502chapter TWENTY-TWO
Refl ective Response 2
Ann B. Townsend
In Chapter 22, Dr. Bloch highlights key issues and challenges that have emerged both
within the profession of nursing and on an individual practitioner level since the
American Association of Colleges of Nursing’s (AACN’s) recommendation in 2004 that
the Doctor of Nursing Practice (DNP) be the entry requirement for advanced practice
nurses (AACN, 2004). The DNP, a clinical practice doctorate, prepares expert practi-
tioners to function as organizational catalysts in practice, leadership, and education.
The basis for the AACN’s recommendation in 2004 was in response to an identified
need to re- conceptualize the educational preparation of health care professionals to con-
front the present and emerging complexities of the health care delivery system (AACN,
2015). Subsequently, the AACN’s decision has sparked concerns, dialogues, and debates
regarding the DNP as a terminal degree for the advanced practice registered nurse
(APRN). Generally, identified issues include title confusion, the DNP or PhD as a termi-
nal nursing degree, role and scope of practice, faculty resources, and professional parity
(Brar, Boschma, & McCuaig, 2010).
Despite these overarching controversies that have surrounded the DNP clinical
practice doctorate as reiterated in Dr. Bloch’s discussion, nurses have enrolled in DNP
programs in exponential numbers. From 2013 to 2014, the enrollment in DNP programs
increased from 14,688 to 18,352 with the number of DNP graduates rising from 2,443
to 3,065 (AACN, 2015). Now, as in the past, nurses in clinical practice have positioned
themselves to accept new roles and responsibilities to meet society’s need for accessible,
affordable, quality health care.
Nursing professionals embarking on the DNP journey, should keep two impor-
tant points made by Dr. Bloch in mind: (a) the DNP is an academic degree, not a
prescribed clinical role; and (b) the responsibility to envision and actualize the DNP
role rests with us. The construction of that vision has definitely progressed over the
past decade and the APRN- DNP role seems to be emerging with clarity. As Dr. Bloch
highlights, APRN- DNP are finding new opportunities for scholarship in clinical,
leadership, and educator roles. Despite limited outcome data to date on the influence
and impact of the DNP role on the profession and the health care system (Pritham
& White, 2016), APRN- DNP graduates reported that throughout their DNP program
they acquired evidence- based practice, leadership, and teaching skills (Graff, Russell,
& Stegbaur, 2007). DNP graduates described an enhanced perspective in clinical