DNP Role Development for Doctoral Advanced Nursing Practice, Second Edition

(Nandana) #1
55

chapter TWO


Role Theory and the Evolution


of Professional Roles in Nursing


H. Michael Dreher and Jeannine Uribe


In the most explicit sense, the “role” of the RN defines the work of the RN. In other
words: What are the job functions of the RN? What are the role boundaries of the RN?
How did the evolution of the work of the RN advance to be a professional role? (Fritter
& Shimp, 2016; Haase, 1990; Zerwekh & Claborn, 2009). As one reflects on the history
of nursing, one can appreciate the struggles of the profession today. The very first for-
mal program for nursing in the United States was a 6- month training curriculum estab-
lished at the Women’s Hospital in Philadelphia in 1863 by physician Emmeline Horton
Clevelend, MD, an 1855 alumna of the Women’s Medical College of Pennsylvania, the
world’s first medical college for women (Robinson, 1946).^1 The historical and opera-
tional creation of the job description of an RN is discussed in this chapter, because one
can make assumptions about the role of the advanced practice nurse only after having
some clarity about the role of the RN. Furthermore, with the advent of the still relatively
new Doctor of Nursing Practice (DNP) degree, the role of the doctoral advanced practice
nurse (DAPN) then needs to be reflected on and addressed (Dreher & Montgomery,
2009).^2 Moreover, some serious questions need to be asked and answered: What should
the role of the DAPN be? How is it or how should it be different from the roles of the
master’s- prepared advanced practice nurse? If the roles are not different now and will
not differ substantively in the future, then the nursing profession has a problem. Finally,
if a more highly educated advanced practice nurse with a doctorate degree does not
improve health, then why bother with the expense and effort of another degree? This
chapter lays some of the groundwork with which to answer these questions in this text.
Moreover, after more than a decade with nurses in critical impact numbers attaining
the DNP degree, is it not time for a new acronym to describe this— DAPN for the doc-
toral advanced practice nurse and DAPRN — for a description of the practice- doctorate-
educated traditional advanced practice registered nurse (APRN) who is a nurse
practitioner, nurse- midwife, nurse anesthetist, or clinical nurse specialist?
This chapter is not meant to be a history of American nursing, which has been
excellently provided by Donohue (1996) in Nursing, the Finest Art: An Illustrated History
(1996); Reverby’s (1987) Ordered to Care: The Dilemma of American Nursing, 1850– 1945 ;
and by Judd, Sitzman, and Davis (2009) in A History of American Nursing: Trends and Eras.

Free download pdf