5: THE ROLE OF THE PRACTITIONER ■ 147■ CLOSING MS-LEVEL NP PROGRAMS: POTENTIAL PITFALLS
Despite the 2015 goal cited by AACN (2004, 2006) as the year graduating NPs would
be required to have DNP degrees to enter advanced practice, a recent study sponsored
by AACN (Auerback et al., 2014) has illuminated very different data. In fact, as of 2014,
approximately 70% of APRNs across specialty roles were still entering practice with an
MS degree (Auerback et al., 2014). The document goes on to describe many of the barri-
ers and facilitators to closing MS-level advanced practice programs as well as exploring
the reasons that the DNP has not been received with as much enthusiasm beyond the
academic world as was previously hoped for. Although it is true that the expansion of
available DNP programs has grown at an impressive rate and still more programs are
in the planning stages, there appears a rather clear dichotomy in viewpoints based on
the data.
The debate regarding whether to close MS-level programs offering APRN educa-
tion remains one that seems to be made at the individual school level. Some have already
closed their MS programs, other have taken a “wait and see” pragmatic approach, and
still others located in educational setting where conferral of a doctoral degree is not
an option, remain committed to their MS programs. Again, the recent data from the
Auerback et al. (2014) study provide important information. We know that only 30% of
APRNs were entering practice with a DNP as of 2014. Additionally, estimates project
increasing percentages of DNPs entering APRN practice over the next several years,
but will the DNP actually reach the level of 100% as put forth by AACN? Not according
to the Auerback et al. (2014) findings, which suggest that in the future, approximately
50% of APRNs will enter practice with a DNP. This is an interesting number, given
the parallels to the ANA position statement from 1965 (American Nurses’ Association
[ANA], 1965) advocating bachelor of science in nursing (BSN) entry for nursing prac-
tice. Despite the ensuing 50 years between the publication of the ANA paper, recent data
demonstrate that as of 2013, the percentage of nurses in practice , who held a minimum of
a BSN degree was somewhere between 55% and 61% depending on the study (Budden,
Zhong, Moulton, & Cimiotti, 2013; Health Services and Resources Administration, 2013).
It should be noted that these data included nurses who had obtained a BSN post-RN
licensure from either a diploma or associate degree program. It will be interesting to see
what impact might be on the push for BSN entry should the federal government realize
its stated goal of free education at community colleges (Obama, 2015). Regardless, it
does not appear that DNP entry for APRNs will be accomplished with any greater suc-
cess than the BSN entry argument made half a century ago.
Today, our discipline has its roots firmly established in the academic setting, with
nursing now recognized as a scholarly profession rather than as an “apprenticeship”
occupation as it was in past decades. Nursing, as a discipline, has a responsibility
toward society to care for the sick and to promote wellness in the larger society. In light
of current needs, is this really the appropriate time to advance this agenda? What will
be the impact to society, to the current nursing workforce, and to the faculty workforce?
At the NP level, shortages exist and are predicted to worsen, especially in cer-
tain specialty areas, such as the national shortage of primary care providers (Pho,
2008) increasing the demand for primary care NPs (Stanik-Hutt, 2008a), the acute care
NP (Howie-Esquivel & Fontaine, 2006), and the neonatal NP (Bellini, 2013). Although
some of these shortages result from small numbers of students within and entering
existing programs, the larger issue is anticipated increased demand for NPs in these
areas consistent with sweeping national changes stemming from the Affordable Care
Act (2010).