The Doctor of Nursing Practice (DNP) degree has been designated by the American Association of Colleges of Nursing (AACN) as the graduate degree for advanced practice nurses (APNs). Currently, obtaining this degree remains an option; pursuit of a doctoral degree in nursing is a personal and professional decision made by some APNs. The trend toward doctoral preparation appears to be gaining momentum, however, and after the year 2015 it may be difficult to find a nurse practitioner program that awards a Master of Science in Nursing (MSN).
The DNP degree is a practice-focused doctorate that has gained enthusiastic support from the nursing community. Currently, 127 universities nationwide are accepting students into DNP programs, and another 100 programs are in the planning stages. The curriculum is built on the DNP Essentials developed by AACN (www.aacn.nche.edu).
My nursing journey
I completed my undergraduate nursing degree in 1992 at Marymount University, Arlington, Virginia. Soon after graduation I took a PRN (per diem) position at George Washington University Medical Center, Washington, DC, in the outpatient clinics. I rotated through various clinics reporting to the Department of Medicine. This experience was great for a new graduate as it allowed me to decide which specialty was the best fit.
One afternoon in April of 1994, I took a phone call from the nurse manager in the cancer center asking if there was anyone who would be interested in doing some per diem work. It took me about 15 seconds to say, “I would be interested.” I was healing from my own mother’s death from a brain tumor. I believed that working with cancer patients would help me continue to heal and allow me to provide great service to those with the disease. The oncology nurses I worked with were wonderful mentors. They were generous with their time and always willing to share their knowledge. I learned quickly and soon took a full-time position with an oncologist. He guided and inspired me to be the best I could be. I constantly thought of continuing my education. I wanted to offer more to cancer patients than I was able to in that position.
In 2004, I began an MSN and Family Nurse Practitioner (FNP) program. In our comprehensive examinations, I argued in favor of the DNP degree in a debate. I had done a fair amount of reading regarding this new degree and felt strongly in favor of it. AACN had published their position statement, and I had read it thoroughly. I knew from that point that obtaining the DNP was my next goal. Although my MSN/FNP education was excellent, I felt a need and desire for more education to fulfill my intellectual appetite for knowledge that would enhance my clinical skills as an APN. The DNP focus was on practice and the application of evidence directly to the bedside. This appealed to me. I would earn this degree.
I graduated with my MSN/FNP degree from Marymount University in May 2007 and immediately was hired by a solo oncologist in a private practice. In a solo practice, I faced challenges such as explaining the role of an NP to patients, who were often resistant to seeing a new provider. With the full support of my collaborating physician, great humility, and perseverance over the next year, the oncology patients accepted me as a full provider. Soon I was seeing a full load of patients and learning how to perform bone marrow biopsies. Life as an oncology NP was good.
Nonetheless, I could still hear that little voice calling out to me to move forward with my doctoral degree. I began researching universities offering the DNP. In December that year, I was accepted into Chatham University, Pittsburgh, Pennsylvania. I would be part of the second cohort to graduate. There were 22 other APNs in my cohort—several NPs, numerous nurse anesthetists, and one chief nursing officer. The program curriculum was rigorous and challenging. My capstone project was a research study looking at cancer patients’ perceptions of the oncology NP’s role in cancer management. The new knowledge gained from my doctoral work provided me with clinical leadership skills as well as an increased awareness of evidence-based practice, which allowed me to bring research results directly to patients at bedside. In May 2009, I walked down the aisle at Chatham University and was announced to the faculty and student body as Dr Catherine Bishop. I knew I had earned the title through my uncompromising work. I am now proud to meet new patients and introduce myself as Dr Bishop, the oncology NP.
Implications for APNs
The DNP is the highest degree that can be earned by APNs. It has been said that this practice-focused doctorate puts nursing on the same level as many other healthcare fields, such as pharmacy, medicine, and physical therapy. It is important to remember, however, that the DNP is a degree, not a role. I continue to function within my scope of practice as a doctorally prepared NP. I am better equipped to manage the complexities of my patient population because of the breadth of knowledge gained within my doctoral program. The degree has led to professional opportunities that may not have presented themselves otherwise. My collaborating physicians are proud of my achievements and my commitment to furthering my education. My patients believe that earning this degree shows the commitment I have made to them to provide excellent, quality care. They feel rewarded by my work and are happy to call me Dr Bishop.