483chapter TWENTY-TWO
Advising Doctor of Nursing Practice
“Clinicians” and How Their
Role Will Evolve With a Practice
Doctorate: Perspectives From a 35- Year
Nurse Practitioner
Joan Rosen Bloch
How similar or different are advanced practice nurses who are Doctor of Nursing
Practice (DNP) graduates from master of science in nursing (MSN) graduates? Since
the inception of the DNP academic degree, the debate about the right academic
degree for entry into nurse practitioner (NP) practice continues. Will roles be differ-
ent for any of the four groups of advanced practice registered nurses (APRNs^1 ) who
first obtained MSN degrees and built up on that with their nursing practice- focused
doctorate degrees? How will they differ? How will they differ from APRNs who
obtain research- focused doctorate, PhD degrees? Will the roles evolve by inductive
or deductive development— or perhaps a combination of both? What determining
factors will shape the roles of APRNs with different “levels” of education prepara-
tion? Must we be prescriptive and restrictive about roles for clinicians with DNP
degrees during a time when many changes are underway in health care and health
care systems? We must not jeopardize the flexibility and creativity of professional
nursing roles that continue to evolve. Perhaps, with knowledge and skills acquired
from doctoral studies, empowered doctorally prepared nurses can build up on their
prior education and practice experiences, and grow their professional journey in
flexible ways that best serve three main stakeholders: the profession of nursing,
health care systems, and, of course, the people served by both the profession of nurs-
ing and systems of health care.
Considering the unprecedented number of APRNs who have sought doctoral
education since the introduction of the practice doctorate in 2004, this is an exciting
time for nursing (Auerbach et al., 2015). It is exhilarating for students and profes-
sors to participate together in doctoral journeys as there is much passion to learn