I’ll be the first to admit that I have scoffed at the concept of the doctorate being required for entry level into nursing practice. My greatest cause for criticism was the fact that we pay more for our education than we can afford to pay off after entering practice. Yes, I am entering my doctoral program with a 120K debt and no vision of increasing my salary upon completion (maybe I’ll integrate a donation button at the conclusion of this post!).
As I read through The Doctor of Nursing Practice by Lisa Chism, I am humbled by the planning and implementation of so many nursing leaders whose innovative vision has paved the way for nursing practice, beyond the bedside nurse, and all accomplished in essentially a single decade. Our profession is in need of its own science so we can stand on our own two feet. Praise the Lord for our PhD nurses; however, our profession requires not only new knowledge, but nurses who can work to utilize this knowledge. The doctorate in nursing practice prepares nurses to be leaders in practice, not in education or research.
Disciplines such as audiology, chiropractics, dentistry, medicine, pharmacology, psychology, and physical therapy require a practice doctorate for entry into practice. Nursing is a practice discipline. We do require bedside nurses and we do require PhD trained nurses for development of nursing research, but I humbly agree that advancing the profession towards a doctoral entry level for independent practice is necessary.
If doctoral trained nurses are denied prescription privileges or hospital privileges, but my associates with doctoral medical training are granted such authority, or if medical doctors are identified as the supervisor of all other doctorate specialties, then what we have before us can not be denied as anything other than a medical monopoly.
Currently in the state of Indiana, Nurse Midwives are only required to hold a bachelor’s degree in nursing and with a midwifery certificate can practice and collaborate freely within their scope, but must have a written collaboration with a physician for prescription privileges. I propose we move to license doctoral trained nurses as independent practitioners, holding independent prescription privileges, with the right to acquire hospital privileges as equal partners within the healthcare infrastructure. Those without a doctorate would continue to practice as they do currently today, within the bylaws of their employer; however, midwives who choose to self employ could find success, free of current restrictions we each face today (and earning enough to pay off their debt!). Win. Win. Right?