of scientific knowledge and practice expertise that prepares us to influence change and empower others’ abilities. The goal is to make a critical difference in the decision-making practices of our profession for the betterment of patient care. The DNP offers an opportunity to supply the health care workforce with nursing practice doctorates, to meet growing demands, and to maintain organizational effectiveness and care delivery on all levels of nursing practice. To suggest otherwise limits the intent of this terminal degree and inhibits the scholarly contributions from other domains of advanced nursing practice. Therefore, I argue that the practice doctorate is an academic degree, not a role. The DNP serves as a bridge between research-science and research-practice, enabling nurses to translate evidence to improve quality outcomes within all realms of practice through leadership in both the clinical and academic areas of our profession.
T
T
www.npjournal.org
he intent of the AACN’s “Essentials for Doctoral Education” is to produce competent advanced practice nurses. Most see this as addressing advanced practice as defined by the Licensure, Accreditation, Certification & Education (LACE) model and supported by multiple professional nursing organizations. However, non-APNs are earning DNPs. Does this dilute the degree, or does the diversity of those earning DNPs strengthen its impact? This conversation will likely continue for many years. The foundational question, however, is not so much who earns the degree as what impact are they having on our profession. If a nurse of any stripe can demonstrate an application of the depth of education and talents to improving outcomes, perhaps the discussion will shift from who should earn a DNP to the overarching expectation of all those who earn DNPs. As more DNP graduates begin to implement the broadened knowledge and capabilities of the degree into their practice, the shift in quality and outcomes will be the “proof in the pudding.” This return on investment has yet to be seen, but as the DNP community grows, health care delivery systems, patient care, policy, education, and research will all improve. Advanced practice nurses, in particular, have the educational and moral imperative to improve and enhance outcomes. This is the foundation of a terminal degree, particularly a professional practice degree. The need for DNP-prepared nurses is growing exponentially to keep pace with the rapidly changing needs of our patients. At the same time, nursing must accept increasing responsibility for the paradigm shift in health care delivery. DNP-prepared nurses will increasingly bring a skill set that we clearly need. Does that make the DNP a role? Maybe. I say that the challenge molds the response and that DNPprepared nurses will rise to the occasion. Exciting times are ahead.
1555-4155/09/$ see front matter © 2011 American College of Nurse Practitioners doi:10.1016/j.nurpra.2011.07.019
The Journal for Nurse Practitioners - JNP
645