Advanced practice nursing and the 2015 DNP
The word is definitely out. Maybe since it’s now 2011, the rumor mill is churning more. The Internet and the bedside seem to be fraught with opinions, questions and down right confusion. From my own circle of the world it seems that everyone wants to know ‘what is up’.
Let me clear the air and maybe shed just a shred of light on the subject of the DNP role and how it affects the world of Nurse Practitioners past, present and future.
- In 2004, the American Association of Colleges of Nursing (AACN) published a ‘position’ paper on the transition from the current Master’s degree prepared requirement (MSN) for Advanced Practice Nurses to the Doctor of Nursing (DNP) terminal degree requirement (via AANP.org). (actual position statement from AACN is here)
- This position statement stemmed from a previously released Institute of Medicine (IOM) comprehensive report concerning medical errors and patient safety. (Yes the very same organization that released : The Future of Nursing: Leading Change, Advancing Health in 2010)
- A PhD is not a DNP. I do not know or think that the PhD is suitable for ‘substitution’ of the DNP degree. The DNP degree is clinically based, where the PhD is theoretic-academic based. Forgive me for such a loose description.
- I believe it will eventually apply to all Advanced Practice Nursing degrees, which includes Nurse Practitioners, Nurse Mid-Wives, and Nurse Anesthetists (CRNA). I read somewhere this may also include Clinical Nurse Specialists at some point (CNS specialty).
- This is a joint-task effort on the national and state level. The National Council of State Boards of Nursing as well as other organizations not mentioned are following in-line with these new requirements.
- The DNP program is active in many schools across the nation already. Many MSN programs are being phased out completely to make the way for the new standard. So applying for a Master’s in Nursing is actually not possible at some institutions.
- Current MSN students will complete their program and then will be required within a certain time frame (no I don’t know how long) must attend a ‘bridge MSN-DNP program’ and attain their DNP. The may start actively practicing as an advanced practice nurse (given they possess all their needed certifications), but will eventually have to have the DNP degree.
- Currently active practicing advanced practice nurses (NP & Nurse Mid-wives mostly) can continue to practice, but they too must enroll in a ‘bridge MSN-DNP program’ with the same specific standards as the new MSN graduate. Once again I do not know the time frame allotted for completion.
- This process is not immediate. The transition is being displaced over a number of years. This transition also addresses current MSN students as well as currently practicing Advance Practice Nurses (NP, Nurse Mid-Wives, etc.)
- The DNP program is a concentration in nursing clinical practice and will require a great deal more clinical time, education, training, and skill. This of course will include rigorous efficiency in evidenced based research.
- The ‘requirement’ to possess the DNP has not been set in stone (or on paper) as of yet. All of these changes are with the intent and assumption that it will be by 2015.
- While the DNP is of course more intense and has many more hours required, the total time in a specific program is only lengthened from generally a 2.5 year program to a 3.5 year program (this is just a loose estimate).
This of course is not an all inclusive list. I don’t have expert knowledge on the inner workings of the framework. What I can tell you is this is happening whether you like it or not, whether you agree with it or not. I used to tell myself this DNP requirement was like the rumor about all RN’s will be required to have their BSN. That all hospital based degree programs and all ADN programs were disappearing.
Unfortunately we are talking about advanced nursing practice, not basic nursing skills 101.
The truth of the matter is, and the evidence supports this : the higher the education level the safer the level of patient care. Sorry folks, for some that is a hard pill to swallow. Whether it be an advanced certification or the advanced degree, possessing more knowledge benefits our patients.
And honestly, isn’t that all that really matters?
If you have anything to add please leave a comment below. What did I miss?
Sean Dent is a second-degree nurse who has worked in telemetry, orthopedics, surgical services, oncology and at times as a travel nurse. He is a CCRN certified critical care nurse where he's worked in cardiac, surgical as well as trauma intensive care nursing.
After five years practicing as an RN, Sean pursued and attained his Masters of Science in Nursing. Sean currently practices as a Board Certified Acute Care Nurse Practitioner (ACNP-BC) in a Shock Trauma urban teaching hospital.
He has been in healthcare for almost 20 years. He originally received a bachelor's degree in Exercise and Sport Science where he worked as a Certified Athletic Trainer (ATC).
By Sean Dent