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DNP Discussions

DNP Graduates: Agents of Social Change

Published January 18, 2017 10:31 AM by Rebecca Bates

As we prepare for a new POTUS, many of us are considering the imminent social changes that directly impact our patients and our profession. In September, we started precepting MSW students in addition to NP and CNS students in our free clinic. The students started with providing SBIRT screening and have expanded, in the past five months, to helping patients navigate the health and social welfare system. Our clinics only provide primary care services to people who live <200% FPL and have no insurance. Consequently, referrals to specialists and surgical consults are challenging and many have barriers to healthy living, such as housing and food insecurity, low income, serious mental illness, recent immigration or language other than English as a first language. As we seek to help patients optimize their health and wellness, I have realized the importance of my competency in all of the DNP Essentials to create a new system of care.

Imagine if everyone had access to appropriate and affordable healthcare at a time and place of their choosing.

This is my goal. Last month, in this column, I considered how the DNP Essentials help achieve this goal. What if we expand this consideration to our interprofessional social work colleagues?  I have learned that social work can follow at least two different tracks (similar to nursing): a clinical or an administrative track. The administrative track is called "social change," and the students who choose this track would be more interested in leading a non-profit organization than counseling individual clients. Many of their nine competencies mirror our eight DNP Essentials.

They are expected to be competent in:

  1. Ethical and professional behaviors
  2. Engage diversity and difference in practice
  3. Advance human rights and social, economic, and environmental justice
  4. Engage in practice informed research and research-informed practice
  5. Engage in policy practice
  6. Engage with individuals, families, groups, organizations, and communities
  7. Assess individuals, families, groups, organizations, and communities
  8. Intervene with individuals, families, groups, organizations, and communities
  9. Evaluate practice with individuals, families, groups, organizations, and communities

The power of interprofessional education and practice is amazing!  When we lead by example through engaging our colleagues to truly care for individuals, families, groups, organizations, and communities, our ability to deliver high quality, cost-effective, evidence-based care is magnified. Our individual patients, families, and communities benefit directly and indirectly through a healthier population. This translates into a healthier economy, improved economic and social stability, and improved quality of life.

As DNP graduates, we are healthcare leaders responsible for shaping the course of healthcare. What better time to showcase and demonstrate our competencies, and those of our interprofessional colleagues, than when our country is going through a major social change with healthcare at the forefront of the discussion?

How will you voice your opinions? Will you have a seat at the table in these assessments, planning, interventions, and evaluations? If we do not speak up for our patients, our profession, and ourselves, someone else will. I urge each of you to be the healthcare leader you were educated and trained to be. We must all practice to the full extent of our education and training and embrace our scope of practice to transform healthcare and social change. Join me!


To the "lowly MSN, NP," why can't DNP's participate in health care management or be a "change agent," regardless of what industrial aspect in our healthcare enterprise? The core of this practice doctorate is saturated with system wide health care managerial concerns, identified deficits, and thereby designing a project or intervention at the doctorate level specifically intending to improve our current health care paradigm.

MD Student, DNP February 3, 2018 8:31 PM

As a practicing FNP and as adjunct faculty in both didactic and clinical courses at multiple universities and as a clinical preceptor for MSN and DNP students, I fully appreciate the impact all nurses have the ability to make in healthcare.  In addition, nursing is not the only discipline to affect change in healthcare, but we are the largest group of healthcare professionals with about 3.6 million nurses in the U.S.  We need all APRNs and all healthcare professionals to engage in healthcare reform, developing new models of care, and educational and research pursuits.

The DNP is a practice degree, not an educational degree.  

This blog is about DNP Discussions and therefore, I try to provide the motivation for all of us who have completed a DNP, are working toward a DNP, or are considering a DNP.  There is no doubt that the DNP transforms the individual from the expectations of the MSN Essentials.  This is not to say that only DNPs can create change.  All healthcare professionals have the ability to impact change.  

I would like for all of us in healthcare to think about and how we can impact health outcomes for our patients, families, and communities using evidence-based practice, health policy, technology, inter professional education, leadership, population health models, and scholarship.


Rebecca Bates February 14, 2017 10:34 PM

In response to the last comment by the MSN, FNP.  The DNP is a clinical degree to promote clinical change and implement research into practice. %0d%0a%0d%0aOne problem of our nursing profession, little support of our discipline and little support for each other.  APRNs are change agents, let's work together for our populations. "It is not about us" our shared responsibilities are to help the  people we serve.

Audrey Taylor-Bond, Rad-Onc - DNP February 14, 2017 4:46 PM
Detroit MI

A comment for Grant. I do not think the author, Mrs. Bates excluded MSN practitioners (CNSs, NPs). I think she emphasized on practicing full extent of DNP education and training. They are different from MSN education and training. Reply to Mrs. Bates. I agree with the power of interprofessional approach. I think educators need to be educated, updated and be aware of rapid socioeconomical changes. I do not think this is happening in academia, thus creating a deep gap between reality and academia. Also, there seems gaps among public health, nursing, social work and medicine. Health education system needs to be updated and improved in order to fill the gap - in this way, "our" voice will be together, stronger and heard.

Keiko Kuykendall , Geriatric - DNP, IFH February 14, 2017 4:40 PM
Falls Church VA

Thank you for your insight Dr. Bates.  DNP's are well trained and positioned to be change agents.  Just to clarify a previous point, DNP's can also be in the trenches as well as educators.  I believe we can all stand united (AD, BSN, MSN, DNP) to be change agents and speaking as a DNP and member of the nursing profession, there is no time like the present to get started.  

Lisa, Nursing - DNP, primary care February 14, 2017 4:27 PM
Roanoke VA

I do not think DNP should be center as agent of change. As a lowly MSN NP I wonder why a person that is more educated in management and education (DNP) should speak for the practitioner in the trenches. No we should be the ones make the change. Let DNP teach and stay out of the way.

grant, Family - FNP, retired Gov. February 14, 2017 2:05 PM
Braxton MS

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