Development Of The Doctorate Of Nursing Practice

Multiple studies have linked professionalism with high amounts of education (Blaney 1986, Jacobs and Bishop 1998, Hess 1996). Other professions such as lawyers, physicians, architects, etc. maintain a high-standardized level of education in which nursing fails to do so. The American Nurse Association (ANA) committee published a position paper that compared nursing to other professions and recommended that the ADN is not sufficient for this profession (Jacobs and Bishop 1998). Jacobs and Bishop (1998) made a point by stating that “the education of professional nurses must take place in institutions of higher learning with a bachelor of science in nursing degree required for beginning professional practice as they should be socialized with philosophic and value system that is compatible with this role” (p. 226). Nursing is an evolving profession where they must be able to utilize their critical thinking skills in order to “assess, diagnose, intervene, evaluate, be a leader, deliver evidence-based care and know how to research and interpret that evidence. These competencies are only achievable through higher education with the baccalaureate level being the launching point” (Tollick, 2013, p. 4).

Healthcare systems and the way safe, quality health care is delivered are continually changing to better serve patients and communities. Professional nursing practice is a large component in the healthcare system today. Back in the 1960s, professional nursing leaders tried to adopt the bachelor degree programs as the only educational track to become a registered nurse (Creasia & Friberg, 2011). Due to nursing shortages and demands this motive did not hold fast. Individuals entering the nursing profession today must first decide which educational pathway to take to become a Registered Nurse (RN).

In addition, a DNP degree will help me better serve my community by advocating for quality and safety healthcare system. Once attained, I would seek employment at either a school or university with the mission of educating nursing students to practice the highest quality of patient care. One of the major issues facing the nursing profession today is the lack of advance nursing practices. The medical field is in crisis. Doctors are stretched to the limits, and patients are demanding more advanced care. To alleviate some of the concerns facing medicine in the 21st century, advance nursing practices is a vital area in the contribution of understanding and working within the bounds of a team structure, and the promotion of communication between the interdisciplinary health team. The mission of the advance nursing practice is to help individual patients, and their families, determine and achieve optimum physical, mental and social potential, and to do so within the challenging context of the environment in which they live and work Nurses are among the largest professional care group within the healthcare service industry. We are responsible for providing quality care and assisting patients towards independent and healthy living. Considering the changing working environment, health care practitioners like nurses are

In the article written by Ford, (2009), the doctorate of nursing practice (DNP) has an important role to play in the current health care system which is constantly changing. As healthcare around the world is transforming, the Institute of Medicine (IOM) 2011 report mentioned that in the United States, Advanced practice nurses play a vital role in the rapid complex changes based on the full extent of their education and training. This article describes some of the positive role of the advance practice Nurse as a facilitator in the regulatory and policy developments. The Advance practice nurse participates and provide cost-effective care models that will improve the access and quality of care of the population. Another positive area for the APN in this current healthcare system is health promotion, health maintenance, and prevention. In this evolving health care system, it gives the Advance practice nurse the opportunity to set up acute and primary care settings that will positively impact health care delivery as they meet the needs of an expanding, aging, and chronically ill population. All over the world, the NP’s role has developed and is beneficial to health care systems and health care consumers. As Advance practice nurses we must use this great opportunity to advance our role and work with others to improve and transform health care globally. DNP graduate 's role is include leadership, research, practice, education, and

As popular as the ADN is today, there is a huge momentum to encourage nurses to receive their BSN instead of an ADN. Nurses that are already entering the workforce at the BSN level are not only more skilled at following and understanding evidenced based practice, but they are also more prepared to go on to school to complete their masters or doctorate degrees. In the changing face of healthcare, more nurses with advanced degrees will be needed to provide primary care as in the role of nurse practitioners. APRNs are going to be in higher demand in community care, public health nursing, evidence based practice, research, and leadership. Shortages of nurses in these positions create a “barrier to advancing the profession and improving the delivery of care to patients” (IOM, 2010, p. 170). Shortages of APRNs and the increasing need for nurse practitioners to provide primary care is why the IOM is recommending to increase the amount of BSN educated nurses entering the workforce to 80% and to double the number of doctorate nurses by 2020 (IOM, 2010, p. 173) The goal to increase the nursing workforce to 80% BSN educated nurses and double the amount of nurses with doctorate degrees is a formidable goal, but increasingly necessary. Patients are becoming more complex inside and outside of the hospital setting with chronic multiple comorbidities. BSN educated nurses are not only better prepared to care for these

With an ever-increasing body of knowledge in the field of nursing, more education is being required to enter the field of nursing. Many healthcare institutions are raising the educational requirements in order to become employed or maintain employment in their facilities. Healthcare organizations are transitioning to hiring registered nurses (RN) who have a higher level of education, such as, a graduate from a Baccalaureate Degree Nursing (BSN) program. The goal of these institutions is to have nurses with a broader array of skills that can meet the growing demands of our patient population. BSN prepared nurses are recognized for their well-rounded skills in critical thinking, management, case management and health promotion versus Associate Degree nurses (ADN)/Diploma nurses that focus on direct patient care.

Role of DNP-prepared nurse. The American Association of Colleges of Nursing AACN (2006) created VIII essentials that define the key elements that are necessary for a doctor of nursing practice program. Two key essentials that played a major role in the project manager’s planning and implementation during the EBP change project are:

The American Association of Colleges for Nurses [AACN], (2006) in 'The Essentials of Doctoral Education for Advanced Nursing Practice ' Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking, affirms "advanced nursing practice (APN) includes an organizational and systems leadership component that emphasizes practice, ongoing improvement of health outcomes, and ensuring patient safety. APNs should be prepared with sophisticated expertise in assessing organizations, identifying systems’ issues, and facilitating organization-wide changes in practice delivery". (p.10) Hameric, Hanson, and Tracy ( 2014) indicates that APN must assess the clinical microsystems in which they perform nursing practices, have knowledge of the medical organizations that impact their specialties, assist with establishing patient centered care reforms to enhance quality of nursing care, improve patient safety, and provide nursing indicators that evaluates nursing performance. (p.266) APNs perform leadership capabilities in four chief areas including clinical practice settings, in the nursing career, within organizations, and in healthcare politics at regional and national levels. (Hameric et al, 2014, p. 266)

This “incorporates the roles of assessing, critical thinking, communicating, providing care, teaching and leading” (Grand Canyon University, para. 7). I also believe that an individual’s maturity over a four-year period has time to evolve with the concepts of critical thinking and decision making the BSN framework offers. The difference in cost and time from ADN to BSN programs is a deciding factor in many educational decisions. The economy and decrease in job opportunities has driven many into the nursing profession that may not have initially considered it a career option. Sadly, I believe that has contributed to the lack of interest in pursing an advanced education. The professional choice wasn’t driven out of a motivation to help humanity or a sense of altruism; it was merely an employment opportunity.

A nursing theory allows the nursing profession to define and differentiate nursing care practice from other professional disciplines. The work of Patricia Benner has been crucial in setting a stage to standardize education and career progression for the nursing profession. The nursing care practice has been changing exponentially since the development of the theory From Novice to Expert. It has enabled facilities across the nation to achieve a higher level of patient care due to its ability to identify the needs of each of the stages of a professional nurse’s career progression.

The Carnegie Foundation reports that nurses today “are undereducated for the demands of practice” (Benner, Sutphen, Leonard, & Day, 2009, ¶ 17). Education of the ADN centers around the hands-on skills needed to care for a patient at bedside and less on the scientific theories that allow the holistic treatment of a patient. A report by the Milbank Memorial Fund in 2001 reports that nurses educated at the ADN level have a higher incidence of mistakes made while performing their duties (Rosseter, 2011, ¶ 24). Registered nurses who graduate with the two year degree lack research skills, leadership and managerial skills as well as informatics needed to deliver quality medical care within today’s health care system (Orsolini-Hain & Waters, 2009, p. 269).

Nursing is a profession that requires individuals to be skilled and knowledgeable in several different arenas. From the use of science in order to apply theories and research into practice, to using critical thinking and advocating for the improvement of healthcare, the Advanced Practice Nurse (APN) must be able to integrate these skills into practice. This paper will review the competencies set forth by the National Organization of Nurse Practitioner Faculties (NONPF). In order to better grasp how an APN implements the use of such competencies, an interview has been conducted with a leader in the profession. This interview was done in person with the use of a tape recorder while the interviewer took notes. To better understand just how instrumental these competencies are to the profession, the APN student must be able to see how it is used in everyday practice by one who is already working as an APN. APN students can review materials concerning the competencies needed; however, the student is able to have a better grasp of the role of the APN by becoming aware of how one in the profession applies these competencies in the real world.

Although the American Association of Colleges of Nursing clearly defined the role of Doctor of Nursing Practice (DNP) degree in 2004, some confusion about the academic programs still exist. The role of both the DNP and PhD-prepared individuals is to improve the quality of health care and the health of population through the use of the best evidence when assisting them in making decisions about treatment options. Melnyk, B. M. (2013). According to the national leaders in major healthcare fields, mentioned a gap between research and practice and the importance to apply research findings and engage in evidence-based practice. In order to translate this knowledge, the clinician must understand the healthcare delivery in order to help narrow the research-to-practice gap and transform health care. DNP-prepared nurses are trained to reduce the research-to-practice gap. Because most nurse lack knowledge to critically appraise research studies and the skills to effectively implement evidence-based practice (EBP) in their clinical settings.

The educational requirement for advanced nursing practice is a master’s level education in a program or track leading to APN licensure, including graduate degree-granting and post-graduate certificate programs with established educational standards and attainment of the APN core, role core and population core competencies (National Council of State Boards, 2012). APN’s acquire increased knowledge in the sciences of anatomy, physiology, microbiology, chemistry, pathophysiology, and pharmacology. The core curriculum for the advanced practice role includes priorities in

There is an increasingly high demand for students going into nursing careers in our society, but there are also varying educational pathways for these students to get into these careers. Are the three educational pathways (Diploma, Associate Degree, and Baccalaureate Degree) preparing prospective nurses to be at the same competency level after schooling? Advancement in education has become an increasingly important topic amongst health care organizations. Educational preparation can indeed affect nursing care and the decision making of nurses. In this paper, an analysis of nursing history and the degree programs themselves will provide evidence of an increased level of patient care by BSN nurses vs. ADN nurses.