“Lest we forget”: An issue concerning the Doctorate in Nursing Practice (DNP)

Abstract

The academic community within nursing is currently discussing an interesting option to the PhD, or Doctorate of Philosophy degree. Termed the Doctorate in Nursing Practice (DNP), it is currently described as a practice-focused rather than a researchfocused doctorate (such as the PhD). Several issues are being explored, including descriptions of the differences between programs of study for the DNP versus the PhD; one of these differences is sometimes described as less of a meta-theoretical focus within the DNP. While this distinction is a clear and worthy one, it brought back remembrances of past nursing practices that are perhaps best seen as unexamined or at least ill informed. Before describing such practices, it is helpful to remind ourselves that one’s view of science (arguably a meta-theoretical issue) dictates how one practices (eg, what is focused upon, how one approaches assessment, interventions, etc). These views of science thus determine the possibilities of and for practice, including (in part) the domains (or proper subject matter) of such practice, the truth criteria (or practice standards) accepted, as well as the persistent questions used to guide the research supporting the evidence base for such practice. Less of a focus within the DNP upon meta-theory might be interpreted as viewing nursing practice as a stand-alone phenomenon, affected remotely, if at all, by philosophic beliefs and views of science held within the discipline. Such a view would not only greatly affect nursing practice, but will concomitantly increase the influence of other disciplines upon nursing practice. When nursing in the past was not clear concerning its meta-theoretical stance, practicing nurses at times assumed the practice values of other disciplines. The result might be described as analogous to a “rudderless ship,” greatly influenced by the winds of the day and not by specific values of nursing. Some cases in point include that from the time of Nightingale to roughly the mid-twentieth century, nursing education and practice was focused primarily on