I like to track conversations and trends related to the doctor of nursing practice degree. This includes legislation, scope of practice, trends in education, and other elements that impact where the degree is evolving. The evolution of this degree is an amorphous process. It is interesting to track because trends are not clearly defined.
One characteristic of the progression of this degree surprised me. I've seen postings on a few DNP discussion groups asking these types of questions: "How fast can I earn a DNP degree?" "What is the cheapest program?" "What program is the easiest?" and "What program is the best?"
Still another question I have seen asked goes something like this: "I don't practice but want to teach. What DNP program will allow me to teach?"
Initially these types of queries made me question why people posted these types of thoughts. However, after thinking about it I don't blame my colleagues for asking which programs are fast, which are good, and which are cheap. Instead, I question what we as professional nurses are trying to accomplish by offering and developing a terminal practice degree in nursing.
Does this degree and what it is supposed to reflect truly support the collective expectation of the professionals who graduate with a DNP? Are we, as a profession, willing to accept a "shortcut" terminal degree? Do terminally-prepared nurses who may have lacked a consistency of rigor in this educational process serve the profession well? If the brevity of a program is the hallmark of its value, are we able to prepare nurses for doctoral-level practice?
The Quest for Answers
These questions do not have easy answers. Perhaps they have no answers at all. The ongoing comparison of the capabilities of the DNP-prepared nurse to the EdD- and PhD-prepared nurse is a source of collective heartburn that will likely continue for many years. Comparing DNP programs using multiple characteristics also takes time and effort. The demonstration of what the DNP-prepared nurse contributes is still a challenge to clarify, both within and outside our profession.
Regardless of what the Institute of Medicine recommends for the growth and development of the profession, if the nursing profession is satisfied with a "doctorate lite" approach to a terminal degree, the DNP degree will lack the expectations of leadership that is anticipated of other terminal degrees both within and outside this discipline.
No doubt colleges and universities will design and provide services to meet the needs of customers. One program may be quicker than another; one college may be cheaper than another; and one school could be perceived as easier or better than another. It's my opinion that the market will influence the success of one program over another depending on the desires of students and how well they meet the needs of health care systems. For example, if University X produces DNP graduates who contribute to improved outcomes better than other schools, it will survive and thrive. Schools that do not produce DNP graduates who can influence practice change and improved outcomes are not as likely to succeed.
SEE ALSO: DNP Practice Expectations
In the context of rapidly changing healthcare delivery systems with added complexity and the need to produce improved outcomes, are terminally-prepared nurses dedicated to practice that rises to the challenge? The number of graduates alone may be one marker of success.
As these numbers increase every year, are we able to appreciate favorable changes in outcomes or improved practice or cost savings as a result of the interventions of DNP-prepared nurses? Aggregate data are needed, yet on anecdotal levels great things are happening-as evidenced by the publications and presentations provided by DNP graduates at numerous conferences.
The Designer's Holy Triangle, a model to guide project management, suggests that when planning a project, the client must choose only two of three options. This can be applied to selecting a DNP program. We cannot have it all. So, do we want it fast, good or cheap? Pick two.
Good + Fast = Expensive
Good + Cheap = Slow
Fast + Cheap = Inferior
Which type of program do you believe will best reflect the goals of the practice doctorate?
David G. Campbell-O'Dell is the director and president of Doctors of Nursing Practice, Inc. Find him at: www.DoctorsofNursingPractice.org.