Improvement of the Healthcare System
There is increased interest in the Doctor of nursing practice (DNP) program owing to its success, which has exceeded the expectations of many. Drawing from the ideas shared by Danzey et al. (2011), the DNP is of great significance in addressing the shortages in the nursing faculty and closing the gap between nursing education and practice. Additionally, graduates of DNP can play specialized roles as nursing education leaders and educators. DNP graduates’ roles have significantly contributed to an influx of previously masters-trained nurses enrolling in the DNP program. The additional sentiment shared by Danzey et al. (2011) is that experienced nurses that are masters-prepared benefit from the DNP as it offers them formal groundwork. The areas in which such formal preparation occurs are curriculum development, evaluation, educational theory, capstone educational practicum, and testing. The DNP program has attracted interest as it focuses on care delivery excellence of practice and addressing education-practice gaps that have remained unaddressed in other nursing education and practice initiatives.
Pursuit of the DNP
Numerous reasons centered on patients, colleagues, and the healthcare system motivate me to pursue the DNP program. To begin with, the objective of leading by example in the clinical setting is one such motivation. The objective of being an example to colleagues is in line with Coyne and Chatham (2015) ‘s arguments regarding mentoring as an approach to enhancing nurses’ readiness and retention. The underlying sentiment is that as an experienced nurse pursuing DNP, it would be possible to foster relationships with inexperienced nurses requiring guidance and leadership. As a DNP graduate, such colleagues new to the profession can learn from the mentor through counseling on career management. Such mentorship would be significantly helpful for the nurses who could be new to the profession through colleagues considering position changes or pursuing further nursing education (Coyne and Chatham, 2015).
Besides, pursuing a DNP is motivated by wanting to be more educated in nursing needs. The motivation aligns with Standard 12 of the American Nurses Association (ANA), highlighting the nurses’ responsibility to seek knowledge and competence, reflecting current nursing practice and promoting futuristic thinking (Coyne and Chatham, 2015). The implication is that the nurse should be committed to lifelong learning to maintain a professional portfolio and be dedicated to mentoring. As a knowledgeable and competent nurse through the DNP program, the intention is to show dedication to quality patient care. Moreover, the program will guarantee experience in evidence-based practice that would enhance employee satisfaction by motivating them. It is also important to highlight the program’s contribution to increased knowledge of policies and procedures in the nursing profession to allow the nurse to be a resource overseeing flow in the respective department under their oversight.
Pursuing the DNP program changes a nurse’s stance regarding the nursing profession. It would be valid to argue that the master’s level of nursing education, to a great extent, only equips the nurse with the skills to practice nursing. On the contrary, as highlighted in Mullin (2010), DNP positions the professional at the policy table where social policy initiatives and political decisions shape nursing practice. Therefore, it means that a DNP graduate views healthcare from the perspective of a policymaker rather than a professional confined to the clinical environment. The changes from a state of powerlessness to that of one of a change agent (Mullin, 2010). A DNP graduate’s practice experience, knowledge of research-based practice, and leadership skills instill a sense of power such that the graduate becomes a healthcare policies advocate. In other words, the nurse turns from being a practitioner into a policy maker owing to the empowerment brought by knowledge, experience, and education. It means that a DNP graduate can influence healthcare equity and social justice concerns, which would not be possible without the DNP program. As Mullin (2010) puts it, the DNP graduate participates in framing the financing, safety, access, efficacy, practice regulation, and quality of health care. The nurse’s scope thus shifts from the institutional level to federal, state, institutional, regional, local, and international levels.
As a DNP program graduate, physicians and non-physicians will address the graduate as a doctor. Even so, concerns have been raised about the confusion brought by the term “doctor” in the clinical environment when used by different professionals. Nonetheless, the fact that patient outcomes and satisfaction do not change when a medical doctor or a doctor of nursing practice treats them means the term can be comfortably used in both circumstances.
The ideal positions I aim to achieve are the levels of Chief Nurse Executive (CNE) working in the executive suite. According to the information shared by Clark (2012), the CNE’s role is a product of the healthcare evolution that has witnessed the consolidation of health facilities into larger systems. Regarding the quality of care, the role of the CNE in the consolidated system is to ensure that the care delivery models across the individual hospitals are aligned. As per Clark (2012), such occurs through the CNEs determining a strategic objective for implementing the aligned models. Such alignment guarantees that the standards of care are reconciled to ensure patient quality—additionally, the CNE advocates for broad strategies necessary for safe and high-quality care. Clark (2012) also highlights the CNE’s role in collaborating with institutional officers to institute desired nursing outcomes for safe and effective patient care.
Regarding the cost of care, the CNE assesses the overall performance at the system level and facilitates budgeting and allocation processes to compensate staff and improve processes. The CNE thus ensures resources are distributed equally across all hospitals. Due to the cost and quality of care contributions, the CNE guarantees that the standardization of care models and allocation of resources boost patient access to care.
On top of that, the CNE contributes to the transformation into evidence-based practice in the clinical environment. Clark (2012) recognizes that the CNE is an experienced professional in nursing practice as they are professionally engaged at regional and local levels. Therefore, such exposure broadens the experience of the system that benefits from the leadership of the CNE. The position also grants the power to the CNE to establish mechanisms for funding staff to enhance their educational and professional competence in reinforcing best practices.
Additionally, consolidating hospitals at various levels enables the CNE to disseminate evidence-based practice as models and processes become standardized. Clark (2012) also underscores the CNE’s role in entity nursing professionals’ professional development and succession planning. The CNE is thus a participant in the selection, employment, assessment, and development of entity personnel to guarantee their competence in the most current best practices.
Regarding the role of the CNE in policy change, Falk et al. (2015), a DNP that takes up the role of a CNE is engaged in the strategic planning that shapes the policies and processes of health care. There is an advocacy role and policy reforms that come with strategic planning and thinking. As such, Falk et al. (2015) support the view that when nurses participate directly in developing and managing strategies, they do so with experiential knowledge regarding the issues existing in the nursing profession. The CNE, therefore, combines business context skills and nursing expertise to develop proactive strategies that address concerns related to nursing staffing, funding, professional development, and patient care processes. Since the CNE makes the table where social policy initiatives and politics on health care are discussed, it is possible to play an advocacy role in ensuring that such policies favor the health care system.
Important to note is that the policy processes that a CNE engages in include shaping the nursing curriculum into a stakeholder-centered model focused on best outcomes (Milstead, 2013).
Skills and Knowledge
A nurse executive comes with skills and knowledge unique to a DNP graduate compared to those shared by nurse executives who did not pursue the DNP program. Drawing from the information of Thomas et al. (2012), the CNE has critical and reflecting thinking skills as a leader. Such implies that they can systematically evaluate issues based on experiential and educational knowledge in resolving problems—additionally, the CNE stakeholder collaboration fosters skills in the quest for healthcare improvement. Thomas et al. (2015) argue that the leader can bring policymakers, patients, healthcare teams, and the community together. Their executive also possesses the skills for developing and implementing innovations that incorporate the principles of change. The effectiveness of skills in oral and written communication of practice knowledge enhances such leadership competencies.
As a nurse faculty member, the CNE is distinguished by the ability to lead in translating new knowledge into practice (Thomas et al., 2015). Moreover, based on accumulated experience, the CNE can generate knowledge from practice for patient outcome improvement. They also play an investigative role in a bid to improve clinical practice. While playing the role of a nurse politician, Thomas et al. (2015) assert that the CNE advocates for ethical procedures that enhance the cost, quality, equity, and access to care. Moreover, they are an authority that assesses health policies’ influence across disciplines. Lastly, the quality skills and knowledge are drawn from Thomas et al. (2015) ‘s evidence point to the CNE’s application of the best evidence to the continuous improvement of the quality of clinical practice. The CNE also upholds a culture of excellence by applying peer review skills.
Recommendations for Transforming the Future
Between 2008 and 2011, the Institute of Medicine (IOM) constituted a committee to deliberate on the role of nursing in health care reform. As a result of the committee, the IOM (2011) compiled a report making recommendations seeking to transform nursing owing to its critical role in health care. The chosen recommendations for the paper are Recommendations 2 and 7. Recommendation 2, per the IOM (2011) report, suggested expanding nurses’ opportunities to be leaders and diffuse collaborative improvement efforts. There was the call for public and private funders, nursing education programs, health care organizations, and nursing organizations to expand opportunities for nurses. Such opportunities would allow the nurses to collaborate with other healthcare stakeholders like healthcare teams and physicians in conducting research. They would also lead and manage efforts to restructure and enhance health systems and practice environments. For the practices that would prove successful, nurses should have the opportunities to diffuse them for the benefit of other healthcare professionals. Such meant that federal programs should reinforce the efforts to develop and evaluate the payment and care delivery models using nurses for cost reduction and health outcome improvement. The funding agencies, on their part, should collaborate to support the advancement of research on innovative solutions and care models (IOM, 2011). Healthcare organizations should also encourage the design and adoption of patient-centered models for nurses to partner with manufacturers. As for the nursing education programs and associations, professional development should be enhanced for nurses to enable them to initiate systems and ventures adding to health care improvement.
Recommendation 7, as the IOM (2011) shared, focuses on preparing and enabling nurses to become change leaders in advancing health. The implication of the recommendation is for nurses to be positioned in leadership roles at all levels, with decision-makers availing such leadership positions to be occupied by the nurses. The IOM (2011) report thus recommended that the responsibility for professional and personal growth should be left to the nurses by being allowed to continue their education and seek development opportunities for exercising leadership skills. The nursing associations thus become the avenues through which nursing leadership can be developed and platforms for mentorship and opportunities. The nursing education programs must also integrate business practices and leadership theory across the curriculum.
The nursing boards should also have representatives accommodated by all healthcare decision-makers and granted presence in crucial leadership positions and executive management teams. The recommendation, in essence, called for adopting a leadership style where nurses work as partners with other stakeholders within and without the healthcare environment.
As a DNP-prepared nurse, I can support the two recommendations by establishing collaborative nursing practice teams that handle healthcare issues in the consolidated health system. Nurses can play leadership roles at the system level through the teams and then collaborate with fellow stakeholders within the consolidated system to guarantee harmonization.
In conclusion, the DNP program is highlighted as a way to equip the nurse with experiential knowledge that allows for taking up leadership roles. Therefore, my motivation for pursuing the program is to be a leader by example in the clinical environment. In that way, mentoring colleagues and sharing best practices to enhance the quality of care and reduce costs would be possible. A DNP graduate also changes the stance on the nursing profession since there are new roles encompassing advocacy and leadership roles played in influencing the profession. It is also highlighted that the position of a Chief Nurse Executive is crucial because it allows the professional to be a policy changer and decision-maker. The evidence-based practice experience of a CNE is also valuable in transforming the clinical environment. As a CNE, there are skills entailing the ability to critically and reflectively think as a leader in addressing nursing issues. The CNE is also empowered to introduce best practices in the clinical environment and act as a political player to secure more resources for the health care system. In a bid to recognize the contribution of nursing to health care, the IOM made recommendations that would position nursing professionals as important stakeholders. The recommendations include allowing nurses to take leadership roles and expanding opportunities to effect change.
Clark, J. S. (2012). The system chief nurse executive role: a sign of the changing times? Nursing administration quarterly, 36(4), 299-305.
Coyne, M. L., & Chatham, C. (2015). Advancing and Managing Your Professional Nursing Career. Role Development in Professional Nursing Practice, 185.
Danzey, I. M., Ea, E., Fitzpatrick, J. J., Garbutt, S. J., Rafferty, M., & Zychowicz, M. E. (2011).
The Doctor of Nursing Practice and Nursing Education: Highlights, Potential, and Promise. Journal of Professional Nursing, 27(5), 311-314.
Falk, N. L., Garrison Jr, K. F., Brown, M. M., Pintz, C., & Bocchino, J. (2015). Strategic Planning and Doctor of Nursing Practice Education: Developing Today’s and Tomorrow’s Leaders. Nursing Economics, 33(5), 246.
Institute of Medicine (IOM). 2011. The Future of Nursing: Leading Change, Advancing Health.
Washington DC: The National Academies Press.
Milstead, J. A. (2013). Advanced Practice Nurses and Public Policy, Naturally. Health policy and politics: A nurse’s guide, 1-27.
Mullin, M. H. (2010). DNP involvement in Healthcare Policy and Advocacy. The Doctor of Nursing Practice: A Guidebook for Role Development and Professional Issues, 141.
Thomas, A. C., Crabtree, M. K., Delaney, K. R., Dumas, M. A., Kleinpell, R., Logsdon, M. C., & Nativio, D. G. (2012). Nurse Practitioner Core Competencies. The National Organization of Nurse Practitioner Faculties, 1-7.
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Using resources other than the Institute of Medicine, describe the expectations that DNP-prepared nurses can contribute to improving the health system.
The U.S. healthcare system has many positive attributes. Yet, the world’s most expensive and advanced system has several shortcomings. These shortcomings contributed to the need for corrective action and the creation of the DNP Degree 300 words APA style.
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