Doctor of Nursing Practice

Last updated

The Doctor of Nursing Practice (DNP) is a professional degree in nursing in the United States of America.

Contents

In the United States, the DNP is one of three doctorate degrees in nursing, the other two being the research degree PhD and the Doctor of Nursing Science. [1] The DNP program may include clinical/residency hours as well as a final scholarly project.

DNP in North America

The curriculum for the United States DNP degree builds on work completed during previous master's level courses. It provides education in evidence-based practice, quality improvement, and systems leadership, and is typically more clinically oriented than a PhD. [2] Although approximately 52% of nurse anesthetist programs will award the DNP, the remaining 48% may use the title doctor of nurse anesthesia practice (DNAP).[ citation needed ]

Rationale for the existence of the DNP

According to the American Association of Colleges of Nursing (AACN), transitioning advance practice registered nursing programs from the graduate level to the doctoral level is a "...response to changes in health care delivery and emerging health care needs, additional knowledge or content areas have been identified by practicing nurses. In addition, the knowledge required to provide leadership in the discipline of nursing is so complex and rapidly changing that additional or doctoral level education is needed." [3] According to the AACN, "...benefits of practice-focused doctoral programs include:

Transitioning toward the doctorate

In the United States, the American Association of Colleges of Nursing (AACN) recommended that all entry-level nurse practitioner educational programs be transitioned from the Master of Science in Nursing (MSN) degree to the DNP degree. [4] The American Association of Nurse Anesthetists has followed suit, requiring the DNP (or DNAP - Doctor of Nurse Anesthesia Practice) degree for entry-level nurse anesthetist programs by the year 2025. [5] Meanwhile, the National Association of Clinical Nurse Specialists (NACNS) announced in July 2015 its endorsement of the doctor of nursing practice (DNP) as the required degree for CNS entry into practice by 2030.[ citation needed ] Nurse practitioners and nurse anesthetists currently practicing with either an MSN or certificate will not be required to obtain the DNP for continued practice.[ citation needed ]

Comparison to other doctorates

The DNP, as a professional degree, has a different focus from a research doctorate such as the PhD in Nursing. The DNP is a practice-focused degree intended to prepare nurses to practice at the highest level, while the PhD in Nursing is a research-focused degree intended to prepare nurses to carry out academic research within their profession. This is reflected in significant differences between the curricula for the two degrees, such as the PhD not requiring any clinical hours and the DNP having a scholarly project rather than the PhD's original research dissertation. [6] [7] The PhD also takes longer to complete on average, taking 5.0–5.1 years for students entering post-master's compared to 2.43 years for the DNP and 5.2–5.9 years for students entering post-bachelor's compared to 3.8 years for the DNP. The faculty profile differs between DNP and PhD programs, with DNP program faculty teaching being more likely to be active in clinical practice and to hold a DNP, while PhD program are more likely to be active in research and to hold a PhD. [8]

When the DNP was proposed, critics described its development as "a major mistake for [the] profession of nursing as well as the discipline of nursing knowledge", due to it separating the missions of practice and research. [9]

The required clinical practice hours to be accepted on a DNP course range from zero to 1000 hours, compared to a minimum of one year of clinical experience for admission to a PhD. [8] There is a requirement that DNP students are expected to complete at least 1000 post-baccalaureate clinical hours. [10] These can include clinical hours undertaken as part of a prior degree and DNP programs do not specifically require additional clinical hours beyond those at master's level, but many programs do include clinical components. [8] [11]

Title confusion in the clinical setting

Some critics have argued that there is scope for patients or service users to be confused about whether they are consulting a physician or a nurse if nurses use the title "doctor" in a clinical setting. [12] [13] Lawsuits have also resulted from this confusion, where holders of the DNP have referred to themself with the title doctor in clinical settings. [14] [15] In some US states, there is a legal basis limiting nurses using the title of doctor in clinical practice. [16] However, in other US states nurses are bringing their own legal arguments to facilitate their legal use of the title. [17]

See also

Related Research Articles

<span class="mw-page-title-main">Registered nurse</span> Nurse who has graduated from a nursing program

A registered nurse (RN) is a nurse who has graduated or successfully passed a nursing program from a recognized nursing school and met the requirements outlined by a country, state, province or similar government-authorized licensing body to obtain a nursing license. An RN's scope of practice is determined by legislation, and is regulated by a professional body or council.

<span class="mw-page-title-main">Doctor of Psychology</span> Doctoral degree

The Doctor of Psychology is a professional doctoral degree intended to prepare graduates for careers that apply scientific knowledge of psychology and deliver empirically based service to individuals, groups and organizations. Earning the degree was originally completed through one of two established training models for clinical psychology. However, Psy.D. programs are no longer limited to Clinical Psychology as several universities and professional schools have begun to award professional doctorates in Business Psychology, Organizational Development, Forensic Psychology, Counseling Psychology, and School Psychology.

<span class="mw-page-title-main">Nurse anesthetist</span> Nurse trained to provide anesthesia care

A nurse anesthetist is an advanced practice nurse who administers anesthesia for surgery or other medical procedures. Nurse anesthetists (NA's) administer or participate in administration of anesthesia services in 107 countries, working with or without anesthesiologists. Because of different historical backgrounds, anesthetist responsibilities and roles vary widely between countries. Depending on the locality, their role may be limited to intraoperative care during anesthesia itself or may also extend before and after. The International Federation of Nurse Anesthetists was established in 1989 as a forum for developing standards of education, practice, and a code of ethics.

<span class="mw-page-title-main">Certified registered nurse anesthetist</span> Professional title for nurse anesthetists in the United States

A Certified Registered Nurse Anesthetist (CRNA) is a type of advanced practice nurse who administers anesthesia in the United States. CRNAs account for approximately half of the anesthesia providers in the United States and are the main providers (80%) of anesthesia in rural America. Historically, nurse anesthetists have been providing anesthesia care to patients for over 150 years since the American Civil War and the CRNA credential came into existence in 1956. CRNA schools issue a doctorate of nursing anesthesia degree to nurses who have completed a program in anesthesia, which is 3 years in length.

The School of Nursing is the graduate school of nursing at Columbia University in the Washington Heights neighborhood of Manhattan, New York City. Founded in 1892, it stands as one of the oldest nursing schools in the United States.

<span class="mw-page-title-main">Nurse practitioner</span> Mid-level medical provider

A nurse practitioner (NP) is an advanced practice registered nurse and a type of mid-level practitioner. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, prescribe medications and formulate treatment plans. NP training covers basic disease prevention, coordination of care, and health promotion.

A terminal degree is the highest-level college degree that can be achieved and awarded in an academic discipline or professional field. In other cases, it is a degree that is awarded because a doctoral-level degree is not available nor appropriate. The two main types of terminal degrees are academic or professional.

An advanced practice nurse (APN) is a nurse with post-graduate education and training in nursing. Nurses practicing at this level may work in either a specialist or generalist capacity. APNs are prepared with advanced didactic and clinical education, knowledge, skills, and scope of practice in nursing.

A Master of Science in Nursing (MSN) is an advanced-level postgraduate degree for registered nurses and is considered an entry-level degree for nurse educators and managers. The degree also may prepare a nurse to seek a career as a nurse administrator, health policy expert, or clinical nurse leader. The MSN may be used as a prerequisite for doctorate-level nursing education, and used to be required to become an advanced practice registered nurse such as a nurse practitioner, clinical nurse specialist, nurse anesthetist, or nurse midwife.

Nursing credentials and certifications are the various credentials and certifications that a person must have to practice nursing legally. Nurses' postnominal letters reflect their credentials—that is, their achievements in nursing education, licensure, certification, and fellowship. The letters usually appear in the following order:

<span class="mw-page-title-main">Vanderbilt University School of Nursing</span> Graduate school in Nashville, Tennessee, US

Vanderbilt University School of Nursing (VUSN) is a graduate school of Vanderbilt University, located in Nashville, Tennessee. VUSN is closely connected with its parent university and the separate nonprofit Vanderbilt University Medical Center. The School of Nursing is ranked in the top 10 in the U.S. News & World Report rankings. Additionally, its Masters of Science program is ranked 8th, and its Doctorate of Nursing practice program 6th in the report's 2022 graduate school rankings.

<span class="mw-page-title-main">Nursing in the United States</span> Overview of nursing in the United States of America

Nursing in the United States is a professional health care occupation. It is the largest such occupation, employing millions of certified professionals. As of 2023, 3,175,390 registered nurses were employed, paid a median income of $86,070.

The University of Virginia School of Nursing, established in 1901, is a school of nursing education. It has an enrollment of approximately 800 students, and is consistently rated in the top 4% of U.S. nursing schools. After the retirement of Dorrie K. Fontaine as the fifth dean of the School, two-term American Nurses Association President Pam Cipriano, a research faculty member at UVA for years, stepped in as interim dean in August 2019.

In the United States, a psychiatric-mental health nurse practitioner (PMHNP) is an advanced practice registered nurse trained to provide a wide range of mental health services to patients and families in a variety of settings. PMHNPs diagnose, conduct therapy, and prescribe medications for patients who have psychiatric disorders, medical organic brain disorders or substance abuse problems. They are licensed to provide emergency psychiatric services, psychosocial and physical assessments of their patients, treatment plans, and manage patient care. They may also serve as consultants or as educators for families and staff. The PMHNP has a focus on psychiatric diagnosis, including the differential diagnosis of medical disorders with psychiatric symptoms, and on medication treatment for psychiatric disorders.

<span class="mw-page-title-main">University of South Florida College of Nursing</span>

The University of South Florida College of Nursing is one of 14 colleges at the University of South Florida. The college has three campuses: Tampa, St. Petersburg, and Sarasota-Manatee.

<span class="mw-page-title-main">Family nurse practitioner</span> Type of certified nurse practitioner

A family nurse practitioner (FNP) provides continuing and comprehensive healthcare for the individual and family across all ages, genders, diseases, and body systems. Primary care emphasizes the holistic nature of health and it is based on knowledge of the patient in the context of the family and the community, emphasizing disease prevention and health promotion.

The Uniform Advantage/AACN Graduate Nursing Student Academy Scholarship is an award that acknowledges the important role nurses play in the health care system. It was developed based on a commitment to improving access to nursing students enrolled in master's and doctoral programs.

<span class="mw-page-title-main">Mayo Clinic School of Health Sciences</span> Private, not-for-profit school

Mayo Clinic School of Health Sciences (MCSHS), formerly known as Mayo School of Health Sciences (MSHS), is an accredited, private, nonprofit school of higher education specializing in allied health education. MCSHS operates within the Mayo Clinic College of Medicine and Science, which is the educational division of Mayo Clinic. As such, MCSHS is fully integrated with Mayo Clinic hospitals and clinics.

Rocky Mountain University of Health Professions (RMUoHP) is a private, for-profit university focused on graduate healthcare education and located in Provo, Utah. It was established in 1998 and is accredited by the Northwest Commission of Colleges and Universities.

Nursing is the largest healthcare profession in the United States, with more than 3.1 million registered nurses. Between 2012 and 2022, employment for nurses is projected to grow by 19 percent, which is more than any other profession. Nurses make up the largest component of staff in hospitals but are also able to provide care in clinic settings, patient's homes, schools, nursing homes, public health agencies, and mental health centers. In addition, nurses can be found in the military, in industry, nursing education, and do health care research. Nurses in these various roles and settings can provide direct patient care and case management, but also develop and establish nursing practice and quality standards within complex healthcare systems. As each degree can provide a different level of care for patients and function in vastly different roles, it is important to differentiate between them. The levels of nursing degrees have different educational requirements, licensure, and credentialing that can vary state to state.

References

  1. Reid Ponte, Patricia; Nicholas, Patrice K. (July 2015). "Addressing the Confusion Related to DNS, DNSc, and DSN Degrees, With Lessons for the Nursing Profession: DNS, DNSc, and DSN Degrees". Journal of Nursing Scholarship. 47 (4): 347–353. doi:10.1111/jnu.12148. PMID   26078101.
  2. "American Association of Colleges of Nursing | DNP Fact Sheet". aacn.nche.edu. Retrieved 19 September 2015.
  3. 1 2 Report of the Task Force on the Clinical Doctorate
  4. American Association of Colleges of Nursing (2004). AACN Position Statement on the Practice Doctorate in Nursing. Available at http://www.aacn.nche.edu/DNP/pdf/DNP.pdf Archived 28 September 2011 at the Wayback Machine .
  5. American Association of Nurse Anesthetists (2007). AANA Position on Doctoral Preparation of Nurse Anesthetists. Available at "Archived copy" (PDF). Archived from the original (PDF) on 30 October 2007. Retrieved 20 April 2008.{{cite web}}: CS1 maint: archived copy as title (link)
  6. "DNP-PhD Comparison | Duke University School of Nursing". nursing.duke.edu. Retrieved 18 October 2023.
  7. "Comparing the PhD & DNP". School of Nursing. Retrieved 18 October 2023.
  8. 1 2 3 Dobrowolska, Beata; Chruściel, Paweł; Pilewska-Kozak, Anna; Mianowana, Violetta; Monist, Marta; Palese, Alvisa (15 November 2021). "Doctoral programmes in the nursing discipline: a scoping review". BMC Nursing. 20 (1): 228. doi: 10.1186/s12912-021-00753-6 . ISSN   1472-6955. PMC   8591938 . PMID   34781935.
  9. Meleis, Afaf; Dracup, Kathleen (September 2005). "The Case Against the DNP: History, Timing, Substance, and Marginalization". Online Journal of Issues in Nursing. 10 (3): 3. doi:10.3912/ojin.vol10no03man02. PMID   16225383. S2CID   10883573.
  10. "Frequently Asked Questions: DNP Programs & CCNE Accreditation" (PDF). AACN. p. 3. Retrieved 17 May 2024.
  11. "Course Descriptions | DNP". SC-UMT. Retrieved 24 March 2022.
  12. Gaddis, Gary (2022). "Nurses With a Doctorate in Nursing Practice (DNP) Should Not Call Themselves "Doctor" in a Clinical Setting". Missouri Medicine. 119 (4): 314–320. ISSN   0026-6620. PMC   9462903 . PMID   36118817.
  13. Miller, Jason E. (4 November 2008). "The Doctor of Nursing Practice: Recognizing a Need or Graying the Line Between Doctor and Nurse?". The Medscape Journal of Medicine. 10 (11): 253. ISSN   1934-1997. PMC   2605113 . PMID   19099003.
  14. "NP Fined $20K for Advertising Herself as 'Doctor Sarah'". Medscape. Retrieved 29 October 2023.
  15. JD, Ann W. Latner (6 June 2023). "DNP Sued for Referring to Herself as Doctor". Clinical Advisor. Retrieved 29 October 2023.
  16. FNP, Julee Waldrop, DNP, PNP (13 March 2013). "State medical boards trying to limit who can be called "Doctor"". Clinical Advisor. Retrieved 29 October 2023.{{cite web}}: CS1 maint: multiple names: authors list (link)
  17. "Nurse Practitioners Sue The State Of California Over Right To Use 'Doctor' In Titles | NurseJournal". nursejournal.org. 8 September 2023. Retrieved 29 October 2023.