1: THE HISTORICAL AND POLITICAL PATH OF DOCTORAL NURSING EDUCATION ■ 25
prepared in master’s degree programs that often carry a credit load equiv-
alent to doctoral degrees in the other health professions. AACNs newly
adopted Position Statement on the Practice Doctorate in Nursing calls for edu-
cating APNs and other nurses seeking top clinical roles [italics my emphasis] in
Doctor of Nursing Practice (DNP programs). (AACN, 2004d, p. 1)Certainly, this is just a press release and not the official policy of the AACN, but
the reader is left to believe that APRNs are the target and who are the “other nurses
seeking top clinical roles?” That is indeed a very odd way to describe the job description
of a chief nursing officer or vice president for nursing. These are not clinical roles. All
the indirect functions in nursing (e.g., administration, teaching, clinical trials manage-
ment) are classified differently from direct care roles, and the point made here is that the
nursing professor who oversees students in the clinical area is as close to clinical as the
administrator in charge of clinical services. Ultimately, the clinical executive role was
made explicit in the AACN’s (2006) Essentials of Doctoral Education for Advanced Nursing
Practice and became an official ANP specialty.
A further examination of the final 2004 AACN position statement document does
indicate that there was no consensus over endorsing only the DNP degree initials, but
the argument that multiple degree initials would create confusion and perhaps lead to
the DNSc, DNS, and DSN conundrum again apparently won (AACN, 2004a). It is largely
unknown, however, how the practice of the nurse executive was deemed “advanced
practice” by the AACN in 2006, but the practice of the nurse educator was excluded. The
authors of Chapter 7 also raise this issue. This author has covered this unfolding his-
tory in detail, mostly because it is unrealistic to assume that PhD enrollment is going to
alleviate the nursing faculty shortage, especially with there being a 3.1% decline in PhD
enrollment (and a 19.1% increase in DNP enrollments) in 2015 to 2016 (Fang, Li, Stauffer,
& Trautman, 2016). Throughout this book, and especially in the last chapter, the very
erratic enrollments and graduations from PhD programs noted do not look promising.
For instance, in 2008, there were only three net new PhD graduates in the United States
with an overall increase of 0.1%, while there was an increase of 5.1% in 2009 with 201 net
new graduates (AACN, 2009a; Fang, Tracy, & Bednash, 2010). Eight years later in 2016,
enrollment in doctoral, research- focused programs decreased by 3.2% (minus 168 stu-
dents) and graduations decreased by 3.5% (net loss of 26 graduates; Fang, Li, Stauffer,
& Trautman). Nevertheless, what is worrisome is that these stagnant enrollments and
graduation from largely PhD programs declines do not represent a trend that will ade-
quately resupply the number of PhD-prepared, senior faculty teaching in the academy.
Already, according to recent data from the Tri- Council of Nursing^13 (April 2, 2014):
The U.S. Bureau of Labor Statistics expects that by year 2022, the number
of practicing RNs will grow by 19% and that employment of NPs, CRNAs,
and CNMs will grow by 31%. Moreover, a 2013 HRSA report anticipates that
waves of retirements in the nursing workforce will leave a significant burden
on the pipeline. Over the next 10 to 15 years, the nearly one million RNs over
age 50 (comprising approximately one- third of the current workforce), will
reach retirement age. (p. 1)Because the DNP degree is still the “sizzling hot nursing degree” it was when we
published the first edition of this book (simply based on numbers and new programs), a
reengineered curriculum that allows at least some inclusion of the educator role without
penalizing students with extra coursework seems to be one realistic option because the
trends are very clear— DNP graduates are going into academia in significant numbers
and the nursing faculty shortage continues.