10: ROLE STRAIN IN THE DAPRN ■ 239THE DNP- PREPARED PRACTITIONER
DAPRNs who are nurse practitioners provide expert primary health care or specialty
health care to diverse populations in various health care agencies and venues. DAPRNs
who are nurse- midwives, nurse anesthetists, and clinical nurse specialists also fulfill
their professional roles. With health care reform, the future is bright for DAPRNs, espe-
cially if they innovate, design, or create efficient models of health care delivery. They
may serve as leaders of nurse- managed clinics, private practices, convenient care clin-
ics, or urgent care centers. They may serve as expert practitioners with additional confi-
dence and knowledge to positively impact patient outcomes.
DAPRN’s practice includes not only direct care, but also a focus on the needs of a
group of patients, a target population, a set of populations, or a broad community. These
graduates are distinguished by their abilities to conceptualize new care delivery mod-
els that are based in contemporary nursing science and that are feasible within current
organizational, political, cultural, and economic perspectives. Graduates are skilled in
working within organizational and policy arenas and in the actual provision of patient
care by themselves and/ or by others. For example, DAPRNs understand principles of
practice management, including conceptual and practical strategies for balancing pro-
ductivity with quality of care. They are able to assess the impact of practice policies
and procedures on meeting the health needs of the patient populations with whom
they practice. DAPRNs are proficient in quality improvement strategies and in creating
and sustaining changes at the organizational and policy levels. They have the ability
to evaluate the cost effectiveness of care and use principles of economics and finance
to redesign effective and realistic care delivery strategies. In addition, DAPRNs have
the ability to organize care in a way that addresses emerging practice problems and the
ethical dilemmas that emerge as new diagnostic and therapeutic technologies evolve
(American Association of Colleges of Nursing [AACN], 2006). Nichols et al. (2014)
noted that CNOs are not well versed in the abilities and potential impact of the DNP.
CNOs’ knowledge of DNP- prepared nurses’ abilities is critical to the widespread adop-
tion and influence of DNPs in the health care system. CNO support is also necessary for
the advocacy of DAPRN’s scholarly release time and increased compensation expected
with a higher level degree, increased knowledge, and expanded skill set.
It is clear that the DAPRNs can contribute significantly to the health and welfare
of our nation; what is not clear is whether the role of the practitioner will change as a
result of the DAPRN’s additional knowledge and skills. If the workplace environment
does not change, DAPRNs may feel frustrated in their role. They may also experience
professional jealousy or other less than supportive behaviors from colleagues as a result
of this relatively new role, as well as role overload based on the sheer amount of work
to be accomplished.
THE DNP- PREPARED CLINICAL EXECUTIVE
The DNP clinical executive (CNOs, vice presidents, division leaders, and other executive-
level nurse leaders) is called to address emergent and challenging issues for nursing
practice, as well as to create opportunities that will shape and implement innovative
changes in the health care system. Today, the DNP clinical executive is in short supply.
Future doctoral level nurse administrators and executive leaders are also charged to
improve health and health care outcomes through evidence- based practice in diverse
clinical and health care settings. The DNP clinical executive emphasizes evidence- based