NURS 8002 THE DOCTORAL DEGREE AND PROFESSIONAL NURSING PRACTICE

As I was researching the role of the DNP prepared nurse, I found many articles that compared having a MSN to having a DNP. Those articles said that employers would prefer a MSN prepared nurse over a DNP because they did not understand the role of the DNP prepared nurse. I finally came across one article that said the DNP prepared nurse was, “an individual who has the skills and competencies to lead efforts or act as a change agent within the health care system”(Walker & Polancich, 2015). The American Association of Colleges of Nurses described the DNP prepared nurse as, “nurse leaders at the highest level of nursing practice to improve patient outcomes and translate research into practice” (AACN,2022). The DNP nurse is expected to be a leader of change through patient outcomes and research. This degree differs from other degrees because it allows the DNP nurse the opportunity to create change through policy, it allows for the nurse to take on leadership roles.

My motivation for becoming a DNP prepared nurse came about one day after a hectic shift in the emergency room. I was worn out and tired, but not from the job itself. I was tired of seeing patients treated differently sometimes it was race, but most times it was social determinants of health. Patients were constantly judged by their clothing. They were almost always judged by where the providers thought they came from economically and by their housing situations. One night it made me so upset that I was unable to do anything about it and I enrolled in school the next week. I know that I can and will make a difference. I think I will meet an organization’s needs by helping to fight inequality. This can be as simple as treating all patients with kindness and like their visit today matters as much to you as it does to them.

American Association of Colleges of Nursing. “AACN Fact Sheet – DNP.” Www.aacnnursing.org, 2022, www.aacnnursing.org/news-data/fact-sheets/dnp-fact-sheet.

Walker, Deborah Kirk, and Shea Polancich. “Doctor of Nursing Practice: The Role of the Advanced Practice Nurse.” Seminars in Oncology Nursing, vol. 31, no. 4, Nov. 2015, pp. 263–272, www.sciencedirect.com/science/article/pii/S0749208115000625, https://doi.org/10.1016/j.soncn.2015.08.002.

I agree with you on the aspect that the DNP nurse is an individual who has the skills and competencies to lead efforts or act as a change agent within the health care system. Those having a Doctor of Nursing Practice (DNP) degree in nursing are essential in many areas of healthcare. DNP program graduates contribute to academia, clinical practice, health policy, and other fields like management, information technology, health economics, and insurance and insurance (Schoenbaum, 2018). One of the most significant accomplishments of DNP graduates is their ability to design and evaluate complex patient care models. They can assess the effectiveness and viability of various treatment plans, which ultimately improve patient outcomes. The DNP program emphasizes the implementation of research-based practices in healthcare through its emphasis on evidence-based practice.

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The adoption of DNP programs is bringing about a dramatic transformation in nursing education and the profession. The ending, neutral zone, and beginning stages of Bridges’ three-stage process can be used to characterize this transition. The nursing field is currently in Stage 1, the closing phase, where outdated beliefs, viewpoints, and facts are being questioned and changed. As more DNP programs are established, the field is moving into Stage 2, often known as the neutral zone, where a new reality and self-image are being constructed. For nurses with a DNP, roles and expectations alter. They can serve as advanced practice nurses, policy advocates, nursing care directors, and supervisors. Because of their extensive skill sets and knowledge, they can carry out these tasks effectively. When one moves up to a DNP position within a company, the expectations are raised (Donley & Kiraly, n.d.). The role of a nurse necessitates the routine use of accuracy, decisiveness, efficacy, critical thinking, and evidence-based practice. The DNP program enhances knowledge and allows engagement with patients and staff to propose process modifications and implement them in ways that would minimize health inequalities among communities.

References

Donley, R., & Kiraly, C. (n.d.). The DNP-prepared nurse’s role in health policy and

advocacy. DNP Role Development for Doctoral Advanced Nursing

Practice. https://doi.org/10.1891/9780826171740.0018

Schoenbaum, A. (2018). Transformation of healthcare and health information technology. DNP

Education, Practice, and Policy. https://doi.org/10.1891/9780826140197.0014

I found your discussion this week relatable. The motivation behind why you chose to pursue your DNP resonated because far too often a patient’s race, socioeconomic class, and status have become one of the determining factors in the quality-of-care patients receive. Very disheartening to read you felt there was nothing you could do. I was recently speaking with a co-worker of mine about the state of our healthcare system. We chatted about how we have gotten so far away from providing quality care for patients and healthcare workers becoming less compassionate. As I thought about our conversation more, I began to think about leadership in healthcare. I worked in an oncology unit for six years and this was the best unit I have ever been a part of. We had a great cohesive unit and the nurses worked as a team. Two of the principles we lived by were no nurse left behind and you are only as strong as your weakest nurse. Putting these principles into practice was reflected in our patient satisfaction scores. We prided ourselves on providing great care and positive patient outcomes. I must admit we would not be the team we were without great leadership. My director at the time held a Master’s in clinical nursing practice. I remember she was a big advocate for implementing changes that would make our unit better, advocated for better working environments for staff, systemic changes, and keeping the patients at the center of it all.

Doctorial education in nursing is designed to prepare nurses for the highest level of leadership in practice and scientific inquiry (American Association of Colleges of Nursing, 2006). Anna, you have a direct advantage in knowing what is needed to implement change. Your first-hand experiences are a driving force to speak on what is needed for positive change, best practices, and better patient experiences. You mentioned helping fight inequality. Possibly coming up with a training program for healthcare workers to become more culturally competent. As a prepared DNP not only will you be able to influence change, but the scientific evidence to help bring the change you want to see. Nurses prepared at the DNP level must demonstrate their value to healthcare administrators and nurse executives by sharing their outcomes and engaging in empirically-based work to substantiate their value (Tussing, et al., 2018).

References

American Association of Colleges of Nursing. (2006). The Essentials of Doctoral Education for Advanced Nursing Practice. American Association of College of Nursing: The Voice of Academi Nursing, 1-28.

Tussing, T., Brinkam, B., Frances, D., Hixon, B., Labardee, R., & Chipps, E. (2018). The Impact of Doctorate of Nursing Practice in Hospital Setting. Journal of Nursing Administration, 48(12), 600-602. doi:Tussing, T. , Brinkman, B. , Francis, D. , Hixon, B. , Labardee, R. & Chipps, E. (2018). The Impact of the Doctorate of Nursing Practice Nurse in a Hospita10.1097/NNA.000000000

I love that you have Oncology experience. I would love to be a provider to Oncology patients. It was definitely the best unit I had ever been on. I think the nurses on those units understand that your patients are already at their lowest due to their diagnosis, it helps to have positive energy when caring for them or any patient for that matter. I always try to be positive, and I came across a quote that stuck with me. “Being positive in a negative situation is not naïve. It’s leadership. — Ralph S. Marston, Jr.” (as cited in, Roberts & Strauss, 2015). There is a theory by Barbara Fredrickson called the Broaden and Build Theory, it, “This theory describes how accumulating positive emotions broadens our minds and awareness, enabling us to develop new thoughts, activities, and relationships and to gain lasting personal resources that persist even after the emotion passes” (Roberts and Strauss,2015). Positivity goes a long way with patients and coworkers. I love that your team was actually team oriented, it helps for a better work environment.

Roberts, Paige , and Kaitlin Strauss. “The Power of the Positive – American Nurse.” American Nurse, 7 July 2015, www.myamericannurse.com/the-power-of-the-positive/.

Thanks for this discussion. I can relate to your discussion in so many ways about bedside nursing, the comfort, and the associated convenience of being used to the role. I commend your effort. I would like to contribute to the discussion and input. Looking at the professors comment that Nurses with master’s degree perform some of the DNP roles already. The major difference of DNP prepared nurse is the Nursing Research, making a determined social change in the community as a Nurse Leader in the highest level of the discipline with multifaceted roles.

According to the AACN, 2022, the roles of Doctor of Nursing Practice (DNP) programs prepare nurse is to be a Nurse Leader who functions at the highest level of nursing practice with one of the primary assignments of improving patient outcomes and translating research into practice. As a DNP prepared nurse, it is necessary that the DNP know the DNP curriculum and understand that it is a buildup on the traditional master’s programs with a goal to provide contents in evidence-based practice into the nursing practice, advocate and implement quality improvement, and in systems leadership, be a leader with a difference among other key areas. In addition, as DNP prepared Nurse, our role is to seek for a terminal degree in nursing practice that offers an alternative to research-focused doctoral programs and fully implement the science developed by nurse researchers prepared in PhD, DNS, and other research-focused nursing doctorates to benefit the nursing practice and the healthcare services. The PhD, DNS individual are called the Nurse Researchers and they conducts the research, while the PhD, DNP practice roles includes the translation and the evolvement of the research, working in collaboration with the nurse practitioners and other health care team members to implement a change (Falkenberg-Olson, A. C., 2019).

As part of the curriculum of the AACN, 2006 and the Walden University vision and mission it is important that the DNP prepared Nurse focus on enhancing competency development through training, faculty, and leadership positions (Walden, 2020). The expectations associated with the DNP degree requirements, the practicum/field experience and completion of the Doctoral Project is to improve knowledge, expand the nursing practice and improve patient outcomes, improve leadership abilities to boost the nursing practice and healthcare delivery, provide a better management of the program requirements, the credit hours and the required practicum hours before any accreditation and credentialing. Moreover, accredited schools have recruited people from non-nursing and nursing backgrounds into the nursing program to increase the number of professors that are readily available to competently teach the practice courses (AACN, 2006).

Anna, thanks for your insight into the topic and sharing your personal experiences.

References.

American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf Download DNPEssentials.pdf

American Association of Colleges of Nursing. (2020). Face Sheet: The Doctor of nursing Practice (DNP). https://www.aacnnursing.org/Portals/42/Newa/Factsheets/DNP-Factsheets.pdfLinks to an external site.

American Association of Colleges of Nursing. (2020). AACN Face Sheet – DNP. www.aacnnursing.org/news-dat/fact-sheets/dnp-fact-sheetLinks to an external site..

Falkenberg-Olson, A. C. (2019). Research translation and the evolving PhD and DNP practice roles: A collaborative call for nurse practitioners.Links to an external site.Links to an external site. Journal of the American Association of Nurse Practitioners, 31(8), 447–453. https://doi.org/10.1097/JXX.0000000000000266Links to an external site.

Walden University. (2020). A Vision for Social Change Report. https://www.waldenu.edy/why-walden/social-change

I found your post to be very shocking due to the simple fact that an employer would state that they would prefer something over something else due to not having the knowledge of the role. I know that we are talking about nursing but that automatically made me question how often is this done in other professions and how many people are not able to get positions for this reason. Often I have heard oof the term “over qualified” maybe this is what they mean when some employers give this rationale to individuals who are obviously qualified for positions yet do not receive them.

The DNP degree is in fact a terminal degree within the nursing profession and I know that individuals like myself strive to be the best and know all at what they doo, so they choose the degree for that reason.

Thank you for your post, very interesting

Reference:

Gray, K., Miller, J. M., & Manning, M. L. (2023). Aligning the Post Master’s DNP with the 2021 AACN Essentials. Journal of Professional Nursing, 46, 65–69. https://doi.org/10.1016/j.profnurs.2022.11.007

Muñoz, L. R., Thomas, S. P., Sebach, A. M., Gibbons, M. M., & Neal, A. M. (2023). Experiences of Doctor of Nursing Practice (DNP)-prepared nurses choosing to pursue a Doctor of Philosophy (PhD) degree. Journal of Professional Nursing, 46, 168–178. https://doi.org/10.1016/j.profnurs.2023.03.003

Thank you, for this post your post. Before the hospital I worked at, the emergency closed, I was introduced to bedside nursing by staffing a small emergency department at times alone. After about six weeks of orientation, three days a week, I was informed that I was now in charge of the seven beds emergency department. This also meant that if I were the only RN in the building, I would supervise the LPNs in the fourteen beds med surge floor attached to the emergency department. This was very challenging for a new nurse who had been out of nursing school for two years. I tried to employ skills learned in school and other fields. I, however, noticed how some nurses treated patients with disdain, especially those nicknamed frequent fliers. This social allocation meant these patients were treated differently, consciously or unconsciously. I decided to rise above those social determinants and prove to them that equal high-quality care was possible. Not long after, I discovered I was starting to fall into the same trap of complacency. I made a point to challenge my peers, most experienced than I, to act better and provide care equally. I am still determining how successful this was, but I hope to have the skills to apply it professionally. As nurse leaders, our influence, even with other healthcare leaders who are not trained in nursing, is essential and can introduce the focus on quality improvement. Bååthe, (et al., 2022) points out that leaders need to recognize, accept, and deliberately act to create virtuous development spirals where managers and health professionals communicate and collaborate, benefitting the quality of patient care, economy, and professionals’ engagement.

Bååthe, F., von Knorring, M., & Isaksson-Rø, K. (2022). How hospital top managers reason about the central leadership task of balancing quality of patient care, economy, and professionals’ engagement: An interview study. Leadership in Health Services, 36(2), 261–274. https://doi.org/10.1108/lhs-02-2022-0009

NURS 8002 THE DOCTORAL DEGREE AND PROFESSIONAL NURSING PRACTICE