In 2019, there were 7,944 Doctor of Nursing Practice (DNP) degrees awarded, and the total number of nurses who have earned a DNP is now approximately 40,000.1 Has the degree had an impact on the practice of these doctoral-prepared nurses? Not all are advanced practice registered nurses (APRNs), and they are employed in various positions, including clinical practice, administration, and academia. All APRN as well as RN roles are represented. DNP graduates have contributed to meeting one outcome from the Future of Nursing, Indicator #2: Double the number of nurses with a doctorate by 2020. The National Organization of Nurse Practitioner Faculties issued a statement in support of moving entry-level NP education to the DNP degree by 2025.2 The American Association of Colleges of Nursing created The Essentials of Doctoral Education for Advanced Nursing Practice (DNP Essentials), containing eight items that offer a good starting point in evaluating outcomes of clinical doctoral education.3
In a cross-sectional design using conventional content analysis of narrative data, Bowie and colleagues interviewed 10 recent DNP graduates and 9 of their supervisors to explore the impact of their doctoral education on their daily work life.4 Nine completed a postmaster's DNP and one the BSN-to-DNP. The supervisors included seven nurses (three DNP, three PhD, and one master's), one physical therapist, and one physician. The overarching theme from the narratives was "becoming more: re-envisioning self as an agent of change."
Results indicated that DNP education prepared APRNs for leadership at a systems level. Authors reported, "Evidence of the DNPEssentials was realized when graduates perceived themselves as equal to other leaders and capable of driving change using evidence and effective collaboration." All of the graduates expressed that they used all the DNP Essentials to guide their practice, supported by supervisor report at 78.8% to 100%.4 Supervisors must understand the knowledge and skills DNP-educated nurses bring to an organization. The study was limited by small sample size and inherent methodological issues, such as the potential influence of "researcher, process, and setting." Studies like this one encourage The Nurse Practitioner editorial staff to continue to highlight the scholarship of DNP-prepared APRNs and their educators every April.
DNP special issue
In this DNP special issue, three articles are featured representing the work of APRNs with a DNP degree. First, Kimberly Posey, DNP, APRN, AGPCNP-BC, GS-C, discusses preparing DNP students for team-based primary care through an online interprofessional learning environment. Second, Christian Ketel, DNP, RN, and coauthors report the analysis of data from a quality improvement project about the implementation of a suicidality screening and treatment protocol in a nurse-managed primary care clinic, with an interprofessional team. And third, Jessica Van Meter, DNP, APN-BC, CCRN, A-EMT, and coauthors describe the evidence-based team training introduced in an ED as part of a disaster preparedness plan in Georgetown, Guyana. Each of these articles demonstrate the impact of the NP role in one or more areas of practice, research, education, and policy.
My personal mantra to every DNP student deserves repeating often, "It cannot be practice as usual after you graduate. Everyone you encounter must see a change in how you practice." Exemplify what clinical doctoral nursing education is intended to accomplish.
Jamesetta A. Newland, PhD, FNP-BC, FAANP, DPNAP, FAAN
EDITOR-IN-CHIEF [email protected]
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