To date, a large number of doctorate of nursing practice (DNP) degrees have been earned by nurse practitioners (NPs) with experience as master’s prepared clinicians. Among those of us who find ourselves in this situation, the question of whether that DNP has affected our patient care has arisen. In my own case, as a graduate of a DNP program designed specifically for experienced master’s prepared nurses, I like to think that my DNP program changed my thinking, my approach to problems, and maybe even to life generally. That is what doctoral degrees are supposed to do—orient us toward knowledge synthesis and development and, in the case of nursing, to develop and apply theoretical contexts that help us to understand our work and deliver care. Do those same contexts apply to our clinical knowledge and approach to our patients?
Amelia Schreibman, DNP, ANP-BC, has practiced over the past 3 decades in critical care, cardiology, cardiothoracic surgery, and primary care. She is also an adjunct professor at Palm Beach Atlantic University in West Palm Beach, FL. Dr. Schreibman hosts a radio show focusing on women’s issues, including family, careers, relationships, and health. She also volunteers with Habitat for Humanity and mentors teenage girls through an organization called Women of Tomorrow.
Obtaining my DNP was one of the most remarkable achievements of my personal life and of my nursing career. The DNP degree has fostered the opportunity for me to grow as an individual and has afforded me a better understanding of how a DNP can influence policy in institutions, locally, regionally, and perhaps globally. As an NP, I was already prepared to enhance my clinical foundation to broaden my scope of practice and provide care that allowed me to have greater independence and insight regarding my patients’ plan of care and treatment.
When it comes to patient care and clinical practice, I do not believe the DNP has changed anything with regard to the care I provide to patients. I remain clinically apt and continue to treat patients with the care and expertise that I already had before I earned my DNP. I continue to learn and remain current in treatment and care modalities and pursue my clinical education. My collaboration with physicians and other health care professionals remains a constant force in my practice to deliver the best care to my patient population. I remain steadfast in becoming a better practitioner every day.
The DNP did not change my clinical practice, my clinical expertise, or my approach to patients and their care. The DNP did not change my scope of practice or my dedication to being a better practitioner every day, nor did it change how I am regarded in the clinical setting. The DNP instead gave me a new headset to understand where I could take my expertise when not in the direct patient care arena. It therefore affords me the ability to influence policy regarding the delivery of patient care, but not once has my DNP influenced my delivery of patient care.
What is Your View on This Topic?
Point/Counterpoint offers thought-provoking topics relevant to nurse practitioners in every issue of JNP. Two authors present thoughtful but opposing viewpoints on current subjects, from scope of practice and regulations to work ethics and care practices. Your opinion on these matters is also important, so go to www.npjournal.org or scan the QR code here to register your vote for either side of each topic. Comments or suggestions for future columns should be sent to Department Editor Donald Gardenier at [email protected]
Rosemary Henrich, DNP, FNP-BC, is a primary care practitioner for the home-bound primary care program of the Veterans Administration Southern Nevada Healthcare System (VASNHS). The program provides longitudinal, comprehensive primary care by an interdisciplinary team. Dr. Henrich’s doctoral process improvement project demonstrated that an enhanced teach-back methodology improved adherence among patients with chronic obstructive pulmonary disease who were prescribed an inhaler. She recently presented her findings to the VASNHS and at the annual conference of the New Mexico Nurse Practitioner Council.
I am the first to admit that I was not sure how getting a DNP would impact my role as an NP and a primary care provider. From the start, each class made it more obvious and I found myself not willing to wait for the actual completion of the degree to start making changes in my clinical practice. This should not have been surprising because a doctorate in any discipline should provide the candidate with new pathways to expanded thought processes and ways to improve their role while increasing the integrity of the discipline itself.
Obtaining my DNP suggested new directions for improving the primary care I was providing, as it defined my responsibility to assure that evidence-based practice was the cornerstone of that care. The implementation of evidence-based practice has been slow over the past 20 years, but that does not mean it should be instituted and never challenged. The DNP provides me with the skills needed to evaluate the outcomes of evidence-based practice on the individuals who are the recipients of my care. These evaluations allow me to recognize the difference in responses that suggest my population may require adjustments to interventions that work in other populations. This does not mean my practice is focused on a population, but rather it is focused on how the individual’s response to the care being provided may impact recommendations that lead to evidence-based practices.
The DNP gives me the confidence and the skill to report such responses and add to our health care system’s body of evidence-based practice. As a doctorally prepared primary care provider, I am not only well-qualified to provide patient care, but my institution expects me to deliver that care in an individualized manner that will result in improved outcomes for the populations we serve.
Published online: May 10, 2017
© 2017 Elsevier Inc. All rights reserved.