The Doctor of Nursing Practice for Entry Into Advanced Practice

The Controversy Continues as 2015 Looms

Sandra Bellini, DNP, APRN, NNP-BC, CNE; Regina M. Cusson, PhD, APRN, NNP-BC, FAAN


NAINR. 2012;12(1):12-16. 

In This Article

Economic Pressures

The state of the US economy in recent years is another considerable issue in terms of the potential cost considerations should the DNP degree requirement be implemented. Unemployment rates are higher than they've been in years, home values have decreased significantly, and the cost of higher education continues to escalate. Taken into consideration with the AACN call for doctoral-level education, it is understandable that there is strong resistance to requiring additional education for entry into practice. Because APRN students are often working nurses with families to support, is it realistic to expect that they will assume additional financial liability for their own education at the same time saving for their children's? Will additional funding for graduate nursing education be available to facilitate a transition to doctoral-level education, or is this to be an unfunded mandate? At present, the answer to this question is uncertain.

Individual costs are not the only costs to consider. On the whole, the US health care system is among the most expensive in the world, with costs consuming 17% of US gross domestic product.[18] Comparatively speaking, other developed nations are able to achieve similar patient outcomes as the US while spending far less per capita. Can nursing contribute to the challenge of lowering the cost of health care in the United States? If calls for substantive reform of health professions education are addressed, the clinicians of tomorrow, both MD and DNP, will be competent in the two most effective ways to improve cost effectiveness: "systems-based practice and practice-based learning and improvement."[18] Again, these concepts are aligned with publications from the IOM, AACN, and the Carnegie Foundation, who are in agreement on these issues.[12–16,18]


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