The Journey to a Doctorate in Nursing Practice

0:00:01 - Announcer

You are listening to the National University Podcast.

0:00:10 - Kimberly King

Hello, I'm Kimberly King. Welcome to the National University Podcast, where we offer a holistic approach to student support, well-being and success - nthe whole human education. We put passion into practice by offering accessible, achievable higher education to lifelong learners. Today, we are discussing tips about earning your DNP, the Doctorate of Nursing Practice. According to a recent article published in the Nurse Journal, a Doctor of Nursing Practice is one of the best options for nurses who want to access the highest positions in their field and earn a higher salary. We learned some informative advice on today's podcast.

On today's episode, we're discussing DNP programs and what they are, tips on whether that's right for you, and we're fortunate to have two guests with us today. Nancy Richmond has been active in the nursing field for over three decades and Dr. Khadija Hamisi has been a nurse for over 20 years. Khadija is a practicing nurse practitioner and a professor who has previously obtained her DNP. Nancy is a practicing nurse practitioner with an MSN in nursing who is considering a DNP, and we welcome both of you back to the podcast. How are you?

0:01:27 - Nancy Richmond

Good. Thank you for having me.

0:01:28 - Dr. Khadija Hamisi

Good, good, but I want to say something. Not 20- I started nursing in 2016, so unless we look at you know, CNAs and stuff- oh, but overall that's so CNAs we look at. CNAs and everything. Yes, it is 20.

0:01:46 - Nancy Richmond

So that's nursing, that is definitely nursing, okay, okay.

0:01:50 - Kimberly King

You're just being humble, but it's. You're applauding all of these years of expertise in here. Why don't you fill our audience in a little bit on your mission and your work before we get to today's show topic?

0:02:02 - Nancy Richmond

Certainly, my name is Nancy Richmond and I'm a practicing psychiatric mental health nurse practitioner. I started as an RN and I first pursued a master's degree as a psych clinical nurse specialist. I wanted to be a therapist and then I became aware of what nurse practitioners could do and I was very interested in that. So I pursued actually two masters different masters as a nurse practitioner and I have been practicing as a psychiatric nurse practitioner in the Los Angeles area for 20 years, working in public mental health. And I'm now teaching. I've been teaching at National University for five years in the psychiatric mental health nurse practitioner graduate program and I would like to continue my education and I am actually considering a doctorate nursing practice.

0:02:59 - Kimberly King

Wonderful. I can see your passion there, and time is of the essence right. It's such a relevant timing for the mental health and all so good for you. And then, what about you, Doctor? I'm sorry, I just upgraded you there.

0:03:15 - Dr. Khadija Hamisi

Yes, oh, actually you're right, it's Dr. Hamisi.

0:03:17 - Kimberly King

You're right. Okay, that's what I thought. I'm sorry about that. Yes, tell me a little bit about your passion.

0:03:23 - Dr. Khadija Hamisi

Yes, so I am actually, too, a psychiatric mental health nurse practitioner. I started working as a psych MP since 2014. So I have, right now, like 10 years of working as a psychiatric mental health nurse practitioner. One of my things that I've done in the past work wise, I worked actually as a doctoral program faculty, so I was teaching doctoral students, and then I also work with Nancy at National University as a psych faculty and I went back to school actually last year and right now I'm pursuing a higher, I mean a different kind of education, but it's still in mental health.

I'm actually in a psych program right now and I should be done by the end of this year with a doctoral, another doctoral name behind me for psychology.

0:04:32 - Kimberly King

Wow, impressive this is. And again, with all of this education and all of these titles behind your name, that shows your passion and again, this timing, that where we are in the world. I commend you both and thank you for your passion. Today we are talking about DNP Doctor of Nursing Programs, and so I'm going to start with you, Nancy. What is the DNP?

0:04:57 - Nancy Richmond

Well, that's actually the place that I needed to start as I began to pursue this, because often you see the EDD or the PhD or the PsyD, those are the doctorates that I was most familiar with. But actually the DNP, which is a doctor of nursing practice, is on par with all of those doctorates and it focuses primarily on translating research into nursing practice and improving health outcomes, which to me was very appealing because we really need to look at the health outcomes. The DNP is geared for organizational and systems leadership, interprofessional collaboration and evidence-based practice. On the American Association of Colleges in Nursing has put out a statement that the DNP programs will incorporate the APRN content currently included in the master's program. They will focus on providing leadership for evidence-based practice, which is essential. This requires confidence in not just translating the research that is done in practice, but evaluating evidence, applying the research in decision making and implementing viable clinical innovations to change practice as well. Very exciting stuff.

0:06:25 - Kimberly King

I love that and you know I mean it is. It's all probably much needed as you want to move up in your career, probably in this day and age. So why should a nurse consider a DNP doctor?

0:06:39 - Dr. Khadija Hamisi

You know what Nancy said at all. You actually. It's a noble profession, nothing else. Now you're enhancing your education. You become an expert or a leader in nursing. That's one thing. And apart from all that, it gives you both clinical competency, depending on what kind of DNP you're going to take. It gives you clinical competency. It gives you the ability to use evidence, practice when you're treating your clients. So, in a nutshell, a DNP would equip a licensed nurse with the highest level of clinical knowledge and practice, expertise, practice expert, critical to meeting the patient's needs, and advanced practical roles. So it's the same thing. Nothing is saying. But when you're pursuing a DNP, you know those people thinking about money. But you may not get the money, but what you're getting is knowledge. Knowledge is always power. You get to be an expert in your field. Before you make any decision, you look at the evidence Is this viable? And that's what you get as a DNP is a very different character, different role, different character. That the valuable lessons that you get from it, you won't get anywhere else.

0:08:12 - Kimberly King

Well, I agree with you as well that nursing is a noble profession, and I think there is. It seems that there is always going to be a need for nurses. I know that when you get your degree you can work anywhere in the country or in the world. So good for you, and I love that you are passing on your passion and knowledge to these students at National University. What are the requirements?

0:08:40 - Dr. Khadija Hamisi

So the requirements all depends. Each institute or each program may have different requirements. So you may get to a DNP going through, you know, from just RN all the way to doing your MSN and your doctoral program, or there's another pathway that you just say from MSN to DNP. So all depends on where you go. Each school has its own requirement and that's how you get to the DNP program. So the requisitions depends on which school you go to. There are some DNP programs that are only like nine months long, depending that maybe you already have your MSN, and there are some programs that are three years long because you need to go from your RN to BSN, to MSN to DNP. So whichever way you, whichever you have the schools different schools will meet everybody needs and how they can really choose their path of becoming a DNP.

0:09:51 - Kimberly King

So I kind of what you're saying is that there is a program for everyone, versus depending on the timing, possibly, and how fast you want to get through there and get to the and where you at that time. Yes, so, Nancy, what are the benefits versus the challenges?

0:10:12 - Nancy Richmond

Okay, well, so Dr. Hamisi has touched on one of the primary advantages is the increase in knowledge and confidence that we have. You know, the focus on evidence-based practice, not just subjective data leading us, but having objective data that's based in research, so you have more exposure to that and knowledge about that. There may be increased opportunities in job, opportunities in leadership, education, administration, and many of these advantages depend on the program that you go to, as Dr. Hamisi had mentioned before. It also can provide you increase independence. You can be an instrument of change, especially with health outcomes. You can be instrumental in that. It will probably eventually, according to the many nursing programs is that it may be the eventually be the entry level degree into nursing. You can become more marketable. You will be in demand because you have the doctorate degree and you will have attained the highest level of nursing education and you may increase your pay scale. That is a possibility. Depending on, you know changing your position. You know what other job you may take. So those are some of the advantages. Many of them appeal very much to me. As I said, the focus on evidence-based practice and increase in knowledge is really important to me.

Some of the challenges that I've found were that it may be expensive. If you're willing to do the research and look into the different programs and have a clear idea about what specialty you want, you can look around to see what different programs have to offer. And there are many online programs for available. And there is a time commitment. As always in any time in education, there is a time commitment. Many times, people are busy with family and jobs and that type of thing, so that's something you have to work at, and then you know the added stress of having to you know deadlines and papers and that type of thing. It can be a little bit of stress. So, yes, absolutely right, and, as Dr. Hamisi said, there are many. We'll get a little bit later. I'll talk a little bit about how many programs there are available now.

0:13:04 - Kimberly King

Thank you, because I know this is. It's great. I love what you are, what you're working toward and how it is really going to help you with. Maybe it is not just about the money, but it's also about the nobility of this profession and putting a doctor in front of your name and I may get in trouble for saying this, but doesn't it seem like sometimes nurses do most of the work and then the doctor shows up? From my experience, the nurses are the ones with the boots on the ground.

0:13:36 - Dr. Khadija Hamisi

You're absolutely right, and so actually the first point of contact with your client. And not only we're not talking about registered nursing on the floor, we are talking about advanced nurse practitioners too, because you're all nurses and you get the same thing. You don't get the credit, especially with the patient.

They'll say I want to see a real doctor, I don't want to see you, and that is another way of at least when you have an expert or when you have your advanced degree, then that will give the patient at least to be more at ease with you. You're probably going to do the same thing. You're going to prescribe the same medication, the same treatment, but the word doctor behind you, even if you have to say I am a doctor of nursing practice because you, you can only want a doctor. You have to put doctorate of nursing practice in behind. But that gives a little bit of a weight and you have the patient be more at ease.

0:14:41 - Kimberly King

So that's one thing that I see, and health care has just changed so much. We're watching this, we're living in the world in real time, and so I really think that's a really great point.

0:14:52 - Nancy Richmond

So factors to consider I just wanted to say one more thing. I'm sorry to interrupt, but I wanted to say one more thing, because I lived in Pennsylvania in the like 2000 and nurse practitioners were fighting for prescriptive rights. But the lobby the AMA lobby was very strong there and as we were trying to negotiate with the physicians about being able to get prescriptive rights, one of the things they wanted was that we were not allowed to refer to ourselves as doctors, even if we had a doctorate degree. We were never to tell the patient that we were Dr. Richmond or Dr. Hamisi. We always had to introduce as our name. That was one of the things that they wanted us to negotiate. So that speaks to what you were saying, Kim.

0:15:41 - Kimberly King

Well, good that we've made that change now, because you've earned it.

0:15:48 - Dr. Khadija Hamisi

Yes, right. If you, if you want to take this out. The reason actually I wanted to do the PsyD is, even now, as mass practitioner, even with a doctorate, there's so many things that you cannot do. There's so many things that you cannot sign. But being a psychologist, PsyD, which is a doctorate of psychology, you are able to actually sign a lot of forms for the patient without getting into any problems. So that's the reason why I went to do psych D because it hinders the, the name doctorate or the anesthetic and nurse. Even if you can do all these quality things, these wonderful things to the patient, you can provide very good care, you still have been pushed back. So doing, doing the doctorate, I think in a way help the nurse or the nurse practitioner have a little bit more say, but we still have to keep on fighting to be on equal footing with all the other. You know specialists who have the name doctorate behind them and they're okay to have the name doctor behind them.

0:17:05 - Kimberly King

It feels interesting that you're saying all of this and here we are in 2024, right, and you would think I mean fortunately. The doors have been opened thanks to you and thanks for it, you know, fighting to make sure that they continue to open into the future. So thank you for your pioneer work there. So I have a question for either one of you what is evidence based practice?

0:17:32 - Nancy Richmond

Well, we can each, I'm sure, comment on that. Evidence-based practice means that there has been research, statistically sound research, that proves that an intervention is effective- a medication, a strategy to approach a patient, that kind of thing. There's actual, substantial statistical research to support the intervention. Not just versus subjective, where, oh, I think this would be a good idea. In research you never know for sure until you test that. So this has the research behind it.

0:18:19 - Dr. Khadija Hamisi

Yes, and I wanted to mention that. I say this right, so I just have to put it down. So evidence practice in nursing is just a process that we use to review, analyze, and then translate whatever we see into the latest scientific evidence. So, for example, when we go, we say, okay, this is how we treat wound care, or this is how the medication works, first of all, before saying, yes, this is how we do it, things have changed. There's so many research behind it. So you go and find out what is the evidence base, what has been researched that has proven to work better without humming the patient. Or maybe, if there's anything, any harm going on, it's very, very minimal. So not only do you provide care, but before you provide care, what is the scientific reason behind this care? How does it work? That is what is evidence-based mean.

0:19:26 - Kimberly King

Thank you for explaining that and again, the difference between subjective and objective, as well as where you're getting the numbers behind that Actors to consider in selecting this program that's most suited to your needs. I know we talked about that a little bit but, Nancy, is that something you can talk to?

0:19:46 - Nancy Richmond

Okay, well, certainly that was an issue definitely to be considered as you're considering the DNP. The first would be the program reputation and accreditation. You know, is this program known? Have they been educating people in this particular field for a while and do they have faculty that is solid in this particular area? The relevancy to your practice and what it is that you wanna do, because different programs focus on different areas. The experienced faculty what degrees and experience and education do the faculty bring to the platform? The cost and the budget how much money do you have to spend? What kind of programs, what can they offer? That type of thing. The length of study and the clinical hours required.

Each program is different. As you go through them. It's actually quite interesting to look and see how they're all very different. The online versus in-person classes some programs are primarily online, but then you have to go on campus for two or three times a year for a weekend, sometimes for a week. Some programs are in-person for every time you can look to see what suits your needs. And then the specializations offered. Not every school has every specialization, so you wanna be sure you look into that. So those are some of the things that you might wanna take a look at as you do your research and picking your program.

0:21:28 - Kimberly King

Great, excellent. This has been so interesting learning about this and we're gonna have to take a quick break, but more in just a moment. And we're talking about earning your DNP. Don't go away. We'll be right back. And now back to our interview with nursing experts Nancy Richmond and Dr. Khadija Hamisi, and we're discussing whether a DNP, a doctor of nursing, would be right for you. And so, Nancy, I'm going to start with you, or actually I think, Khadija, how long does the DNP take to complete?

0:22:07 - Dr. Khadija Hamisi

So really that depends on your pathway. MSN to DNP typically takes two years and then BSN to DNP may take up to four years. So also depend on where you want to be, you know, because the doctorate of nursing practices have different fields, right. So depending on the field you choose to pursue, sometimes the DNP can take at least four years for full-time learning and, but the good thing about it is, most nurses are able to work while they pursue their DNP Because many institutes have different programs. Most of them are flexible Because you know this is most of the time it's an adult learning program, it's a DNP, but you're able to go do your work, take care of your family, do whatever other things you do, as long as you put time in your studies. So there are so many programs out there. They are flexible, which is encouraging.

0:23:11 - Kimberly King

Yeah, that's really encouraging. So how many DNP programs are available and can you specialize in your area of study?

0:23:23 - Nancy Richmond

Okay, so I'm going to give just a little bit of statistical data for us. In the fall of 2008, the Commission on Collegiate Nursing Education began to accredit DNP programs for the first time and to date, as of 2023, there are now 354 programs that have been accredited and they are available in all 50 states. And in 2021 to 2022, to talk about how much it's grown 41,000 students were enrolled in a DNP program, up from 9% from the previous year. So it grew by 9.9% in one year, and now there are currently, in 2023, there are 426 DNP programs and there are 70 more in the planning stages, and they cover every specialty that you could think of.

0:24:29 - Dr. Khadija Hamisi

Just to help Nancy out there. So there are very many specialties, but the most common that we see all the time there's acute care nurse practitioner. There's the adult, gerontology, primary care nurse practitioners. In the doctorate program we have FNP doctoral program. We have pediatric, psychiatric, mental health nurse practitioner. We have what is that? Certified nurse, anesthesiologist, DNP programs. So all depends on your specialization. That's the beauty of it. There are so many different kind of DNP programs. That is up to you. You're not just tied to one thing.

0:25:22 - Kimberly King

Right, well, and that's again really impressive. I think that the growth over 9% in this amount of time. Yeah, in one year, and I know you've really kind of discussed earlier that some of it could be done online, which is probably really helpful, but then probably some of it does need to be completed in person as well. What are the licensure and regulatory requirements? I don't know if that's- Dr. Kadisha.

0:25:55 - Dr. Khadija Hamisi

So they vary state based right? Because different states have different statutes and regulations and some specific requirements across states may vary, but all the DNP programs include the valid educational background, professional certifications and they have specifically clinical hours that have to be met. You have continuing education, collaborative practice agreements and prescription authority based on different states. So, like I said, each state have its own regulations and requirements.

0:26:37 - Kimberly King

Okay, right, and that's- Okay. That makes sense. I mean, every state is different there. What tips do you have for somebody that is considering, in a general way, you know, obtaining and earning their DNP?

0:26:51 - Dr. Khadija Hamisi

Okay, so we have so many DNP programs, right? Different state, different specialties. You look within yourself what do you want? What is your pleasure no, I'm sorry, maybe that's a different way of putting it- Like what is your passion? Because the DNP, especially in NACI, we have different specialties...

But then within NACI there's so many different specialties. So look within yourself what do you like, what makes you want to get happy in your work? So that should be the first thing when you're looking at what DNP program you should go to. And then, what is your time? Are you able to go full-time? Are you able to go in person? Do you want just to do online? All these are the things that you need to look at to make an informed decision about what program you should be in.

Talk to your family, because even if the problems are flexible, you still need to do your part. You still need to put in work for you to be able to complete the program, to benefit from the education that you're provided. What is your work like? Are you able to get time off work? Are you able to change your schedule? So all these, you just sit down with your family. Look at what you like, what would benefit you, what would make you succeed- And then, once you put all those things together, then look at the programs that fit your needs and then just continue. You've got to stay focused, you've got to stay committed.

And look this anybody can do a DNP. Anybody that is a registered nurse can do a DNP, and I really highly encourage everyone to do a DNP. Does it take time? Yes, depending on where you are in your educational level. But you're learning so much. You get to be an expert in your field, you get to use your critical thinking. So there's so many things that come with the doctoral program. So I encourage everyone to pursue a doctoral program or certificate.

0:29:23 - Kimberly King

Excellent. What about you, Nancy? Do you have any tips?

0:29:26 - Nancy Richmond

Well, actually mine has more to do with the research into whether or not the DNP would be appropriate or desirable for me for practice.

And one of the things I read, a couple of things that were particularly meaningful to me, and one of them was if a nurse desires an advanced practice degree education and has a choice between a DNP or the master's preparation, it would be better to pursue the DNP because in the long run it's more cost effective for the time spent, and that's because it really would prepare me or someone else for future practice with the DNP. Your position to push the boundaries of clinical practice. You're aware of what it is that you can do and what are the best- What are the outcomes If I do this, this is the outcome that's going to come. You're more aware of that and you can push the boundaries and practice as well. As something that's appealed to me is leading change in the healthcare system, which I think we very much need in this country, and contributing to evidence-based advancement, participating in research, the implementation of that research. So for those reasons, the DNP is very appealing to me as the next degree for myself.

0:31:01 - Kimberly King

Well, congratulations to both of you and, as you said, your instruments of change, and we are on this precipice of change in healthcare and we're writing that in real time and I love your passion and I know you're making a difference. Nancy, tell me a little bit about National University's DNP program specifically.

0:31:21 - Nancy Richmond

Okay, so currently at National University they have a doctor of nursing practice and executive leadership, and according to the website, when I looked at it, it says that the student will explore key topics such as organizational leadership, economics, finance and advocacy for healthcare policy improvement and how to use data and technological resources for decision making in leadership. So that's the description of the program. The credit hours are 46. The number of courses is 13. And the estimated time to complete is 30 months. And this program is accredited by the Commission on Collegiate Nursing Education. It also aligns with the American Association of Colleges of Nursing Essentials and the competency from the American Organization for Nursing Leadership.

0:32:21 - Kimberly King

Wow, thank you for adding that part of it and you know you're probably perking up a lot of interest as you explained that, but I love the leadership aspect of that and I again I love the difference you both have made and are making and continue to be pioneers in your field and the instruments of change and as a doctorate of nursing. So thank you, and thank you for your time today and discussing how important this topic is, and if you want more information, you can visit National University's website at nu.edu. Thank you.

0:32:56 - Dr. Khadija Hamisi

Thank you so much for having us today.

0:32:59 - Nancy Richmond

Yes, thank you very much for having us. It was a pleasure.

0:33:05 - Kimberly King

You've been listening to the National University podcast. For updates on future or past guests, visit us at nu.edu. You can also follow us on social media. Thanks for listening.