141chapter FIVE
The Role of the Practitioner
Sandra Bellini and Regina M. Cusson
In their 2004 position statement, the American Association of Colleges of Nursing
(AACN) declared that the future entry-level educational requirement for nurse prac-
titioners (NPs) would be the Doctor of Nursing Practice (DNP) degree. The move has
raised many controversies for both currently practicing MS-prepared NPs and NP fac-
ulty. More than a decade has passed since the publication of the position statement
and the target date of 2015 for entry into DNP has arrived. What progress has been
made? In 2015, the MS-entry option remains the degree of choice for the majority of
NPs (Auerback et al., 2014). However, the degree has become an extremely popular
option for clinicians seeking advanced nursing education. Some of the continuing con-
troversies are: (a) whether the DNP is a degree or a role, (b) how DNP-prepared NPs
are currently practicing, (c) whether DNP-prepared practice is really different from
MS-prepared NP practice, (d) what effect DNP education will have on certification, and
(e) whether programs conferring a DNP degree truly are at the doctoral level of scholar-
ship. In this chapter, we explore these issues to date and discuss the potential etiologies
for, and resolutions to, many of the issues impacting the future role of the NP.
■ EVOLVING ACADEMIC PREPARATION FOR THE PRACTITIONER
The academic preparation path for NPs has evolved several times since the initial
establishment of the NP role. From early certificate programs, to MS-required prepara-
tion, to the more recent 2004 AACN position statement elevating future NP entry-level
education to the doctoral level, nursing continues to strive for the highest education
standards in order to best serve our patients and society. That said, the move to doc-
toral degree–only preparation for NP education raises many questions, with answers
that may remain elusive for some time. In fact, in light of this second edition text, it
is important to assess the extent to which progress has been made toward the AACN
(2015) goal to raise entry into advanced practice registered nurse (APRN) practice to
DNP preparation (AACN, 2004). At the time of writing of this second edition chapter,
it is interesting to note that of the four APRN roles targeted for “elevation” of practice
entry academic credentials, three organizations have endorsed the move to the DNP (all
except the American College of Nurse-Midwives [ACNM] reaffirmed in 2012), but only