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In preparation for this special issue on the Doctor of Nursing Practice (DNP), we recently posed this question to our readers on the journal's website at http://www.tnpj.com, "Should the DNP be required for licensure as an NP?" It was not difficult to decide the consensus. Decisively, 75% of respondents voted "No." Demographic data were not collected, so I am unable to comment on the meaning of these results with any confidence; the population of NPs or other roles represented by the survey is unknown. I can, however, guess the reasons why some might not have answered "Yes": master's preparation is good enough; the new alphabet soup will confuse the public even more; the high expense of tuition will not translate into comparable increases in compensation; work schedules do not leave much time for studying; and many others.
Even so, the DNP degree remains a topic of lively discussion in the nursing community-by necessity in academia and increasingly due to the interest and impact among clinicians. Understandably, everyone is speculating: Will the American Association of Colleges of Nursing's recommendation that the minimum educational preparation for advanced nursing practice roles be the DNP degree become reality in 2015? To an observer outside the nursing field, this change probably seems impossible given that nursing has yet to make the decision (and commitment) to mandate a baccalaureate (BS) degree as the minimum educational preparation for entry into professional (registered) nursing. It would seem unlikely that a graduate degree would be approved before the basic degree. However, who says logic must rule?
This month's journal marks our second annual issue devoted to DNP topics and features articles written by authors who are degreed or students in a DNP program. Emily Burke's article informs us about care for immigrant women who underwent female genital mutilation in their home countries and now are in the United States. When these women seek healthcare services, NPs must examine their personal knowledge, skills, and attitudes in order to deliver culturally appropriate care. Burke aptly uses Choi's theory of cultural marginality to frame the discussion. Smith et al. report on a project that demonstrates application of skills for a competency information systems/technology expected of the DNP graduate. The authors explain how the use of clinical decision support systems and online databases can assist NPs with clinical decision making and improve the delivery of healthcare services. Kaplan and Brown report on results from a faculty survey during implementation of a DNP program and 2 years later. Their findings are very interesting and probably mirror some of the concerns of individuals who completed tnpj.com's survey. Finally, the Education Matters column sponsored by the National Organization of Nurse Practitioner Faculties addresses the DNP and certification. The DNP is an academic degree and not a license to practice; graduates who enter post-BS must become licensed before they are permitted to practice, which might also entail certification. Every NP should find useful information relevant to their position in NP education or advanced practice in one or all of these articles.
It does not matter what side you are on in the DNP debate. As noted by Kaplan and Brown, what matters is that we all remember the profession's ultimate goal is to create an educational environment that will prepare an advanced practice nurse workforce to meet the challenges of an increasingly complex healthcare system. What is your vote? Where is your voice?
Jamesetta Newland, PhD, RN, FNP-BC, FAANP, FNAP
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