The Consensus Model In Nursing Practice

The Consensus Model is reprinted in the appendix of the Institute of Medicine report and is “recognized by policy makers and others outside of nursing as foundational to the future of APRN practice” (Stanley, p. 242). Stanley (2012) discusses the Institute of Medicine (IOM) Report, Future of Nursing: Leading Change, Advancing Health, that supports the AACN in reorganizing the role and impact of APRNs to practice to the full extent of their education and training; collaborate with other professionals in addressing healthcare issues in the United States; and work as full partners with other health care professionals. Dennison & Payne (2012) describe the characteristics of the nurse interested in the DNP degree as “those committed to a career focusing on nursing practice and improving patient outcomes.” and “APRNs in direct

delivery of care to individuals and populations, in direct delivery of care through a leadership role, and development and implementation of health policy...

the DNP/NP is expected to provide visionary leadership in nursing practice” (Dennison & Payne, p. 227). Further, Dennison, Payne, & Farrell (2012) postulate that “it is likely that the DNP will remain controversial for the next decade, it is also evident that this degree has been ardently embraced by individual nurses seeking advanced degrees that focus on nursing practice” (Dennison, Payne, & Ferrell, p. 288).
Barriers and Challenges
Controversies around the DNP entry into practice continue to abound. Many nurses express the belief that it is not necessary to require a DNP entry preparation into advance practice, that the MSN is adequate. While the DNP degree was meant to increase access to affordable care, “some healthcare providers claim that the additional time and money for achieving APRN preparation will actually contribute to a shortage of APRNs” (Dennison, Payne, & Ferrell, 2012, p. 235). Other issues creating controversy include the financial

investment in completing a DNP, especially for older NPs who are nearing retirement; the shortage of doctorally prepared nursing faculty to prepare the DNP/NP; health care reform and the impact of numbers of stakeholders in need of services with increase access to services through the Affordable Care Act. Moreover, Grey (2013) identifies controversy around clarification of the DNP role, the range of clinical practice hours after the mandatory 1000 hours required, “there is little consistency in the capstone experience and product” (Grey, p. 463). “An additional concern regarding clinical experiences relates to the need for appropriate sites and preceptors (Grey, p. 463). Grey elaborates on the issue of lack of doctorally prepared faculty, preceptors, and practice project mentors, and limitations on the practice sites for the students entering into programs. Lastly, Grey addresses the question about whether the original goals of the DNP have been reached, “many DNP graduates in community sites, especially in inpatient settings, are in administrative roles, not clinical roles” (Grey, p. 464) and “it is critical to understand whether practice has evolved from traditional one-on-one primary care to population-based care and how the model of practice has improved health outcomes (Grey, p.104). It will be important for DNP programs to address these issues to insure viability, credibility, and growth of DNP programs.