170 ■ II: ROLES FOR DOCTORAL ADVANCED NURSING PRACTICE
the workforce under their span of control, due to their position and the fact that nurses
generally are one of the largest sectors of the health care workforce within health care
organizations. This opportunity to influence many people who ultimately provide the
delivery of care at the bedside is not a position to be understated. It is critical that the
individuals in these roles are well prepared for the challenge and are capable of making
a difference in health care outcomes.
Our view is that the DNP clinical executive tract is unique in that this degree prepares
nurses to be better leaders in a very challenging, dynamic health care arena. Nurses in the
role of the clinical executive are no longer invited to the table solely based on their clini-
cal insight, but more so for their ability and capacity to lead organizations based on their
leadership competencies. Many of these key competencies are outlined in the AACN’s
Essentials for Doctoral Education for Advanced Nursing Practice document and they include
organizational and systems leadership, health care policy for advocacy in health care, and
inter professional partnerships for improving patient and population health outcomes.
■ NURSE EXECUTIVE PREPARATION: THE DNP VERSUS OTHER
DEGREE OPTIONS
In terms of reviewing options to prepare the contemporary nurse executive (aside from
the DNP or DrNP at one school), the options include: an MSN degree with an admin-
istrative focus and a master’s of business administration (MBA); some colleges offer a
combination of the MSN/ MBA as a concurrent option.
Curriculum and course descriptions were obtained and reviewed from an online
search of the following institutions: Indiana Wesleyan University (MBA); University
of Texas Tyler (MSN/ MBA); and hard copies were obtained from the University of
Kentucky (DNP) and Eastern Kentucky University (MSN).^1 Through a juxtaposed
comparison, some of the following initial conclusions can be made: The MSN with an
administrative focus appears to be more focused on a microperspective of leadership
development, preparing a novice leader or someone with leadership aspirations; the
MBA seems to offer a broader base of courses to better equip the nurse executive, because
it includes management concepts, managerial economics, ethics, law, and some leader-
ship courses as well; the MSN/ MBA option seems to be the most broad in that it has a
good blend of the financial competencies along with some basic entry- level leadership
development courses. Overall, any of these three options would be feasible pathways
to prepare novice leaders or individuals pursuing a leadership career. In comparison,
the post- master’s DNP degree with a clinical executive option offers a much more in-
depth preparation for advanced leadership roles, such as the clinical executive who
may serve as the VP of nursing, CNO, chief operating officer, and/ or the chief nurse
executive. With the DNP, one satisfies the requirements of a doctorate, which prepares
the individual on a different graduate level (a doctorate) in comparison to the MBA and
the MSN options (i.e., a master’s degree). Although being a doctorally prepared nurse
executive does not always confer credibility, it does confer the unique competence of the
individual who holds the degree (Gerrish, McManus, & Ashworth, 2003).
When further comparing these different degree programs, the DNP degree appears
to offer a more in- depth overview of leadership and focus on reaching leadership capac-
ity through self- knowledge and self- mastery. The key benefits revolve around the well-
designed, focused residency hours; the extensive overview of leadership literature from
diversified author- based sources; the initiation of the capstone project at the inception
of the DNP program; the liberty to take elective courses outside the College of Nursing,