Comments surrounding the doctor of nursing practice (DNP): Stress, ambiguity, and strain

Abstract

Background/Objective: The Doctor of Nursing Practice (DNP) degree is the recommended preparation for advanced nursing practice. However, lack of clarity surrounding the DNP degree has contributed to role ambiguity for the DNP prepared nurse. The present study sought to evaluate the written comments obtained from a quantitative analysis that utilized a framework adapted from works on role conflict and ambiguity, role stress and strain, and classical organization theory.

Methods: The sample consisted of 113 participant comments. The length of the comments ranged from 1 to 28 lines. Content analysis was performed and the areas of role stress, ambiguity, and strain were identified.

Results: Distinct areas for intervention to address DNP role stress and strain with the goal of preventing the harmful outcomes of role ambiguity were identified. For example, comments centered along the lines that the benefits of pursuing a DNP degree did not outweigh costs. There is contention among PhD, DNP, and MSN prepared nurses. The DNP causes role confusion among health care providers and the public and conflict exists about the DNP role and professionalism, faculty preparation, and leadership.

Conclusions: The authors provide several recommendations that can reduce role stress, strain, and ambiguity in order to meet the ultimate goal of achieving improved patient/population and policy outcomes. The nursing profession must not only articulate clear and distinct intended outcomes of the DNP degree, but then must also assure that the product of the DNP degree is consistent with those outcomes.