28 ■ I: HISTORICAL AND THEORETICAL FOUNDATIONS FOR ROLE DELINEATION
by Agger, Oermann, and Lynn (2014) titled Hiring and Incorporating Doctor of Nursing
Practice– Prepared Nurse Faculty Into Academic Nursing Programs, they write, “we
found that in many baccalaureate schools, DNP- prepared faculty are still held to similar
tenure expectations as PhD- prepared faculty, which is why many are not or will not be
considered for tenure” (p. 443).
Finally, with regard to scope of practice, the AACN in 2004(a) stated, “master’s pre-
pared advanced practice nurses identify additional knowledge that is needed for a higher
level of advanced practice” (p. 7) and “a new and higher level of preparation for APN is jus-
tified if and only if it results in sufficient knowledge and skill above that already included at
the master’s level” (p. 12). Even the National Panel for Nurse Practitioner Practice Doctorate
Competencies (2006) states: “The practice doctorate for the NP includes additional compe-
tencies that are to be combined with the existing Domains and Core Competencies of Nurse
Practitioner Practice” (p. 1). It is for this reason that the term doctoral advanced practice is
used to refer to practice by nurses with the DNP or DrNP to differentiate their practice from
master’s- prepared advanced practice nurses (Dreher & Montgomery, 2009). Extending this
definition, we now suggest that the term “DAPRN” be used for “doctoral advanced prac-
tice registered nurse” instead of simply “APRN.” For nonclinicians, the term suggested is
“DANP” for “doctoral advanced nursing practice” instead of “ANP.” This issue of the doc-
toral ANP role is actually the focus of this text. Much has been written about the effectiveness of
master’s- level APN, but with a paucity of outcome data on the DNP degree, a solid decade
after it was launched, these authors and contributors agree it is time to focus more delib-
eratively on this new level of practice, with an emphasis on the role. Other books conflate
DNP role development with DNP- related issues. We continue to think that a particular
emphasis on role remains essential, especially because the success of this degree will
depend on how the role of the DNP graduate evolves and is embraced or rejected by other
health professions and the health care market. Despite the degree’s surge in popularity,
there is no guarantee that the degree will enact all that it was intended to do. Dr. David G.
Campbell- O’Dell’s comments as a DNP practitioner in Chapter 24 illuminate this. Only
with conscientious attentiveness and concern by stakeholders for the degree, professional
development of graduates in their new roles, and the elevated stewardship of its graduates
to the discipline beyond what master’s degree preparation has historically provided, will
the degree’s future success be ensured. If the degree becomes watered down and “quick to
get,” it will simply become a replacement for the master’s, and not perceived by employ-
ers as having additional skills they need (or should pay for). If the degree, however, helps
improve the health care delivery system (and with opportunities for us to prove its worth
with millions of more getting new primary care under the Affordable Care Act), and simul-
taneously advance the profession, then the degree’s creation will have been a triumph.
As enthusiastic as this author has been toward DNP education, the story of this degree
is still a new one and will continue to evolve, and not necessarily along predictable lines.
Remember, just the explosiveness of this degree was not foreseen by its founders.
These two groups, the AACN and the NONPF, therefore, became the drivers of the
DNP degree. And as reported to this author by attendees at various subsequent AACN
meetings (remember that only deans could vote and only recently have nonvoting asso-
ciate deans been invited to attend one of the two annual meetings if the dean is in attend-
ance), it was evident that the PharmD and DPT degree models were being promoted
over the research- oriented hybrid professional doctorates like the PsyD. This decision
was likely made by conference conveners to perhaps better differentiate a new practice
doctorate from the PhD. But in retrospect, the decision to exclude empirical research or
some form of “dissertation or doctoral thesis” was for some nursing academics a reac-
tionary overreach. This decision, left unchallenged for many years, ultimately harmed