October 8, 2017

Nurse Practitioner Showdown: Masters vs. Doctorate

Nurse Practitioner Showdown: Masters vs. Doctorate

By: Kathleen Colduvell BSN, RN, BA, CBC

According to the U.S. Bureau of Labor Statistics, the need for advanced practice nurses, which includes Nurse Practitioners (NP) and Doctors of Nursing Practice (DNP), is expected to grow by 31% by 2024. Current changes to healthcare have given additional opportunities for nurses. As the baby boomer generation continues to age there will be an overwhelming need for advanced practice nurses, especially those specializing in geriatrics.

What is the role of a Nurse Practitioner?

Nurse Practitioners deliver advanced care to a variety of patients in the clinical settings. According to the [American Association of Nurse Practitioners] (AANP) (, NPs work “autonomously and in collaboration with healthcare professionals and other individuals, to provide a full range of primary, acute and specialty health care services.”

These services include:

  • Order, perform and interpret diagnostic tests 
  • Diagnose and treat acute and chronic conditions 
  • Record and examine the medical history, diagnoses, and symptoms 
  • Prescribe medications 
  • Manage patients' overall care
  • Counsel
  • Educate patients and family on disease prevention and plan of care

Nurse Practitioner Specialities

For those considering advancing their nursing career, it is important to research all possibilities before choosing the best-suited program. Differences between programs may be subtle. All programs are a combination of clinical application and didactic coursework. 

Nurse Practitioners have a master’s degree, known as an MSN, as well as board certification in a specialty. This specialty is determined prior to applying to a program. It is important to note that not all specialties are offered at schools so determining a specialty before researching programs is key. Once accepted into a specific program it can be difficult to switch and not all coursework will be transferable.

Specialities include but are not limited to:

  • Family
  • Pediatric
  • Neonatal
  • Geriatric
  • Trauma
  • Acute Care
  • Women’s Health

Not sure which specialty to focus on? Generally, nurses use prior work experience to determine the NP path they will take. The differences between the specialties determine the course load. Nurses specializing as a neonatal nurse practitioner will focus specifically on the neonate and most likely will not take advance geriatric courses. Some specialties cover a broad spectrum, such as family and trauma, and these individuals take a wide variety of courses. 

Nurse Practitioners can specialize even further with additional classes and certification exams. Classes for these are generally done online and might require individuals to contact other NP programs to obtain needed requirements.

These subspecialties include: 

  • Allergy & Immunology
  • Cardiac
  • Emergency Medicine
  • GI
  • Neurology
  • Occupational Health
  • Oncology
  • Pulmonology
  • Urology

What is a Doctor Of Nursing Practice (DNP?)

Doctors of Nursing Practice (DNP) deliver high-quality advance nursing care in a clinical setting, similarly to an NP; however, these individuals have taken their career a step farther. A DNP is a terminal degree for advanced practice nurses.  

The American Association of Colleges of Nursing (AACN), states that transitioning from advance practice NP degrees to the doctoral level is a “...response to changes in health care delivery and emerging healthcare needs, additional knowledge or content areas have been identified by practicing nurses. In addition, the knowledge required to provide leadership in the discipline of nursing is so complex and rapidly changing that additional or doctoral level education is needed."

Essentially, DNP graduates are leaders in advanced nursing practice that bring evidence-based knowledge into the clinical setting to help improve healthcare outcomes and strengthen the leadership role of nurses in both the clinical and academic setting. 

DNP Roles and Responsibilities

Individuals with a doctorate degree can function in a provider capacity but most work to generate new scientific and clinical knowledge in nursing and healthcare. Conversely, NPs practice primarily in clinical settings and do not focus on scientific and academic research in their practice. For this reason, most DNPs work in academia, as administrators, and/or researchers. 

The benefits of a DNP program according to the AACN are,

  • enhanced knowledge to improve nursing practice and patient outcomes
  • enhanced leadership skills 
  • increased supply of faculty for clinical instruction
  • development of needed advanced competencies for increasingly complex clinical, faculty and leadership roles

Top 5 DNP Programs In The U.S

The 2017 U.S. News & World Report ranked the best DNP programs in the country. These programs are highly competitive and vary in size and price.

The top 5 are as follows:

  1. Duke University
  2. John Hopkins University
  3. University of Washington
  4. Rush University
  5. (tie) Columbia University, (tie) Ohio State University

To pursue a DNP, individuals already would have completed a traditional or accelerated BSN programs and most will have a MSN. There are only a handful of programs that accept students into the DNP program without an MSN. A MSN program take approximately 2 years full time while a DNP program can vary between 1-4 years. Overall it takes approximately a decade for an new nursing student to obtain all three degrees (BSN, MSN, DNP). 

DNP Salary

On average NPs make an annual salary of $101,260, according to the U.S. Bureau of Labor Statistics; interestingly, there is no concrete data on the average annual salary of a DNP. Healthcare salary trends suspect DNPs average $125,000 to $150,000 per year. The key determining factor for salary is the career nurses pursue after obtaining an advance degree. A Chief Nursing Officer will earn more than a Nursing Professor. Ultimately, additional advanced education is reflective in higher annual salary earnings. 

Masters Degree or Doctorate Degree?

In 2004, the AACN developed a position statement suggesting that all schools move towards DNP programs in combination with an MSN degree for advanced practice nurses. The goal would be for all programs to have incorporated the new curriculum and suggested guidelines by 2015. Pre-existing advance practice nurses would enroll in fast-track programs to obtain their DNP. 

While this goal has not be obtained, several major universities are graduating an increasing number of DNPs each year. The AACN felt that this was important because nurses often work with other healthcare professionals in their field who have more training and education and a DNP can provide nurses with an education that is comparatively advanced to those with advanced skills and education. 

Healthcare is a fluid industry that is constantly changing with advancement in medicine and new technology. It’s vital that advance practice nurses stay abreast of recent changes and the trends that are emerging. Employers feel a key way to do this is through advanced education. While some jobs require a DNP it is still a relatively new and underutilized nursing degree. With bold position statements by the AACN and AANP, DNP programs are rising and the number of applicants is increasing on a yearly basis.

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