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    DNP vs Ph.D. in Nursing - What is the Difference?

    By: Kathleen Gaines BSN, RN, BA, CBC

    Nurses that have earned a Master’s degree and are ready for the next step may consider earning their DNP or Ph.D. Both are considered terminal degrees for advanced practice nurses but are rooted in a very different practice. In the most general terms, a doctor of nursing practice (DNP), is a clinical practice degree while a doctor of philosophy in nursing (Ph.D.) is a research-focused degree. 

    Nurse Practitioners have the option to earn either degree but a DNP is preferred. Individuals with a Master’s degree in Nursing Education will generally earn their Ph.D. 

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    FAQ:

    • What is a DNP?
      • A DNP is a terminal nursing degree rooted in clinical practice and intended for advanced practice nurse practitioners.
    • What is a Ph.D.?
      • A Ph.D. is a terminal nursing degree rooted in research and intended for individuals wishing to work as nurse educators or nurse researchers. 
    • What is the difference between DNP and Ph.D. salary? 
      • Healthcare salary trends suspect DNPs average $125,000 to $150,000 per year. This ultimately depends on the place of employment.
      • Ph.D. nurse educators had a median annual wage of $81,350 while nurse researchers earned an average salary of $81,500.
    • Does it take longer to become a DNP or Ph.D.? 
      • It takes about twice as long to earn a Ph.D. DNPs can be earned in as little as one year or full-time study while a Ph.D. takes a minimum of three years.
    • How long does certification last?
      • DNP’s must renew their certification every five years either through examination or practice hours and continuing education hours. Ph.D. prepared nurses do not have a certification to renew other than their advanced practice degree. 
    • Are DNPs and PhDs in demand?
      • With an ongoing nursing shortage, an aging population, and retirement of a large percentage of nurse educators, nurses with terminal degrees are in high demand.

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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.

    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. 

    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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    DNP Scope of Practice

    An individual with a DNP can function in a provider capacity but most also work to generate new scientific and clinical knowledge in nursing and healthcare. A nurse practitioner with a doctorate does not change the scope of practice. DNPs that work in the clinical setting can, 

    • 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 patients and their families
    • 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

    DNPs that work solely in the clinical setting will rarely conduct scientific research or teach. For this reason, most DNPs also work in academia, as administrators, and/or researchers. 

    The duties of a nurse with a DNP, outside of the clinical setting, can include the following:

    • Use informatics to lead improvements in healthcare outcomes.
    • Develop or update policies and procedures.
    • Educate patients and public about healthcare.
    • Innovate new healthcare strategies to improve patient health outcomes.

    In 23 states, DNPs have “full practice authority” which means they do not have to work under the supervision of a doctor. Full practice states include,

    • Washington
    • Oregon
    • North Dakota
    • Iowa
    • Maine
    • Oklahoma
    • New Mexico

    In states with reduced practice (Alabama, Wisconsin, and New York) and restricted practice (Virgina, Massachusetts, and California), DNPs must have a medical doctor sign certain medical patient care decisions. DNPs have prescriptive privileges in all 50 states and can administer controlled substances in 49 states.

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    DNP Salary

    In 2018, on average NPs made an annual salary of $113,930, according to the U.S. Bureau of Labor Statistics; interestingly, there is minimal concrete data on the average annual salary of a DNP. Healthcare salary trends suspect DNPs average $125,000 to $150,000 per year. 

    The U.S. Bureau of Labor Statistics has very limited data on DNP salaries but the reported average is $135,830. This average is based on only a small number of reported salaries. 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.

    It is impossible to determine which DNP specialty has the highest salary but hospital administrators, DNP-prepared certified nurse midwives, and DNP-prepared certified nurse anesthetists are at the top. 

    According to the 2019 U.S. Bureau of Labor Statistics, Certified Midwives can earn on average $147,820 in the San Francisco, California area while certified nurse anesthetists can earn $285,460 in Akron, Ohio.

    DNP Programs, Length of Time, & Classes

    According to the 2019 U.S. News & World Report, the top five DNP programs in the country are,   

    1. Johns Hopkins University
    2. Duke University and Rush University (tie)
    3. University of Washington
    4. Vanderbilt University
    5. University of Maryland - Baltimore

    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.

    DNP programs can be completed both online and in class. 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. 

    A DNP program completion can take roughly one to four years. This will depend on the program and whether it is being completed on a full time or part time basis. Programs are typically between 30-40 credit hours and 1,000 clinical hours. A percentage of clinical hours earned during an MSN program can transfer in some programs. 

    Individuals should expect to take the following classes:

    • Advance Leadership
    • Advance Healthcare Policy
    • Clinical Information Systems
    • Research
    • Evidence Appraisal
    • Project Development
    • Clinical Information Systems
    • Statistics
    • Clinical Reasoning
    • Clinical Pharmacology
    • Advanced Health Assessment and Measurement
    • Health Promotion and Risk Reduction Across the Lifespan
    • Epidemiology
    • Ethics for advanced nursing practice

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    DNP Admission Requirements

    Requirements for DNP programs will vary but most will require the following:

    • MSN degree from a regionally accredited higher education institution and a nationally accredited school of nursing
    • GPA of at least 3.0 or higher in the Master’s program
    • Current, unencumbered nursing license
    • RN experience 
    • Letters of Recommendation (both academic and professional references)
    • Official Transcripts (from all previous colleges/universities)
    • Current Resume/CV
    • Goal statement
    • Personal essay
    • Advanced Practice Registered Nursing license
    • Interview with faculty (if moved forward by admissions committee)
    • Test of English as a Foreign Language (TOEFL) or the International English Language Testing System (IELTS) if applicable 
    • Application fee

    What is a Doctor of Philosophy in Nursing (Ph.D.)?

    A Doctor of Philosophy in Nursing (Ph.D. in Nursing), is a research-focused doctorate in which students conduct research to advance the science and practice of nursing. PhDs are considered the gold standard for terminal degrees in nursing and at one time was the only doctorate option. 

    Individuals must have a strong desire to conduct research or teach students as this is generally what this degree is used for. 

    Ph.D. Scope of Practice 

    The scope of practice for a nurse with a Ph.D. is tricky. Individuals can work as a bedside nurse, but unless they are a CRNP, they do not have any advance responsibilities or roles beyond a normal bedside nurse. 

    Nurses who earn a PhD typically fall into two employment categories: nurse researcher and nurse educator. 

    For a nurse researcher, typical duties may include:

    • Identify research questions, and design and conduct scientific research
    • Collect and analyze scientific data and publish reports detailing findings
    • Write proposals and apply for grants to help fund their research
    • Establish and maintain quality assurance programs to ensure the validity of their data findings
    • Writing articles and research reports in nursing or medical professional journals or other publications
    • Presenting findings at conferences, meetings, and other professional speaking engagements
    • Train and supervise laboratory staff and other nurses or scientists

    For a nurse educator who has chosen to pursue a faculty position at a university or college, typical duties may include:

    • Plan, prepare and revise curriculum and study materials for nursing courses
    • Deliver lectures to undergraduate and graduate-level nursing students
    • Design curricula and develop programs of study
    • Evaluate program outcomes
    • Research and publication of scholarly work
    • Participating in professional associations
    • Speaking engagements at a nursing conference
    • Writing grant proposals
    • Writing or reviewing textbooks and other educational material
    • Seek continuous improvement in the nurse educator role
    • Advise students and perform many of the tasks associated with academic careers
    • Grade students’ classwork, laboratory and clinical performance
    • Mentor and advise students’ regarding their future work in the nursing industry

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    Ph.D. Programs, Length of Time, & Classes

    A Ph.D. program takes a minimum of three years if taking classes full time. Most individuals complete the programs in five to seven years. The curriculum is between 45 and 70 credit hours. There is no direct patient care practicum but there is a dissertation. 

    A dissertation is a requirement of all Ph.D. programs and individuals must defend their manuscript during a presentation at the end of their program. The dissertation is a technical paper that is intended to show the growth of the student throughout the program. It includes theory, research, and experimentation.

    Individuals should expect to take the following classes:

    • Philosophical Perspectives in Health
    • Scientific Perspectives
    • Quantitative Research Design and Methods
    • Qualitative Research Design and Methods
    • Mixed Methods Research Design
    • Grant Writing
    • Measurement in Health Care Research
    • Responsibilities and Activities of the Nurse Scientist 
    • Leadership in Science: The Role of the Nurse Scientist
    • Statistical Methods
    • Dissertation
    • Longitudinal Methods
    • Integrated Interdisciplinary Research Practicum
    • Intervention Research Methods in Health Care

    Ph.D. Admission Requirements

    Requirements for Ph.D. programs will vary but most will require the following:

    • Graduate of an accredited Master’s in Nursing Program 
    • A written statement of research goals 
    • Research interests that match faculty expertise and School resources
    • GRE scores are accepted but not required
    • GPA of at least 3.0 or higher in the Master’s program
    • Interview with faculty (if moved forward by admissions committee)
    • Writing sample (publication or graded paper)
    • Resume or curriculum vitae
    • Letters of recommendation (both academic and professional references)
    • Copy of official RN license(s) 
    • Nursing experience
    • Application fee
    • Official Transcripts (from all post-secondary schools)
    • Test of English as a Foreign Language (TOEFL) or the International English Language Testing System (IELTS) if applicable 

    Comparison: Ph.D. vs. DNP

    Length of Program 

    • Ph.D. Degree: 
      • BSN to Ph.D.: 5-10 years
      • MSN to Ph.D.: 3-7 years
    • DNP Degree: 
      • ADN-to-DNP: 5-6 years
      • BSN-to-DNP: 3-4 years
      • MSN-to-DNP: 2 years

    Average Salary

    • Ph.D. Degree: 
      • Ph.D. nurse educators had a median annual wage of $81,350 according to the U.S. Bureau of Labor Statistics as of May 2018.
      • According to Payscale, nurse researchers earned an average salary of $81,500.
    • DNP Degree: 
      • Healthcare salary trends suspect DNPs average $125,000 to $150,000 per year. This ultimately depends on the place of employment.

    Job Opportunities

    • Ph.D. Degree: 
      • The greatest need for Ph.D. prepared nurses is in academia. According to 2018, Special Survey on Vacant Faculty Positions 1,715 faculty vacancies was identified. There is also a need for 138 additional positions to fit the current demand. 
    • DNP Degree: 
      • According to the AACN, the biggest opportunity for DNP individuals is also in academia. The data show a national nurse faculty vacancy rate of 7.9%. Most of the vacancies (90.7%) were faculty positions requiring or preferring a doctoral degree.

    Certification

    • Ph.D. Degree: 
      • Renewal: None
    • DNP Degree: 
      • Renewal: 5 years. Retake the exam or provide proof of at least 1,000 clinical practice hours and 75 CE unit

    Work Environments

    • Ph.D. Degree: 
      • Colleges & Universities
      • Research facility
      • Hospital
      • Medical laboratory
      • Government agency
    • DNP Degree: 
      • Universities
      • Public Health Offices
      • Hospitals
      • Specialty Practices
      • Autonomous Practices
      • Health Care Administration Settings
      • Health Care Policy Advocacy Organizations

    Career Options after Graduation

    • Ph.D. Degree:
      • Nursing researcher
      • Health policy positions
      • Nursing faculty positions
    • DNP Degree:
      • Leadership in nursing practice
      • Management positions
      • Healthcare policy, administration, or government positions
      • Academia in practice-based nursing programs

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