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The lived experience of those who work with or hire Doctor of Nursing Practice-prepared nurses in practice: A
Amy Manderscheid1, Karen Kesten2, Katherine Moran1
1Grand Valley State University, Grand Rapids, Michigan.
Background:
Health care systems require strong practice leadership to address increasing complexity, workforce demands, and quality outcomes. Doctor of Nursing Practice (DNP) nurses are educated to lead evidence-based practice, quality improvement, and system-level change; however, variability in role clarity and organizational support limits full utilization, and qualitative evidence describing their impact remains limited.
Purpose:
To explore the lived experiences of those who hire or work with DNP-prepared nurses.
Methodology:
A qualitative phenomenological design was used with a purposive sample of 21 US-based participants recruited through prior study participation and professional networks. Virtual interviews were transcribed and analyzed using a modified Giorgi method, including identification of meaning units, structural statements, and thematic synthesis until data saturation was achieved.
Results:
Two themes emerged within each group and were synthesized into one overarching theme: DNP-prepared nurses drive value through leadership, competencies, and system-level impact when supported by organizational culture and structure. Participants described DNP nurses as influential leaders demonstrating advanced clinical reasoning and systems thinking; however, inconsistent role clarity and limited organizational support constrained full enactment of DNP-level capabilities.
Conclusions:
Doctor of Nursing Practice-prepared nurses are essential practice leaders capable of advancing quality outcomes and system performance. Their impact depends on organizational alignment, including clear role differentiation, leadership support, and structural investment.
Implications:
Institutions must cultivate cultures that provide protected time, clear role expectations, and leadership support to enable DNP-prepared nurses to practice at full scope. Without structural alignment, DNP competencies remain underused, reinforcing the need to treat organizational investment in DNP roles as a strategic priority.
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