22: ADVISING DOCTOR OF NURSING PRACTICE “CLINICIANS” ■ 489progression from entry to expert levels, preparing the practitioner with developmental
knowledge and skill sets transferable to practicing within complex health care systems.
The BSN degree provides core competencies for entry into practice. The MSN degree
builds up on this and allows the professional nurse to focus in a particular specialty
area of nursing. In general terms, the specialization can be within the systems of nurs-
ing education, administration, or clinical practice. For APRN clinical specialties, there
are regulatory licensures and professional certifications required for the specific APRN
clinical practice (see Chapter 3). Though the historical evolution of APRN roles and
resulting regulatory requirements dependent on first obtaining professional certifica-
tion occurred over several decades, MSN education today is more prescriptive and
shorter than those in the 1970s that produced the “rebels, renegades, and trailblaz-
ers” of yesteryear. Specific MSN programs differ depending on the knowledge and
skills needed. For example, MSN nurse- anesthetist programs are quite different from
pediatric NP and nurse- midwifery programs. At the completion of a master’s degree,
advanced practice nurses have a concrete idea of what their clinical role will be as an
MSN- prepared APRN; they choose their specialty area. Their studies are focused on
their specific specialty role and socialization to that specialty APRN role. Their class-
room and clinical practicum experiences are therefore tailored to meet learning goals
for their clinical specialty APRN role.
■ PATHWAYS TO POTENTIAL DNP ROLES
With a leap of faith, a love of clinical nursing, and a passion for learning, DNP stu-
dents are ripe for an empowering journey in academia during their doctoral stud-
ies. Acquisition of a terminal degree, which allows an individualized approach to
self- direct clinical experiential learning during doctoral studies, is an amazing post-
master’s nursing experience. Intensive advisement from doctoral nursing faculty
facilitates this process and simultaneously creates a synergistic relationship between
doctoral faculty and doctoral students. Thus, doctoral education differs dramati-
cally from master’s APRN- prescriptive education. Prepare to disrupt yourself and
your thinking, as innovative change is needed (Samit, 2015). Grow how you think,
broaden your perspectives and be part of the change that will happen to our chal-
lenged health care systems.
Glowing as it sounds, what about the practicalities? What exactly will the graduate
do? Will employers want to hire, and even pay more for a practice doctorate? This line
of reasoning has never interfered with the attainment of higher academic degrees. Do
students pursue PhDs in the humanities because of potential salaries? A PhD in early
American Victorian romance literature surely was not a ticket to becoming a millionaire.
However, it may have provided the particular individual with an irreplaceable intellec-
tual satisfaction above and beyond any other. Should clinical nurses not have advanced
educational opportunities that permit them to build up on what they already know, and
occupy professional roles that can advance practice, perhaps in ways in which the PhD
graduate cannot? The evidence confirms that nurses, staff nurses, and APRNs often take
a salary reduction after obtaining a PhD and transitioning to faculty positions (Yucca
& Witt, 2009). Imagine, practice- based APRNs can advance their academic degree and
remain in practice. Perhaps their income will change— maybe for a higher rate, but not
necessarily; however, their opportunities will expand. If a position requires indepen-
dent thinking, creativity, innovation, and leadership, it is only natural that the applicant
with the best credentials is most likely to get it. It may be the academic degree that