When you first made the decision to become a nurse, you chose a career rooted in caring and compassion. As your focus on the health and wellbeing of your patients and the community at large has grown, so too has your dedication to the profession. Pursuing a Doctor of Nursing Practice degree (DNP) represents the highest level of commitment and will place you at the pinnacle of your field.
The Doctor of Nursing Practice degree, or DNP, is referred to as a terminal degree in nursing because there is no higher level of education available for practice-based training in nursing. Nurses who have their DNP are sought after for positions in nursing leadership focused on clinical applications and are considered key players in the future of healthcare in the United States.
As a DNP, you will have much more than advanced clinical skills. Your education will provide you with expertise in areas such as statistics and data analysis and decision making, evidence-based practice, systems management, and quality improvement. You will have greater responsibilities and be looked to as an esteemed authority for input on critical strategies and problem-solving. DNPs are rightly viewed as having higher-level skills and valued for making invaluable contributions to healthcare policy.
Importantly, the recent emphasis on higher level learning for nursing is leading to a shift in requirements for advanced practice nurse specialties such as Nurse Anesthetists, Nurse Practitioners, and Certified Nurse Midwives. Nurses who wish to practice in these areas will eventually need a DNP rather than the current credentialing requirement of MSN.
In this comprehensive guide, we have collected what you need to know in order to pursue your DNP, as well as why a DNP degree is a smart choice. You will also find helpful information on how to find the best programs and how to pay for your education.
>> Related: DNP vs PhD in Nursing — What’s the Difference?
Nursing is one of the most rewarding career choices available, and for those who want to truly elevate their career to the highest level, pursuing a Doctor of Nursing Practice degree is the ultimate answer. According to the Medscape Nurse Career Satisfaction Report 2016, nurses who pursued Doctoral levels of education have the highest level of satisfaction with their educational preparation, despite the significant investment of time that the degree represents. There are several reasons for this, including:
- Higher earnings potential. Having a DNP degree adds significantly to earning potential. According to a 2018 survey conducted by Lippincott Solutions, the DNP salary was $7,000 more than nurses with an MSN and had an average annual salary of $94,000, while Medscape reported an average annual salary of $97,000.
- More choices in both position and specialization. Nurses who have earned their Doctor of Nursing Practice degree are eligible for the most in-demand positions and have greater opportunities to improve patient outcomes. Some of the most popular positions chosen by nurses who have earned their DNP include Nurse Educator, Chief Nursing Officer, Clinical Nurse Specialist, and Advanced Practice Nurse.
- Greater job security. Because employers value the contributions that nurses with DNPs can offer, the demand for their services has grown, and so has their job security. Where the demand for nurses at all levels is growing overall, the positions that graduates of DNP programs are being recruited into are seeing even greater levels of need, and continue to grow. There is increased recognition of the importance of advanced-degreed nurses’ enhanced knowledge in advanced nursing practice, organizational leadership, healthcare policy and more.
- More opportunity for advancement. By pursuing a DNP degree, you are establishing yourself as a dedicated professional and giving yourself a far greater opportunity to advance your career. More and more healthcare systems are actively seeking DNP-degreed nurses to fill positions as nurse managers and nurse leaders in order to qualify for Magnet Hospital status.
- DNP is rapidly replacing the MSN degree as the required preparation for Advanced Practice Nurse positions. In 2004, the member schools affiliated with the American Association of Colleges of Nursing voted to transition the requirements for advanced nursing practice from an MSN to a DNP. Though MSN prepared nurses are still acceptable in most instances, the transition to DNP requirements is a certainty, and those who already hold a DNP degree will be in even greater demand.
- DNPs are able to practice independently. There are 23 states that permit DNPs to run private practices independently. If you are interested in operating a medical practice with complete autonomy, a DNP degree may be the right choice for you.
Earning your Doctor of Nursing Practice degree opens the door to the top levels of leadership and organizational roles within healthcare settings. DNP nurses can pursue roles in shaping policy or can continue to work hands-on in clinical practice with a higher degree of evidence-based expertise and managerial skills.
The doctoral-level degree endows you with both the training and credentials to work in clinical and non-clinical settings, bringing with you the ability to participate in all levels of decision making and helping to shape the future of healthcare. The duties fulfilled by DNP-degreed nurses are as varied as their titles, which can include:
- Clinical nurse leaders
- Nurse practitioners
- Certified nurse midwives
- Clinical nurse specialists
- Certified Registered Nurse Anesthetists
- Nurse administrators
- Nurse educators
DNP-degreed nurses can work in any environment in which hands-on healthcare is needed, as well as in healthcare leadership and policy roles. According to the Bureau of Labor Statistics, there is a projected 31 percent change in employment for advanced-degreed nurses in a clinical setting, while in careers outside of a patient care setting, growth is expected to be even greater.
>> Related: Top Online DNP Programs
There are many different routes that nurses can follow to earn a Doctor of Nursing Practice degree. Students can enter the program with either a Bachelor of Science in Nursing degree or a Master’s of Science in Nursing degree, and there are even programs that have been created to allow those holding ADN degrees to “bridge” to a DNP degree. These programs are available as traditional brick and mortar academic programs that are offered on a full-time basis, as well as in more flexible part-time, accelerated and online formats that allow those who want to continue working to do so while also pursuing their studies. All programs have the same goal: to provide the skills and tools necessary to assess the evidence gained through nursing research, evaluate the impact of that research on their practice and, as necessary, make changes to enhance the quality of care.
- RN-to-DNP Programs – These programs generally take between four and six years. Though most require students to have earned their Bachelor of Science in Nursing (BSN) degree, some programs do provide extra coursework to allow ADN candidates to fill in missing nursing and bachelor’s degree curriculum requirements. These bridge programs consist of highly concentrated on-campus sessions combined with extensive clinical hours and online instruction.
- BSN-to-DNP Programs – These programs generally take three to four years to complete, allowing nurses who have already fulfilled the basic Bachelor of Science in Nursing requirements and who have at least one year of working experience to fulfill the more extensive clinical hour requirements at an approved site close to their home, while also pursuing extensive credit hour and research requirements online.
>> Related: Top BSN to DNP Programs
- MSN-to-DNP Programs – These programs generally take one-and-a-half to two years to complete and are specifically designed for those who have already completed the rigorous Master of Science in Nursing degree. They build on the already strenuous graduate coursework that the student has completed, frequently offering advanced training in a specific field of study while furthering their focus on systems leadership, evidence-based practice and quality improvement.
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Coursework and Curriculum
Though every DNP curriculum is different, accredited nursing programs follow the framework provided by the American Association of Colleges of Nursing in The Essentials of Doctoral Education for Advanced Practice Nursing. This outlines the curriculum and foundational outcome competencies expected of DNP programs, and the goal of elevating nursing practice to the same levels as is found in other areas of healthcare, including doctor of medicine (MD), doctor of physical therapy (DPT) and doctor of pharmacy (PharmD). The framework outlines the need for DNP-degreed nurses to be prepared to lead change, promote health, and elevate care in every setting in which they serve. The core of a Doctor of Nursing Practice program stresses eight key elements aligned with foundational outcome competencies, as well as specialty competencies in particular areas of interest and practice. The eight foundational outcome competencies are:
- Scientific Underpinnings for Practice (human biology, the science of therapeutics, psychosocial sciences, the science of complex organizational structures, philosophical, ethical and historical issues inherent in the development of science)
- Organizational and Systems Leadership for Quality Improvement and Systems Thinking
- Clinical Scholarship and Analytical Methods for Evidence-Based Practice
- Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Healthcare
- Healthcare Policy for Advocacy in Healthcare
- Interprofessional Collaboration for Improving Patient and Population Health Outcomes
- Clinical Prevention and Population Health for Improving the Nation’s Health
- Advanced Nursing Practice
The specialty competencies focus of the DNP degree will either emphasize a direct care focus such as nurse practitioner (NP), certified nurse midwife (CNM), certified registered nurse anesthetist (CRNA) or clinical nurse specialist (CNS), or an organizational focus such as organizational and professional leadership, management health policy or nursing/health informatics.
Every DNP program will be different, but the AACN suggests that all programs consist of a minimum of 1,000 hours of post-baccalaureate practice that provides students with opportunities for feedback from experts in nursing and other disciplines within the practice environment, as well as a final project designed to demonstrate their mastery of an advanced specialty within nursing practice.
Depending upon whether DNP candidates are pursuing an Advanced Practice Nursing Direct Care Focus or an Aggregate/Systems/Organizational focus, they are likely to pursue courses in the following content areas:
- Advanced physiology/pathophysiology
- Health/physical assessment
- Advanced Pharmacology
- Systems (including information systems)
- State and national policies
No matter the focus chosen by an individual student or emphasized by the program that they select, all DNP programs aim to address changing healthcare needs and to meet those needs by providing DNP-degreed nurses with the highest level of scientific knowledge and practice expertise to raise the levels of care and improve patient outcomes.
>> Related: Top Direct-Entry DNP Programs
Salary and Pay
Where the U.S. Bureau of Labor and Statistics indicated that registered nurses earned an average salary of $81,220 in 2022, Advanced Practice Registered Nurses and DNP-degreed nurses in non-clinical settings earned substantially more: the median pay for Nurse Practitioners, Nurse Midwives, and Nurse Anesthetists was $125,900 during the same period.
DNP-degreed nurses earned a national average of $117,859, according to ZipRecruiter.
DNPs have demonstrated a personal commitment to their profession and to leadership, and as a result, they are in high demand. Employers offer them a wide range of executive benefits and enticements, including vacation pay, bonuses, tuition reimbursement, onsite childcare, sick leave, and more.
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While the career outlook for all nurses is extremely high, the need for nurses with DNP degrees is expected to continue to grow to an even greater degree.
There are more than half a million new RN positions anticipated through the year 2026 and another half million RNs that will be needed to replace those who leave the field.
DNPs have a wide range of environments in which they can work, including all of the traditional and non-traditional settings where you will find registered nurses. However, their advanced education makes it most likely that you will find DNP-degreed nurses in high-level positions in settings including:
- Internal medicine practices
- Specialty practices
- Autonomous practices
- Universities or colleges
- Healthcare administration settings
- Healthcare policy advocacy settings
DNP-degreed nurses who chose to focus on advanced practice direct care have the opportunity to work in every healthcare specialty including,
- Family medicine
- Home Health
- Substance abuse
- Geriatric care
- Labor and Delivery
- Public health
Key Differences Between RN and DNP Degrees
Both RNs and those who pursue the more rigorous DNP degree are Registered Nurses who can work closely with patients, treat illness and monitor health, but pursuing an advanced degree will make a significant and immediate difference in compensation, responsibilities, and ability to work in a specialized area, as well as in the opportunity to assume a leadership position.
DNP-degreed nurses are not only provided with the education they need to provide an advanced level of patient care: they can also do research, teach, impact public policy, consult with corporations and lead health systems. They will play an integral role in the future of healthcare in the United States.
The differences between an RN and a DNP include,
- A substantial difference in salary, with Advanced Practice Registered Nurses such as Nurse Practitioners and Clinical Nurse Specialists earning an average of $113,930 in 2018 compared to $57,000 to $71,000 per year earned by Registered Nurses depending upon whether they have their Associates Degree in Nursing or a Bachelor of Science in Nursing.
- Potential for leadership and executive positions
- DNP-degreed nurses often take on the responsibilities traditionally assigned to physicians They are able to diagnose and treat acute and chronic illnesses, prescribe medications and create patient treatment plans, and can work autonomously in their own practice in 23 states across the nation.
Types of DNP Programs
Deciding to pursue a DNP degree represents a significant commitment. There are a few different options on how to achieve this goal, and much of your decision on which program is best for you will depend upon your current situation. The approaches available include:
- RN-to-DNP Program – These programs are most frequently designed for those who already have earned their BSN degree, though there are a few that offer the opportunity for registered nurses who have earned their ADN to take additional coursework to make up for the education they lack. These students may be required to complete an additional year of hands=on nursing and a statistics course. These programs generally take four to six years to complete.
- BSN-to-DNP Program – This type of program is for nurses who have earned their Bachelor of Science in Nursing. It acknowledges their clinical experience and education and provides them with all of the coursework that would provide an MSN, as well as the more advanced DNP level of education. These programs allow them to pursue a specific area of focus, which may be organizational or direct practice. BSN-to-DNP programs take between three and four years to complete.
- MSN-to-DNP Program – Nurses who already have earned their Master of Science in Nursing degree provides students with a higher level of academic and clinical training they need to facilitate change in today’s healthcare environment. Students select either an advanced practice nursing direct care focus, an aggregate/systems/organizational focus, or both. These programs can be taken in a traditional, campus-based setting on a full-time basis that takes two years, on a part-time basis that takes about three years, or on a one-year accelerated basis.
Many individuals who are interested in earning their Doctor of Nursing Practice degree are already in the workforce and would prefer to continue working while pursuing their studies. There are numerous high-quality programs available to facilitate this goal. If you are a working professional, an online program will allow you to achieve your goals in less time than a traditional educational environment, while still supporting your career and/or your family. As long as an online program is accredited by The Accreditation Commission For Education in Nursing and the Commission on Collegiate Nursing Education (CCNE), it meets all of the required curriculum criteria.
Online programs are available for at least a portion of each of the various types of DNP degrees and offer distinct advantages, including:
- Flexibility. They offer the ability to learn while accommodating existing work schedules and busy lifestyles
- They are eligible for federal financial aid
- Efficiency. They offer you the ability to earn your DNP degree in less time
- No waiting for online DNP programs, as admissions are “rolling” throughout the year
- No commute
- Full and part-time programs are available
- Accessible no matter where you live
- Less expensive than degrees earned in traditional educational settings
There are a number of factors for you to consider when choosing a program that is right for you. In addition to the program’s reputation and cost, you need to determine whether a program will work for your individual needs and convenience. An online DNP program that requires you to attend a percentage of classes in person may not make sense: likewise, a program that is not in your immediate area and that requires you to participate in clinical hours at a specific facility may also pose a challenge.
It is also very important when searching for an online DNP program that you select one that has been accredited. Accreditation assures both you and future employers that the program from which you graduated meets current, evidence-based standards.
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There are two accrediting bodies for RN programs:
Classes and Clinicals
DNP coursework moves far beyond basic nursing and clinical education, providing a comprehensive, higher-level education specific to the student’s chosen course of study. Though each program is different and has its own emphasis, priorities, and philosophies, all accredited programs are a reflection of the national standards set forth under AACN recommendations these includes,
- A program structure consisting of 36 months of full-time study: for those who have already attained their MSN, this generally means an additional 12 months of full-time study.
- Post-baccalaureate practice experiences of at least 1,000 hours are also suggested.
- DNP degrees are considered complete when these requirements have been met, as well as a final project that demonstrates what the student has learned and achieved during the course of their studies.
Some examples of what a final project might consist of include,
- A pilot study
- A research project
- A quality improvement project
- A practice portfolio
DNP programs vary based on the individual school and the focus of the program, but prospective students should be aware that acceptance into DNP programs is extremely competitive as a result of the growing number of positions requiring an advanced degree. Those considering pursuing a degree should do everything they can to ensure that they meet the basic general requirements for admission of the schools to which they are applying.
For direct-entry DNP programs, applicants should expect to meet the following requirements,
- Current U.S Registered Nurse (RN) license in good standing in the state that you will be doing your clinical practice in
- Minimum of one year of nursing experience, with many programs requiring a minimum of two years
- Completed application with all appropriate fees and required document, which may include a resume, a personal statement, and official transcripts
- Completion of prerequisite courses
- Minimum GPA
- Letters of recommendation
- Personal interviews
Choosing to pursue a Doctor of Nursing Practice is a big decision and one that should only be pursued after careful consideration. Here are some things for you to keep in mind:
A DNP program represents a significant time commitment.
Pursuing your DNP is a big commitment of both time and money, but it is also a life-changing investment in your future. The additional years of education you pursue will make a substantial difference in your knowledge and skill, and this will not only show up in the level of care you provide to your patients, but also in your earnings potential, your upward mobility within the field, and the respect accord to you as the holder of a doctoral degree.
DNP programs can be challenging to get into.
Like all nursing programs, DNP programs are growing increasingly competitive. Doing the work that is needed to qualify for acceptance requires dedication, but the rewards for doing so are very real and will continue to expand as the need for advanced placement nursing and nurse executives become greater. Nursing is a profession that is highly respected, and those who have worked to ensure that they have the highest level of training and education are viewed as extremely favorably.
DNP programs are more expensive.
Though DNP programs cost more to attend, there are many organizations and resources to help students with financial aid. Additionally, those who earn their DNP will find that upon graduation they are quickly able to earn back the difference in tuition: the more advanced degree brings more high-level job opportunities that offer significantly higher salaries.
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There are many factors that contribute to the cost of a DNP degree including,
- Where the school is located
- Whether you choose an online program on an in-person program
- Whether you choose to enroll at a private college or a state school, and if the latter, whether you are attending as an in-state student or an out-of-state student.
There are currently 348 DNP programs available across the country, with another 98 in the planning stages: this means that applicants have choices available across all 50 states that can fit their budgets and needs. Costs per credit hour or for full-time tuition also depends upon the reputation of the program.
The average total cost of an in-state, online, accredited DNP program is $27,745, with the most affordable costing under $12,000 and the costliest adding up to over $60,000 in 2017.
Though cost is always an important consideration, it is also important that you remember the significant benefits and increased earnings that follow earning your DNP degree, as well as that you can lower your costs significantly by attending public institutions, seeking financial aid, and applying for governmental grants.
The cost of education is high, and a DNP degree represents a substantial investment. Many organizations offer tuition reimbursement for advanced degree programs, and there are many other options available to help defray costs, including grants, scholarships, and loans.
Here are just a few:
Scholarships. A number of organizations offer scholarships that are specifically dedicated to encouraging students to pursue advanced degrees in nursing. Searching online reveals numerous options, but a few notable examples can be found below:
- A.T. Anderson Memorial Scholarship – $2,000 for the academic year for graduate students pursuing a STEM-related degree, is of Native American background, has at least a 3.0 GPA and is a member of AISES (American Indian Science and Engineering Society).
- AfterCollege/AACN $10,000 Scholarship Fund – $10,000 in support of students seeking a baccalaureate, master’s or doctoral degree in nursing. Special, consideration is given to students in a graduate program with the goal of becoming a nurse educator; students completing an RN-to-BSN or RN-to-MSN program, and those enrolled in an accelerated program.
- AORN Foundation Scholarships – The Association of Perioperative Registered Nurses foundation offers scholarships to registered nurses who are continuing their education in perioperative nursing by pursuing a bachelor’s, masters or doctoral degree.
- Johnson & Johnson/AACN Minority Nurse Faculty Scholars Program – Johnson & Johnson has partnered with the AACN to expand diversity among the nurse faculty population and address faculty shortages by offering $18,000 in scholarship funds per year to five qualifying scholars as they complete a doctoral or master’s degree program in nursing.
Grants. A variety of grants are given out to students who demonstrate financial need. These are offered by the federal government, as well as by states and individual colleges. There are also numerous organizations, including charitable foundations, professional associations, corporations and others that disburse grants to doctoral candidates. Like scholarships, grants do not require that you repay them.
Student loans. Though student loans will eventually need to be repaid, students who enroll in DNP programs do so with the knowledge that once they’ve earned their degree, they are likely to earn a significant salary. The best source of a student loan is the federal government, which provides both more protection and lower interest rates. Applying for these loans requires filling out the same form that you use to apply for a grant — the FAFSA. Students who have significant need may qualify for loans that do not accrue interest until after they have earned their degree. Private loans are also available through banks, credit unions, and other sources. Make sure that you read all terms carefully, as there are unethical organizations that can include misleading terms, hidden fees, and high-interest rates.
Payment plans. If you are going to pay cash for your tuition, the DNP program that you enroll in may allow you to set up a payment plan. Many schools also offer financial aid, so contact the school directly to ask what options are available.
Once you’ve made the decision to pursue a Doctor of Nursing Practice degree, there are a number of important steps that are either required or recommended to help you achieve your goal.
- Investigate the programs that are available to you. Just as in choosing any educational program, you want to determine the type of campus and program that you want to apply to. Considerations include your specific educational and career background, the role you want to fill, the program location, the program reputation, how competitive the program is, and cost. Once you’ve identified those that are of interest, make a checklist for each one’s application requirements and deadlines.
- Collect all appropriate documentation. Collect all pertinent transcripts, proof of graduation, resume, letters of recommendation and other requirements.
- Apply to the accredited DNP programs that you have identified.
- Apply for financial aid if needed
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Choosing to pursue a Doctor of Nursing Practice degree is a big decision that should be based on your own personal goals, dreams, and needs. If your long-term goals including earning significantly more income, earning the respect of your colleagues and community, and playing a key role in the quality of the healthcare that people receive, then pursuing a Doctor of Nursing Practice degree is the right choice for you.