[Wichanee Borisuthirattana]

Thank you, David, for posting the updates during this unprecedented time. During the normal school year, there are already issues and challenges for clinical DNP students to find and secure clinical site, a preceptor, and clinical hours. It is even more difficult during the pandemic for the students to secure and complete the 500 clinical hours. 500 clinical hours may not be enough for the students to learn about everything they wanted before they apply for a job and actually practice as NPs. However, it may seem a lot during this pandemic time when they are trying to complete all of the hours in order to graduate. I agree with Avery that DNP students are competent enough to be responsible of securing and completing their own clinical hours. Nevertheless, NP residency program may post great benefits for both the NP candidates/graduates and the future of healthcare system. Since 500 clinical hours may not be enough for some students to feel confident to practice as a newly graduated NPs, an optional residency or a fellowship program offered either by the school or teaching hospitals may not only help create more competent NPs in the market, but it may also attract more potential NP candidates. Currently, the responsibility of providing clinical sites may be the school’s, and I understand that there may not be enough students for the school to make an actual contract with the hospitals/primary care practice sites to create a more permanent clinical site. However, I propose that the NP schools and the hospitals/primary care practice sites work together to improve our primary care system. An organization managing NP residency/fellowship programs can be created to act as a liaison and collaborate between the schools and the hospitals/primary care practice sites to facilitate the process. Last but not least, I learned that students may pick and choose NP programs according to their clinical hours requirements and whether they have to secure their own clinical sites. Hence, I believe that creating a new way to facilitate their education and building their confidence to practice will attract more students to the profession.

[Wichanee Borisuthirattana]

Thank you, David, for sharing this article. The potential concerns about the number of nurse practitioners in the near future, and the perspectives toward nurse practitioners and relating clinicians may become critical reasons for potential NP candidates to decide against the profession. As reported in Mundinger & Carter (2019), since the American Association of Colleges of Nursing allowed DNP programs to include nonclinical DNP curriculum, the number of graduate students pursuing clinical DNP degree, such as NP and CNS, are decreased. There are also other concerns regarding the nonclinical DNP programs such as the fast-growing nonclinical DNP programs that is exceeding the number of clinical DNP programs. A more flexible schedule and curriculum between part-time and full-time study may also post some doubt regarding the credibility and the competency of the graduates. I understand the future issues that Dr. Mundinger and Dr. Carter may feel uneasy about. However, I think there are still some hope that there will be a rising number of clinical DNP graduates in the near future. More and more clinical nurses view NP as a great opportunity for professional growth. And as NPs are allowed to practice independently in more states, I believe the option of pursuing clinical DNP degree will be a more favorable one. Although the data from the article may be recent, I believe that NP is becoming a more and more popular profession among clinical nurses. I also think that the flexibility of the schedule and the curriculum would promote the growth of the NP candidates. As nurses are working full-time trying to earn income for their family, it is the flexibility of the school that they needed in order to complete their degree. Some may need longer time than the others, but eventually the profession would welcome another competent clinical DNP graduate.

[Wichanee Borisuthirattana]

Avery, I am very sorry you had to encounter people with negative comments against your personal and professional growth. Sadly, I had received somewhat negative comments about pursuing a DNP degree as well. However, it might not be as opposing as yours. Regardless of the comments, I do not hesitate to tell as many people as I can that I am pursuing a higher degree and a more advanced practice in order to improve patient outcome and our healthcare system. Becoming any type of advanced practice nurse with a DNP degree does not only improve patient care, but it also advances our nursing profession. As nurse practitioners, we can reduce the workload of the primary care doctors as well as allowing more access to healthcare to different patient population. As clinical nurse specialists, we can improve the nursing workflow and the healthcare system by using evidence-based practice. As DNPs in education, we can produce more effective and reliable nurses in the future. As DNPs in administrative and executives, we can collaborate with different organizations and government sectors to improve public health and healthcare policy at a state, federal, and international level. As you can see, Avery, some people may not understand the potential of the DNPs and what impact we can make in the near future, and that may be the reason why they opposed the idea of earning a DNP. Your decision to continue your education and pursue a DNP degree is something to be proud of. And what we can do as DNP candidates is to educate our colleagues about the impact we can make in the future as DNP graduates. I wish you the best of luck in your journey to earn a DNP.

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