A Doctor of Nursing Practice (DNP) is a terminal nursing degree that is the highest education level available in the field. Some universities will accept you into a DNP program with a bachelor’s degree, but most require you to have a master’s degree in nursing.
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Most DNP programs stress areas of nursing leadership, including systems management, quality improvement, and decision making driven by data. It is important to understand the difference between the DNP and other terminal nursing degrees, such as the Ph.D. in Nursing.
The DNP focuses on nursing practice-based training in clinical applications of advanced nursing knowledge. On the other hand, other terminal nursing degrees stress research skills, scholarly inquiry, or high-level academic-related skills.
Most DNPs can be finished in three to six years, depending on the specific program and your personal schedule. However, a DNP program that accepts students with only a bachelor’s degree in nursing will take longer. Some of the courses you may take in a DNP program include:
- Evidence-Based Practice for Nursing
- Clinical Leadership in Complex Systems
- Epidemiology and Population Health
- Management and Analyses of Health Data
- Health Informatics
- Health Care Quality Improvement
- Health Care Economics and Financial Analysis
- Advanced Health Policy and Advocacy
- Graduate Statistics
DNP Specialties
Earning your DNP generally prepares you to work in either leadership and administration or advanced practice nursing (APRN):
Leadership and Administration
The DNP prepares you to work in leadership and administration, which plays a vital role in improving executive nurse leadership roles. It also affects healthcare outcomes with scientific findings. They play a vital role in creating healthcare programs that are both economical and sustainable.
With a DNP, you may find a nursing leadership and administration role in these areas:
- Nursing management
- Organizational leadership
- State and national health policy
- Health informatics systems
Advanced Nursing Practice
The DNP graduate who chooses the advanced practice nursing path will offer direct care to patients in assessing, managing, and evaluating care. After graduation, you are required to site for the APRN certification examination. You also may need to sit for advanced speciality certification. (Nursingworld.org).
Jobs that you may qualify for after you graduate include:
- Certified nurse midwife (CNM): Nurses who offer reproductive health services before, during, and after childbirth. They also offer primary care and counseling during infancy.
- Certified nurse anesthetist (CRNA): Nursing professionals who offer anesthesia services.
- Nurse practitioner: Clinicians who offer patient care and manage common patient illnesses. Nurse practitioners often specialize in patient populations, including neonates, family practice, adult-gerontology, pediatrics, mental health, and women’s health.
Essential Elements of the DNP
In 2006, the AACN released The Essentials of Doctoral Education for Advanced Nursing Practice. This paper outlined the vital curriculum that are now required by DNP programs. (AACNNursing.org). The DNP Essentials outline details the eight competencies that are mandatory for all DNP graduates, whatever their specialty:
- Scientific Underpinnings for Practice: Nursing science advances have expanded the nursing discipline in the last 20 years. Complete understanding of modern nursing theory offers a strong foundation for advanced nursing practice. This degree prepares the nursing graduate to integrate nursing science with biophysical, psychological, analytical and organization sciences. The DNP also stresses the use of science-based concepts to enhance and evaluate healthcare delivery and enhance patient outcomes.
- Organizational and Systems Leadership for Quality Improvement: DNP graduates contribute in a unique way to nursing science; they evaluate, translate, and disseminate nursing research into practice. This area stresses the DNP graduate’s role in the assimilation of nursing practice and science with the many healthcare needs of patients. Vital skills include development of clinical practice guidelines, the design of interventions based on evidence, and the evaluation of patient outcomes.
- Clinical Scholarship and Analytical Methods for Evidence-Based Practice: Being prepared for organizational leadership and systems level thinking helps the nursing professional to devise unique ways to approach the many issues facing healthcare and nursing today. This essential focuses on the graduate’s role in ensuring quality care accountability and patient safety. It also looks at the critical examination of ethical issues that are involved in patient care, healthcare organizations, and scientific research.
- Information Systems and Patient Care Technology for the Improvement and Transformation of Healthcare: Technology is vital for efficient, safe, and patient-centered healthcare. This essential prepares DNP graduates to use information and patient care technologies in support of clinical decision making and practice leadership. Having a solid understanding of technology places the graduate at the forefront of healthcare delivery and gives them the skills they need to be a part of technological innovation.
- Healthcare Policy for Advocacy in Healthcare: To work in healthcare policy actively, the graduate needs to be able to identify challenges in the healthcare delivery system and to support legislation with consensus building and negotiation. This essential stresses learning how to critically analyze health policy with the goal of advocating for social justice and the nursing profession generally.
- Inter-Professional Collaboration for Improving Patient and Population Health Outcomes: The Institute of Medicine stresses the need for team-based care to ensure the wellbeing and safety of all patients. This essential prepares the graduate to lead interprofessional teams to analyze multifaceted practice and systems challenges with effective collaboration and communication. DNPs take leadership roles in the implementation and development of practice standards, models, and care.
- Clinical Prevention and Population Health for Improving the Nation’s Health: Nursing theory is founded on risk reduction and health promotion. The DNP degree prepares the student further to interpret and evaluate biostatistical, epidemiological, occupational, and environmental information that are vital to enhance individual and community health.
- Advancing Nursing Practice: To improve patient outcomes, the DNP holder demonstrates advanced levels of systems thinking, clinical judgment, systems thinking, and delivering evidence-based care. This essential stresses the need for comprehensive needs assessments, providing mentorship for other nurses, and guiding patients through the healthcare system.
DNP and Ph.D. in Nursing
Recently, the American Association of Colleges of Nursing (AACN) shifted the focus of the DNP. Until now, advanced practice nurses were able to qualify for working in nursing specialties with an MSN only. But now it is becoming standard for nurses who want to work as nurse practitioners and other specialties to hold a DNP. This is the degree you should hold if you wish to work in clinical nursing practice at the highest level.
To understand the differences between the DNP and Ph.D. in Nursing, consider these points:
DNP
- Stresses higher levels of nursing practice; DNPs strive to enhance patient outcomes with more advanced clinical care.
- Curriculum centers on healthcare leadership, evidence-based practice decisions, and advanced specialty practice in nursing. Coursework usually covers evidentiary diagnosis, statistics, administration, budget planning, healthcare policy, and improvement of the healthcare system.
- Candidates must complete up to 1,000 hours of clinical practice.
- Requires students to finish a capstone project.
- Programs can often be found online and can be completed while still working, in some cases.
- A DNP holder usually is employed in major healthcare organizations or healthcare facilities. Other common roles are as expert clinicians, or academic roles that stress clinical education and practice.
Ph.D. in Nursing
- This terminal nursing degree is focused on scholarly inquiry and research. Ph.D.s attempt to enlarge and improve the body of nursing knowledge.
- Illness trajectories are studied, as well as the care systems that are used to treat them. Coursework includes advanced nursing theory, research methodology, data analysis, care systems, and chronic illnesses.
- Teaching experience is required to complete the Ph.D., but there are no clinical requirements.
- Degree candidates are required to write a thesis before they graduate.
- Most Ph.D. programs are based on campus and are not designed for the working student.
- Most graduates eventually work in research or academia. Some may work in management roles in research organizations.
Advantages and Disadvantages of a DNP
Advantages
- Having this degree will make you more marketable in the nursing field. You will be able to qualify for many advanced nursing practice roles, such as nurse practitioner, certified nurse-midwife, and nurse anesthetist.
- In the near future, you will need to hold your DNP to work in advanced nursing practice roles; it no longer will be enough to have your MSN to work in advanced nursing practice.
- Intense clinical practicum standards offer many chances for advanced nursing training in a clinical environment. (lww.com)
Disadvantages
- Can take four or five years to complete, depending on whether you are working full or part time.
- You may be able to find a job in academia, but tenure-track positions are usually held by professionals with a Ph.D. in Nursing.
- There is some division in the nursing industry about the necessity and long-term outlook of holding a DNP.
Summary
Earning a DNP degree is an excellent path to working at an advanced level in nursing. Whether you choose the leadership and administration or advanced nursing practice path, the DNP will provide you with many outstanding career opportunities and the ability to advance human health at the highest levels in the profession.