Understanding the Role of a Doctor of Nurse Practitioner

Leading health care systems have confirmed doubling the number of doctorally prepared nurses to attain future health care interests over the past decade (Hartjes et al., 2019). However, before proceeding to attain higher education, one must understand the difference in this doctoral program between Doctor of Philosophy (Ph.D.) versus Doctor of Nurse Practitioner (DNP). The National Organization of Nurse Practitioner Faculties, committed in 2018, proposed moving nurse practitioner degree programs to DNP degree by 2025. As numerous doctoral prepared nurses to enter the workforce, other nurses consider returning to school for a terminal degree (Hartjes et al., 2019).

At the beginning 20th time, EdD degrees became possible for nurses into schools of education. Professor's at Columbia University and New York University were two of the first-degree curricula (Canady, 2020). Nevertheless, EdD degree programs lacked nursing content. During the 1940s, doctoral programs in primary and social science disciplines became possible for nurses; however, they also needed nursing focus (Canady, 2020).

Further, nursing schools began to improve doctoral programs in nursing but soon confronted queries about whether the doctoral programs should focus on the discipline of nursing or other science-related disciplines (Reid & Nicholas, 2015). In later decades of the 20th century, schools began to allow a Doctor of Nursing Practice-focused degree, the first of which was Case Western Reserve University, opening its program in 1979. In 2000, seventy-nine nursing doctoral programs were developed by universities (Canady, 2020).

In 2004, the American Association of Colleges of Nursing (AACN) inaugurated remarks about the needs and provocations facing nursing practice. It endorsed the DNP as the entry-degree for advanced practice nursing, and this made the DNP the only practice-focused doctorate in nursing (Canady, 2020). On the contrary to the research-intensive focus of the Ph.D. and Doctor of Nursing Science (DNS) or Doctor of Science in Nursing (DSN) degrees, the DNP degree focuses on enhancing nurses practice roles and translating, implementing research findings, and other evidence to improve patient, organizational, and health system outcomes (Reid-Ponte & Nicholas, 2015).

Nurses now can decipher whether to choose between a practice-focused versus a research-focused doctorate as a terminal degree for nursing. The DNP degree focuses on clinical practice and the center of the Essentials of Doctoral Education for Advanced Nursing Practice (American Association of Colleges of Nursing [ACCN] 2006), which involves leadership, advocacy, and information technology. In comparison, Ph.D. prepares nurses research based on the Indicator of Quality in the Research-Focused Doctoral Program in Nursing (ACCN, 2001).

The most distinguished variation is the degree's focus is research versus practice focused; additionally, the coursework's scope also differs significantly (Chism, 2019). The Ph.D. nurse has a focused line of research and funding to generate new nursing or health care system knowledge. Also, PhDs are autonomous research investigators with expertise in design, implementation, statistical analysis, and interpretation, utilizing research methodologies, developing theories, generalizing and replicating findings, secondary analysis of results from quality improvement projects, grant writing regulatory compliance, and academia (Hartjes et al., 2019).

While the DNP program was formed to address significant gaps in nursing practice such as patient safety; faculty shortages; an increasingly complex health care delivery system based on the Core Competencies Content Work Group in 2017; enhanced knowledge needed to improve nursing practice and patient outcomes; enhanced leadership skills needed to improve practice and health care delivery (Hartjes et al., 2019). It also strengthens nurses' clinical expertise, quality development methodologies, translating research to practice, building clinical contacts, evaluating healthcare providers' qualities, improving clinical education designs and implementation, access to quality data and indicators, and evaluating sustainability, performance measures, and financial impacts (Hartjes et al., 2019).

Though nursing's two terminal degrees differ in the center and prepare nurses with well-defined sets of competencies, these programs serve integral, alternative methods to the most distinguished level of educational preparation in nursing (Canady, 2020). Ph.D. and DNP-prepared nurses are essential collaborators when it attains accelerating the pace at which new nursing interventions are translated from the board to the healthcare bedside (Trautman et al., 2018).

The complexity of health care in today's society cannot be overstated. In fulfilling the DNP, nursing has responded to this complexity by envisioning and then implementing credentials and roles in which practitioners align with traditional researchers to combine their understanding of the science and nursing practice to further knowledge in health care in all areas (Canady, 2020). The collaboration that occurs when nurse researchers join with practice leaders redefines the discipline's path to implementing science and translational research (Trautman et al., 2018). The translational study advances patient care and supports public health by transforming scientific discoveries from laboratory, clinical, or population studies into new clinical guidelines, processes, or implementation (Trautman et al., 2018).

The evolution of the DNP program supplements the value in addressing a practice problem that has significantly impacted nursing and the shaping of health care in my workplace (Edward et al., 2018). This program prepared higher educated nurses to be proficient in evidence-based practices strategies in implementing cost-effective and high-quality care, influence health policies at various levels, and being innovative through enhancing technology.

Further, DNP roles in our hospital help raise quality improvement, enhance disaster planning, reducing hospital readmission, improve care transitions and safe care outcome, increase access to healthcare and patient flow healthcare by strengthening the framework and guidelines to achieve high-quality care in clinical expertise (Edward et al., 2018). DNP education has furthered in nursing leadership skills areas (Canady, 2020). Emphasis on quality improvement and leading collaborative teams has brought about knowledgeable engagement in quality initiatives throughout all healthcare areas, highlighting the importance of multi-disciplinary partnerships. Their ability to significantly impact all areas of the health care system can be evidenced in numerous ways, such as electronic medical records, redesign of systems of care, and patient flow through a healthcare system (Edward et al., 2018). For instance, the Director of Nursing in our department, who achieved the DNP scholar, developed a fall prevention rounding checklist to reduce falls for our altered mental patients. Implementing the fall prevention rounding checklist every shift reduces the events of fall in our department, which resulted in success and helped the risk prevention department.

Moreover, a terminal degree is the highest level of education for a specific discipline's professional or academic track. The terminal degrees in nursing are the Ph.D., DNSc/DNS, DNP/DSN, or EdD; however, some of the controversies around the DNP degree for educators where uncertainty as to what serves of the DNP in academia were Ph.D. centers on research-based strategies and its focus in the university settings (American Association of Colleges of Nursing[AACN, 2020]. Controversy surroundings refer to the standard of academic excellence that professors and administrators expect for the students, and often, rubrics and curricula were less defined. Few university settings do not accept the DNP candidate for classroom instruction, but this practice's purpose is not explicitly described (Cari & Anderson, 2016). In advancing your nursing career and achieving the terminal degree, one must understand its differences to serve its purpose. On the other hand, EdD is a route that some nurse educators would consider. The EdD can be recognized as a research doctorate or a practice doctorate. Overall, the research doctorates in nursing education center on a higher education level and scholarship and on conveying scholarly research (Sebastian et al., 2018).

Initially, I had to ask myself several times questions, such as; do I want to create knowledge that requires research and create a theory to build the science of nursing and utilize knowledge to change practice?

The DNP program is especially suited and designed to prompt me to achieve my career goals. Although there are controversies associated with the DNP's scope of practice, the issues raised by those opposing it can be resolved. Using the AACN's Essentials of Doctoral Education for Advanced Practice Nursing, curriculum guidelines can be established to ensure all DNP programs record the same rigor level in the course. The DNP degree enables me to address issues about the quality of care, patient safety, and nursing leadership in a transformative manner; nonetheless, it also ensures the sustainability and stability of the health care delivery in the long run.

References

American Association of Colleges of Nursing. (2020). DNP Fact Sheet.

https://www.aacnnursing.org/News-Information/Fact-Sheets/DNP-Fact-Sheet

American Association of Colleges of Nursing. (2006). Essentials of doctoral education for advanced nursing practice. http://www.aacn.nche.edu/publications/position/DNPEssentials.pdf

American Association of Colleges of Nursing. (2001). Indicators of quality in research-focused doctoral programs in nursing. http://www.aacn.nche.edu/publications/position/quality-indicators

Canady, K. (2020). Practical and philosophical considerations in choosing the DNP or Ph.D. in nursing. Journal of Professional Nursing, 1-6. https://doi.org/10.1016/j.profnurs.2020.06.002

Chism, L. A. (2019). The Doctor of Nursing Practice: A guidebook for role development and professional issues (4th ed.). Jones & Bartlett Publishers.

Edwards, N., Coddington, J., Erler, C., & Kirkpatrick, J. (2018). The impact of the role of doctor of nursing practice nurses. Medical Research, 6 (4), 1-11.

Hartjes, T. M., Lester, D., Ruddock, L. A., Bradley, S. M., Munro, S., & Cowan, L. (2019). Answering the question: Is the doctor of philosophy or doctor of nursing practice right for me. Journal of The American Association f Nurse Practitioner, 31(8), 439-442. https://doi:10.1097/JXX.0000000000000273

O’Connor, S. (2019). EDD vs PHD in education: What’s the difference? Northeastern University. https://www.northeastern.edu/graduate/blog/edd-vs-phd-in-education/?fbclid=IwAR3ZrSGCVogtDkFS9xxeaqPXx5Ib666p94NF4FhJigj-yO0YNt6HT19mxBM

Reid-Ponte, P., & Nicholas, P. K. (2015). Addressing the confusion related to DNS, DNSc, and DSN degrees, with lessons for the nursing profession. Journal of Nursing Scholarship, 47(4), 347–353. https://doi.org/10.1111/jnu.12148.

Sebastian, J., Trautman, D., & Cary, A. (2018). Moving ahead with the transition to the Doctor of Nursing Practice. Nursing Outlook, 66(2), 105-107. https://doi: 10.1016/j.outlook.2018.02.004

Simpson, C. S., & Anderson, D. A. (2016, March 21). The Value of the DNP (Doctorate of Nursing Practice) in Nursing Education. https://sigma.nursingrepository.org/handle/10755/602538

Trautman, D. E., Idzik, S., Hammersla, M., & Rosseter, R. (2018). Advancing scholarship through translational research: The role of Ph.D. and DNP prepared nurses. The Online Journal of Issues in Nursing, 23 (2). http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No2-May-2018/Advancing-Scholarship-through-Translational-Research.html