1. Beglinger, Joan Ellis MSN, MBA, RN, FACHE, FAAN


Nurses are knowledge workers. The evidence that informs our practice is ever changing, and we recognize that one of the obligations of knowledge work is lifelong learning. There is a newly emerging phenomenon occurring in our profession-one that we did not see a decade ago. Increasingly, chief nursing officers (CNOs) are pursuing advanced degrees late in their careers. This month, we will shine the spotlight on what's driving this change and gain insights from conversations with 3 CNOs, all recently having attained a DNP, after an astounding, collective 110-plus years in practice.


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Why would a successful chief nursing officer (CNO), at a point in his/her career trajectory when thoughts of less hectic days and a relaxing retirement might occupy the mind, invest time, energy, and resources in attaining another degree? Transformational leaders lead by example. As we mobilize to achieve a national goal of "increase the proportion of nurses with a baccalaureate degree to 80% by 2020,"1(p12) recent DNP graduates express the belief that there is no more compelling statement they can make to others than to advance their education. The message is clear. Nurses are lifelong learners.

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In addition to the desire to lead by example, CNOs express an understanding of the tremendous fluidity of healthcare structures and roles, fueled by the turmoil of the changing healthcare environment. Educational preparation is a way to prepare and position themselves for emerging roles and opportunities. It is clear that the future will require more competence from the CNO than ever before and present new opportunities for leadership.


There was yet another factor, identified by recent DNPs, as motivating their decision to return to a formal educational program. This was the pursuit of new knowledge that might inform their thinking in new ways, to generate new solutions, in a dramatically changing world. The more experienced the CNO, the greater the awareness that everything we may think we know is subject to change in a new world. New theories, new applications, learned professors, and fellow students all held the promise of a rich and stimulating experience from which the CNO would grow and emerge with new tools, renewed confidence, and expanded networks.


The Experience[horizontal ellipsis] and a Few Words of Wisdom for Colleagues

Recent DNPs interviewed for this column consistently expressed both relief that the work had been completed and great satisfaction with their decision to proceed with this tremendous undertaking. It was noted that experienced CNOs are uniquely positioned to contribute what they have learned over the years to the learning environment, while simultaneously applying what they were learning, through their coursework, to practice. Significantly expanded knowledge and skills, coupled with greatly enhanced confidence in the ability to lead, were universal outcomes of the educational experience. Here are some words of advice for colleagues contemplating a similar path.


Select a Program That Meets Your Needs

There are significant numbers of emerging DNP programs that are responsive to a variety of learning needs and styles. There are programs that utilize online formats, as well as traditional classroom settings. There are programs that are focused on an area of concentration, such as leadership, those that have a structured curriculum, and some that allow for significant customization. A prospective candidate is well advised to be clear about personal and professional goals to enable the ideal matching of needs and interests with program structure and content.


Design Your Experience to Facilitate Growth and Goal Attainment

With a clear scholarly focus, individual course assignments can be used as building blocks for your scholarly project and for career advancement. As an example, a literature review for a research course may serve as the foundation for the literature review related to the scholarly project; however, the learner should consider linkages among courses or with career opportunities.


Be Organized

A resounding and consistent theme from recent DNPs is the sometimes overwhelming challenge of juggling the demands of full-time work with the demands of the educational program. Suggestions for survival include setting aside realistic amounts of time to read and write and finding ways to say no, when possible, whether to an optional assignment at work, a volunteer professional activity, or hosting a family dinner. This endeavor is time limited, and during its course, something has to give.


Select a Scholarly Project Over Which You Have Some Control

The world of a CNO provides significant access to the healthcare environment, creating the conditions to make a well-chosen scholarly project easier to complete. Recent DNPs suggest considering the ease of completion when selecting a project, emphasizing that you do not need to complicate your life by pursuing a project whose elements are outside your access, beyond your control, or unachievable within a realistic timeframe.


Release Yourself From the "4.0" Mindset

Many of us are high achievers. Grades mattered as we progressed through our academic programs throughout our lives. As a late-career DNP student, it is time to release yourself from the mindset that anything less than a 4.0 grade point is unacceptable. Now is the time to immerse yourself in the luxury of learning to improve performance. Perfection is not required.


Enjoy Your Cohort of Fellow Students

The pursuit of the DNP certainly holds the potential to be overwhelming at times, as the competing demands of work, home, and student life compete. The support and encouragement of fellow classmates are an important and helpful part of the experience. The common experience of student colleagues uniquely positions the peer group to provide support.


Forever Changed

Perhaps most inspiring in the reflections of recent DNPs are their thoughts about how they have been personally and professionally changed by the experience. Included in their musings are renewed credibility to articulate the importance of, and lead the pursuit of, baccalaureate education and beyond, for all nurses; new leadership knowledge and competency, an expanded world view of leadership development; the commitment to contribute to the body of nursing knowledge; and renewed commitment to clinical scholarship and education. Renewed confidence and extreme pride in this incredible accomplishment punctuate the experience in a way that portends well for the future. It seems likely that we will continue to see increasing numbers of our seasoned colleagues pursuing their DNP as a strategy to prepare for an uncertain and challenging future. Let's celebrate them and cheer them on, as they gear up, while some are winding down.



The author thanks Paula Hafeman, DNP, RN, FACHE; Barbara Pinekenstein, DNP, RN-BC, CPHIMS; and Susan Rees, DNP, RN, CPHQ, CENP, for their inspirational sharing of their experiences and insights.




1. Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine. The Future of Nursing; Leading Change, Advancing Health. Washington, DC: The National Academies Press; 2011. [Context Link]