BOSTON—The new Doctor of Nursing Practice (DNP) degree is meant to be to nursing clinical practice what the PhD is to nursing research, Sharon Krumm, RN, PhD, said at the Oncology Nursing Society 31st Annual Congress (abstract 34). Dr. Krumm is administrator and director of nursing at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital.
Dr. Krumm said that the DNP is intended to provide “clinical, organizational, economic, and leadership skills needed to critique scientific findings and design care delivery programs to address local needs and effect positive health care outcomes.”
The DNP curriculum has three parts: core essentials; Advanced Nursing Practice core and differentiated competencies based on direct care or the indirect influence of clinical outcomes; and specialty competencies and content defined by specialty nursing organizations.
Dr. Krumm said that this new degree is designed, in part, to increase the number of faculty available at schools of nursing, enabling them to increase enrollment in schools of nursing and to attract individuals who might not otherwise consider nursing as a career. Enrollment into a number of nursing programs is currently limited because of a faculty shortage, she said.
Meanwhile, the projected need for staff nurses in the year 2020 is expected to exceed the supply by 20%, and vacancy rates will increase from 6% today to 29% in 2020. “The demand for health services will increase by 40%, while the number of nurses will increase by only 6%,” Dr. Krumm said.
Another question is how the DNP will affect relationships with other professions. “The American Medical Association task force on the scope of practice partnerships seeks to limit nonphysician practices. Would the DNP change this?” Dr. Krumm asked.
The continuing turf dispute is highlighted by the American Medical Association’s “Policy Regarding Supervision of Medical Care Delivered by Advanced Practice Nurses in Integrated Practice.” This document states that physicians must retain authority for patient care in any team care arrangement; that medical societies should lobby legislatures and licensing boards “to prevent dilution of the authority of physicians to lead the health care team”; that only physicians should be able to independently prescribe drugs; and that physicians should run the quality control programs for nonphysicians delivering medical care in integrated practices. Dr. Krumm commented: “Consensus in the academic and clinical communities about the DNP has yet to be achieved. Role clarity, both within the profession and for patients and society, is essential. We need to remember that it takes courage to change, and it takes courage to resist change if that is the appropriate stance.”
