10 ■ I: HISTORICAL AND THEORETICAL FOUNDATIONS FOR ROLE DELINEATION
advanced practice registered nurses^2 (APRNs) by 2015 (which ultimately did not hap-
pen in 2015). However, this author has nonetheless been a keen observer of the practice
doctorate movement from the beginning and even prior to 2004 (AACN, 2004a; Dreher,
2005; Dreher, Donnelly, & Naremore, 2005; Smith Glasgow & Dreher, 2010). And now as
a dean starting its college’s first doctorate, a DNP in advanced clinical care, the contem-
porary realities of DNP education are even more apparent, especially the cost models to
launch a degree that looks different than in 2005.
In a previous academic appointment, my own university sponsored what was the
very first national conference on the practice nursing doctorate in Annapolis, Maryland,
in 2007 titled Practice Doctorate: Where Is It Headed? The First National Conference
on the Doctor of Nursing Practice: Meanings and Models and the third held in Hilton
Head Island, South Carolina, in 2009 titled Doctor of Nursing Practice: The Dialogue
Continues... Later the conference morphed into something to attract a different audi-
ence, including PhD programs. At each of these venues, many of the contemporary
discussion points were highly visible in the podium papers, poster sessions, and in the
conversations and networking that took place among faculty, some of the first graduates
with the degree in the country, and current students. Actually, as the conference chair
for each of those conferences, one of the primary objectives of the organizing committee
was to attempt to provide a safe platform for nursing scholars with diverse points of
view. We thought that the profession was in need of more critical discourse about the
DNP degree, especially from a broader subset of doctoral nursing faculty who were not
necessarily academic administrators or not tied more publicly to the mission or position
statements of various nursing organizations. We even invited a very prominent anesthe-
siologist (herself a former certified registered nurse anesthesiologist [CRNA]) who had
been publicly criticizing the CRNA- to-doctorate movement, to share her professional
perspective.
Internal debate, nonetheless, is nothing new to nursing. We only have to look at
our profession’s failure, now about 45 years and counting, to require the bachelor of sci-
ence in nursing (BSN) degree for entry into professional nursing for example (Donley
& Flaherty, 2008). Labor historian Barbara Melosh (1982), in her outstanding sociolog-
ical analysis of nursing in The Physician’s Hand: Work, Culture and Conflict in American
Nursing , calls the history of nursing a battle between the “professionalizers” and the
“traditionalists.” The battle lines again appear to be drawn (perhaps less visibly these
days) between those perceived to be the most in favor of replacing the master’s degree
with the practice doctorate— the professionalizers (nursing academics), and those who
prefer the post- master’s DNP (against phasing out the master’s)— the traditionalists
(the masses of currently practicing advanced practice nurses and many nursing aca-
demics, too). This divide exists because APRNs, despite being only master’s prepared
(and without a DNP degree), astutely know the literature, which touts their outstanding
outcomes as widely acknowledged (American College of Nurse- Midwives [ACNM],
2012a; Horrocks, Anderson, & Salisbury, 2002; Malina & Izlar, 2014; Mundinger et al.,
2000). Of course, this description is partly an oversimplification, as these lines are not so
black and white. There are nursing faculty who oppose the DNP degree (increasingly
fewer it seems) and APRNs who support it (increasingly more it seems). And of course,
if you are a DNP student reading this book, you are likely matriculating in a DNP pro-
gram of your own volition, and therefore absolutely not a traditionalist! Nonetheless,
discourse, debate, and critique are very healthy for our discipline. Absolute division is
not. Maybe with the surge of the DNP degree (and make no mistake, nursing education
has never seen a degree captivating the profession so quickly), professionalizers and
traditionalists can learn from each other. It would be helpful in the spirit of egalitari-
anism (not elitism) and continuous improvement, however, if the nursing profession’s