371chapter FIFTEEN
Refl ective Response
Jared D. Simmer
The American Association of Colleges of Nursing (AACN) issued a position statement
holding that the Doctor of Nursing Practice (DNP) degree should provide advanced
clinical competencies, in addition to enhanced leadership skills to strengthen practice
and health care delivery, and later developed specific doctoral competencies in 2006
(AACN, 2004, 2006). In 2008, The Robert Wood Johnson Foundation (RWJF) partnered
with the Institutes of Medicine (IOM) to launch a 2- year initiative that would assess and
transform the nursing profession. It focused on the following question: What roles can
nursing assume to address the increasing demand for safe, high- quality, and effective
health care services? How well nurses are educated and do their jobs is inextricably tied
to most health care quality measures that have been targeted for improvement. Thus for
nursing, health care reform provides an opportunity for the profession to position itself
to help address the demand for safe, high- quality, patient- centered, and equitable health
care services (IOM, 2011).
Nichols, O’Connor, and Dunn (2014) noted that it remains to be seen what roles
DNPs will be expected to fill, and the competencies nurse- leaders will need in order to
succeed. These authors observed that chief nursing officers (CNOs) are not well versed
in the clinical outcomes of DNP practice or the population health outcomes that may
be impacted by DNP- prepared providers. CNOs’ knowledge of DNP- prepared nurses’
abilities is critical to the widespread adoption and impact of DNPs in the health care
system. The nursing profession envisions an even broader health care– centric educa-
tion, and practice role for DNPs, including applying research findings to improve
out comes, policy development, project management (e.g., Quality Improvement [QI]
initiatives, the Magnet® application process), nursing unit management, participation
on cross- disciplinary health care teams, and risk management, to name just a few.
However, wherever DNPs find themselves, in my opinion, the most important skill
set they need in order to succeed will involve their ability to act as advocates, persuade
others to their point of view, anticipate and resolve conflict, manage staff, encourage col-
laboration, and improve clinical outcomes— all skills that have at their heart the ability
to negotiate with others effectively. Although career opportunities for DNPs continue to
evolve, the chapter is correct to point out that they can expect to encounter many situ-
ations requiring sound negotiation skills. However, research suggests Cavanagh (1991)
and my first- hand experience confirms that rather than take advantage of opportunities