10: ROLE STRAIN IN THE DAPRN ■ 247The majority of the informants in this study felt that their confidence has led to
the acceptance of them and their role at their places of work. In the beginning they were
looking for a place to fit and now feel more accepted and settled in their current role.
In summary, theme three seems to be the theme that connected and linked the
three themes together. Overall, informants in this study expressed feeling more con-
fident, respected, and settled in their current DNP role. Nurse executives seemed to
have the clearest view of their role and the most support from their context or work
environment. Informants felt more settled about the future and their evolving roles in
administration, education, and practice. However, they would also like the profession,
schools of nursing, and employers to continue to be clear about the expectations of the
DNP in advanced practice, nursing education, and nursing administration. Informants
felt that their programs prepared them in a manner that has helped them to feel confi-
dent and respected in their role. They continued to express concerns that in some cases, the
work environment is not always accepting of the DNP especially in advanced practice. For
those in nursing education, the environment appeared to be supportive as time goes
on when there is a mutual “settling” and “fit.” Overall, the informants in this study
expressed feeling confident and more settled in their role than when they started
their positions.
DISCUSSION AND CONCLUSIONS OF STUDY
There has been only one published study on the lived experience of the DNP gradu-
ate (Smith Glasgow & Zoucha, 2011). The DNP graduates are truly pioneers in prac-
tice, education, and administration as they bring their advanced knowledge and skill to
the table. The informants’ confidence and sense of respect is needed in today’s nursing
environment to effect change, as well as being consistent with the AACN’s vision for the
degree (AACN, 2006). Overall, informants were proud about their advanced knowledge
and wanted to apply that knowledge in their respective roles. When compared to the
findings of the previous study in 2011 there is a perceived change and in some cases a
confirmation in the perceptions of the DNP role in practice, education, and adminis-
tration. Informants reported feeling that the context of their work was more support-
ive and conducive to confidence and respect in the role. Nurse educators and nurse
leaders felt more settled and supported in their roles. There was slight improvement in
the perceptions and experiences of DNP’s in practice, but there was still a sense of not
feeling understood or supported by their advanced practice peers. However, there was
improvement when compared to the 2011 study.
When the researchers reflect on the findings in this study, it provided some hope
that things were changing for the DNP in nursing education, administration, and prac-
tice over time. In this study, DNP graduates employed in advanced nursing practice
roles continued to express concern that in some cases, the work environment is not
always accepting of the DNP role in advanced practice settings. From our history, we
know that nursing practice, and to some degree education, has been slow to recognize
or come to terms with the distinct differences of educational preparation. At present, the
DAPRN’s role and expectations are no different than that of the master’s- level advanced
practice nurse’s role and expectations for the informants.
Based on the findings of this study, the informants feel that DAPRNs can contrib-
ute significantly to the advancement of the profession, quality, and safety metrics, and
are confident about its role in the future. It is not clear, however, whether the role of the
doctoral- level advanced practice nurse will actually change as a result of the DAPRN’s
additional knowledge and skills. The informants have sought opportunities to use their