Today's nurse practitioners have an opportunity to promote the profession in a new and visible way: by earning a doctor of nursing practice (DNP) degree. NPs must assume a visible role in the incorporation of research and practice within the science of nursing, and the DNP will help us do this.
The DNP degree has been created to produce experts in advanced practice nursing and to place emphasis on innovative practice that is evidence-based. DNP graduates have identified benefits to the degree, including advanced clinical leadership, increased involvement in healthcare policy and a stronger focus on research-based standards. DNP graduates also report that the degree has provided them with a higher level of maturity, motivation and self-confidence.
Completion of the DNP degree prepares an NP to effectively handle the more complex challenges in today's healthcare settings. The NP with a DNP displays improved skills in information technology, interprofessional collaboration and mentoring.
Nurse practitioners should take a more active role in stimulating nursing theory guided by research and practice. It is important to thoroughly understand the infusion of nursing science with knowledge from other disciplines, so that NPs can effectively use science-based theories to enhance nursing practice and develop new approaches to practice. In addition to textbooks, NPs should use existing methods and tools of clinical inquiry. Examples are clinical reasoning, clinical conceptual frameworks, participation in research, grounded theory methodology and structured reflection.
NPs should challenge nurses who are not theory knowledgeable to obtain a better understanding of nursing theory. This can help increase awareness of the important role theory plays in guiding research and practice, and allow for the continued advancement of the nursing profession.
Non-nursing theory should also play a role in practice. Nursing researchers are still using borrowed theories more often than nursing theories. It is important to understand theories from sociology and similar disciplines. The link between behavioral sciences, nursing science and practice is clear. The four non-nursing theories commonly used in nursing research are the Lazarus and Folkman's Theory of Stress and Coping, Bandura's Social Cognitive Theory, Prochaska's Transtheoretical Model, and the Health Belief Model. Nursing also borrows from Maslow's Hierarchy of Human Needs and Von Bartlaffny's General Systems Theory.
Before using a theory borrowed from another discipline, NPs should systematically evaluate its appropriateness for the situation in which it will be applied. It is also important that borrowed theories be substantive and reflective of the nursing paradigm, along with the underlying tenets of nursing practice.
I believe it is imperative that NPs continue promoting the science of nursing and contributing to its body of knowledge by pursuing advanced education such as the DNP degree, incorporating nursing science into research and practice, and using nursing theory to guide research and practice. The use of theories from other disciplines provides knowledge that enhances the future of nursing practice.
Mary Atkinson Smith is a family nurse practitioner at Starkville Orthopedic Clinic in Starkville, Miss. She is pursuing a doctor of nursing practice degree at the University of Alabama in Tuscaloosa.