Should the AACN, proposed Doctor of Nursing Practice degree, be used as a model for international nursing?

Editorial Should the AACN, proposed Doctor of Nursing Practice degree, be used as a model for international nursing? On October 23, 2004, The American Association of Colleges of Nursing (AACN) announced a new position statement recommending the Doctor of Nursing Practice (DNP) as the terminal degree for advanced nursing practitioners (http://www.aacn.nche.edu). This policy decision has implications for global nursing as well as US nurses. The case for using the DNP as a model for international nurse education is made in two important ways. First, nurses are flowing across the globe in response to the worldwide nursing shortage, and practicing internationally in large numbers. 'Although hospitals have experienced many shortages of registered nurses (RNs), most have not lasted as long as the current shortage, which began in 1998. [However, hospital RNs' employment and earnings increased sharply in 2002, which suggests that the shortage may be easing]. Two-thirds of the increase in employment came from older RNs, with the remainder supplied by RNs born in other countries. The employment response of older and foreign-born RNs indicates how the labor market is likely to respond to future shortages, and it emphasizes the challenges confronting policymakers as the RN workforce ages and eventually shrinks in size' (Millwood, 2003). With older and foreign-born RNs making up the shortage of nurses in the USA, and elsewhere, the easing of the shortage of nurses will be short-term. The movement of nurses around the globe will increase, and many more nurses will be practicing internationally. Second, the level of nurse education does make a difference. Research addressing links between nursing education and patient mortality rates is reported in an article published in the Journal of the American Medical Association (Aiken et al., 2003). This scientifically rigorous study clearly demonstrates a significant association between educational levels of hospital nurses and variation in mortality; patients experienced significantly lower mortality and failure to rescue rates in hospitals where more highly educated nurses were providing direct patient care. As an international advanced practice nurse who has contributed to advanced practice nursing curriculums over the last two decades in the USA, China and Japan, my experience has shown that when developing Master degree curriculums for advanced practice nursing anywhere in the world, the same problems predominate. There are critical problems associated with crowded curriculum and the difficulty of finding adequate clinical hours for the APN role in a 2-year Master's curriculum. Everywhere I …