Letter to the Editor on "Doctor of Nursing Practice..."

The Doctor of Nursing Practice (DNP): Need for More Dialogue

November 1, 2005
in response to topic The Doctor of Nursing Practice (DNP): Need for More Dialogue (Sept. 30, 2005)

Dear Editor:

Thirty years ago, those of us who are Nurse Practitioners can remember the confusion and bitter battles over what our name should be and what educational pathway was sufficient. The system was broken and needed to be fixed. The role of the NP emerged, however, and has evolved into a credible and well respected role. Now, again the system appears to be broken and the new degree of the DNP has been suggested to fix it. All the arguments seem to have merit. Isn't that usually the case?

Proud to be NPs since the 1980s, many of my colleagues and I look back to how we were empowered to think out of the box and create incredible programs of care for individuals and their families. More recently, some of us have obtained PhDs at prestigious universities. We soon learn, however, that continuing to contribute to society through our expert practice is difficult or no longer possible. Now we are confronted with the tripartite mission of teaching, scholarship, and service that comes with becoming a university faculty member. Little time is left for serving society while trying to build our CVs for tenure.

Research is exciting and stimulating, but difficult for the new nursing PhD without real mentorship. Unlike new scholars or junior faculty in other disciplines, the discipline of nursing has not embraced relationships whereby junior investigators are mentored by senior investigators. For many of us, the umbilical cord is cut when we graduate, and we must find our own way as a novice in the culture of academia. The prior years of nursing practice experience may help land the new academic job, but may not have much relevance after that. For the nurse who loves nursing and is very proud of nursing practice, there is something wrong with the picture when returning for the terminal degree is not enhancing your nursing practice expertise, and in fact keeps you away from it. Establishing a program of research that is worthwhile to anyone outside of academia is extremely difficult. Teaching, nonetheless, is fun and is a worthwhile contribution to society as we help prepare the next generation of nurses.

DNP programs have emerged and soon graduates will appear on the scene and be available with their advanced knowledge to help fix the systems of nursing practice, education, administration, and health care policy. I hope we will join together with wisdom and advance the roles of nursing in academia and practice in our ever changing world with many vulnerable populations. Amidst a shortage of nurses and faculty to prepare them, there should be room for all of us.

Joan Rosen Bloch, PhD, CRNP
Assistant Professor
Drexel University
Philadelphia, PA 19102