Congress Abstracts 2006

34

THE DOCTORATE OF NURSING PRACTICE: WHAT IS IT AND WHAT DOES IT MEAN FOR ONCOLOGY NURSES? Sharon Krumm, RN, PhD, Sidney Kimmel Cancer Center at Johns Hopkins Hospital, Baltimore, MD; JoAnn Coleman, RN, MS, CRNP, AOCN^®, Johns Hopkins Hospital, Baltimore, MD; and Anne Belcher, PhD, RN, AOCN^®, FAAN, Johns Hopkins University School of Nursing, Baltimore, MD.

The American Association of Colleges of Nursing has proposed the Doctor of Nursing Practice (DNP) as a terminal degree. The DNP would replace the master's degree for nurses in advanced practice or leadership roles by 2015.

Oncology nurses must be engaged in the dialogue about the DNP, and must understand the rationale, and its potential impact on practice, the profession, and society.

The proposal's rationale include: 1) other health care disciplines (medicine, pharmacy, physical therapy) require a doctorate; 2) the terminal practice degree will address the projected shortage of faculty; and, 3) the complexities of managing care (e.g., increasing acuity and complexity of care, and technology and knowledge expansion) require a DNP.

Clinical nurse specialists, educators, researchers, and administrators are included in the Oncology Nursing Society's (ONS) definition of advanced practice nurses (APN). Similarly, the American Nurse Association Policy Statement from 1995 states that advanced practice is used to refer exclusively to clinical practice.

The American Association of Nurse Practitioners has endorsed the proposal. Similarly, the American Association of Nurse Anesthetists plans to move nurse anesthesia education to the doctoral level. However, the National Association of Clinical Nurse Specialists identified issues that need to be addressed, such as how will current practitioners be grandfathered into this change.

The National Academy of Sciences reports that the need for doctorally prepared practitioners and clinical faculty would be met if nursing developed a non-research clinical doctorate. This statement which supports the DNP proposal forces oncology nurses to seek answers to the following questions: 1) Will the DNP disenfranchise current APNs who believe that they are appropriately educated for their roles? 2) Will the separation of the research and practice doctorate erode nursing's progress in the development and utilization of knowledge? 3) How will the DNP contribute to or detract from cost, quality, and access to care? 4) Will the DNP strengthen society's image of nursing or lead to further confusion about entry into practice? 5) Should the DNP occur only at the post-master's level?