To the editor
When Whall’s guest editorial on the Doctorate in Nursing Practice (DNP) degree appeared in Nursing Outlook,
1
I began to draft a letter to the editor supporting Whall’s stand on the relevance of nursing philosophy/theory, but questioning the need for another professional doctorate and suggesting the redundancy of the word “practice” in such a degree. In discussing my concerns with an active member of AACN, I was told that it was a fait accompli, implying that it was too late to question the position that AACN had taken. I am heartened by the last issue of Nursing Outlook, in which the debate is alive and well,2
and I hope to contribute to the considerations of this movement.First, I think the designation of the DNP as a terminal degree is a fallacy regarding professional education. Professional education begins with a doctorate, as in DDS, JD, MD. That was what the original ND degree was intended to be. Its failure, if we can deem it such, was a result of misplaced expectations of the degree as an advanced degree rather than a basic professional degree. If this were understood, it would build on undergraduate prerequisites and be completed in about 3 years devoted to professional education. It would not take a lifetime of hop-scotching from one degree to another with inherent gaps and redundancies. The curriculum of this basic professional education would be based on the discipline of nursing and its cognates. If a graduate of such a program desired specialization, then another program would be needed.
The program described by Mundinger
2
emphasizes a curriculum grounded in other disciplines and aimed at answering the shortage of primary care physicians. The fears expressed by Dracup et al3
regarding the possibility of the DNP’s detracting from PhD programs and the subsequent effect on nursing research would not be a factor if the professional doctorate were seen as a basic degree rather than an advanced degree. The length of time taken to complete the degree and, if desired, a PhD to prepare for research would not be longer than current routes, and perhaps be even shorter.So what happens to the “plethora” of degrees we now have? And how does this suggestion relate to the needs of the health care system?
Clearly there will be a continuing need for practitioners of nursing/medical technology as well as for professional nursing clinicians. Educators in associate degree and baccalaureate programs are doing a commendable job of preparing graduates for the technology role. The components of baccalaureate education that are properly a constituent of professional education could be moved into an ND program. Specialization in nursing practice would be at the post-ND level and remain at the master’s level. That leaves associate degree and some baccalaureate ladder programs to prepare for nursing technology, an ND program for professional practice, Master’s programs for practice specialization, and PhD for research. Not much of a plethora.
Foundational to all of this is a clear understanding of the philosophical/theoretical underpinnings of the nursing discipline. Without it we lose our place in the whole scheme of things.
References
- Lest we forget.Nurs Outlook. 2005; 53: 1
- Who’s who in nursing.Nurs Outlook. 2004; 53: 173-176
- Reflections on the doctorate of nursing practice.Nurs Outlook. 2005; 53: 177-182
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© 2005 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
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- “Lest we forget”: An issue concerning the Doctorate in Nursing Practice (DNP)Nursing OutlookVol. 53Issue 1
- PreviewThe academic community within nursing is currently discussing an interesting option to the PhD, or Doctorate of Philosophy degree. Termed the Doctorate in Nursing Practice (DNP), it is currently described as a practice-focused rather than a research-focused doctorate (such as the PhD). Several issues are being explored, including descriptions of the differences between programs of study for the DNP versus the PhD; one of these differences is sometimes described as less of a meta-theoretical focus within the DNP.
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- Who’s who in nursing: Bringing clarity to the doctor of nursing practiceNursing OutlookVol. 53Issue 4
- PreviewAdvanced practice nurses across the country are informally learning expanded skills and are assuming significant autonomy. The growing complexity and acuity of care, the aging of the US population, and the dwindling number of primary care physicians all contribute to the need for increased knowledge and practice competency. A formal and standardized educational process leading to a doctoral degree is essential for quality assurance, to clarify and validate authority/responsibility, and to recognize and identify these practitioners.
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