22 ■ I: HISTORICAL AND THEORETICAL FOUNDATIONS FOR ROLE DELINEATION
third nursing accrediting agency—the NLN Commission for Nursing Education
Accreditation (CNEA)—which began nursing accreditation services in Spring 2016, need
to be more proactive (like the Association to Advance Collegiate Schools of Business)
and include adequate faculty compensation to their review criteria. The AACN does
publish extensive salary data each year and it is an excellent resource when academic
nursing administrators need to negotiate internal salary adjustments and external com-
petitive offers to new faculty.
■ THE SECOND PROFESSIONAL DOCTORATE IN NURSING:
THE ND DEGREE
To be completely true to history, Case Western Reserve University’s (CWRU) initiation
of the extraordinarily innovative ND degree in 1979 was never called nor classified as
a “practice” doctorate. Indeed, it was called a “professional doctorate” (p. 308) by its
founder Dean Rozella Schlotfeldt (1978) of the Frances Payne Bolton School of Nursing at
CWRU. Only now do revisionists call it the “first practice doctorate” (AACN, 2006; Case
Western Reserve University, 2016; Hathaway, Jacob, Stegbauer, Thompson, & Graff, 2006;
Lenz, 2005). Again, the 1970s was a time of rapid growth in nursing education. The DSN
and DNS clinical doctorates were initiated, more PhD and DNSc programs were found-
ed, MSN NP programs began to flourish, and the ANA was still battling to require the
BSN for professional nursing (Nelson, 2002). Then Schlotfeldt (1978), followed by Dean
Luther Christman (1980) of the Rush University School of Nursing in Chicago, affirmed
this vision that the doctorate should be the entry- level degree for nursing (Nelson, 2002).
If there were ever a larger gap in the nursing profession between the professionalizers
and the masses of practitioners or traditionalists, it was at this time. The ND degree at
CWRU was designed after the MD degree. Students entered the doctoral nursing pro-
gram with any basic college degree (just like medicine) and then completed a 3- year
full- time curriculum including the completion of an ND thesis (somewhat differentiated
from the university’s PhD dissertation). Without a doubt, this was a professional doctor-
ate model, and graduates initially were not prepared for advanced practice roles. This
changed in 1990 when alternate pathways to the ND were created, including a post-
master’s option for nurses with an MSN, and indeed graduates at this time were pre-
pared for advanced practice roles (Dr. Joyce Fitzpatrick, personal communication, April
13, 2010). Technically, this degree modification could be termed “a practice doctorate”
(entry level vs. advanced practice), but again the term practice doctorate was not yet part
of the nursing vernacular. In the end, the ND was a failure of innovation and only three
other schools ever adopted the degree model (Rush University in 1987, the University
of Colorado in 1990, and the University of South Carolina in 1999). All four of these pro-
grams subsequently closed and transitioned to DNP programs in 2004 and 2005.
One day someone will write the history of the ND degree and why it failed. Was it
the unrealistic initial concept that any nurse needed a doctorate for entry into practice?
In hindsight, and with apologies to Christman, a true pioneer in nursing, retrospectively
this idea seems absurd or, more kindly, extremely idealistic. For whatever reason, the
first working group on the clinical doctorate established by the AACN in 2002 did not
see much of a future for the degree. Were the initials “ND” perhaps too foreign? Was
the degree confusing to some outside the discipline who thought it was a doctor of
naturopathy— also an ND degree as the AACN has noted (AACN, 2004a)? Certainly,
the post- master’s ND model was an alternative doctorate model to the PhD. But this
author thinks it was more properly a “second generation clinical doctorate” (the DNSc,