Doctor of Nursing Practice programs routinely offer two entry points to accommodate BSN and MSN-prepared nurses, giving RNs and APRNs the opportunity to pursue the highest practice-focused education available. DNP-prepared nurses earn an increased salary, occupy leadership roles, mentor other nurses, and effect change in health policy by translating research into practice. Nurses who have earned DNP credentials are able to revise policy at the clinical level by personally evaluating standards of patient care and procedures.
In the midst of a nationwide physician and skilled nursing shortage, Texas became an area of concern due to its large population and growing need for medical services. In 2001, Texas began to develop legislation to combat the shortage of nurses, introducing the Nursing Shortage Reduction Program and the Nursing Innovation Grant program in the same year. Both initiatives aimed to introduce more funding into nursing educational programs in the state as well as increase faculty budgets.
According to the Texas Nursing Workforce Shortage Coalition, by 2020 the shortage of nurses in Texas is expected to widen to a staggering 70,000 as the state’s aging population places stronger demands on the healthcare system while at the same time nurses begin retiring from the workforce at a faster rate than nursing schools produce new graduates. In fact, the Texas Hospital Association reported that Texas nursing schools turned away 11,217 qualified applicants in 2010, with the prime reason being lack of qualified faculty.
The American Association of Colleges of Nursing (AACN) reported that out of 28,637 students enrolled in nursing programs throughout the state of Texas in 2015, the state produced 10,404 graduates, including 613 graduates of DNP programs.
DNP-prepared RNs and APRNs have the ability to fill faculty positions to increase the capacity of the state’s nursing schools, serve as primary care providers to help stem the shortage of physicians, and step into organizational leadership and health policy roles where they can effect meaningful change from within. From their extensive education and experience to the unique role they play as leaders and change agents, DNP-prepared nurses are the key to combating the shortage of nurses and primary care providers in Texas.
Doctorate-prepared nurses hold positions of influence, including important positions within professional nursing associations:
- Rhonda Winegar, DNP, FNP-BC, CCRN, CPN, Central Regional Director of the Texas Nurses Association board of directors
- Cole Edmonson, DNP, RN FACHE, NEA-BC, President of the Texas Organization of Nurse Executives
Earning a Doctor of Nursing Practice (DNP) in Texas
DNP programs offer two entry points to accommodate nurses that hold either a Bachelor of Science in Nursing (BSN) or a Master of Science in Nursing (MSN):
- BSN-DNP (post-bachelor’s) programs, which allow nurses to earn both a master’s and a doctorate degree in one program, are often used as a path to initial APRN certification and licensure for aspiring nurse practitioners, nurse midwives, nurse anesthetists and clinical nurse specialists. Although credits may vary according to the nurses’ chosen specialization, most programs will consist of about 90 credits completed over 36 months. Tracks in organizational leadership, informatics and more are also available.
- MSN-DNP (post-master’s) programs are for master’s-prepared nurses looking to advance their clinical career opportunities or pursue non-patient care tracks in executive leadership, informatics, health policy and more. Some master’s-prepared APRNs pursue a DNP degree in order to add an additional patient population focus or specialty. Depending on specialization, MSN-DNP programs generally consist of 36 credits taken over 18 months.
The Commission on Collegiate Nursing Education (CCNE) and/or the Accreditation Commission for Education in Nursing (ACEN) maintain national accreditation standards for DNP programs. Accredited DNP programs must meet two basic requirements:
- Graduation is contingent upon completing at least 1,000 post-baccalaureate practice hours (500 hours earned during a master’s program can be applied to the total)
- Programs must allow students to specialize in either an advanced practice nursing direct care focus or an aggregate, systems, or organizational focus
Currently, Texas offers 9 CCNE accredited traditional in-state DNP programs. Nurses interested in pursuing a DNP degree may also choose from a variety of accredited online programs. Offering flexible coursework, the opportunity to complete clinical hours close to home, and fully accredited curriculum, online degree programs are a practical option for many professional nurses.
Both traditional and online DNP programs are heavily made up of practicum requirements, requiring nurses to log extensive hours in hospitals, physician’s offices, and clinics in order to fulfill degree requirements. Nurses enrolled in DNP programs in Texas would fulfill practicum requirements in clinics and hospitals that partner with their university.
Online and traditional programs often offer three pace options to accommodate the professional nurses’ schedule:
- Traditional programs, which can be completed in 18-24 months
- Accelerated programs, which can be completed in 12 months
- Part-time programs, which can be completed in about 30 months
DNP Program Structure and Components
DNP programs are made up of three main components: DNP core classes, additional credits focusing on the nurses’ chosen specialization, and a DNP project.
The core classes will focus on the scientific foundations of nursing, evidence-based practice, transforming health policy, health promotion, epidemiology, and leadership development.
Specialty courses will vary according to the nurses’ focus. APRN focuses cover topics such as theories and foundations of advanced practice nursing, as well as pathophysiology and clinical assessment. If nurses have chosen an aggregate, systems, or organizational focus, classes will focus on leadership techniques and organizational management.
DNP projects, the final component of the DNP program, generally consist of both a written paper and a presentation, focusing on the nurses’ chosen specialization within advanced practice nursing.
When completing coursework at the doctorate level, nurses will become competent in scientific foundations of nursing and epidemiology. Earning a DNP gives nurses the unique opportunity to effect change in health policy from a clinical standpoint. In order to pursue leadership roles, DNP nurses must be well-versed in advocacy, ethics, and policy as it relates to population health. In addition, nurses will complete coursework on clinical decision making and study healthcare organization leadership in preparation to lead their own team of nurses.
BSN-to-DNP Programs for BSN-Prepared Nurses
BSN-to-DNP programs are intended for bachelor’s-prepared nurses to earn both their Master of Science in Nursing (MSN) and their Doctor of Nursing Practice (DNP) degree while becoming eligible for either advanced practice licensure or for roles in informatics, policy and leadership that don’t involve direct patient care. BSN-DNP programs provide the most direct route to the doctoral degree for bachelor’s-prepared nurses.
Master’s level coursework consists of 30 core credits, as well as additional credits focusing on the nurse’s specialty track, whether in advanced clinical practice or in an aggregate/systems/organizational focus. Those in an APRN track must pass national certification in one of the four roles before moving on to doctoral level coursework:
- Nurse practitioner
- Nurse midwife
- Nurse anesthetist
- Clinical nurse specialist
Core courses at the master’s level cover the following topics:
- Practical Application of Statistics in Healthcare
- Population Health and Epidemiology
- Informatics & Technology to Improve Health Care
- Advancing Policy and Politics in Health Care
- Systems Leadership for Effectiveness and Quality
- Financial Intelligence for the DNP Leader
- Leading Teams in Complex Health Care Environments
- Health Care Economics
- Integrating Community Mental Health into Health Care Systems
- Ethical Dimensions of Nursing
Additional courses (APRN core) for programs that offer an APRN track cover the following topics:
- Advanced Practice Development
- Advanced Practice Physiology/Pathophysiology
- Advanced Practice Pharmacotherapeutics
- Advanced Practice Health Assessment
BSN-to-DNP and MSN-to-DNP Programs Available in Texas
The following DNP programs have been accredited by the Commission on Collegiate Nursing Education (CCNE) (current as of 2016).
Other DNP programs in the state not shown here 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.
A larger selection of CCNE and ACEN (American Commission for Education in Nursing)-accredited DNP programs are available online.
- Baylor University, Dallas
- Family Nurse Practitioner
- Neonatal Nurse Practitioner
- Nurse Midwifery
- Texas Christian University, Fort Worth
- Post-MSN and BSN-DNP
- APRN roles
- Family Nurse Practitioner
- Post-MSN and BSN-DNP
- Texas Tech University Health Sciences Center, Lubbock
- Texas Women’s University, Denton
- University of Texas at Arlington
- University of Texas Health Science Center at Houston
- Nurse Practitioner
- Nurse Executive
- Nurse Anesthetist
- Nurse Informaticist
- University of Texas Health Science Center at San Antonio
- Advanced Practice Leadership
- Executive Administration Management
- Public Health Nurse Leader
- Prarie View A&M
- BSN-DNP and Post-MSN
- Family NP
- BSN-DNP and Post-MSN
- University of Texas Medical Branch at Galveston
- University of the Incarnate Word, San Antonio
- BSN-DNP and Post-MSN
- BSN-DNP and Post-MSN
Opportunities Available to DNP-Prepared Nurses in Texas
Graduates of DNP programs in Texas have the opportunity to pursue the highest level nursing careers, both in the clinical environment and in roles that don’t involve direct patient care. Whether in direct patient care or outside of the clinic, DNP careers allow nurses to fulfill critical leadership roles.
The following job listings for doctorate-prepared nurses in Texas were surveyed in April 2016. They are shown for illustrative purposes only and are not meant to represent job offers or provide any assurance of employment.
Director of Nursing Research at the UT Southwestern Medical Center in Dallas, TX
- DNP, PHD or DNS required
- At least 6 years of experience in clinical nursing
- At least two years of experience in nursing leadership
- Develop plan for nursing research across hospital system
- Provide administrative oversight to staff
- Implement and evaluate nursing research
Neonatal Nurse Practitioner at Cypress Fairbanks Medical Center in Houston, TX
- MSN or DNP degree required
- Prior experience as a neonatal nurse practitioner
- Provide in-house neonatal care to patients
- Provide high flow nasal cannula support, oscillators, and nitric oxide to patients
- Provide guidance to other members of staff
Pulmonary Nurse Practitioner at Baylor Scott & White Health in Waco, TX
- MSN required, DNP preferred
- Experience as a pulmonary nurse practitioner
- Provides primary care treatment to a variety of patient populations
- Performs physical exams, medical screening, and interprets laboratory results
- Teaches health awareness to patients
- Collaborates with nursing administration in support of policies
Director of Nursing Education and Research at St. Luke’s Health in Houston, TX
- DNP or PhD degree required
- Three years of nursing leadership experience
- Conducts and participates in research to improve clinical procedures
- Guides and mentors other members of staff
- Develops creative approaches to research and education