NURS 8002 Doctoral Degree and Professional Nursing Practice –


NURS 8002 Doctoral Degree and Professional Nursing Practice
A doctoral degree carries a certain set of expectations associated with the completion of advanced educational attainment. Earning a DNP degree is no exception. What are the expectations associated with a DNP-prepared nurse? How might these expectations differ among nursing staff without a DNP degree?
The role of a DNP-prepared nurse is multifaceted; they can serve as nurse educators, policy and legislation advocates, direct nursing care supervisors, or advanced practice nurses responsible for tracking, installing, and monitoring initiatives aimed at improving nursing and healthcare delivery. Regardless of the expectations associated with a DNP-prepared nurse, throughout your program of study, you will hone the skills necessary to enact each of these roles. Consider which role you are most excited about. What do you hope to accomplish in the realm of professional nursing practice with your DNP degree?
For this Discussion, reflect on your personal motivations to pursue a DNP degree. Consider the expectations associated with the DNP-prepared nurse, including how these may differ with a PhD-prepared nurse. Reflect on the DNP degree requirements, including your practicum/field experience and completion of your Doctoral Project. Then, think about how you will demonstrate the alignment of the AACN DNP Essentials to the completion of these program-of-study milestones.
To prepare:
• Review the Learning Resources and reflect on the reasons you have chosen to pursue a DNP degree. How do you anticipate that earning this degree will support your professional goals?
• Reflect on the differences between DNP and PhD degrees. How may this relate to your decision to pursue the DNP degree?
• Review the degree requirements for completing your DNP at Walden. Specifically, consider the focus of the Doctoral Project and practicum experiences as discussed in the DNP Essentials document. Keep in mind that you will be required to identify a site or sites for completion of your DNP project and your practicum hours required for the degree. You can refer to the Field Experience requirements presented in the Learning Resources.

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• After reviewing the DNP Essentials document and the DNP Project Process Guide for the DNP project, reflect on what it means to address an organization’s needs to attend to a gap in practice or implement a practice change. What is the difference between a gap in practice and a practice change? How does your role as the DNP-prepared nurse contribute to meeting a stakeholder need?
By Day 3 of Week 4
Post a brief explanation of the role of the nurse with a practice doctorate. Be specific. Explain the expectations associated with obtaining this degree, including how these expectations might be different for a nurse who holds a different degree. Then, explain how these considerations relate to your motivation to pursue a DNP, including a brief description of how your role as a DNP-prepared nurse will meet a potential organization’s need to address a gap in practice or implement a practice change. Discuss any experiences you have had in addressing a gap in practice or a practice change within an organization. Be specific.
By Day 6 of Week 4
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting an additional perspective on what it means to be a nurse with a practice doctorate, offer support to the expectations with obtaining the degree that your colleague posted, or expand upon your colleague’s post.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Submission and Grading Information
Grading Criteria

To access your rubric:
Week 4 Discussion Rubric

Post by Day 3 of Week 4 and Respond by Day 6 of Week 4

To Participate in this Discussion:
Week 4 Discussion

SAMPLE 1
Why DNP
COLLAPSE
There are two routes to go to achieve the highest levels in nursing. One track is to get a PhD which is research based and tends to lend itself to a career in research or education (Gaines, 2019). Many nurse educators at the Masters level require a doctorate and of course to teach doctorate nurses that is required. The PhD nurse does not often work in clinical settings and while the degree often takes longer to receive, the PhD does not need renewal. The DNP nurse is based in clinical practice. There are many articles that discuss how there is a lack of definition with regard to the exact purpose of the DNP and that more studies are needed to determine what they do most often but there are some generalities. They often act as advanced practice nurses at the bedside, working as providers to patients or they hold leadership roles in hospital systems such as chief nursing officers (Beeber, Jones, Palmer, Waldrop, Lynn, 2016).

In order to receive a PhD one must complete three to four years full time with the education being primarily online, however students are expected to be on campus for specific events such as their dissertation and defenses. The dissertation is a research based final project that all students of a PhD program must complete and successfully defend. In a DNP program, it can be completed in three years, post bachelor and two or sometimes less if the student already has a masters. However, while it is shorter, these students must obtain clinical hours and they must create and carry out a quality improvement project.

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NURS 8002 The Doctoral Degree and Professional Nursing Practice

NURS 8002 Doctoral Degree and Professional Nursing Practice

I understand the challenges that will come with attempting to obtain a nursing degree of the highest level but I want to make a bigger difference. That is why I am doing this. I have interest in all areas of nursing but especially in mental health and the emergency department which often blends together very closely. I do want to do patient care, I enjoy patient interactions and helping people on an individual level. I do not see myself ever giving that up completely. I also think I will continue teaching in some capacity, although probably only part time. I truly want to implement some upper level changes though. I already have been working on my quality improvement project which is based in the departments I said I enjoy, the ED and mental health. Too often, I see nurses outside of mental health units not knowing how to treat patients with mental illness and it often leads to injuries and/or unnecessary restraints. I want to implement crisis prevention intervention (CPI) training throughout an emergency department and see if those injuries and restraint numbers go down. It would be safer for the staff and lead to better patient care and outcomes. Previously, I have done a training in a few hospitals with my mother, the ED nurse, regarding these ideas of improved patient care of the mental health client in non-mental health environments and it has seemingly been well-received.
References
Beeber, A., Jones, C., Palmer, C., Waldrop, J., & Lynn, M. 2016. Determining the role of the nurse with a doctor of nursing practice degree. Research Brief. Retrieved from https://www.shepscenter.unc.edu/wp-content/uploads/2016/12/ResearchBrief_DNP_Beeber_final.pdf
Gaines, K. 2019. Dnp vs phd in nursing- what is the difference? Education. Retrieved from https://nurse.org/education/dnp-or-phd-in-nursing-difference/

SAMPKE 2
Hurst, K main post
COLLAPSE
Role of the nurse with a practice doctorate
Due to the rigorous curricula set for doctorate prepared advanced nurse practitioners, as well as the clinical skills acquired, the DNP is in a prime role for leadership and making changes through research, making this a pretty versatile role. (Falkenburg.-Olson. 2019) Reading the assigned readings this week, it appears one commonality is that the role of the doctorate of nursing practice (DNP) is not clearly defined. (Beeber. 2019). DNP’s have been noted to carry the traditional role of an APN in clinical practice whereas some have been found in administration roles. In one instance a DNP was noted to have used this position and used the position to promote equitable healthcare and in another instance a DNP led an interdisciplinary team with the use of evidenced based practice. (Tussing. 2018) Otherpositions that have been filled by DNPs are healthcare policy, executives, informatics, and community focused roles.
When developing the DNP programs, part of the rational was to learn how to recognize gaps and develop practice knowledge and skills to improve healthcare delivery (Falkenburg-Olson. 2019). This type of training would also serve purpose in becoming an educator as it would allow for ability to share and train new DNPs to not only recognize gaps but also ways in solving problems. In one example from Tussing, a DNP who was in an educator role, “led a multidisciplinary team in the development of educational resources and a staff training plan for the care for patients experiencing infection and emerging pathogens such as Ebola Virus disease” (Tussing. 2018)
Other examples of DNP’s is as a clinical coordinator to build better care plans, assist with maintaining goals and provide support for patients and families on medical-surgical units due to a need for increased quality and increased length of hospital stays. Another DNP was noted to have worked on quality improvement projects using evidenced based practices. (Tussing. 2018)

Expectations associated with obtaining doctorate, similarities and differences to other degrees
The DNP is a practice focused degree and takes into consideration the clinical experience and skills an NP has developed that will help align DNPs to take leadership roles. In embarking on the journey to obtain the DNP degree, anticipate the completion to be a doctoral project that is inclusive of scientific content and research methodology (AANC. 2006). While taking courses and furthering education to support the final project, one must put emphasis on learning scholarly approaches to navigate through making advances in nursing practice and addressing gaps in practice using evidenced bases, implementation and evaluation. (Falkenbur-Olson. 2019)
Hartjes recommends that if the DNP is going to be used in the role of becoming an educator that educational coursework should be considered during this process. (2019). “to critically appraise current evidence, translate research into practice, and implement quality, process, organizational, and operational improvement methods to positively impact patient outcomes and the delivery of health care” (Hartjes. 2019)
Another terminal degree that can be obtained is a PhD however this is a more research focused education path. The PhD curricula will place more emphasis on theory, research and statistics. The goals that have been set in each program are slightly different however are complimentary to each other. The completion of the PhD program is displayed by a dissertation with an extensive research study. (AANC. 2006) The PhD focuses much on “producing data that can be translated into practice to advance all levels of health care” (Falkenburg-Olson. 2019) When you combine a PhD with an NP you are widening the scope of practice by having strong research abilities and skilled clinical practice which is quite effective in trouble shooting areas of concern.
“Requirements for admission, the length of the programs and the graduation requirements, as well as the overall cost also differ” ( Hartjes. 2019) PhD programs are typically research based, are more commonly online and have smaller classes. Many PhD programs allow admission once a semester and require a mentor to be in place. The amount of work necessary during the program often makes it impossible for students to partake in work outside of their education process and the program could be quite lengthy. Whereas, DNP programs are doing hybrid classes, allowing for higher quantity. Admission to these programs are frequently throughout the year and allow more flexibility in the students life. (Hartjes. 2019)

My motivation and how will I contribute to potential organization

We are often being asked, how we are going to make a change, what are we going to do. This is a struggle for me to come up with an answer. Over the last few years, I have learned that if you take a step back and just pay attention, take note of what is happening, you will see where you are needed and what you are needed to do. I have also learned that I am very much a problem solver. I am not a “put a bandaid on it” kind of person. I like to look for the root cause and try to find a solution from the bottom up. I do believe obtaining my DNP is the path that was created for me and am excited to see where it leads.
I have, however, come across some areas that I recognize need improvement. Medication errors that occur during transfer of facilities happen quite often. I have had a patient go to the hospital on two medications and those medications just disappear from their profile, no rationale, and new medications started. As I am experiencing these situations, I take everything in. It does appear that it is due to a poor medication reconciliation, poor communication or lack of preparedness upon discharge and admission. It is difficult for me to explain how I problem solve, but I take things in, constantly. I trouble shoot in my head until I can figure out a possible way for it to be better. I am always taking in the systems I work within and how they function so I will hopefully one day be able to connect the pieces and produce an effective solution.
Formally, I could do a questionnaire, possibly asking individuals of their transfer process, not what policy is but what they actually do. The questionnaire alone may actually help solve some of the problem as it could represent a self-evaluation as well. Often self-evaluations help individuals recognize their weaknesses and strengths. Chart review could also be used as part of the assessment of the gap in care. Once completed and a plan is established, it would be implemented. Afterwards, chart audits would be able a simple way of evaluation. (Fiset. 2019)
I do believe part of these errors occur because many people just do not take that little extra step. This is also why I want to become an educator. I see how many errors that I have caught, with my patients alone. I work in mental health, many of my patients are unable to advocate for themselves. My hope in becoming an educator is to add a touch of humanization to practitioners. To teach them to take that one extra step because someone’s life really could depend on it.

What experiences have you had in addressing a gap in practice or a practice change?

In my role now, I provide psychiatric care to people in the community-skilled nursing facilities, assisted livings and in their homes. In doing so, I have seen many patients admitted to the hospital due to a lack of knowledge or education on the caregivers part. There are many things that come into play with this. I am working with our hospital systems education department to start a program that we can offer to outside facilities and families, anyone who provides care to dementia patients, giving them a virtual experience on what it is like to have dementia as well as supportive basic education.

American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf

Beeber, A. S., Palmer, C., Waldrop, J., Lynn, M. R., & Jones, C. B. (2019). The role of Doctor of Nursing Practice-prepared nurses in practice settings. Nursing Outlook, 67(4), 354–364. https://doi.org/10.1016/j.outlook.2019.02.006

Falkenberg-Olson, A. C. (2019). Research translation and the evolving PhD and DNP practice roles: A collaborative call for nurse practitioners. Journal of the American
Association of Nurse Practitioners, 31(8), 447–453. https://doi.org/10.1097/JXX.0000000000000266

Fiset, V. J., Davies, B. L, Graham, I. D., Gifford, W., & Woodend, K. (2019). Developing guideline-based quality indicators: Assessing gaps in pain management practice.
International Journal of Evidence-Based Healthcare, 17(2), 92–105. https://doi.org/10.1097/XEB.0000000000000160
Hartjes, T. M., Lester, D., Arasi-Ruddock, L., McFadden Bradley, S., Munro, S., & Cowan, L. (2019). Answering the question: Is the Doctor of Philosophy or Doctor of Nursing
Practice right for me? Journal of the American Association of Nurse Practitioners, 31(8), 439–442. https://doi.org/10.1097/JXX.0000000000000273
Tussing, T., Brinkman, B., Francis, D., Hixon, B., Labardee, R., & Chipps, E. (2018). The impact of the Doctorate of Nursing practice nurse in a hospital setting. The Journal of Nursing Administration, 48(12), 600–602. https://doi.org/10.1097/NNA.0000000000000688

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