The Doctor of Nursing Practice (DNP) degree is gaining more prominence within the nursing profession.
Steps are being taken to transition to the DNP as the standard for advanced practice registered nurses. While the profession is not quite there yet, the DNP is a terminal degree that prepares the nurses for leadership, given the constantly changing demands of a complex U.S. healthcare system.
How to Become a DNP Nurse
Nurses have many points of entry into the nursing profession — and, ultimately, to a Doctor of Nursing Practice, including entering as licensed practical nurses (LPN) or licensed vocational nurses (LVN). Registered nurses often seek licensure after completing a diploma program or earning an Associate Degree in Nursing(ADN) or a Bachelor of Science in Nursing (BSN), according to Angela Renee Stewart, DNP, APRN, ACNP-BC, AOCNP, TTS, Clinical Assistant Professor at Baylor University, Louise Herrington School of Nursing.
“The LPN and LVN nurses can complete an associate degree or diploma program to become an RN and then would have to complete a BSN program prior to entering graduate school,” she said. “After obtaining the BSN, they could then apply and complete the BSN-DNP program. The ADN or diploma nurse would need to complete an RN-to-BSN program first, and then apply to a BSN-to-DNP program.”
AN RN with a Master of Science in Nursing degree (MSN), who is seeking a DNP, would need to apply to a DNP program and complete the course requirements to earn the terminal degree, according to Stewart. Programs like Baylor University’s Online DNP Programs can offer clinical placement support, as well as access to world-class faculty and networking.
Unlike the research-focused PhD in nursing degrees, the DNP has more of a clinical focus. The DNP curricula, according to the AACN, “build on traditional master’s programs by providing content in evidence-based practice, quality improvement, systems, leadership, among other key areas.”
DNP nurses study the most up-to-date technologies in clinical medicine and can apply those technologies to solve problems. They have a population health perspective, which allows them to collect, analyze, and report on epidemiological data. They also can specialize in providing care for specific populations, from birth to geriatrics. Their education prepares them not only to make a difference at the bedside but also in systems of care, according to a paper in Nursing Outlook.
Completing a DNP degree can take from two years for a master’s prepared nurse to five years for those with an Associate Degree in Nursing (ADN).
DNP Nursing Roles
DNP nurses work in clinical practice in inpatient and outpatient settings and specialize in particular areas, such as family practice, adult acute care, pediatrics, nurse-midwifery, and nurse anesthesia, according to Stewart. These nurses practice at hospitals, as well as private practices, including family, internal medicine, or specialty practice, such as cardiology and oncology. Some practice in the emergency room, at community clinics, free clinics, surgery centers, schools, and other settings.
“DNPs must practice within the scope of practice of their specialty training, and their practice is regulated at the state level,” Stewart said. “Some states allow DNPs to own their own practice without an attending physician, and some are semi-independent requiring a physician to be available for consultation. “The institutions will usually have bylaws that must be followed in addition to the state nurse practice act and the scope of practice for the specialty in which the DNP is certified.”
DNP nurses also can join the ranks of much-needed nurse faculty. A 2019 survey of 892 nursing schools with baccalaureate and/or graduate degree programs uncovered 1,637 faculty vacancies, according to AACN’s Special Survey on Vacant Faculty Positions.
“The data show a national nurse faculty vacancy rate of 7.2%. Most of the vacancies (89.7%) were faculty positions requiring or preferring a doctoral degree,” according to AACN.
Some choose to become nurse leaders, including nursing administrators or chief executive officers, while others prefer careers in information technology and analytics.
While a doctorate in nursing may not be required for all of these positions, it can improve a nurse’s chances of moving into leadership or management roles, according to Nurse.com’s Higher Education Guide.
DNP Job Outlook
The market for DNP nurses is strong, and schools nationwide are reporting considerable and competitive student enrollment, according to Stewart. “Employers are recognizing the contribution of DNPs as expert nurses in the practice arena creating demand for DNP-prepared nurses as it continues to grow,” Stewart said.
There are several options for nurses seeking a Doctor of Nursing Practice degree, according to Stewart.
Among those: the Family Nurse Practitioner (FNP), Adult-Gerontology Acute Care Nurse Practitioner (AGACNP), Adult Gerontology Primary Care Nurse Practitioner (AGPCNP), Neonatal Nurse Practitioner (NNP), Pediatric Acute Care Nurse Practitioner (PNP-AC), Pediatric Primary Care Nurse Practitioner (PNP-PC), Psychiatric and Mental Health Nurse Practitioner (PMHNP), Women’s Health Nurse Practitioner (WHNP), Clinical Nurse Specialist (CNS), Certified Nurse-Midwife (CNM), and Certified Registered Nurse Anesthetist (CRNA).
“The DNP also includes executive and director level roles dealing in decision-making and policy development,” Stewart said. “The DNP degree offers APRNs and other nurses seeking top leadership and organizational roles the education and opportunity to implement evidence-based practice, quality improvement, and systems leadership where they practice.”
Overall employment of nurse anesthetists, nurse midwives, and nurse practitioners is projected to grow 45% from 2020 to 2030, which is much faster than the average for all occupations, according to BLS.
DNPs, in particular, are in short supply, according to Stewart. They’re needed in practice and educator roles.
“Many students do not have the opportunity to be precepted by a doctorally prepared nurse practitioner, and often must reach out to master’s level NPs or physicians to serve as preceptors during their DNP program,” Stewart said.
Another concern is that the nursing workforce is aging and retiring, creating shortages in practice, education, and leadership.