To the Editors:

Kudos to the American Journal of Critical Care for a thoughtful analysis of the doctor of nursing practice (DNP) proposal and the related history of education and credentialing in nursing (July 2005: 278–281). Two perspectives on the issue:

The first perspective is viewing the DNP proposal in relationship to the clinical nurse leader (CNL) proposal. According to the American Asociation of Colleges of Nursing, “In practice, the CNL oversees the care coordination of a distinct group of patients and actively provides direct patient care in complex situations. This master’s degree–prepared clinician puts evidence-based practice into action to ensure that patients benefit from the latest innovations in care delivery. The CNL evaluates patient outcomes, assesses cohort risk, and has the decision-making authority to change care plans when necessary. The CNL is a leader in the health care delivery system, and the implementation of this role will vary across...

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