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Return to table of contentseliminating master’s or bachelor’s degree programswill ultimately aggravate the shortage of health careprofessionals. 147One recent analysis of the DNP mandate succinctlydescribed the dilemma regarding nursing degrees 148 :[W]ill a new degree (the DNP) add to the public’sconfusion about educational requirements in thenursing profession? When a patient consults with aphysician for care, that individual must, by law, holdan MD degree. When a patient meets a “nurse,”that person must, by law, be an RN. The individualmay hold a diploma in nursing, an associate degree,or a BSN. When a nurse says that he or she holdsa doctoral degree in nursing, that degree may be aPhD, a DNS or DNSc (doctor of nursing science),a DSN (doctor of science in nursing), or an ND(a doctor of nursing).Critiques of the DNP mandate from advancedpractice nursing organizationsControversy surrounding the DNP degree is not exclusiveto academia. In fact, much public debate within thenursing community has criticized the haste in creatinga mandatory entry-level doctorate for APNs, withoutin-depth study into the rationale, the effects on currentlypracticing APNs and/or the evidence demonstrating aneed for mandated doctoral preparation for entry-leveladvanced practice nursing. All APNs, including NPs,nurse anesthetists, nurse midwives and clinical nursespecialists, are affected by the 2015 DNP mandate. TheAmerican Association of Nurse Anesthetists (AANA)issued a February 2006 interim position statement noting,“evidence currently does not support mandatoryclinical doctorate degrees for entry into nurse anesthesiapractice.” AANA did, however, approve a subsequentposition statement in June 2007 supporting the DNPdegree for entry-level nurse anesthetists by the year2025. 149,150The National Association of Clinical Nurse Specialists(NACNS), the American College of Nurse Midwives(ACNM), and the Association of Women’s Health,Obstetric and Neonatal Nurses (AWHONN) have eachexpressed serious concerns over the imposition of amandatory DNP degree for entry-level advanced practicenursing. 151 Among the many concerns, the NACNSarticulates the following:• There are no studies showing that doctorally preparedAPNs achieve better outcomes than master’s preparedAPNs.• The impact of adding another degree with morecredit hours on already scarce faculty resources isnot known.• Potential nurse scientists may opt for the DNP asopposed to traditional PhD programs, thus the DNPcould compete against the PhD for scarce resources,reducing the number of nurse scientists and limitingnursing practice research. (Apparently one of theconsequences of the PharmD is that it significantlydecreased numbers of PhD-prepared people in thediscipline.)• Future faculty members who hold a DNP degree mayface tenure or promotion difficulties.It is unclear how the proposed DNP will contribute topatient safety, as there have been no studies done tosupport this premise. The ACNM raises additionalconcerns, which include:• “We agree that there is inadequate evidence tosupport the DNP as the entry-level requirement formidwifery …”147. Id.148. Web. Dracup K, Bryan-Brown C. Doctor of nursing practice – MRI or total body scan? Am J Crit Care. 2005;14:278–281. http://ajcc.aacnjournals.org/cgi/content/full/14/4/278. Retrieved March 25, 2008.149. Web. American Association of Nurse Anesthetists. Interim position statement on the DNP as entry into advanced practice for nurse anesthetists. February2006. www.aana.com/uploadedFiles/Professional_Development/Nurse_Anesthesia_Education/Educational_Resources/DNP/interim_dnp_position_stmt.pdf. RetrievedMarch 25, 2008.150. Web. American Association of Nurse Anesthetists. AANA position statement on doctoral preparation of nurse anesthetists. June 2007. www.aana.com/uploadedFiles/Members/Membership/Resources/dtf_posstatemt0707.pdf. www.aana.com/uploadedFiles/Professional_Development/Nurse_Anesthesia_Education/Educational_Resources/DNP/interim_dnp_position_stmt.pdf. Retrieved March 25, 2008.151. See National Association of Clinical Nurse Specialists White Paper on the Nursing Practice Doctorate (2005). www.nacns.org/nacns_dnpwhitepaper 2.pdf.Retrieved March 25, 2008. See also American College of Nurse Midwives. The President’s Pen “The Doctor of Nursing Practice Degree: Is this the rightdegree at the right time for nursing and is it right for Midwifery?” Quickening, Nov/Dec. 2005. www.midwife.org/siteFiles/president/PresidentsPenNovDec2005.pdf.Scope of Practice Data Series: Nurse practitioners • V. Education and training of NPs31