Nurses Are Doctors, Too

Eileen Barroso
The first recipients of the doctorate in nursing practice.
Beginning this fall, Columbia’s School of Nursing will initiate a four-year program leading to a doctorate in nursing practice (DrNP), the first degree of its kind in the United States. The new doctors of nursing, says Dean Mary O’Neil Mundinger, will be able to provide “a comprehensive hybrid between conventional nursing and conventional primary medical care.

“In many ways, graduates will be similar to general practitioners of old,” she adds, “but in addition to primary-care medicine they will have the skills that nurses gain in early education. So a doctor of nursing will do more than just take on the medical diagnostic and treatment work; the program builds on nursing areas that we all know and love nurses for.”

Along with increased responsibility, graduates will have a greater degree of mobility and autonomy. While nurses who begin the program will already be experts at giving care at one site, such as a clinic or an office, as doctors of nursing they will be able to follow patients wherever they can best be cared for, whether it is an emergency room or rehabilitation facility. Some, like the nurse midwives and nurse anaesthetists of today, may choose to set up independent practices. And like physicians, they will be able to secure the right to admit patients to specific hospitals and determine their courses of treatment there and at other facilities.

Graduates will have the highest level of clinical expertise, including competency in sophisticated diagnostics and treatment, creating “an accountability model as well as an advanced diagnostic model,” Mundinger says.

The doctoral program, which builds on Columbia’s existing master’s program in advanced practice, adds a year of course work and clinical seminars and another year of full-time residency. It was approved by the school’s Trustees in June 2004 and registered by state officials last January. Even before approvals from the University and state were in place, Mundinger says, word that Columbia was developing the program prompted more than 800 inquiries. “The interest is there, and I think that’s why other schools of nursing are beginning to take this on.”

More than a dozen existing faculty members received Columbia’s first nursing doctorates in May 2005. “While the approval process was ongoing, the provost allowed me to put my faculty through an accelerated program so they would be qualified to take incoming students,” Mundinger explains.

“These are the pioneers who, over the past 10 years, learned to practice at this higher level with the help of Physicians and Surgeons faculty,” she says. Because they already had 10 years of case studies, the participating nurses “worked diligently to come up with final portfolios of complex case studies that demonstrated they had achieved all the higher-level competencies of this advanced clinical model.” After that it was just a matter of actually taking the courses.

A charter class of 15 to 20 students with bachelor’s degrees in nursing, and a requisite four or five years of experience with patients, will enroll this September. Mundinger says she expects a diverse class in terms of personal background.

The program will grow over the next five years to accommodate about 100 students, with the school working to find suitable clinical sites for training. National standards, too, will be developed in conjunction with other leading nursing schools, many of which plan to initiate similar programs of their own.