251chapter TEN
Refl ective Response
Rita K. Adeniran
DNPs: This is our time. The evolving healthcare environment provides a unique
opportunity to make a positive difference in health and healthcare. The future of
DNPs is in our hands.
— Rita K. Adeniran
The passage of the Patient Protection and Affordable Care Act (ACA) on March 23, 2010,
ushered the beginning of a new era of health care delivery in the United States. As the
various provisions of ACA move through the multiple implementation stages of the
law, the landscape of the U.S. health care system is witnessing transformation (Nichols,
O’Connor, & Dunn, 2014). These transformations have tremendously increased the
complexity, uncertainty, volatility, and ambiguity (CUVA) that seems to have plagued
the U.S. health care delivery system for decades (Blumenthal, Abrams, & Nuzum, 2015;
Larkin, Swanson, Fuller, & Cortese, 2016; Leopardo, 2013; Nair, 2011). It is within CUVA
that Doctor of Nursing Practice (DNP)- prepared nurses are uniquely positioned to play
a role that will distinguish them from nondoctoral-prepared advanced practice nurses
and other members of the interprofessional care team.
It is worth noting that DNP programs in the United States continue to proliferate
in response to the increased recognition of the value of nurses prepared at the doc-
toral level to lead and work side by side with other members of the interprofessional
care team in addressing many of the nation’s long- standing health and health care
problems (Institute of Medicine, 2010; Lathrop & Hodnicki, 2014; Nichols et al., 2014).
DNP- prepared nurses pursue roles in academia, clinical practice, health policy, and
administration. Indeed, all roles that provide a platform for advancing and positively
influencing all aspects of the nation’s health and health care system.
I would argue that DNP- prepared nurses are not, and will not be bogged down or
pressured by what has been described as role strain, because to some degree, role strain
is associated with most new roles, distinctive job positions, and many forms of transi-
tion that are related to professional advancement (Cantwell, 2014; Carte, 2014; Cranford,
2013; Gallagher, 2005). DNP nurses have the capacity and ability to manage and allocate
energies to reduce role strain to tolerable proportions and maximize role adjustment
as they work to lead and deliver health care services that minimize CUVA, and meet