Information on the DNP-Doctorate of Nursing Practice

BOSTON--The new Doctor ofNursing Practice (DNP) degree is meantto be to nursing clinical practice what thePhD is to nursing research, SharonKrumm, RN, PhD, said at the OncologyNursing Society 31st Annual Congress(abstract 34). Dr. Krumm is administratorand director of nursing at the SidneyKimmel Comprehensive Cancer Centerat Johns Hopkins Hospital.

Dr. Krumm said that the DNP is intendedto provide "clinical, organizational,economic, and leadership skillsneeded to critique scientific findings anddesign care delivery programs to addresslocal needs and effect positive health careoutcomes."

The DNP curriculum has three parts:core essentials; Advanced Nursing Practicecore and differentiated competencies based on direct care or the indirectinfluence of clinical outcomes; and specialtycompetencies and content definedby specialty nursing organizations.

Dr. Krumm said that this new degreeis designed, in part, to increase the numberof faculty available at schools ofnursing, enabling them to increase enrollmentin schools of nursing and toattract individuals who might not otherwiseconsider nursing as a career. Enrollmentinto a number of nursing programsis currently limited because of a facultyshortage, she said.

Meanwhile, the projected need for staffnurses in the year 2020 is expected toexceed the supply by 20%, and vacancyrates will increase from 6% today to 29%in 2020. "The demand for health serviceswill increase by 40%, while the numberof nurses will increase by only 6%," Dr.Krumm said.

Another question is how the DNP will affectrelationships with other professions."The American Medical Associationtask force on the scopeof practice partnerships seeksto limit nonphysician practices.Would the DNPchange this?" Dr. Krummasked.

The continuing turf disputeis highlighted by the AmericanMedical Association's "Policy RegardingSupervision of Medical Care Delivered by Advanced Practice Nurses inIntegrated Practice." This documentstates that physicians mustretain authority for patientcare in any team care arrangement;that medical societiesshould lobby legislatures andlicensing boards "to preventdilution of the authority ofphysicians to lead the health careteam"; that only physicians shouldbe able to independently prescribe drugs;and that physicians should run the qualitycontrol programs for nonphysiciansdelivering medical care in integratedpractices. Dr. Krumm commented:"Consensus in the academic and clinicalcommunities about the DNP has yet tobe achieved. Role clarity, both within theprofession and for patients and society,is essential. We need to remember that ittakes courage to change, and it takescourage to resist change if that is theappropriate stance."