The UB DNP: Faculty and Students on the Frontlines of Health

BUFFALO, N.Y. -- What kind of advanced degree is available to an RN who loves patient care?

Until recently, the PhD was the only terminal degree that schools of nursing offered.

But with the American Association of Collegiate Nurses' (AACN) recommendation that the doctor of nursing practice (DNP) become the new standard for advanced clinical practice in 2015, RNs are being encouraged to attain the highest level of education possible to be partners and leaders in health care.

To address this need, the University at Buffalo School of Nursing initiated a Doctor of Nursing Practice degree (DNP) in the summer of 2011 and is making the degree more accessible with its "Go the Distance at UB" campaign which offers the DNP via distance learning to RNs with a master's degree And offers the PhD through distance learning for those with either a baccalaureate or master's degree.

"The DNP addresses the demands of our complex health care environment because it provides the highest level of knowledge and practice expertise for advanced practice nurses. It also offers needed competencies for the increasingly complex nurse-leadership role," said Marsha Lewis, PhD, dean of the UB School of Nursing.

Why get a DNP instead of PhD in nursing?

UB clinical assistant professor in nursing, Pamela Paplham, RN, DNP and the first DNP faculty member to be hired at UB, says the role of a nurse who possesses a DNP and the nurse who has a PhD in nursing –referred to as a nurse scientist -- not only differ, but also complement each other.

"The DNP is on the front lines of clinical outcomes for patients," says Paplham. "Our interactions with patients and the treatment challenges we face -- the ability to observe in the field how well evidence-based methods are working -- are what we can discuss with our PhD colleagues in nursing.

"A nurse with a DNP is an equal at the health-care team 'table' with physicians, dentists, pharmacists, psychologists, audiologists and physical therapists. Whereas, a PhD in nursing focuses on research -- those nurse scientists are experts in developing new knowledge for healthcare."

Paplham also explains that nurses with PhDs and DNPs can work together to determine what clinical areas need to be studied, devise studies, carry out the research study in the clinical area, record outcomes of the study, publish the research, teach it in the classroom and in the clinical areas, and help to affect the nursing policies that drive better results for patients.

Paplham is a board certified family nurse practitioner (NP) who specializes in oncology and has worked in the bone marrow transplant unit at Roswell Park Cancer Institute (RPCI) for 20 years. She was one of the first NPs in the acute care setting at RPCI and continues to work there as a DNP in addition to being UB nursing faculty.

"I was a pioneer as one of the first NPs at RPCI and helped to evolve that role there. And I continue in the pioneer role in helping Roswell Park evolve the DNP role."

Paplham also says that her students respect her clinical experience -- they know that when she's teaching them that she's "been there, done that" and are more inclined to pay attention.

Laurie Connors, MS, RN, is a nurse practitioner and a UB clinical instructor in nursing, who began studying for the DNP because she wanted more of a challenge.

"I wanted to be a principal investigator on clinical studies," she says.

Connors is one of the UB DNP cohort who started in 2011 and will be graduating in August. She works at RPCI with women who are at high risk for genetic breast and/or ovarian cancer and test negative for the genetic BRCA genes, but have a strong family or personal history for these cancers.

She explains, "The nursing PhD generates new knowledge. The DNP builds on current knowledge to improve patient outcomes."

Connors agrees with Paplham that the students respect her clinical knowledge because they know it comes from experience.

Regarding the important role of the DNP, Connors says, "I think it's important for nurses not to ride on the tails of doctors -- we are the largest cohort of health workers; we need to be an equal at the table."

Connors' final project in the DNP program is called "Information Delivery and Decision Making in Women at Risk for Hereditary Breast and Ovarian Cancer."

Both Paplham and Connors agree that DNPs can move on to careers in health care settings, educational settings or as policy makers or patient advocates.

"I was told in graduate school that you are granted a degree but you evolve, develop and cultivate your role," Paplham said. "It's not them or us -- doctors versus nurses, PhDs versus DNPs; it's all of us working together for the betterment of health care."

The UB School of Nursing offers a post-baccalaureate DNP program with specialties in adult clinical nurse specialist, adult, family, and psychiatric/mental health nurse practitioner as well as nurse anesthetist. The post-master's DNP program is available with a distance learning option and can be completed in five semesters of part-time study.

For more information, visit http://nursing.buffalo.edu/Academics/DoctorofNursingPractice.aspx or call (716) 829-2537.