The Doctor of Nursing Practice Degree


Happy Monday! I hope weekends were restful, sleep was had, and an exhale of appreciation for the coming of spring was on your breath. We’re suffering through 4 month old sleep regression here in Alaska. Mainly, screaming for an hour straight from 8-9pm before collapsing from exhaustion. I found the baby carrier helps a lot though! I just strap the babe in and get my Kindle fired up…and we walk the same circle while he calms down, and I read.

Anyways…moving onto some midwifery things!

The pictures are me as a baby about 13 years ago when I graduated nursing school. It was also a time in which I thought bangs would be a good look for me. They are not, and I haven’t had bangs since.

I graduated with my Doctor of Nursing Practice (DNP) degree last December and wanted to offer some advice and reflections on my experience now that a few months have passed. Really, I just needed some time to reflect since I argued my final project and had a baby the next day.

Here’s my main takeaway: The degree prepares individuals to improve the healthcare system. The degree prepares you to be a leader. The degree sets a solid foundation for you to continue to grow from. Ultimately, I am glad I completed the program and am stronger because of it.

Let’s go back to the beginning though.

My DNP Experience

I decided to complete a DNP back in 2018. It was one of my goals for 2019 and I ended up applying for the program because one of my spouse’s goals for the year was “help Jamie complete a DNP program.” Talk about a spark to a fire babe!

I wanted to go back for the degree for two main reasons: one, I wanted credentials to teach as a faculty member at the college/graduate level, and two, because I really enjoy learning and being challenged.

And so I embarked on my program search in spring 2019. I knew I was going to have to go the online route for school because we live in Alaska and I was planning on continuing to work full time. I had heard about Frontier Nursing University’s program and precepted many of their students. I had a program locally, but the reviews from the candidates currently in the program were terrible. Alas, I applied to Frontier’s program and was accepted into their class that started in Fall 2019.

I opted for the 15-month, 28-credit, full time program. My timeline was motivated by our reproductive life plan. We knew we wanted to try to have another baby in 2020 and I was optimistic I could complete the program before our next babe arrived.

I started classes immediately after a 3 day in-person orientation in Hyden, Kentucky. I felt the schoolwork and increased stressors immediately! My son was about 9 months old when I started that first semester and he wasn’t sleeping through the night (yet…). I would put him down to bed and then do work from 7-10 pm – or until he woke up for his first nursing session! If I needed to, I would wake up at 4:30-5:00 am to do homework as well. And I definitely needed a 3-4 hour block of time every weekend as well.

In the end, I took 9 courses and averaged 4-7 credit hours a semester. The hardest semester was the semester I led my quality initiative. All I did for those 12 weeks was live and breath quality improvement. There is nothing like learning on the job!

What I liked about the DNP

The DNP program was scaffolded on my combined prior degree and work experiences and asked me to be better in the roles I was already doing. That’s what I liked most about the program. It was like being given a new pair of glasses to see things a little sharper and clearer than I was able to see before. To look for areas to improve and to see how I could facilitate solutions.

For example, my evidence-based practice class offered assignments that were much higher critical thinking than I ever received in nursing or graduate school. We read and combed through research articles – assessing the type and quality of the research and discussing research implications for practice. It was lesson after lesson in the critical assessment of research.

My class on becoming a nurse educator challenged us to write our own philosophy on teaching and education. We learned methods to teach – far beyond that of death by PowerPoint – and were encouraged to find ways to motivate student or peer learning from the foundation of our own philosophy. I loved this class especially because one of my goals is to go back and teach (one day!).

My policy class required analysis and examination of policy in our own community. This led me down a rabbit hole of postpartum long acting reversible contraception in the state of Alaska and taught me lessons in how to research policy, how to write letters to legislators and how slow the cogwheel of politics and legislation truly is.

Throughout the entire program, the professors challenge you to speak to the benefits of the DNP prepared leader – it’s almost like an elevator speech. At times this was annoying. No one wants to listen to themselves say the same thing over and over. But at the end of the program, it’s second nature to talk about the benefits of the degree and the potential a DNP prepared leader can offer an organization or a team.

My program had some phenomenal professors, speakers and curriculum. Frontier Nursing University also uses the IHI (Institute for Healthcare Improvement) model for quality improvement. I found the model to be well suited to assess, implement and evaluate change across any healthcare platform.

Regarding the online nature of the school, overall, it was very well done. The platform isn’t perfect, but no online platform is. I was able to complete all of my schoolwork online via the learning platforms, video conferences and presentations and many, many emails. It was perfect for what I was looking for in this phase of my life.

My DNP Class at orientation

What I didn’t like about the DNP

There is very little I didn’t like about my program. My frustration about the 1-2 professors I didn’t like or that I disagreed with some of the grading comments on my assignments are inherent in every program. Additionally, I found that sometimes you just aren’t going to see eye to eye on a point or a discussion with your professors. At the Doctorate level of education, that’s healthy and to be expected.

The degree itself is little different. The DNP programs across the country aren’t the same. Each graduate is prepared differently. This isn’t the fault of anyone in particular, it just makes it harder for the nursing profession as a whole. Ultimately, it probably won’t make much of a difference but it is something to be aware of. If two DNP prepared nurses apply for the same job, most employers aren’t going to see a difference in those degrees unless they are intimately knowledgable about each program, or, the candidate offers strengths of one program in the interview while the other candidate doesn’t mention their program. These are littles nuances but they are potential tripping hazards for the profession.

The other dislike comes from misuse of the the term Doctor. I didn’t go back to graduate school to be called Dr. Jamie. In fact, if you never called me that, that would be great. But there are some individuals that prefer to go by Doctor and do little to educate the patients on the difference. A DNP is an expert in nursing practice, not a medical doctor. The degrees are not meant to be the same or equal. They are vastly different. And rightly so, the models of nursing and medicine are different!

Other common questions about the DNP

Are all DNP programs the same?

No. There are DNP Essentials published by the American Association of Colleges of Nursing (AACNM). You can view them here. Programs differ in the courses they offer and requirements to graduate. Some DNP programs have courses that overlap with their nurse practitioner programs.

What courses were included in your program?

The courses included in my program (Frontier Nursing University) included:

  • Epidemiology and Biostatistics
  • Evidence-Based Practice
  • Nurse as an Educator
  • Principles of Independent Practice
  • Leadership and Organizational Dynamics
  • Health Policy and Advocacy
  • DNP Clinical Scholarship Planning
  • DNP Clinical Scholarship Implementation
  • DNP Clinical Scholarship Dissemination

Is the DNP needed to practice midwifery or to be a nurse practitioner?

Nope. In fact, when I applied to midwifery school in 2012, I specifically looked at programs that did not include the DNP. I wanted the basic skills to practice the art of midwifery and start serving women. I would advise anyone looking to become a nurse midwife or a nurse practitioner to ask what a BSN to DNP offers versus a MSN to DNP.

I practiced as a nurse midwife for 6 years before going back for my DNP. I became proficient as a provider and was able to go back into graduate school with a different perspective. As a brand new nurse midwife and having never practiced as a provider, I would not have had the same perspective if I had just obtained my DNP at the same time I obtained my MS. That may not be the case for everyone, but it was the case for me!

Do you think every graduate prepared nurse or nurse practitioner needs a DNP?

No. But it’s probably not a bad thing either. If you are motivated and willing to do the work to improve health care on the front lines, a DNP leader is extremely beneficial to have on a team. Additional DNP prepared nurses will only make an organization stronger.

I like to think that even if a DNP prepared nurse isn’t performing quality initiatives back to back, they still have an eye and an ear for processes and measures of improvement and will likely have excellent feedback to offer any team or organization simply because of their training.

Would you recommend working during a DNP program?

Yes. The course work full time took 10-30 hours a week depending on the nature of the assignments. With kids and a working spouse, it was doable but you have to be spot on with time management. Also, my program required a quality initiative done at your place of work – so I needed my job to complete the degree in some aspects!


That’s a wrap for Monday! I’m happy to answer any questions about DNPs – or seek out the answers if I don’t know the answer.

Hugs,

Jamie

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