5: THE ROLE OF THE PRACTITIONER ■ 153participation in research, business ethics, and the role of ethical principles such as “jus-
tice” as it relates to health care economics and reform. Topics such as these are important
to include, as the DNP graduate is expected to bring a higher, broader level of under-
standing of the complexity of issues and leadership to the practice setting. If, however,
ethics are not truly being incorporated in the light of competing priorities, perhaps the
decision not to recognize ethics as a separate essential was not a wise one.
Opinions on these controversies concerning the Essentials may vary. What is evi-
dent, however, is that the content areas addressed in the Essentials (e.g., health policy,
leadership, quality, advocacy) are still very much relevant. Indeed, they dominate the
national news media and inspire national debate. Rather than asking are the Essentials
fluid enough, perhaps what nursing needs to ask is: “As a discipline, are we creative
enough to envision what the Essentials do not say?” Myopia is a dangerous condition,
regardless of its context.
■ SUMMARY
The move to require a DNP for entry into NP practice by 2015 has raised many contro-
versies; yet, while some strides have been made, the goal remains largely unmet as of
- Among the continuing controversies are: whether the DNP is a degree or a role,
how DNP-prepared NPs are currently practicing, whether DNP practice really is differ-
ent from MS-prepared NP practice, what effect DNP education will have on certifica-
tion, and whether programs conferring a DNP degree truly are at the doctoral level of
scholarship. In this chapter, we have explored these issues to date. As with the rest of
the nursing profession, we continue to await the arrival of large numbers of DNP–NPs
(and other DNP–APRNs) for the future. What will be their contribution to health care,
to patient outcomes, to faculty roles and to nursing? Additionally, as time passes and
demographics of faculty compositions change to an obvious tipping point, where DNP-
prepared educators serve as the primary educators and directors of DNP education,
we likely can and should anticipate future paradigm shifts in relation to the content,
design, and level of scholarship expectations for DNP students. Although this remains
to be seen to a large extent, the potential impact of the DNP–practitioner role appears
very promising indeed.
■ CRITICAL THINKING QUESTIONS
- What strengths do preparation as a DNP bring to the advanced practice practitioner role?
In what ways do you think NP practice will change once the majority of NPs are prepared at
the DNP level? - What is the role of teachers of various educational backgrounds in the education of the DNP
practitioner? Should the majority of DNP educators be practicing clinicians? Explain. - Do you anticipate that outcomes should be different from MS-prepared practitioners? What
outcomes can be expected from DNP-prepared practitioners? - Do you think that attaining competency as an NP is necessary before becoming a change
agent? How will DNP student practitioners gain the skills to become change agents in clini-
cal practice if they cannot practice as NPs until they complete their DNP education? - Should DNP students be encouraged to develop original scholarly work through the scholar-
ship of application? Would this approach better prepare NPs with the skills to demonstrate
enhanced patient outcomes resulting from their care? In what way?