Doctorate of Nursing Practice (DNP) - What Is A DNP and Is It Worth It?
By Danielle LeVeck, DNP, AGAC-NP, CNS, RN, CCRN
If you’re considering a Doctorate of Nursing Practice (DNP) degree you might be having a hard time deciding if it’s the right degree for you. There strong opinions on the degree throughout the nursing community and while some are true, there are also a lot of myths. Before I decided to pursue my DNP, I heard all sorts of comments,
- “The DNP is a watered-down Ph.D.”
- “The DNP is another excuse to squeeze more money out of nursing graduates”
- “The DNP is not worth it”
You may have found this article as a brand new researcher who knows very little about the DNP. I’m here to share the first-hand experiences I received while trekking toward and completing my degree including,
- Debunk myths and false information about the DNP degree
- Provide valid resources regarding the DNP
- Discuss the career outlook - benefits, salary, job growth, specialties, requirements
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5 key points to consider before pursuing a Doctorate of Nursing Practice (DNP)
- The DNP is a degree, not a role. For example, other degrees include a Doctorate of Philosophy in Nursing (Ph.D.), Master of Science in Nursing (MSN), or a Bachelor of Science in Nursing (BSN). Examples of roles are Advanced Practice Registered Nurses (APRNs), or Registered Nurses (RN). You need a certain degree to fulfill these requirements of these roles and to sit for each of the required certification exams.
- Obtaining a DNP does not make you a physician. The training of a doctorally educated Nurse Practitioner versus a physician is very different. Both are imperative and valuable to patient care, but they are not the same.
- Not all DNP programs are created equal. Do extensive research on your program to make sure you will meet the educational requirements of the APRN Consensus Model if you plan to practice as an Advanced Practice Registered Nurse (APRN) upon graduation.
- You can have a DNP and not practice as an APRN (Nurse Practitioner, Nurse Midwife, Nurse Anesthetist, Clinical Nurse Specialist). However, many nurses with DNPs practice as APRNs, hence it is a practicing doctorate.
- Master’s programs still remain for APRN training. Although the AACN is suggesting all master’s programs transition to Doctorate programs for APRN training, some master’s programs still remain for APRN training. Also, APRNs are currently allowed to sit for certification exams with a master’s degree.
What is a DNP?
The Doctorate of Nursing Practice (DNP) is ultimately designed to produce leaders in nursing. Such nurses possess the highest level of nursing expertise and work either in a clinical setting or leadership role upon obtaining the required credentials. They possess adept knowledge to influence healthcare outcomes through organizational leadership, health policy implementation, and direct patient care.
DNP prepared nurses generally work in one of two settings,
- Leadership and administration
- Advanced Practice Nursing (APRN) - direct patient care
Leadership and Administration
DNP prepared nurses who choose to work in leadership and administration play a key role in strengthening executive nurse leadership roles as well as directly influencing healthcare outcomes through scientific findings. They play an essential role in creating innovative care programs that are not only sustainable but, economical as well.
In the workforce, you may find DNPs in the following roles,
- Nurse Management
- Organizational leadership
- Health policy - state and national
- Health informatics systems
Advanced Practice Nursing - direct patient care
DNP graduates who take the advanced practice nursing (APRN) pathway will provide direct care to patients that include managing, assessing and evaluating care.
DNPs who focus on advanced practice nursing are required to sit for the advanced practice registered nurse (APRN) certification exam. They may also be required to sit for advanced specialty certification as well.
In the workforce, you may find DNPs in the following roles,
- Nurse Midwife (CNM)- professionals who provide reproductive health services before, during and after childbirth. They also provide primary care and counseling throughout infancy.
- Nurse Anesthetist (CRNA) - professionals who work collaboratively with the healthcare team to administer anesthesia.
- Nurse Practitioner (NP) - clinicians who work autonomously to provide patient care and manage illness. Nurse practitioners specialize in a specific patient population such as,
- Family Nurse Practitioner (FRNP)
- Adult-Gerontology Nurse Practitioner
- Neonatal Nurse Practitioner
- Pediatric Nurse Practitioner
- Psychiatric-Mental Health Nurse Practitioner
- Women’s Health Nurse Practitioner
Is a DNP different from a Ph.D.?
There are only two doctoral level degrees in the nursing profession - the Doctorate of Nursing Practice (DNP) and the Doctorate of Philosophy (Ph.D.)
Both degrees are terminal degrees, this means that neither is considered more “advanced” than the other. However, it’s important not to get the two confused.
Upon earning the proper credentials, both DNP and Ph.D. graduates are eligible to work as nurse practitioners. If you’re planning to work as a Nurse Practitioner after graduating and you earn a Ph.D. you’ll typically need a post-graduate certificate. The Ph.D. degree is heavily research focused and is generally pursued by those who are interested in scientific and scholarly work.
Although both are terminal degrees in the nursing profession, a practice-focused degree will place more focus on translating and implementing evidence into practice. While both degrees require extensive research reported in a final DNP Project or dissertation, practicing doctorates generally include integrative practice experiences and the manuscript is like “telling the story” of research implementation.
My experience: The purpose of my DNP project was to initiate palliative care consultations for end-stage heart failure patients in the cardiac critical care unit. I had a foundation of research, and heart failure guidelines, known as a literature review, strongly suggesting palliative care consultations were necessary to provide the best care for patients.
Easy, right? Not exactly.
The DNP walked me through the process of making the current research become reality while taking into consideration stakeholders, unit culture, organizational behaviors, financials, and measurable outcomes. My research was not considered generalizable and was most beneficial to my institution. My manuscript encompassed my original plan, plus the story and the difficulties I encountered.
Why Earn a DNP?
- The doctorate degree may soon be the standard entry-level requirement for certification and licensure in advanced nursing practice. In 2004, members of the American Association of Colleges of Nursing (AACN), voted to increase the requirements of advanced practice nursing from a master’s degree to a doctorate level.
- The DNP curriculum builds upon the masters by including training in evidence-based practice, systems leadership, informatics, and quality improvement. Meaning, the DNP is ultimately designed to produce “leaders” in nursing.
- The current healthcare environment demands nurses possess a comprehensive skill set of scientific knowledge, outcome measurement, and leadership qualities, to assure the best patient outcomes.
- Doctorally educated nurses are needed to address shortages of doctorally prepared nursing faculty, increasing educational expectations, and national concerns about healthcare quality. Of note, a practicing doctorate is not new in other professions, nursing is simply moving in the same direction. Pharmacists obtain the PharmD, Psychologists can obtain a PsyD, Physical Therapists obtain the DPT, Audiologists obtain the AudD, etc.
- Access to opportunities in a variety of settings that were previously unattainable to those without a DNP degree from private practice to hospitals to universities and more.
- DNPs will continue to see increased salary and pay for years to come. According to the Bureau of Labor Statistics, advanced practice nurses earned an average annual salary of $110,930 is 2017. Nursing salaries, in general, are projected to grow by 22% by the year 2022.
My Experience: My certainty regarding the DNP did not come full circle until the beginning of my third year. At times, I did not exactly understand what I was doing, but at my core, I knew I wanted to help lift the profession to the next level.
I learned to trust the process and not only grew as a researcher, leader, and clinician but grew exponentially as a human being through the degree.
I feel equipped to educate new nurses, lobby for nursing policy, implement evidence into practice, and I have a better understanding of historical aspects of nursing that have led us to our current state.
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How do you get a DNP?
Most DNP programs have multiple specialties to choose from including, adult acute/primary, pediatric acute/primary, women’s health, family medicine, emergency medicine, neonatal, psych, and nurse anesthesia. These programs can be completed in three, four, and sometimes five years.
There are several tracks one can take toward earning a DNP:
- BSN-DNP: I completed a BSN-DNP track with a specialty in Adult-Geriatric Acute Care (AGAC). Upon completion, I met the requirements to sit for my AGAC-Nurse Practitioner and AGAC-Clinical Nurse Specialist certification exams. Therefore, once I pass both exams, I will be a doctorally educated, dual board certified APRN (it’s confusing, I know).
- MSN-DNP: One can already have a master’s degree, be working as a board-certified APRN in a given specialty and go back to school to complete their DNP coursework.
- Post-Master’s DNP: Options are available for administrators or educators who work in healthcare to get their DNP without repeating coursework. This option is beneficial for applicants with MPH, MBA, or MPA.
Why The DNP Was Worth It For Me
I wholeheartedly believe in the training of this degree and would not change my academic path. I feel pressure to deliver as an expert clinician first and foremost, but then to expand upon my leadership abilities to promote and professionally represent the DNP. I plan to use my inclusive education to its full extent in the future and feel equipped to tackle clinical, academic, organizational, and systemic challenges to advocate for the nursing profession.
Completing the BSN-DNP AGAC-NP/CNS track was my hardest academic challenge to date, but graduating was my proudest moment.
Keep in mind that Much of the advice regarding the DNP that is currently available to the general public is often written by people who do not have one. Therefore, check sources before believing what you read. Below are some trusted sources with information on the DNP:
- AACN DNP Fact Sheet
- AANP Discussion Paper
- U.S. News and World Report Top-Ranked DNP Schools (Research the top school’s websites for information on each specialty DNP)
Danielle LeVeck, DNP, AGAC-NP, CNS, RN, CCRN an ICU Nurse Practitioner, blogger, writer, and social media influencer, who strives to empower and inspire nurses from all backgrounds, to partake in regular self-care and multidisciplinary teamwork, for the sake of providing optimal patient care. Follow her on Instagram @nurseabormalities and Facebook for her latest.