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    EDUCATION
    August 24, 2021

    NP vs. DNP | What's the Difference?

    Kathleen Gaines
    By: Kathleen Gaines MSN, RN, BA, CBC

    When it comes to career paths, nurses have no shortage of opportunities for advancement. From CNMs to CRNAs and everything in between, the options seem almost endless. But how do you decide which is right for you? In this guide, we'll be digging into the nurse practitioner career path, what the difference between an NP and a DNP is, and which degree you should pursue.

    NP VS DNP: What's the Difference?

    An NP stands for nurse practitioner, which is a job title registered nurses can achieve by pursuing an advanced degree. Nurse practitioners can earn this role through either a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP). Essentially, a DNP is a degree option to become an NP. 

    As an aspiring nurse practitioner, you'll need to choose whether you want to attend an MSN program or a DNP program. 

    NP: MSN vs DNP Degrees Compared

      MSN Degree DNP Degree
    Length of Program

    ADN-to-MSN: 3-5 years

    BSN-to-MSN: 2 years

    ADN-to-DNP: 5-6 years

    BSN-to-DNP: 3-4 years

    MSN-to-DNP: 2 years

    Average Salary $96K  / year  $105K / year
    Certification

    Renewal: 1-5 years

    Depends on NP specialty

    CEUs depend on specialty and state

    Renewal: 5 years

    Retake the exam or provide proof of at least 1,000 clinical practice hours and 75 CE units

    Work Environments

    Hospitals

    Physicians' Offices

    Educational Services

    Office of Other Health Practitioners

    Long-Term Care Facilities

    Community Clinics

    Universities

    Public Health Offices

    Hospitals

    Specialty Practices

    Autonomous Practices

    Healthcare Administration Settings

    Health Care Policy Advocacy Organizations

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    NP vs DNP FAQs

    • Should I Pursue an MSN or DNP to Become a Nurse Practitioner?

      • First, start with obtaining your MSN and sitting for the NP boards. DNP school will often be paid for by your employer if it is relevant to your current job. Plus, you can work as an NP without having a DNP.
    • Are DNPs Paid More than an NP With an MSN?

      • According to Payscale, nurses with a Doctor of Nursing Practice (DNP) degree earned an average base salary of $105K as of August 2021. Nurses with a Master of Science in Nursing (MSN) degree, on the other hand, earned an average salary of $96k, $9k less per year than the DNP degree.
    • Is a Master of Science in Nursing (MSN) the Same as a Nurse Practitioner?

      • Yes! In order to be a nurse practitioner, you must have your MSN. After graduating from an accredited NP program, you will have earned your MSN and then once you sit for your state NP boards you will earn the title of a nurse practitioner in your specialty.
    • Is a DNP a More Advanced Degree Than an MSN?

      • A DNP is a terminal degree. This means that it is the highest degree that can be earned in that specialty. An MSN is NOT a terminal degree.
    • How Long are MSN to DNP Programs?

      • Programs can be completed in 1-2 years of full-time study or 3-4 years of part-time study. Most DNP programs will allow students five years to complete the degree.
    • Are DNPs Called Doctors?

      • Technically, nurse practitioners that have earned a DNP are doctors but are not called this in the clinical setting. Those that teach in academia will be referred to as Dr. but those that practice solely in a hospital or outpatient setting will be referred to as a nurse practitioner. Referring to an NP as Dr. can cause confusion with patients. Most patients, when meeting someone with the title of doctor, will assume the person is an MD. Certain states have rules that indicate a nurse practitioner with a DNP must inform patients they are a doctoral-prepared nurse practitioner. Certain healthcare organizations may also restrict the use of doctor for NPs.

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    What is the Role of a Nurse Practitioner?

    Nurse Practitioners deliver advanced care to a variety of patients in the clinical setting. 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 medical history, diagnoses, and symptoms
    • Prescribe medications
    • Manage patients’ overall care
    • Counsel
    • Educate patients and families on disease prevention and plan of care
    • Monitor and operate medical equipment
    • Perform physical examinations and patient observations
    • Collaborate with other healthcare professionals
    • Detect changes in a patient’s health and change the treatment plan if necessary

    In 23 states, nurse practitioners have “full practice authority” which means they do not have to work under the supervision of a doctor. Full practice states include Oregon, Maine, Alaska, Hawaii, Washington, and Iowa. In states with reduced practice (Ohio, Pennsylvania, and Utah) and restricted practice (Texas, California, and Florida), NPs must have a medical doctor sign certain medical patient care decisions. NPs have prescriptive privileges in all 50 states and can administer controlled substances in 49 states.

    Map depicting practice authority for nurse practitioners in US

    Nurse Practitioner Specialties

    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 and only noticeable upon further investigation. All programs are a combination of clinical application and didactic coursework. The didactic coursework can be offered in an online format. Depending on the program, some students might have to find their own placement for NP clinical while others will assist students in finding suitable arrangements. This is important to consider depending on your location, as clinical locations may be limited or reserved for only specific local universities.

    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 apply 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.

    Specialties include:

    • Family – Primary or Acute
    • Pediatric – Primary or Acute
    • Neonatal
    • Adult-Gerontology – Primary or Acute
    • Trauma
    • Women’s Health/Gender-Related
    • Psychiatric/Mental 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 specialties will determine the course load. Nurses specializing as a neonatal nurse practitioner will focus specifically on neonates and the management of neonatal diseases. They will not have to take courses in geriatric medicine. Programs often require a certain number of years’ experience in a specialty before acceptance into the program.

    Some specialties cover a broad spectrum, such as family and trauma, and these nurses will have to take a wide variety of courses. Individuals should expect to take courses ranging from pediatrics to geriatrics, even if they plan to only work with one specific age group.

    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. Nurse Practitioners can often complete on the job training in subspecialties.

    Not all NPs have to work in a subspecialty. This is an individual decision and does not have to be based on past nursing experience. Nurse practitioner subspecialties are focused on a specific condition, body organ, clinical focus, environment, or sub-population.

    The subspecialties include:

    • Allergy & Immunology
    • Cardiac
    • Dermatology
    • Emergency Medicine
    • Gastroenterology
    • Holistic Care
    • Hospice
    • Nephrology
    • Neurology
    • Occupational and Environmental Health
    • Oncology
    • Orthopedics
    • Palliative Care
    • Pain Management
    • Plastic Surgery
    • Pulmonology
    • Sleep Management
    • Sports Medicine
    • Surgery
    • Travel
    • Urology

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    What is a Doctor Of Nursing Practice (DNP?)

    Doctors of Nursing Practice (DNP) deliver high-quality advanced 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 advanced 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. 

    DNP Salary

    According to Payscale, nurses with a Doctor of Nursing Practice (DNP) degree earned an average base salary of $105K as of August 2021. The key determining factor for salary is the career nurses pursue after obtaining an advanced degree. A Chief Nursing Officer will earn more than a Nursing Professor. Ultimately, additional advanced education is reflective of higher annual salary earnings.

    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 role

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    Top 5 DNP Programs 2021

    The top DNP programs in 2021 are:

    1. Columbia University
    2. University of Washington
    3. Johns Hopkins University
    4. Duke University
    5. Vanderbilt University

    Johns Hopkins, Duke, and Rush have consistently been in the top 5 DNP schools the last several years. Rush University has the largest DNP program with over 800 enrolled students while Johns Hopkins and Duke have approximately 200 DNP students.

    Types of DNP Programs

    To pursue a DNP, individuals already would have completed a traditional or accelerated BSN program and have an MSN. There are only a handful of programs that accept students into the DNP program without an MSN. These programs are bridge programs that offer BSN-DNP programs. Students will work to complete coursework for an MSN and then continue directly into the DNP curriculum. An MSN program takes approximately 2 years full time while a DNP program can vary between 1-4 years. Overall it takes approximately a decade for a new nursing student to obtain all three degrees (BSN, MSN, DNP).

    Should You Choose a Masters Degree or Doctorate Degree to Become an NP?

    In 2004, the American Association of Colleges of Nurses 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. 

    The AACN explains, “The DNP provides a clinical option for advanced preparation in nursing practice that is more comparable to other interprofessional education.” It is believed that by earning a DNP, nurse practitioners will be more prepared and better suited to take care of their patients.

    While this goal has not been obtained, 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. As of right now, the plan continues to be re-evaluated each year.

    Healthcare is a fluid industry that is constantly changing with advancements in medicine and new technology. It is 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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    MSN vs. DNP Compared

    Infographic depicting different salaries and roles for nurse practitioners

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