Doctor of Nursing Practice vs Nurse Practitioner

When it comes to career paths, nurses have no shortage of opportunities for advancement. But how do you decide which is right for you? In this guide, we’ll be digging into the difference between an NP and a DNP, both the NP and DNP salary potentials, and how to decide which degree you should pursue.

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

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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

>> Related: Top Online Nurse Practitioner Programs

In 28 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 Alabama) 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.

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. Nurse practitioner specialties are determined before 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.

>> Related: Top Online DNP Programs

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 of 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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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 careers a step further. 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 who 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 $112K as of November 2023. The key determining factor for salary is the career nurses pursue after obtaining an advanced degree. A Chief Nursing Officer (CNO) 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 2024

The top DNP programs in 2024 are:

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

Johns Hopkins, Duke, and Rush have consistently been in the top 5 DNP schools over the last several years.

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).

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. Pre-existing advanced practice registered nurses would enroll in fast-track programs to obtain their DNP. 

While this goal has not been achieved, 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 a comparatively advanced education. As of right now, the plan continues to be re-evaluated each year.

Similarities Between a DNP and an MSN

• Both a DNP and MSN are advanced nursing degrees, giving NPs the advantage of having an advanced understanding of diseases, pharmacology, and pathophysiology. 
• Both a DNP and MSN degree allow NPs to practice and teach. 

Differences Between a DNP and an MSN

• While both are advanced degrees, an MSN degree focuses on developing nursing skills needed to become an NP while a DNP focuses more on policy, leadership, and administration. 
• NPs holding a DNP usually hold higher-level positions such as Nursing Director or Chief Nursing Officer. 
• Finally, a DNP is considered a terminal degree and most nurses end their education after completing a doctoral.