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DNP Answers

Inspiration to Get a DNP Degree

Published January 20, 2012 9:50 AM by Catherine Nichols
To DNP or not to DNP, that is the question.

I am an adult nurse practitioner currently working with a vast array of multiple socioeconomic status, multicultural, multilingual and indigent populations, diagnosing and treating breast cancer patients and survivors. The outpatient clinic is in urban Detroit, and is a research-based teaching hospital that is accredited by the National Cancer Institute, one of an elite 40 in the country.

The process of obtaining my MSN and subsequent NP licensure facilitated my personal goal to obtain my doctoral degree. This process opened my eyes to the innate set of challenges and unique facets of the nursing profession. As I was acquiring the MSN and throughout my DNP experience, it has not ceased to amaze me that nursing is the only profession with a multitude of entry-level educational requirements. This dilemma first points to the need to define nursing as a profession or merely a “job.” Historically, nurses have been seen as “physicians' helpers,” dependent upon the medical and other disciplines for our mere existence in the healthcare arena. There are no other disciplines and professions that have constantly been under the “thumb” and direction of another discipline. Medicine has historically thought itself the guide and director of nursing, sometimes to our advantage, but vastly to our loss. The paternal relationship between medicine and nursing has stifled our progression and professional autonomy, while at the same time, created an environment of nursing dependent upon another profession for direction and guidance. As I look at other nurses, and even advanced practice nurses, I am constantly reminded of these truths through such beliefs and statements as, “Nursing needs to be more medically focused,” and “We don’t need all of that nursing theory, what a waste of time.” How can we, as a nursing profession, develop and grow in our own right, discipline and thought without a theoretically defined base identifying who and what we are?

The issue of our autonomy as a profession is answered in the development of a standardized terminal nursing degree. The DNP is the standardization of the nursing discipline, and will provide a theoretic al, research and practice focused nursing role, giving us parity with other positions. It is imperative we rely on our own discipline for autonomy, meaning, direction and focus. The DNP degree will provide excellence in healthcare provision, unparalelled to previous nursing care.

I picture nursing as a journey, rolling through the current maze that is the healthcare system. The power of the journey is nursing theory to guide and navigate our practice as an independent practice discipline. We have struggled for autonomy and independence since well before the days of Florence Nightingale who championed this effort on our behalf. The question she and we continue to ask is, are we a job or a profession? The doctor of nursing practice degree will hopefully and finally legitimize nursing as an autonomous discipline in its own right, providing true collaboration with other professions, not direction under other professions. We are nurses.Let’s "roll on" in this healthcare journey.

Editor's note: Here at the DNP Answers blog we take your questions about the DNP and answer them as best we can. This question is answered by blogger Catherine Nichols, MSN, ANP-BC, a DNP student and adult nurse practitioner. Comment below to discuss this topic, or send new questions to jford@advanceweb.com.

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posted by Catherine Nichols

5 comments

Carolyn,

    I appreciate your thoughts and concerns. Until I enrolled in the DNP program, I was unable to grasp the depth and completeness the DNP brings  to both my personal clinical practice and to the nursing profession itself, as well as actively answering the call by the IOM to "redesign and reinventing" our healthcare system (2001).

    As DNP's we are prepared to provide the type of care necessitated by our current fluxuant healthcare system. The DNP degree prepares us to translate knowledge into practice, collaborate at an interdisciplinary level that is par with our colleagues, relate the changing technology of healthcare to our patients and surroundings meaningfully, increase access to care by providing primary care to all (underserved and uninsured), and the list goes on (IOM, 2001). This is accomplished on a level not previously seen or understood by nursing The DNP transforms not only clinical practice, but our very crippled healthcare system.

    To me, these are the issues and possibilities of the DNP. I am proud our profession is responding to the healthcare crisis in a transformative manor.

Reference: IOM. (2001). Crossing the Quality Chasm. Retrieved from http://www.nap.edu/html/quality_chasm/reportbrief.pdf

Catherine Nichols, Oncology,Oncology,Oncology - Nurse Practitioner,Nurse Practitioner,Nurse Practi, ,, January 31, 2012 2:09 PM
Detr MI

I also agree that DNP is not worth my time and more loans for the title "Dr" if I don't plan to go into teaching or research. With a DNP in my work setting, I'm still a nurse practitioner and it absolutely makes no difference in my salary which I'm already at the higher end of the spectrum.

Wendy, FNP January 29, 2012 6:25 PM
New York NY

Thanks for the post! I know this is a hotly debated topic, and we devoted many classroom hours to it in my graduate degree.

I too have toyed with returning to school for my DNP. However, I am not wholly convinced this is the right route ensure consistency with advanced practice nursing. We have all heard the term "high tide raises all boats," and I believe that to be true with nursing. I interpret that in this context to mean that we need to focus on standardizing the entry level process first- what ever happened to that supposed requirement of Bachelor-educated nurses? Once this is in place, then we can worry about what happens at the terminal end of the field.

The primary reason I would get my DNP would be to teach, and if there is a question as to whether I could teach without a "research-based" doctorate, then I really cannot see the value in spending more supervised practice time that I pay money for. In the end that's what I'm getting at work, and I get paid for it.

My alternative suggestion: if DNP shall be required, let's make it like a residency- everyone gets a similar degree (e.g. Family or Adult NP), and then the residency determines your practice. The residency could be incorporated in the DNP process, and would provide valuable learning experience.

As a graduate within the past year, I have felt so overwhelmed learning all the ins and outs of basic practice that would have been so helpful to learn under another NP's supervision (or MD, experienced PA for that matter). I did my Masters degree in Maine, where there is a required 2-year supervisory period post-graduation during practice. Although I don't think it should be state-mandated like that, I do value the opportunity for a safe learning environment to get me "NP legs" under me.

I think residency in this context makes sense, rather than an advanced degree without reliable return on the investment. However I welcome others' perspective in this matter!

Hannah, Pediatrics - FNP, Primary Care Office January 23, 2012 2:08 PM
Tacoma WA

I totally know where you are coming from, Carolyn.  I was concerned the DNP would not be worth the time or money before enrolling at the University of South Carolina.  As I attempt to graduate with my DNP in May 2012, I must share that the journey I have been on obtaining this degree has been well worth the time, money, and effort spent.  There is no way you can go through this program and not come out as a better practitioner on the other side.  While I did get "appetizers" of policy and politics, the "main course" for me has been the focus on evidence based practice.  It is so exciting to be able to see your ideas for improvement in practice be guided by more experienced nursing researchers and NPs and then come to fruition.  Good luck to you as you consider your journey down this path!  You will not regret it!

Jamie Cunningham, Cardiology/EP - ACNP, Providence Hospital January 23, 2012 12:01 PM
Columbia SC

This is an issue I struggle with. One thing to keep in mind is that the DNP is NOT a research degree and schools are moving to keep DNPs out of tenure track positions. They use the "practice degree" argument as the justification, and that may be valid.

I keep toying with the idea of the DNP, but I'm not convinced I will be a better practitioner because of that. I'm already pretty politically aware and active within this profession and so there's not much for me to gain there. Overall, so far it seems to me that I would just be jumping through hoops for the sake of that "Dr." title. Not sure it's worth the money or my time.

Carolyn Ewell, FP/IM - FNP, VA January 23, 2012 11:44 AM
Roosevelt UT

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