Shifting grounds: How do changes in nursing education upend the balance of justice?

Background & Issues: Advanced practice nursing education experienced a seismic shift when the American Association of Colleges of Nursing (AACN) changed graduate nursing education by creating the Doctorate in Nursing Practice (DNP). In 2006, the AACN deemed entry into advanced practice by 2015 would require a DNP. Additionally, to be accredited through AACN, nursing programs must meet the new essentials for baccalaureate and graduate degree programs. What ramifications do these changes have for community/public health nursing (PHN) education, for addressing the public's health, as well as for ensuring social justice and equity for vulnerable populations? Description: Findings from an examination of U.S. graduate nursing program tracks and analysis of AACN's graduate education essentials are used to discuss the effects of recent changes in nursing education. Lessons Learned: Changes in nursing education may be costly in terms of reduced time and attention devoted to population health content in graduate nursing programs; the number of graduate students who may be priced out of pursuing the DNP; a reduced PHN workforce if nurses with DNPs forgo public health department employment; and ultimately, declining efforts to reduce health disparities among vulnerable communities. Recommendations: The Institute of Medicine, the federal government's Healthy People 2020, and the American Nurses Association strongly support the need for a well-educated public health workforce to meet the health challenges facing the nation. Efforts are needed that document and address aftereffects of the changes in nursing education on PHN and its mandate to pursue social justice in health and health care.