Agents of change: Doctor of Nursing Practice

By Linda Hulton

Above: Inaugural DNP class of 2016

The year 2020 marks the 200th birthday of Florence Nightingale, a British social reformer, a statistician, and the founder of modern nursing. Florence was an original agent of change in the world of healthcare reform. By displaying extraordinary talents in administration and leadership in reforming healthcare practices in the British military, Florence’s acuity in mobilizing forces to reform healthcare lead to her most famous achievement of creating a nursing training program. Her original practice principles thrive to this day as the nursing profession.

Today, graduate education in nursing occurs within a similar context of societal demands as well as a complex interprofessional work environment, not unlike the historical challenges facing Florence Nightingale’s work. Early in this century, the Institute of Medicine (IOM, 2003) and the National Research Council of National Academies (2005) called for a new era of nursing education that prepared individuals for practice with interdisciplinary, information systems, quality improvement, and patient safety expertise. These hallmark reports called for a dramatic restructuring of all health professionals’ education leading to the endorsement of the doctor of nursing practice degree (DNP) by the American Association of Colleges of Nursing (AACN) as the entry level for advanced nursing. This new degree in nursing would be a means to augment advanced practice roles, improve health care outcomes, facilitate excellence in population-based practice, and impact leadership and policy.

The development of the DNP program at James Madison University first began in 2006 after the study of national trends for nursing doctoral education. A nursing faculty DNP taskforce was appointed to develop a feasibility study and a needs assessment. After

initial approval for the program at the college level, a downturn in the general economy in 2008 delayed the start of the program as the growth of the undergraduate nursing program demanded the talents and expertise of the nursing faculty. Finally, in July 2010, the State Council of Higher Education for Virginia (SCHEV) approved a proposal to start the DNP at JMU. The inaugural cohort of ten post-MSN DNP students enrolled in 2013 with the first graduates of the program completing in December 2016.

Each DNP graduate has completed a DNP clinical project through defined academic-clinical partnerships and has developed strong skills sets that are critical for the nursing profession to navigate a new era in healthcare reform. Namely, the DNP projects of JMU School of Nursing students have reported accomplishments and scholarship that deliver quality care, improve outcomes, and reduce cost. In December 2020, the fifth cohort of DNP students will graduate from the program and continue to lead healthcare reform with many of the same tenets and tenacity of Florence Nightingale.