I am old enough to have been able to watch the nurse practitioner role in medicine evolve from a misunderstood and distrusted ‘physician extender’ to a real colleague. It will be interesting to see how the doctorate of nurse practice (DNP) evolves.
As a family practice resident more than 30 years ago, I was part of an experiment. There was argument in our residency about whether NPs would enhance or degrade resident education, so we set up a trial. Some two resident teams worked with a NP on the team and some did not, and after a year, charts were reviewed and some evaluations were done. It was certainly not rigorous enough to be publishable, but it was informative enough to be memorable. The patients cared for by resident teams with a NP had a wider range of problems noted on the problem list and assessed or managed than the teams without a NP, and the resident teams with a NP adamantly refused to participate in the second arm of the study, reversing roles and not having a NP to work with.
I have also witnessed the steady (but certainly initially quite grudging and still sometimes limited) acceptance of NPs in the medical center where I work. I hope I have been able to contribute with my support.
Now comes the DNP, changing the landscape again. I don’t claim to know how this will play out. The NP I work most closely with in practice has just finished her DNP this year, so I will once again have the great fortune of watching this happen both on a personal level and on the larger scale. Here is some additional information for those who might be interested, found on the MSN to DNP site.