In Hawaii, more and more bachelor’s and master’s-prepared nurses are seeking additional credentials by earning a Doctor of Nursing Practice (DNP). Bachelor’s-prepared nurses pursuing the degree are able to obtain advanced practice licensure en route to doctoral status, while master’s-prepared nurses seeking the degree cite benefits such as an increased salary, more advanced employment opportunities, and the ability to effect practical policy change from a clinical standpoint. The benefits are so vast that The American Association of Colleges of Nursing (AACN) proposed making the DNP the minimum educational requirement for advanced practice registered nurses in all roles (nurse practitioner, nurse midwife, nurse anesthetist, clinical nurse specialist).
While the U.S. has experienced a growing shortage of healthcare professionals over the past decade, Hawaii is experiencing an especially acute shortage of primary care providers and qualified nursing professionals. According to the State of Hawaii Employment Outlook Report (2000-2010), nearly 80% of Hawaii’s nursing workforce is expected to retire by 2026, many of which are nurse practitioners and other advanced clinicians serving as primary care providers.
Over the past several years, the Hawaii state government has worked tirelessly to dedicate additional funding to nurse education programs in order to provide incentives for enrollment and faculty retention. The AACN reported that Hawaii was granted over $600,000 specifically for advanced nursing education in 2015. The AACN also reported that in 2015, out of 1,388 students enrolled in nursing programs in Hawaii across all program levels, just 89 students graduated with DNP degrees. However, as this number continues to rise, nurses who have earned DNP degrees will continue to enjoy a respected position in the healthcare community along with improved salaries and a greater number of professional opportunities.
Some of Hawaii’s doctorate-prepared nurses have taken on leadership roles within state nursing associations and hospital boards:
- Elizabeth Kelly, CRNA, DNP—Treasurer of the Hawaii Association of Nurse Anesthetists
- Cynthia Greywolf, DNP-PMHCN/NP-BC, Professor, University of Hawaii at Manoa
- Jessica Nishikawa, DNP, NP-C, Professor, University of Hawaii at Manoa
Earning a Doctor of Nursing Practice (DNP) In Hawaii
Both bachelor’s and master’s-prepared nurses in Hawaii are eligible to enroll in DNP programs:
- Nurses with a bachelor’s degree may enroll in BSN-DNP programs, which will allow them to focus first on master’s coursework before then moving into the doctorate program. Many nurses use this program as a path to APRN certification and licensure. Most BSN-DNP programs consist of about 90 credits and can be completed over 36-48 months of study. Programs are also available in an aggregate/systems/organizational focus in areas like administration, informatics, and healthcare policy.
- Nurses with a master’s degree may enroll in MSN-DNP programs, which launch straight into doctorate preparation. If the nurse is seeking a DNP degree in a focus different from their current APRN certification, the program will consist of additional credits on the master’s level. The MSN-DNP program is at least 36 credits long and usually takes about 18 months to complete. Programs are also available in an aggregate/systems/organizational focus in areas like administration, informatics, and healthcare policy.
Accredited programs may vary in number of required credits, specializations offered, and individual course offerings, but all programs must include at least 1,000 post-baccalaureate practice hours, 500 of which may be carried over from the master’s level. In addition, programs must offer students the ability to specialize in either an advanced practice nursing direct care focus or an aggregate/systems/organizational focus such as executive leadership or health policy.
Due to the extensive nature of clinical hours, many DNP students choose to log clinical hours independently of practicum requirements within the program.
Many DNP programs offer three broad program tracks to accommodate student needs:
- Traditional, about 18-24 months of study
- Accelerated, about 12 months of study
- Part-time, about 2 ½ years of study
DNP programs consist of three main components:
- DNP core: Core classes will cover topics of scientific foundations for nursing, epidemiology, and clinical scholarship, and will also prepare nurses for executive positions through the study of management in healthcare and leadership roles for nurses.
- Specialty courses in line with the chosen focus: Depending on whether the nurse has chosen an advanced practice focus or an aggregate/systems/organizational focus, specialty courses will delve into topics relevant to the focus.
- Final project: The final project, normally involves a final paper and presentation in the nurse’s area of focus.
Post-Bachelor’s BSN-to-DNP Programs for BSN-Prepared Nurses
As the most direct route to APRN licensure and doctorate credentials, many bachelor’s-prepared nurses choose to earn both their MSN and DNP in one comprehensive BSN-to-DNP program. Due to the extensive nature of the requirements, most BSN-DNP programs require three to four years of study.
Program requirements vary, but most BSN-DNP programs will require nurses to designate a focus for their master’s study, which may include an advanced nursing practice focus. The master’s track usually includes about 500 clinical hours, and nurses will be required to obtain national certification in their APRN role.
The MSN core will cover the following topics:
- Scientific Underpinnings for Practice
- 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
- Health Care Policy for Advocacy in Heath Care
- Interprofessional Collaboration for Improving Patient and Population Health Outcomes
- Clinical Prevention and Population Health for Improving the Nation’s Health
MSNs for APRNs would also include core classes that would cover:
- Advanced Practice Pathophysiology
- Advanced Practice Pharmacotherapeutics
- Advanced Practice Patient Population Outcomes
BSN-to-DNP and MSN-to-DNP Programs Available in Hawaii
As of 2016, the following DNP programs have been accredited by the Commission on Collegiate Nursing Education (CCNE). CCNE and ACEN-accredited online programs are also available to advanced nursing students in Washington, DC. Other DNP programs not shown here may hold regional accreditation or specialty accreditation through the Council on Accreditation of Nurse Anesthesia Educational Programs or the Accreditation Commission for Midwifery Education.
- University of Hawaii at Manoa, Honolulu
- Offers both BSN-DNP and MSN-DNP tracks
- Specializations in:
- Adult-Gerontology Clinical Nurse Specialist
- Advanced Public Health Nursing
- Adult-Gerontology Primary Care Nurse Practitioner
- Family Nurse Practitioner
- University of Hawaii Hilo, Hilo
- Offers BSN-DNP (80 credits) and MSN-DNP (40 credits) tracks
- APRN Specializations
Opportunities Available to DNP-Prepared Nurses in Hawaii
Doctorate-prepared nurses in Hawaii may seek advanced nursing positions in hospitals, clinics, and physician’s offices. The DNP also qualifies nurses to hold faculty positions in nursing education programs and step into clinical leadership roles.
The following job listings (sourced in April 2016) represent current job opportunities and provide insight into the many types of professional opportunities available to DNP graduates in Hawaii, but are not meant to imply any guarantee of employment:
Advanced Practice Nurse, Oncology—Ewa Beach, Hawaii
- MSN required, DNP or other advanced degree preferred
- At least one year of experience as an APRN
- Coordinating patient care and follow up under head oncologist
- Working as part of a team with a leadership role
- Identifying opportunities for improvement within the system
Emergency Services Nurse Manager at Castle Medical Center, Kailua, Oahu
- BSN required; MSN, DNP, or more advanced degree preferred
- Leadership experience in a nursing setting required
- Supervise activities of emergency nursing team
- Provide and delegate care, delegate staff assignments
- Supervise and coordinate while providing excellent patient care
Primary Clinic Care Nurse Manager, Aureus Medical, Honolulu, HI
- BSN required; MSN, DNP, or more advanced degree preferred
- Prior leadership experience
- Lead team in the outpatient liver center
- Oversee staff, evaluate standards of patient care, implement new systems when necessary
Associate Professor of Nursing at Hawaii Pacific University, Honolulu, HI
- Doctorate (PhD, EdD or DNP) required
- Clinical experience within the last five years
- One year of teaching experience
- Lead classes in nursing curriculum
- Assist students to achieve positive learning outcomes and goals