174 ■ II: ROLES FOR DOCTORAL ADVANCED NURSING PRACTICE
■ SUMMARY
Nurses in the clinical executive role are no longer invited to the table solely based on
their clinical insight but more so for their ability and capacity to lead organizations
based on their leadership competencies. The nursing profession can lead the “way to
knowing” and the capacity to lead by continuing to offer the DNP as a credible degree
option for nurses seeking to expand their leadership skill set and knowledge to be better
prepared to function in the increasingly turbulent health care environment.
In summary, because there are other strategies necessary to prepare nurses
for clinical executive roles, the nursing profession cannot solely depend on a new
degree. They must be proactive in developing a framework that ensures ongoing
development of leaders in executive roles that can be incorporated in the context
in which they practice. These frameworks must include organizational charts that
are aligned with the corporate strategic plan and that create the propensity for
nurse leaders to have the capacity to lead and be involved in decision making at
every level. The frameworks must provide ongoing opportunities for professional
development, mentoring opportunities, and, last but not least, succession plan-
ning. Leadership development should not be by default or a second thought, but
by design. It must be part of the culture established and supported by the nurse
executive in collaboration with the other executive team members. It is too soon to
say that a DNP should be required for individuals in clinical executive advanced
nursing practice roles. However, it is not too soon to reexamine the process in
which nurse executives are prepared for their leadership roles. Because leadership
development is a process, it cannot be learned in a day or by completing another
degree. The DNP degree offers an innovative educational experience that superbly
prepares the nurse executive, but it is only the beginning of the process of leader-
ship development. Nurse executives must be proactive and create organizational
cultures that cultivate empowerment, ongoing professional development, and suc-
cession planning so that no leader is left behind and organizations advance from
good to great.
Over the past 7 years, the number of DNP programs has grown to more than 289
with 125 achieving accreditation by CCNE ( AACN, 2015a). The emphasis on DNP learn-
ing, and the significance of the eight DNP essentials focus development of the student
on assuring competency in navigating complex health care environments, including
advocating, leading, and advancing the nursing profession. Nurse executives must pos-
sess leadership skills and educational competency that is significantly valued by others,
which assures them a seat at the table with responsibility to contribute and participate.
DNP education preparation although evolving, is the foundational piece needed for the
future.
The interest and affinity for a DNP versus a PhD are clearly different. The dis-
tinction is directly related to the type of work and the intent of the individuals’ impact
once the degree is achieved. PhD nurses focus on new knowledge and research that
advances science as compared with DNP nurses who are focused on research integra-
tion and changing practice through translation of evidence (Rodriguez, 2016). Nurse
executives are far more focused on implementing change through leading practices that
result in higher clinical quality, improved outcomes, and are patient focused than con-
ducting actual research. A DNP provides the needed academic advancement to meet
the demands of the executive role and fully prepares the nurse leader to contribute in a
meaningful way.
In August 2015, the AACN provided updates to their position statement on the
DNP following a RAND study (Auerbach et al., 2014) completed at their request.