Nearly 15 years ago, the American Association of Colleges of Nursing (AACN) was the first to recommended that by 2015 the Doctor of Nursing Practice (DNP) become the educational minimum for all four APRN roles– nurse practitioner, nurse anesthetist, nurse midwife and clinical nurse specialist. The recommendation went so far as to push for all existing MSN programs for APRNs to transition to DNP programs. Though universities and state nursing boards didn’t unanimously join the movement within that timeframe, citing the many complications involved in changing licensing requirements and the fact that it would delay entry during a time when NPs and other APRNs were in short supply, there is a new call for making the DNP the minimum standard.
This time the movement is being led by the National Organization of Nurse Practitioner Faculties (NONPF), which released a position statement in 2018 calling for the DNP to replace the MSN as the mandatory minimum by 2025.
According to both the AACN and the NONPF, the DNP answers the need for administrative and advanced practice leaders with a strong preparation in systems-based practice improvement and translational research.
It is yet to be seen if universities and state nursing boards will join the movement this time around, but even as the MSN remains the educational minimum for advanced clinicians, a vote of confidence for the DNP from respected organizations like the AACN and NONPF have cemented the Doctor of Nursing Practice as the degree employers prefer when considering nurses for career opportunities at the highest levels. The DNP is second to none in preparing graduates for leadership roles in the clinical environment and in areas outside of direct patient care.
DNP Careers by State
- District of Columbia
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Rhode Island
- South Carolina
- South Dakota
- West Virginia
A 2015 study commissioned by the AACN Board of Directors and conducted by RAND Corporation revealed a near-universal consensus that the DNP is best suited to prepare advanced practice nurses and leaders outside of direct patient care to meet our nation’s future healthcare needs.
All DNP programs offer a decided focus in either:
- Direct Patient Care / Advanced Practice Roles – The provision of direct care or management of care for individual patients or the management of care for populations
- Roles Outside of Direct Patient Care / Administration and Leadership – The provision of indirect care, such as nursing administration, executive leadership, health policy, informatics, and population health
Direct Patient Care: Jobs for DNP-Prepared Nurses in Advanced Clinical Practice
DNP nurses in direct care serve in an advanced practice registered nursing (APRN) role:
- Nurse practitioners (NPs)
- Certified nurse-midwives (CNMs)
- Certified registered nurse anesthetists (CRNAs)
- Clinical nurse specialists (CNSs)
Although the Master of Science in Nursing remains the minimum educational requirement for national certification and state licensure in each of the APRN roles, the DNP has become widely recognized for its positive influence on the practice of nursing, on the quality of patient care, and as the level of education best suited to preparing APRNs to meet the demands of an increasingly complex and technologically reliant healthcare field.
The DNP provides nurses with the opportunity to specialize in a clinical area within their chosen APRN role and/or assume leadership and management roles in clinical settings, both of which set the stage for higher salaries and more opportunities to make significant contributions to the nursing profession.
Through a DNP education, nurses are able to:
- Demonstrate their clinical practice expertise
- Provide direct patient care and clinical leadership
- Use information technology and evidence-based practice to improve healthcare outcomes
DNP programs are designed for:
Currently Practicing APRNs
Currently practicing APRNs pursue a DNP in an effort to advance their expertise within their current APRN role. DNP programs often include minor concentrations that allow students to specialize in and earn certification specific to a particular clinical area, such as:
- Hospice and palliative care
- Community health
- Pain management
- Emergency Care
Clinical nurse specialists and nurse practitioners can also gain the patient population-specific knowledge necessary to become certified in an additional patient population focus:
- Family/Individual Across the Lifespan
- Women’s Health/Gender Specific
- Psychiatric/Mental Health
According to the American Academy of Nursing, with a doctoral education after entry into APRN practice, APRNs are able to bring a deep level of practice and systems knowledge and experience to their work. Hospitals that employ DNP-educated nurse practitioners and other APRNs reap the benefits of doctoral level knowledge and skills, while DNP-prepared APRNs themselves enjoy salary increases and more opportunities to be influential in their role and effect positive change.
Registered Nurses Seeking Initial APRN Certification and Licensure
Many DNP programs are designed for registered nurses seeking initial APRN certification and licensure and entry into advanced practice. These programs are most often available as post-baccalaureate (BSN-DNP) programs, though post-master’s (MSN-DNP) programs are also available for MSN-educated RNs who have earned a generalist master’s and that don’t currently hold certification in an APRN role.
Registered nurses with their sights set on advanced practice often choose to favorably position themselves in the nursing workforce by completing their DPN as a path to initial APRN certification and licensure, which better prepares them to take on many of the advanced clinical leadership roles often reserved for DPN-prepared nurses.
Non-Direct Care Roles: Jobs for DNP-Prepared Nurses in Administration, Executive Leadership, Informatics and More
Not all nurses seeking a DNP have their sights set on careers in direct care. Therefore, many DNP programs provide nurses with specialty tracks that would focus their nursing careers on an aggregate/systems/organizational role:
- Organizational and professional leadership
- Nursing/health informatics
- Health policy
- Population health
- Clinical nursing education
This puts DNP-educated nurses in the unique position to take on roles in which they bring innovation to healthcare and exert positive influence as:
- Public health program directors
- Health policy specialists
Of course, DNP nurses can also achieve some of the highest executive-level positions in hospital systems, managed care organizations, and governmental agencies, often holding titles that include:
- Chief executive officer
- Chief operating officer
- Chief information officer
- Chief nursing executive officer
- Chief clinical officer
- Vice president, patient services
- Chief patient experience executive
DNP programs with an aggregate/systems/organizational focus address the most contemporary aspects of nursing practice while offering in-depth study in leadership, health systems design and evaluation, evidence-based practice, applied research, health policy, and more. This means DNP nurses are prepared to transform healthcare by:
- Analyzing health policy proposals, health policies, and related issues
- Demonstrating leadership in the development and implementation of health policy at every level
- Influencing policy makers through active participation in task forces and committees
- Educating others at all levels regarding nursing, health policy, and patient care outcomes
- Advocating for the nursing profession with the healthcare and policy communities
- Developing, evaluating, and providing leadership for healthcare policy
- Advocating for social justice, equity, and ethical policies