18 ■ I: HISTORICAL AND THEORETICAL FOUNDATIONS FOR ROLE DELINEATION
Despite significant advances in nursing education, however, education- focused
research in the discipline has unfortunately suffered, and this author believes that this
did not need to happen. For example, nursing health systems research (oriented toward
the administrative indirect care role in nursing) has grown in sophistication over the
decades. One only has to look at the extensive work of Dr. Linda Aiken and Claire
M. Fagin, leadership professor in nursing, professor of sociology, and director of the
Center for Health Outcomes and Policy Research at the University of Pennsylvania
School of Nursing, to see the kind of high impact that nursing health system research
can make. Nursing education research, however, has suffered from a lack of innova-
tion and too many education- oriented dissertations that have focused on minor issues
of importance inside and outside the profession. Maybe this will change as the NLN
ramps up its nursing education funding, and if DNP faculty scholars and graduates
seriously conduct and publish outcome data.
Severely complicating this early drive to the doctorate were data in 1965 indicat-
ing that only approximately 22% of all nurses had been prepared in academic pro-
grams (this included associate degree graduates; Nelson, 2002). As mentioned earlier,
the American Nurses Association (ANA) in 1965 first tried to change this percent-
age by mandating that nursing education should take place in a college or univer-
sity setting, and that the BSN be required for entry into professional nursing (Donley
& Flaherty, 2008). Today, this percentage exceeds 50%; hence, although the mandate
was never realized, perhaps we can recognize there has been success at upgrading the
overall preparation of RNs. Next, the emergence of the NP role at the University of
Colorado, Denver, in 1965 and the rise of NP programs offering MSN degrees in the
1970s increased the need for the doctoral credential for faculty NPs, as nurses with-
out common university credentials (typically the PhD) were marginalized in academia
(Dunphy, Smith, & Youngkin, 2009; Silver, Ford, & Day, 1968). What is not known,
however, is how broadly current faculty NPs (or other APN faculty) are indeed pre-
pared at the doctoral level. This author’s cursory review of many nursing school web-
sites across the country indicates that there are still a plethora of NP track coordinators,
particularly nurse anesthesia program coordinators, who do not possess the doctorate.
Perhaps the DNP degree will help alleviate this.
■ NOW: THE DWINDLING SUPPLY OF NURSING FACULTY
WITH THE PhD
In 2008, the AACN published a white paper The Preferred Vision of the Professoriate in
Baccalaureate and Graduate Nursing Programs indicating that nurses who teach in univer-
sity settings (not the community college) should have a doctorate degree at minimum
(AACN, 2008). Unfortunately, in challenging economic times, the profession faces two
issues on this front to accomplish this: (a) how to attract more nurses to doctoral study
and to the educator role and (b) how can we help the masses of MSN- prepared faculty
across the country complete a doctorate? These two issues are critically important be-
cause it is the nursing faculty role that most drives the need for nurses with doctorates.
For instance, DNP programs would not be offered, nor would you be sitting in your
classroom (or behind your computer), if there were not a faculty member in front of you
or online.^8 Similarly, it will likely take time for the consumer health care market to ex-
pect the nurse clinician (certified registered nurse practitioner [CRNP], CRNA, certified
nurse- midwive [CNM], or CNS) to have a doctorate in the same way that it is expected
in academia.