The Doctor of Nursing Practice (DNP) degree has arrived. While no absolute mandate exists for nurses to pursue this clinical doctorate, nurses are overwhelmingly choosing the DNP. In fact, according to the American Association of the Colleges of Nursing (AACN), over 200 colleges and universities are conferring the DNP degree to nursing graduates, while approximately 18,000 students are enrolled and over tens of thousands of DNP graduates exist. One may ask, “What is fueling this exponential growth?” The reasons are vast and include:
- AACN’s Position Statement on the Practice Doctorate in Nursing that called on nursing programs to transition from conferring master’s degrees to doctorate degrees for advanced practice nurses by 2015;
- the National Organization of Nurse Practitioner Faculties document, The Doctorate of Nursing Practice NP Preparation: NONPF Perspective 2015, that recently reaffirmed the DNP for entry-level for the nurse practitioner role;
- the Institute of Medicine’s 2011 landmark report The Future of Nursing: Leading Change, Advancing Health’s recommendation of doubling the number of nurses with a doctorate degree by 2020;
- increased financial support from public and private foundations in the form of scholarships and grants for doctoral degrees in nursing;
- our health care system’s seismic reform of how care is delivered with a hyper focus on health outcomes and how care will be reimbursed on quality rather than volume.
The aforementioned collective reasons for the DNP make a compelling enough case to justify the degree, but the most important reason is the impact the DNP has on patient care. This is where the DNP degree possesses the greatest potential to transform patient interventions leading to enhanced outcomes. One of the foundational tenants of DNP curricula is evidence-based practice. While this concept makes perfect sense, the reality in clinical practice is that decision making is not always made based on the best available evidence. A confluence of factors, including institutional and patient psychosocial barriers, can make evidence-based practice nearly impossible to fully adopt.
DNP-prepared nurses are typically prepared to systematically review evidence and critically appraise data. Current and future clinicians need not only be proficient in diagnostic and treatment acumen but also in analyzing the vast loads of available data. Translating evidence into practice is another important DNP concept because duplicating a prior successful intervention into another particular setting is not always ideal nor possible. DNP-prepared nurses acquire a skillset intended to artfully meld this new knowledge in clinical practice leading to improved outcomes that are measurable while having the ability to refine the interventions as needed.
Other components of DNP education include health economics, information technology, population health, legal/ethical issues, and health policy. These additional areas comprise health care today and are just as significant as understanding the pathophysiology of diseases. For example, many DNP-prepared advanced practice nurses in particular are advocating to eliminate outdated and archaic practice barriers that will ultimately lead to increased access to care. One such barrier is the federal restriction of nurse practitioners being able to prescribe medication for patients addicted to heroin. DNP-prepared nurses are leading the way to advocate for this important change.
As advanced practice nursing programs transform to the doctoral level, we can finally put to rest the question of whether one should return to school for the DNP. While debate may remain regarding the variety of DNP program offerings, it is time to recognize the contributions of these uniquely educated clinicians. The DNP degree is here and thousands of DNP-prepared nurses are practicing in the system today. As the number of DNP graduates grow, we can expect a health care workforce comprised of doctorally-prepared nurses to meet the demands of the ever-changing health care system.
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