The Doctor of Nursing Practice (DNP) exists as the highest terminal practice-focused nursing degree available, differing from the PhD in Nursing, which is designed for nurses interested in careers in research and academia. DNP nurses are clinical leaders in advanced practice nursing and also hold some of the top nursing administrative/executive positions in hospitals, managed care organizations, and governmental agencies, among many others.
A report released by the North Carolina Area Health Education Centers, titled The NC Nursing Shortage: Under Close Examination, revealed that North Carolina’s elderly population is expected to double by 2020, creating an unprecedented demand for highly skilled nurses. As a result, the organization has recommend that the state develop a highly skilled workforce prepared at the baccalaureate level and above.
Nursing faculty and nurses with experience in critical care, emergency rooms, operating rooms, and long-term care settings are in particular demand, according to the North Carolina Area Health Education Centers. Given the growing need for nurses with advanced skills amid a shortage of primary care providers, North Carolina’s DNP-prepared APRNs will enjoy more professional opportunities now and in the years to come than ever before in the state’s history.
Thanks to a growing number of DNP programs available online and throughout the country, many of which offer dual points of entry for both MSN- and BSN-prepared nurses, now is the perfect time for North Carolina nurses to respond to the need for a more highly skilled nursing workforce by earning their DNP.
Earning a Doctor of Nursing Practice (DNP) in North Carolina
Accredited programs generally require at least 1,000 post-baccalaureate clinical practice hours (practice hours gained during an MSN program can be applied to this total) and must offer students the ability to specialize in at least one of the following:
- An advanced practice nursing direct care focus
- Nurse practitioner
- Clinical nurse specialist
- Nurse anesthetist
- An aggregate/systems/organizational focus, such as:
- Clinical education
- Nursing informatics
- Executive leadership
- Public policy
- Public health
A Doctor of Nursing Practice (DNP) degree prepares nurses with the critical skills required to implement advanced evidence-based care, measure the outcomes of groups of patients and communities, and improve systems of care.
DNP programs are available to nurses with either an MSN or BSN:
- BSN-DNP programs allow BSN-prepared nurses to complete both their MSN and DNP in one, streamlined program. BSN-DNP programs, which consists of about 90 credits and three years of full-time study, depending on the specialization, allow BSN students to first earn their MSN in an APRN role and population focus, earn national certification in their chosen APRN role, and then transition to the DNP program. Other tracks are available for those interested in organizational/executive leadership.
- MSN-DNP programs, designed for MSN-prepared nurses, offer study in a number of areas, including advanced practice nursing, clinical education, nursing informatics, administration, and more.
Colleges and universities with online DNP programs allow students to complete all of the didactic requirements of the program through interactive, web-based courses, with on-campus requirements generally limited to one or two campus-based immersion experiences. Immersion experiences provide students with the opportunity to meet with faculty and engage in networking activities with their peers and nursing professionals.
Students work alongside faculty advisors in DNP programs, who coordinate the clinical requirements of the program.
DNP programs, both online- and campus-based, offer a number of formats to accommodate the needs of students:
- Traditional DNP programs consist of about 18-24 months of study
- Accelerated programs total about 12 months of study
- Part-time programs take about 2 ½ years to complete
DNP programs consist of three, main components:
- DNP core – The DNP core consists of courses such as:
- Organizational and Systems Leadership
- Applied Epidemiology and Biostatistics for Nursing Practice
- Research for Evidence-Based Practice
- Health Promotion in Individuals and Clinical Populations
- Effective Project Planning, Implementation, and Evaluation
- Specialty courses in line with the chosen focus – Specialty coursework focuses on an advanced practice nursing focus or an aggregate/systems/organizational focus
- Final Project – DNP programs culminate in a final project, designed to highlight the student’s acquired knowledge. Final projects may consist of pilot studies, program evaluations, or integrated critical literature reviews, among others.
BSN-to-DNP Programs for BSN-Prepared Nurses
Many of today’s DNP programs provide a point of entry for BSN-prepared nurses. These streamlined programs allow students to first complete MSN curriculum in an advanced practice nursing role and population focus or organizational leadership track. In most cases, these programs confer both an MSN and DNP degree upon completion.
The MSN component includes coursework in an MSN core, coursework associated with the chosen APRN role or other specialization, and at least 500 hours of clinical rotations applied to the 1000 total necessary to earn a DNP.
The MSN core includes study in such topics as:
- Clinical prevention/population health
- Evidence-based practice
- Program evaluation for improving patient and population outcomes
- Quality and safety
- Interprofessional collaboration
- Organizational and systems leadership
MSN programs in an APRN role also include an APRN core:
- Advanced physiology/pathophysiology, including general principles that apply across the lifespan
- Advanced health assessment, including the assessment of all human systems, concepts and approaches, and advanced assessment techniques
- Advanced pharmacology, including:
- Pharmacotherapeutics of all broad categories of agents
Upon completing all MSN requirements, students of BSN-DNP programs specific to advanced practice would then achieve national certification before moving into the DNP program. Similar to post-master’s DNP programs, BSN-to-DNP programs may be offered in part-time, accelerated and/or online formats.
BSN-to-DNP and MSN-to-DNP Programs Available in North Carolina
The following DNP programs have been accredited by the Commission on Collegiate Nursing Education (CCNE), and/or the American Commission for Education in Nursing (ACEN) (current as of 2016). Both CCNE and ACEN-accredited DNP programs are often available online.
Duke University, Durham
- Post-MSN and BSN-DNP
- Healthcare leadership
- Advanced specialty practice roles
East Carolina University, Greenville
- Post-MSN and BSN-DNP
- Advanced Practice Nursing Roles
University of North Carolina – Chapel Hill, Chapel Hill
- Post-MSN and BSN-DPN
- Nurse administrators/healthcare systems leaders
- Advanced practice nursing roles
Winston-Salem State University, Winston-Salem
- BSN-DNP: Family nurse practitioner
- MSN-DNP: Advanced practice nursing
Hunt School of Nursing
- Advanced practice leadership
- Educational leadership
UNC Charlotte/Western Carolina University WCU Dual DNP Program
- Leadership in clinical practice
Other DNP programs in the state may be regionally accredited or hold specialty accreditation through the Council on Accreditation of Nurse Anesthesia Educational Programs or the Accreditation Commission for Midwifery Education.
Opportunities Available to DNP-Prepared Nurses in North Carolina
Graduates of DNP programs develop and implement best practices to improve healthcare and healthcare systems; serve as organizational directors, where they design, direct, and evaluate system changes; and engage in complex, evidence-based advanced nursing practice.
Whether advancing in their current position or exploring new professional opportunities, DNP graduates in North Carolina are able to deftly address the increasingly complex nature of patient care amid national concerns about quality of care and patient safety.
The following job listings (sourced in April 2016) provide insight into the types of jobs available for DNP-prepared nurses in North Carolina. These job vacancy announcements are shown for illustrative purposes only and are not meant to provide any guarantee of employment:
Nurse-Psychiatric Mental Health Instructor/Professor: South University, High Point
- Instruct and facilitate meaningful learning
- Proactively support all facets of the learning environment
- Provide education through learning-centered instruction
- PhD, DNP, or MSN
Team Leader-Certified Registered Nurse Anesthetist: Mission Hospital, Asheville
- Assist in the coordination of management activities
- Provide leadership that facilitates the coordination and delivery of care for patients undergoing anesthesia
- Oversee area daily operations, programs, and activities
- Master’s degree; PhD/DNP preferred
- At least two years of clinical CRNA and two years of supervisory experience
Assistant Program Administrator: Raleigh School of Nurse Anesthesia, Greensboro
- Maintain a working knowledge of the application process, student records, meeting and committee functions, and other day-to-day activities
- Communicate with faculty, students, professional representatives, members of the Board of Directors, and others
- Develop clinical curriculum for students
- Coordinate specialized rotations
- Teaches in the DNP nurse anesthesia didactic curriculum
- Doctoral degree
- At least one year of experience as a clinical CRNA
- Excellent clinical anesthesia skills