Nowadays, earning the Doctorate Nurse Practitioner (DNP) degree is considered a responsible step for a Bachelor or Master of Nursing Practice as well as an essential contribution to the healthcare system evolvement. Modern demands of giving care reveal a challenge and need in reconceptualization because healthcare should be effective, sufficient, professional, and constantly developing besides being a standard and used in a wide practice. Modern caregiving requires a complex approach in gaining the highest levels of scientific knowledge and the ability to employ this knowledge for the real nursing. Everything should be done to improve the quality of patient outcomes. Therefore, the development of educational programs plays a pivotal role in the preparation of healthcare professionals. Such educational programs, similar to the DNP degree, are devoted to the development of high-skilled, responsible, and practice-oriented medical workers. Nurses represent the category of medical staff that should be aware of at least the basics of different illnesses and have the ability to provide sufficient care for patients’ recovery and well-being. Thus, DNP completion can significantly enhance the nursing career and help to achieve greater success in the chosen field of activity.
Differences and Similarities Between the DNP and Other Doctoral Degrees
The motivation for building a strong system for professional preparation in nursing has been caused by a range of factors, concerning mostly the quality of care and the safety of patients. In addition, the growing complexity in nursing care is fueled by all-encompassing extension of theoretical knowledge, with lack of a practice expertise at the same time (AACN, 2016). Today, in the circumstances of the shortage of nursing personnel, the healthcare system experiences an acute need in professionals who could manage and assess care efficiently. However, future Doctors of Nursing Practice face the challenges of increased expectations of educational programs. Since 2005, educational non-research clinical doctorate programs have been developed for practitioners’ preparation (AACN, 2016). Moreover, these programs have played a key role for the graduates who would like to continue their career in clinics and apply all their efforts to become professionals in practice. In general, a doctoral degree in nursing represents a helpful tool for development of the medical career as far as it allows taking leadership positions in the future. Furthermore, while PhD in nursing stands mostly for research and teaching, DNP is more aimed to the practical side of clinical expertise. Furthermore, DNP enhances promotion to a manager or executive level.
Generally, nursing doctorate degrees include several main types, and they are focused on different areas of the whole body of medical theory and practice. Thus, Doctor of Nursing Practice is the best option to choose for the practical skills development because such educational programs are practice- and leadership-oriented (All Nursing Schools, n.d.). Further, Doctor of Nursing Science (DNSc) is aimed at research and investigation while Doctor of Nursing Philosophy (PhD) deals with scholarly research (Thomas Edison State University, 2016; All Nursing Schools, n.d.). However, it is undeniable that both degrees are equally necessary for a healthcare system since any research propels the implementation of findings into practice.
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To have a deeper understanding of the issue at hand, it would be useful to emphasize the differences and similarities between these three types of degrees. Firstly, there are some variations in curriculum content, for instance, of DNP and PhD. Thus, DNP embraces gaining knowledge through a direct clinical practice. Usually, curriculum content is more aimed at organizational management, clinical practice administration, leadership, care quality the improvement and evaluation of recovery programs in addition to other clinical areas (Thomas Edison State University, 2016). On the contrary, PhD deals mostly with research methodologies, including providing the evidence for practical nursing and scientific investigations; in other words, it contains the improvement of general nursing knowledge through research (Thomas Edison State University, 2016; All Nursing Schools, n.d.). While DNP students complete an evidence-based project and practice immersion experience, PhD students should present an original research paper or dissertation, concerning new applicable findings to improve caregiving (AACN, n.d.). Moreover, DNP project, unlike dissertations, can have various forms (AACN, n.d.). In addition, there are some differences in research competencies. It is important to notice that the focuses of DNP, PhD, and DNS are related. Thus, PhD and DNS activities occupy scientific and methodological approaches, including enhanced analytical knowledge and decision-making, thus giving new information for DNP to employ (Thomas Edison State University, 2016). In turn, DNP professionals act in a practical way and develop special skills to implement investigational findings into the improvement of care-practicing (All Nursing Schools, n.d.). The roles of DNP and PhD or DNS are also a little different. As mentioned above, DNP educational programs prepare advanced practice nurses along with clinical nurse specialists, nurse practitioners, or nurse anesthetists (Thomas Edison State University, 2016). Correspondingly, the DNP graduates usually occupy the executive roles in healthcare entities, leadership roles with a practical orientation, care quality managers, or clinical program directors. Further, PhD and DNS offer alternative ways in nursing such as researchers, scholars, or nurse scientists. Usually, PhD and DNS graduates take academic or governmental positions.
The prospective of having many benefits, such as broadening the experience and availability of different medical fields to work, has influenced the decision to gain DNP degree. In addition, nurses work alongside with practitioners, such as pharmacists, therapists, physicians, etc., and DNP gives a possibility to obtain nursing education ratable to learning of these disciplines (Thomas Edison State University, 2016). The practical expertise is highly essential for modern caregiving and for its development in the future. The opportunities of practice doctorate help to use research to use the findings in a clinical setting and environment (All Nursing Schools, n.d.). Regardless of the variations of curriculum in different schools, DNP programs often include advanced practice, disease treatment, and diagnostics. This knowledge will help not only to work in some sufficient medical organization but also to become an independent practitioner (Admin, n.d.). In addition, DNP is linked to dentistry and psychology; thus, a graduate has a possibility to change the field of practice. Furthermore, the Doctorate in Nursing Practice degree will never allow being without a job. A graduate can work as a Nurse Practitioner (NP), and in turn, it includes many specializations to work in. More to say, there are positions of Certified Nurse Midwife (CNM), Certified Registered Nurse Anesthetist (CRNA), and Clinical Nurse Specialist (CNS).
At the same time, the attainment of the DNP degree reveals a paramount feature for a future practitioner and gives great preferences in further practice. Firstly, it establishes a framework, directing a graduate to prove the findings in practice. Secondly, it ensures the employment in different medical organizations. All of this could happen because a well-educated DNP graduate begins to approach problems critically and analytically, and such professionals are needed in the healthcare system (Admin, n.d.). With a grounding set of practice orientation and interdisciplinary practice, a graduate can prove themselves to be a serious and responsible practitioner. Moreover, they can be promoted to leadership positions and help to find and develop new leaders, thus overcoming nursing shortage. Improvement of academic tenure would help to enhance the views on current nursing practice and encourage others to discuss and implement new plans of care. Apparently, in addition to clinical practice, a graduate will gain valuable management and business experience. Furthermore, there is an opportunity to turn into other medical degree with the same standards such as medicine (MD), pharmacy, (PharmD), psychology (PsyD), physical therapy (DPT), and others.
However, some challenges might arise for the students who would like to attain the DNP degree. It has been discussed that DNP tends to be changed into a research degree and become almost identic to PhD (Admin, n.d.). Nevertheless, the need in good practice professionals is still acute and, in the case of changing, there would still be lack of truly experienced personnel. Researchers and practitioners co-exist, and the availability of researchers only could hardly help with nursing shortages. In addition, DNP requires many years to complete, and it represents an excessive stress for a nursing student. At the same time, it is useful because of acquiring greater experience for further fast promotion at job and helpful for the selection of true professionals, devoted to their occupation. However, not everything looks as attractive as it could seem. The resistance to the proposed independence of nurses to gain and develop advanced practice degree still exists (Admin, n.d.). This issue remains due to several factors. Firstly, giving a greater independence to the future nurse personnel means forcing healthcare reforms and reviewing legislation, including certification requirements, standards, regulations, etc. Secondly, it could cause divisiveness among the nursing staff (Admin, n.d.). Considering the factors, mentioned above, one can predict a system fracture, leading to the expulsion of the nurses who would like to work practically, in bedside clinical practice (Admin, n.d.). Regarding the time necessary to complete the degree, many students would re-think the decision of acquiring DNP when they think about this factor. Therefore, the nursing shortage would be difficult to overcome. Additionally, educational institutions encounter the problem of creating a greater number of nursing educators who would be practically-oriented and who give students appropriate knowledge, instead of making them turn away from the DNP degrees.
In any case, DNP brings more benefits after its completion. Doctoral programs, focused on practice, ensure the development of practical skill set, including leadership roles, complex practice, and faculty. In addition, strengthening nursing practice and patient outcomes can be improved not only by enhanced knowledge and care delivery but also by leadership skills (AACN, n.d.). Besides better matching of requirements and credits, a student can gain a good credential to focus more on the practice knowledge, with a well-designed base of supply for practice instruction instead of on research activities.
Importance of Evidence-Based Interventions
The necessity for evidence-based interventions and practice is aimed at involving students into the practical side of clinical activity, making them think critically, thus improving patient outcomes. Moreover, such practices enhance the provision of high-quality care through reviewing and eliminating obsolete and ineffective practices and reducing costs (Salinas, 2017). Thus, evidence-based nursing practice plays a key role in gaining practical experience and the achievement of excellence in nursing, with a strong orientation towards patient safety and ensuring long-term recovery (Salinas, 2017). Generally, evidence-based practice is not new, and it involves conducting researches and investigations that could be implemented into practice further to deliver cost-effective and sufficient care. The research for evidence-based interventions is based on looking-up previous evidence-based practices, concerning a particular disease (Salinas, 2017). It can be explained by seeking new ways, methods, and approaches to deliver care instead of following traditions, colleague’s advice, obsolete textbooks, etc. Moreover, such practices could also be useful for older nurses to improve their knowledge and experience.
Students, engaged in DNP educational programs, have great opportunities to develop themselves as constantly-learning professionals. Clinical practice should suggest a young professional nurse to use evidence and provide a more effective care. For instance, Chris Kowal, a full-time nurse and an American student, found that the tool for pain assessment was outdated so he conducted a great research to define the most convenient and suitable tool and implemented it (American Sentinel University, 2011). This is a good example of a real practice-oriented nurse, interested in the development of patient care improvement. The main task of evidence-based practice lies in gaining experience and knowledge of the best resources and places to find the right information. Unfortunately, many nurses now rely only on the materials they have learned in nursing schools instead of finding accurate and timely information about particular questions (American Sentinel University, 2011). This situation means that nurses could not provide an appropriate care since they use outdated information and methods to deliver care to their patients.
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The problem in Professional Practice Today
Looking from the point of a DNP graduate working in a medical organization, one can emphasize the issue of managerial concern. Thus, the increase of healthcare costs usually happens due to the shortage of the nursing personnel. Consequently, expanded job duties can lead to different problems and stress. Therefore, some states have implemented fixed nurse-to-patient ratio to regulate this issue (Ward, 2014). The second problem is inter-professional relationships that can emerge between nurses and patients as well as among staff members, administrators, or other physicians (Ward, 2014). Furthermore, these relations might lead to a range of other challenges such as being threatened by anger and disrespectful behavior by patients or verbal abuse from care team members. In addition to this, many patients and their families can ask to provide a detailed description of diagnoses and their development and other similar questions (Ward, 2014). Nevertheless, building strong and confident relations without conflicts should be in priority for the nursing profession. Another problem lies in meeting patients’ expectations and needs in the conditions of staff shortages, greater responsibilities, and stress (Ward, 2014). Additionally, mandatory overtime, derived from the staff shortage and inappropriate work planning, causes the insufficiency of staffing levels and high patient acuity (Ward, 2014). Moreover, sometimes, the advancement in technologies represents a real challenge, especially for older staff members (Ward, 2014). Therefore, nurses should be always familiar with innovations to be able to have an immediate understanding of the principles of work with new technologies because it is essential for efficient caregiving in modern conditions. Considering everything mentioned above, there emerges the issue of certification and the continuing training of nursing personnel.
Personal and Professional Goals
The doctorate of nursing practice can give many useful tools and opportunities to develop as a professional and continue to improve the practice in the fields that are the most favorite and inspiring for a nurse. Thus, the completion of undergraduate and graduate programs meant becoming the best family nurse practitioner and clinical nurse. Firstly, it was the intention to gain as much knowledge and technical skills as possible to deliver the most convenient and effective care to patients. Someone can be content with such work, but it can be exhausting to do the same thing during one’s entire life. Therefore, there appeared the need to grow and finally become a serious and competitive professional. Having the experience of working as the nurse for about 10 years, including assisting in surgeries and monitoring pre- and post-surgery patients, high managerial skills along with wide knowledge of technologies, and position of spa specialist, there comes an understanding that a professional should expand the experience and employ it further. The knowledge and practice in surgery, in cosmetics, particularly, reveals a great possibility to go further. Therefore, being plastic operator has become the main goal for future achievement. Furthermore, it could be better to have the freedom to increase the access to cosmetics and surgery. Assisting experience in surgeries and the practical orientation in general will help to gain DNP. Since this degree means research integrated to the implementation, it will enhance gaining necessary knowledge and practice to become an expert in plastic surgery. In addition, the managerial experience, mentioned above, could help to build friendly and professional relations with other nurses of a team.
Area of Clinical Specialization
The major part of nursing experience was the position of registered nurse, occupying the areas of surgery (as an assistant) and patient care. Since 2005, professional practice has prevailed over the health assessment of patients through physical examinations with the help of medical equipment. The position of nurse anticipated the work with patients, including the provision of wound care, medication administration, and monitoring the conditions of post-surgery patients stent placement, breast augmentation, and abdominoplasty. The specialization became more centered on the assisting in different medical and bedside procedures such as triple lumen catheter placement, stent placement, lumbar puncture, thoracentesis, chest tube insertion, sheath placement, etc. as well as the monitoring of post-surgery patients. In general, assisting has given many useful skills that can be used in the future practice improvement. In addition, there were coordination, assessment, and the implementation of patients care plans. At the same time, the duties included core measures tracking, reviewing of hypothermia protocols, wound prevention measures, etc. Moreover, other duties included the management of drug titrations, EKG interpretation, and sheath pulling. The work with patients contributed much to understanding people, their needs and helped to find a common language with them. After the practice, which was mostly connected to assistance and monitoring, the position of dialysis nurse allowed involving more technologies in the work, such as Braun, Fresenius, and K hemodialysis machines, and coordinate the development of patient treatment plans along with educating patients on daily care. Generally, the work was related to dialysis monitoring and treatment. Recently the work in Spacious Body and Spa opened new horizons of experience. The position of a spa specialist implies the evaluation of clients’ skin condition and the selection of appropriate facial peels, lotions, creams, and other products to improve the appearance of facial skin. This experience represents a significant feature for the future development in plastic surgery. Moreover, being a spa specialist has widened the knowledge about different means for skin care, which is essential not only in cosmetology but in medicine in general.
The current experience in nursing practice makes such a person the best candidate for DNP educational program. The significant expertise in all aspects of patient care, diagnostics, treatments, and consultations reveal a valuable tool for gaining the doctorate of nursing practice. At the same time, the experience in administering medications, patient education, and treatment along with medical technologies skills, including Meditech Software and Cerner Medical Software, can make a huge contribution to research work and the implementation of findings for the practical utilization. Moreover, the interpersonal skills and flexibility in relations allow solving conflicts and problems within a team. Furthermore, organizational leadership skills and team orientation together with planning and prioritizing could help to build comprehensive plans for working and for patient care as well. Finally, the orientation at supporting patients will improve the development of high-quality care and pay attention to every patient through an individual approach. The list of certifications and licenses enclosed in the Appendix proves the sustainability of a candidate for gaining the Doctor of Nursing Practice degree.
Not only is the Doctorate Nurse Practitioner degree is a good opportunity to have a high-paid job, but it also enables one to grow as a professional. It is vital for a clinic to have a sufficient nurse practitioner who has profound knowledge and the ability to use it in practice. Today, many medical organizations suffer from lack of real professionals with miscellaneous skills. The healthcare system should develop constantly. When research and investigations do not reveal a serious problem and they remain at a high level, the implementation of findings still needs to be more enhanced. A good practitioner is always necessary and valuable in any medical organization. Thus, the Doctorate Nurse Practitioner degree is a strong step to extending the nursing expertise, growth in the chosen career, and contribution in the whole healthcare system; however, it also ensures safety and improved patient outcomes, and these are the key priorities in this profession.