People commonly question the utility, standardization, and compensation associated with the Doctor of Nursing Practice (DNP) degree. It's a fair question and one that elicits a variety of answers. While there is a lot of data to support the benefits of additional education, many nurses who have their DNP degree report personal satisfaction and wanting a seat at the table. I emphasize DNP nurses, as this question is mostly directed toward the DNP degree and not the PhD (referring to the variations in curriculum). In this article, I thought it would be fun to share an article I wrote during my DNP residency course at the George Washington University. I discuss the changes in healthcare that led to the development of the DNP degree and the push for more doctorally-prepared nurses and how, at the time, I could incorporate the DNP Essentials into my practice. As I celebrate two years since graduation, I invite you to reflect with me and thousands of graduates this season to remember your WHY. May this walk down memory lane reach someone who needs inspiration.
The picture above is from the graduation ceremony for my Master's in Nursing where the commencement speaker was then President of the American Association of Nurse Practitioners, Dr. April Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN.
~6 minute read
Background
I enrolled in the BSN to DNP program at the George Washington University from 2016 to 2022 part time while continuing to work full time at the bedside as a staff nurse in DC and subsequently as a travel nurse (starting in Indiana and ending in Colorado) until the summer of 2023. This article, was written for my first DNP course in the summer of 2019 after graduating from the Adult-Gerontology Primary Care Nurse Practitioner program that May.
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Doctor of Nursing Practice
The Doctor of Nursing Practice (DNP) is one of two terminal degrees in nursing and the preferred route for those interested in specialized advanced nursing practice (American Association of Colleges of Nursing, 2015). Several healthcare changes in the 21st century led to the call for nurses to receive higher levels of education in new ways to prepare for the changing landscape and escalating demands. With the passage of the 2010 Affordable Care Act, more Americans received access to healthcare requiring nurses to fill expanding roles, master information systems and coordinate care with interdisciplinary teams. Adults aged 65 and older became the fastest growing age population and were projected to become 20% of the majority by 2030. These changes shifted the focus of nursing care and education from acute illness and injury to chronic disease management of diverse communities (Institute of Medicine, 2010).
The Creation The DNP degree was created in 2004 after the American Association of Colleges of Nursing (AACN) Board of Directors released the DNP position statement which called for nurses practicing at the highest level to obtain doctoral preparation. In 2005, the AACN created a task force that developed the Essentials of Nursing Education for the Doctorate of Nursing Practice which outlined the DNP curriculum and competencies (American Association of Colleges of Nursing, 2006). The Institute of Medicine (IOM) joined the Robert Wood Johnson Foundation (RWJF) in 2008 to examine the state of nursing education and subsequently made recommendations that could transform the profession moving forward. In their following report, The Future of Nursing: Leading Change, Advancing Health (2010), the IOM reported nurses were uniquely suited and positioned to meet the challenges of healthcare and the needs of the population. Their recommendations called for an increase in the number of nurses with baccalaureate degrees by 2020, to double the number of nurses with a doctorate by 2020 and to promote engagement in lifelong learning (Institute of Medicine, 2010).
DNP Essentials The eight DNP Essentials address the core competencies considered essential for all DNP graduates regardless of speciality or functional focus (American Association of Colleges of Nursing, 2006). In my current role as a bedside night nurse on a medical-surgical telemetry unit, I can begin to address DNP Essentials I, II, III, IV, V, VI and VII. I recently joined the Nurse Practitioner Association of the District of Columbia and I plan to join the Virginia Association of DNPs so I can inform policy makers, help shape legislation and generate new clinical policies (Essential V) (American Association of Colleges of Nursing, 2006). I can research the latest evidence applicable to my area of practice that can be applied to improve our multidisciplinary rounds which have been underperforming in large part because of the nursing staff (Essentials I, II, III and VI). I can research innovative ways to disseminate this information to managers, educators and directors, and then present it to the staff directly. I can then collect data, evaluate the outcomes and create the policy on how to effectively conduct multidisciplinary rounds (Essentials I, II, III, V and VI) (American Association of Colleges of Nursing, 2006).
Incorporating the DNP Essentials into Practice I can collaborate with local high schools to increase awareness and educate the students (and the community) about the vast array of options a career in nursing can offer and the numerous contributions they can make as leaders via scholarship, innovation, population health and policy change (Essential I and II) (Institute of Medicine, 2010). I can reach out to interdisciplinary health care professionals and organizations so we can collaborate on innovative ways to address the community at large about the benefits of care coordination and local resources (Essential VI and VII). Using evidence-based practices and after identifying shared interests, we can create elevator pitches to lobby legislators in preparation for the local election season (Essential I, II, V, VI and VII) (American Association of Colleges of Nursing, 2006; Pritham & White, 2016).
My Love for Medical Education I can create new online geriatric educational content for clinical and non-clinical staff for my DNP Project (Essential IV and VI). This endeavor uses science-based theories to serve as the resources for the content on the nature and significance of geriatric health and healthcare delivery mechanisms within the organization, and can be used to evaluate the outcomes of practice change (Essential I and VI). While developing the content for online modules, I would compare the clinical practice guidelines provided by the corporate office to the latest interprofessional practice models for geriatric care and collaborate with them to improve practice policies (Essential V). By doing this project I would automatically take an informal leadership role in education with an aim to improve the practice environment and health of the geriatric population at the hospital (Essential I and VII ). I would evaluate the health outcomes and data for quality improvement projects, and then lead program development and evaluation (Essential II and VI) (American Association of Colleges of Nursing, 2006; Pritham & White, 2016).
I could disseminate the results of my DNP Project by submitting a summary for the two monthly newsletters. Then, I could present my project and its findings during the annual nursing convention and perhaps to the nursing, medical, and dental students at the sister university (Essential III and VI) (American Association of Colleges of Nursing, 2006; Pritham & White, 2016).
Future Doctorate Students
If you are a student or prospective student reading this, just know that what you do with your degree(s) is all up to you and your imagination. At the bachelor's level, people tell you how to think. At the master's level, people want to know what you think. At the doctorate level, you become the people.
Institute of Medicine. (2010). The future of nursing: Focus on education. Washington, DC: The National Academies Press.
Moran, K., Burson, R., & Conrad, D. (2016). The Doctor of Nursing Practice Scholarly Project. (2ne ed.). Burlington, MA: Jones & Barlett Learning. Pritham, U. & White, P. (2016). Assessing DNP impact. The Nurse Practitioner, 41(4), 44-53.
Kimberly Madison, DNP, AGPCNP-BC
Kimberly Madison is a nurse practitioner with a passion for writing, entrepreneurship, education, and mentorship. I created this blog to share my journey as source of motivation and as a blueprint as you embark on your journey. Most importantly, I’m looking forward to increasing access to dermatology education and clinical training for aspiring and practicing nurse practitioners. I invite you to view the mission and vision statement on the homepage to see how we can best partner to make our dreams align.
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