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

Potential Impact on Neonatal Nursing

The DNP as entry into advanced practice is supported as an option by the National Association of Neonatal Nurse Practitioners (NNPs), but not as a mandatory requirement.[31] It cites reasons similar to those presented above as the basis for its position: lack of evidence that education beyond the MS would create a better NP, safe cost-effective care has been provided by MS-prepared NPs, and increased health care costs are likely to result from additional required education. Consider that a master's degree has only been required for entry into advanced neonatal nursing practice for the past 11 years. There are national shortages of qualified NNP applicants.[32] Even with the economic woes facing the United States, NNP graduates often find NNP positions readily available to them. However, the number of NNPs entering practice has remained stagnant over the past 10 years, averaging approximately 240 graduates annually.[33] The impact of a significantly prolonged NNP education program would delay NNP entry into practice and worsen the shortages already identified. With a total workforce of fewer than 5000 NNPs[34] and even fewer neonatal CNSs, neonatal nursing is a very small specialty. Many NNP education programs have been forced to close, primarily because of small enrollments, with only 32 programs active in 2011. Approximately half of those programs either offer or plan to offer an NNP/DNP option.[35] The DNP may drive the NNP specialty out of existence because neonatal specialists are very much needed in the marketplace. Although institutions may prefer to hire NNPs, the market may force other solutions, including the hiring of intensivists or physician assistants to fill the gap left by the shortage of NNPs.


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