Position Statement on the Doctor of Nursing Practice

The National Association of Clinical Nurse Specialists (NACNS) endorses the Doctor of Nursing Practice (DNP) degree as entry into practice for Clinical Nurse Specialists (CNSs) by 2030. i While NACNS has consistently supported both masters and DNP preparation for entry into the CNS role, considering the complex needs of patients and the future direction of nursing practice, we believe that DNP preparation for practice in the CNS role will better position the CNS to meet the demands of an evolving healthcare system. Consistent with the strategic recommendations proposed to facilitate health care transformation, NACNS believes it is imperative to increase the number of doctorally-prepared Advanced Practice Registered Nurses (APRNs), which will increase the number of doctorally prepared nurses overall (IOM Future of Nursing, 2010; Educating Nurses: A Call for Radical Transformation, 2009). As a result, NACNS endorses the DNP degree as an important opportunity for CNS education and supports the need to increase doctoral preparation for nursing practice (IOM, 2010).

Over the past decade since the American Association of Colleges of Nursing (AACN) recommended a transition to the DNP degree as the level of entry into APRN practice, NACNS has carefully considered the opportunities, impact, and influences of the DNP degree. NACNS responded to the AACN endorsement of the DNP degree with the White Paper on the Nursing Practice Doctorate (2005). In 2010, NACNS re-examined the DNP degree at the request of its members and affirmed a “position of neutrality” (NACNS, 2010) along with a commitment to continue its examination of the DNP degree specific to trends in CNS education and practice. These organizational positions have been consistent with NACNS’ definition of CNSs as “licensed registered professional nurses with graduate preparation (master’s or doctorate) from a program that prepares CNSs” (NACNS Statement on Practice and Education, 2004, p. 12). Through this ongoing examination, NACNS now endorses the DNP for educational preparation of individuals seeking to enter CNS practice.

NACNS concurs with the IOM Report (2010, S 6) assertion that seamless transitions to higher degree programs are essential. NACNS recognizes that there are two routes for completing a clinical doctorate in nursing: post-baccalaureate (i.e., post-BSN) and post-masters. Post-BSN programs must use validated CNS competencies and education standards to guide the curriculum and ensure that graduates are prepared to practice in the CNS role. NACNS has developed and published nationally vetted CNS competencies (Core Competencies, 2010). In addition, graduate programs must use the Criteria for the Evaluation of Clinical Nurse Specialist Master’s, Practice Doctorate, and Post-Graduate Certificate Educational Programs (2012) for guidance during CNS education program evaluation and/or development. Completion of the CNS specialty didactic and clinical courses in a population of interest, along with completion of the DNP role/practicum hours will enable graduates to meet or exceed the 1,000 clinical hour requirement and to sit for national certification. Post-MSN students who hold current advanced practice certification with verified specialty clinical hours will be required to complete the DNP role/practicum to meet the DNP Essentials competencies and the remaining clinical hour requirement.

While NACNS supports the DNP as the appropriate degree for future clinical practice as a CNS, the organization supports the right of CNSs who pursued other graduate education to retain their ability to practice within the CNS role without having to obtain the DNP for future practice as an APRN after 2030.

References

Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Retrieved from, http://www.thefutureofnursing.org/sites/default/files/Future%20of%20Nursing%20Report_0.pdf

Educating Nurses: A Call for Radical Transformation, 2009
http://archive.carnegiefoundation.org/elibrary/educating-nurses-highlights

NACNS. (2005). White Paper on the Nursing Practice Doctorate.
http://nacns.org/wp-content/uploads/2016/11/PaperOnNPDoctorate.pdf

NACNS. (2009). Position Statement on the Nursing Practice Doctorate.
http://www.nacns.org/docs/PositionOnNursingPracticeDoctorate.pdf

NACNS. (2004). Statement on Clinical Nurse Specialist Practice and Education (2nd ed.).
http://nacns.org/wp-content/uploads/2016/11/NACNS-Statement.pdf

NACNS. (2006-2008). Core Competencies Executive Summary
http://nacns.org/wp-content/uploads/2017/01/CNSCoreCompetenciesBroch.pdf

NACNS. (2012). Criteria for the Evaluation of Clinical Nurse Specialist Master’s, Practice Doctorate, and Post-Graduate Certificate Educational Programs
http://nacns.org/wp-content/uploads/2016/11/CNSEducationCriteria.pdf

AACN Essentials
http://www.aacn.nche.edu/education-resources/essential- series#.VYBwkorDaHE.mailto

APRN Consensus Model
https://www.ncsbn.org/Consensus_Model_for_APRN_Regulation_July_2008.pdf