22: ADVISING DOCTOR OF NURSING PRACTICE “CLINICIANS” ■ 485as a full- time research scholar (Bloch, 2005; McGrath & Piques, 2009). Though the degree
is separate, but equal, nursing doctorate graduates must work together for the greater
good of nursing and health care.
Nursing is central to the key policy issues and has the ability to shape health care
reform (Fairman, 2010). Nursing made great strides in the last half of the 20th century,
with profound role successes in practice as APRNs and in academia as PhD schol-
ars. The fight for the development and acceptance of nursing PhD programs and the
APRN role did not happen overnight, but took more than a quarter century (McGrath
& Piques, 2009). The work of the past century emphasized getting our foothold into
academia and into independent practice arenas where we are now more visible to other
“players” (i.e., beyond those of our patients who were cared for by nurses). The pro-
fession is now well positioned to participate in shaping and improving the health and
health care system of our nation. Yet, much improvement is needed. There is a sig-
nificant health disadvantage of the American people compared to those in countries
of comparable wealth (Institute of Medicine [IOM], 2013). Despite the fact that the
United States is the wealthiest country in the world and spends the most money on
health care, health indicators such as infant mortality rates are the worst compared to
all other nations of comparable wealth (IOM, 2013). It is quite apparent that our health
care system is broken and desperately needs help. As we forge ahead, we must allow
our insights from our nursing disciplinary lens to be shared and heard at interdisciplin-
ary forums.
With the success of nursing roles (the independent role of APRNs in practice and
PhD scholars in academia), it is exciting that the evolving practice doctorate has been
embraced nationally, and in record speed. This is evidenced by the rapid growth in the
number of DNP programs. Nearly half of all nursing schools with any graduate- level
nursing education ( N = 564 schools) offer a DNP program ( N = 251 DNP programs)
(Auerbach et al., 2015). The need exists for another level of expertise that builds on
MSN education in practice, despite a clear prescription for the role in the marketplace
for the DNP graduate. As McGrath and Piques (2009) explain, nursing’s commitment to
this practice doctorate reveals our commitment to advancing health care by educating
a generation of very motivated nurses to create unprecedented opportunities within a
multilayered, complex health care environment. Unity and coalitions between all those
in nursing, regardless of all degrees and the “alphabet soup of credentials” within the
nursing profession are necessary. Thus, the future roles will be shaped by the expertise
the DNP brings to health care practice and policy.
■ MSN VERSUS DNP: WHICH IS BETTER ENTRY
INTO APRN CLINICAL PRACTICE?
Should the DNP degree be required for entry into APRN practice? As many are aware,
this was proposed by key nursing stakeholders and then endorsed by the American
Association of Colleges of Nursing’s (AACN’s) proclamation that all master’s programs
that educate APRNs to enter practice should transition to the DNP by 2015 (AACN,
2004). Well, the year 2015 has come and gone, and this did not happen. Though some
schools transitioned their APRN master’s degree programs into DNP programs, most
have not. The MSN remains the predominant entry- level academic degree for APRN
practice (Auerbach et al., 2015). The introduction of the DNP degree can be viewed
as a catalyst of major changes introduced in the last decade. However, nonetheless,
NPs still acquire their critical clinical skills in diagnosis and management of patients