To the Editor:
According to the American Association of Colleges of Nursing (AACN), as of April 2009 there were 92 Doctor of Nursing Practice (DNP) programs currently enrolling students and an additional 102 in development. Thirty-four states and the District of Columbia currently have colleges or universities that offer DNP programs. The proliferation of DNP programs has doubled the students enrolled in DNP programs from 1,874 to 3,415 and increased the number of graduates from 122 to 361 (AACN, 2009).
As a DNP candidate, I am on the leading edge of this new wave of doctorally prepared nurses. I am also on the leading edge of the current generation of students who are completing at least some of their education online and completing it within a decade of graduating from high school. This unique position has provided great insight into the current state of education in nursing and the confusion and disappointment associated with the DNP that permeates throughout the nursing world.
In a letter to the editor in 2006, Dr. Jeanette Lancaster rebuffs claims made by Chase and Pruitt (2006) in their article “The Practice Doctorate: Innovation or Disruption?” when she states that Drs. Chase and Pruitt overstate the effect the DNP movement will have on the faculty shortage and the ability of DNP-educated nurses to serve as nursing faculty and receive tenure. To date, there has not been a review or synthesis of the education requirements to be eligible for tenure track positions at schools of nursing.
Furthermore, with the proliferation of DNP programs, there has not been a review of the acceptance of the degree for tenure track faculty positions at the schools offering the DNP degree. I have been told by multiple schools that offer or plan to offer the DNP degree that it is not currently accepted for tenure track faculty appointment. As a graduate of one of the first DNP programs, I feel it is important for every school that offers the DNP program to clearly state this to their incoming students so they are aware of the potential lack of employment opportunities as tenure-track faculty once they receive their DNP degree. Schools of nursing should also allow DNP graduates to become full-time faculty members who have opportunities for tenure and advancement.
Because of the lack of tenure-track faculty positions for DNP graduates, the funding opportunities for DNP students are severely limited. The AACN reported that $171.03 million was appropriated by the fiscal year 2009 Omnibus Appropriations Act for Title VIII funding (AACN, 2009). Included in Title VIII funding are Nurse Education Practice and Retention Grants, Loan Repayment and Scholarship Programs, and Nurse Faculty Loan Programs (AACN, 2009). However, many of these programs require a commitment to teach fulltime to be eligible for the loan programs.
Because DNP-prepared nurses are not eligible for tenure track positions in many universities, their ability to find full-time teaching positions is severely diminished. Therefore, this lack of available teaching positions turns into a lack of funding for many DNP students. With limited financial support from universities and the government, the cost of DNP students’ education accrues considerably more debt compared with PhD students. Therefore, once they graduate, DNP graduates cannot afford to become even adjunct faculty members due to the low salaries in nursing education compared with provider or educator positions in other organizations.
In addition, because many future DNP graduates will have limited practice experience, they may desire to practice nursing and return to teach later in their careers. A separate source of funding should be made available to students who do not want to teach immediately after graduation, but who guarantee to teach fulltime for a defined period of time, such as committing to teach for 5 years within 10 years of graduating.
The change from practicing nurse to faculty frequently requires a substantial pay cut, and as such prohibits doctorally prepared nurses from joining the faculty ranks, especially if they are receiving their advanced degrees earlier in their careers while incurring more debt during the process.
Even with the financial and political challenges presented to DNP graduates, it is still a needed degree and adds tremendous value to the nursing community. Doctorally prepared nurses will be leaders in health care, policy, public health, and the nursing community; however, DNP-prepared nurses should be accepted by the schools of nursing that educate them if they are to be accepted by other institutions. The DNP should be viewed no differently from the EdD, DrPH, or other clinical doctorates (i.e., PharmD) degrees that are accepted by colleges and universities throughout the country. It sends the wrong message if DNP graduates are not accepted by their own degree-granting institutions for faculty positions.
As a soon-to-be DNP graduate, I believe that DNP programs should continue to be created, but in a transparent and cautious manner. Financing for DNP students needs to be secured before additional DNP students are accepted into programs. It is not acceptable to allow students to graduate with tens of thousands of dollars of debt and a degree that is not proven and not accepted by their own institution. All schools should disclose whether they will accept the DNP degree as a full-time tenure track position in their school or whether they will consider the DNP graduates for other full-time-equivalent positions.
We are on the verge of creating mass discontent within a profession dedicated to helping and healing. We are creating stress for DNP students and graduates by not accepting them as part of our community and allowing them to graduate with debt that may never be recovered. The nursing community, especially the community of nurse educators, must act quickly to prevent regret and dissatisfaction among the future leaders of the nursing profession.
Jared Kutzin, RN, MPH, DNP(c)
University of Massachusetts-Amherst
- American Association of Colleges of Nursing. (2009). The doctor of nursing practice fact sheet, 2009. Retrieved from http://www.aacn.nche.edu/Media/FactSheets/dnp.htm
- Chase, S. & Pruitt, R. (2006). The practice doctorate: Innovation or disruption?Journal of Nursing Education, 45, 155–161.
- Lancaster, J. (2006). DNP discussion continues. Journal of Nursing Education, 45, 295–296.