Across the country, schools of nursing faculty have broadly defined the concept of nursing "practice," to encompass delivery of direct patient care, as well as educational, administrative, and policy roles in the development of doctor of nursing practice (DNP) programs. Curricula for advanced nursing practice (ANP) master's educational programs are filled to capacity with little room to add content for new knowledge and skills that are currently mandated for basic and advanced competency in today's healthcare practice environment.
The DNP degree is a natural next step for practitioners and creates a viable option for the clinician who is not interested in pursuing a PhD degree or research career but who does want to earn a terminal degree in nursing. Unfortunately, divergent opinions abound about the DNP degree. The process of moving toward a degree of standardization and consistency across DNP programs is progressing and holds promise.
Is the DNP degree right for me?
Why should nursing not have a practice doctorate as do most all other major healthcare professions? Why should nursing students continue to earn only a master's degree for completing course work that extends well beyond that standard comparatively? Is it not preferable to learn advanced leadership skills rather than lead under fire on the position?
The DNP is a practice doctorate conceived to prepare advanced clinical leaders in developing the skills necessary to bring about change within a healthcare organization to improve quality of care and health outcomes. An advanced degree, such as the DNP, does not cancel out maintaining clinical practice. Quite the opposite really-the DNP graduate is expected to continue to practice with an expanded knowledge base and an enhanced skill set. Advanced practice nurses (APNs), particularly NPs, are challenged daily to demonstrate that they possess the educational preparation and clinical training to be independent providers of care. The DNP degree is no quick fix, but it is a step in the right direction.
This month's issue features three articles related to DNP education. Boland, Treston, and O'Sullivan write on the development of the DNP degree, how to evaluate options in choosing a program, and future issues and considerations. The authors discuss the American Association of Colleges of Nursing (AACN) recommendations that the DNP become the entry level for ANPs by 2015; the AACN's The Essentials of Doctoral Education for Advanced Nursing Practice, which are meant to guide curriculum development in DNP programs; the competencies for DNP graduates developed by several NP professional organizations; and policy and legislative considerations pertinent to APN practice in the current and future healthcare fields.
Langston and Appel present the results of an inpatient smoking cessation interventional program for self-reported smokers with coronary artery disease. Mai Kung examines point-of-care rapid influenza diagnostic tests, providing evidence-based guidance on indications for testing, patient selection, reliability of available tests, cost, and legal, ethical, and cultural considerations for testing. I am sure you will find all three of these articles interesting and informative.
Practice makes perfect
My personal definition of nursing practice follows the old meaning of the term-practice is providing direct patient care. Throughout my professional career, as positions and roles would pull me away from the bedside, I have insisted that I maintain clinical practice, which is the very reason I became a nurse. I am intuitively and functionally a self-proclaimed DNP clinical scholar who remains grounded and energized by practice.
As more and more nurses pursue DNP degrees, the commitment to and the practice of "practice" must not be forgotten or forsaken.
Jamesetta Newland, PhD, RN, FNP-BC, FAANP, FNAP
Editor-in-Chief [email protected]