For many years, the Master of Science in Nursing (MSN) marked the standard for advanced practice registered nurses (APRNs). However, in 2004, member schools affiliated with the American Association of Colleges of Nursing (AACN) endorsed a proposal to make doctoral-level preparation, such as the Doctor of Nursing Practice (DNP) degree, the preferred pathway.
The DNP is the highest-level practice-focused degree for advanced practitioners, nurse executives, and other nurse leadership roles. What types of jobs do DNP degree holders perform? Read on to learn more.
The 2004 Position Statement on the Practice Doctorate in Nursing proposed that the preparation level for advanced nursing practice transition from a master’s degree to the doctorate level by 2015. That hasn’t happened; currently, the MSN remains the most common degree held by APRNs.
The movement isn’t dead, however. Accreditation and certification bodies such as the Council on Accreditation of Nurse Anesthesia Educational Programs and the National Organization of Nurse Practitioner Faculties support the recommendation. Both organizations are calling to move to the DNP for entry into the practice by 2025. Other specialization areas may yet follow suit.
The DNP is one of two terminal degrees for the nursing profession: the Doctor of Nursing Practice degree, which is practice-focused; and the Doctor of Philosophy in Nursing (PhD) degree, which is research-focused. PhD holders typically work in academia or research positions as professors or research scientists or within government roles developing health care policies.
A DNP degree prepares nurses for several nursing practice jobs that we’ll discuss in this article, including:
To keep up with the complexity of patient care and the quality of care, the Doctor of Nursing Practice (DNP) degree builds on the master’s degree preparation. The DNP curriculum provides foundational competencies in evidence-based practice, quality improvement, systems leadership, healthcare policy, patient outcomes, and other areas.
A Doctor of Nursing Practice program traditionally takes three years to complete. However, APRNs with an MSN degree can earn their DNP in as little as six semesters.
DNP programs are also open to prospects with non-nursing baccalaureate degrees who wish to pursue nurse leadership roles. A DNP program may take such students longer to complete.
DNP graduates work in various settings within the nursing discipline. Some roles—nurse practitioners, nurse anesthetists, and nurse midwives, to name a few—work directly with patients in clinical settings, Others indirectly impact patients, using informatics, leadership, health policy, and educational instruction to support patient care and improve patient outcomes. Those roles include chief nursing officers/executives, nurse administrators, and nursing faculty/educators. Clinical nurse specialists dabble in both direct and indirect patient care.
Nurse practitioners (NP) encompass an extensive range of specialties, certifications, and job titles, including adult gerontology nurse practitioner (AGNP), psychiatric mental health nurse practitioner (PMHNP), pediatric nurse practitioner (PNP), and additional advanced registered nurse practitioner roles.
Nurse practitioners draw a median salary of $120,680 and can earn higher wages based on education, years of experience, certifications, licensure, and location. NPs enjoy one of the most autonomous roles in nursing, performing many of the same functions as physicians without oversight (their level of autonomy varies by state). Their job responsibilities include:
Nursing and primary care physician shortages are rising, putting a strain on healthcare systems. As a result, NPs have become the nation’s second-leading primary healthcare providers. According to the American Association of Nurse Practitioners, 88 percent of NPs have certification in primary care. 70.3 percent function as family nurse practitioners (FNPs).
Most NPs exit at the master’s degree level. However, the National Organization of Nurse Practitioner Faculties committed to moving all entry-level NP education preparation to the DNP by 2025.
Certified registered nurse anesthetists (CRNAs) are the highest-paid nursing professionals, averaging an annual salary of $195,610. CRNAs, considered advanced practice registered nurses, specialize in anesthesiology. Their responsibilities can include:
CRNAs work in emergency rooms, outpatient surgical centers, military medical facilities, and hospital operating rooms. Due to the complexity of this role, proper certifications and a doctoral degree are prerequisites. Furthermore, following the decision to make doctoral education the mandated nurse preparation level for all APRNs, the Council on Accreditation of Nurse Anesthesia Educational Programs required all incoming CRNA students to enroll in an accredited doctoral nursing program by January 1, 2022, for entry into the practice.
Certified nurse midwives (CNMs), another APRN specialty, provide prenatal, pregnancy, labor and delivery, postpartum, and newborn care. CNMs can work independently or as part of a healthcare team. CNMs must have, at minimum, a graduate-level degree from a program accredited by the Accreditation Commission for Midwifery Education (ACME) to practice. Unlike NPs and CRNAs, the ACME did not endorse the decision to make the DNP a requirement to practice as a CNM.
Certified nurse midwives average an annual base salary of $112,830, with a job outlook expected to grow faster than average.
While advanced and specialty care practitioners such as nurse anesthetists and midwives provide direct patient care, clinical nurse specialists (CNSs) provide patient care with an added leadership component. CNSs perform high-level functions such as:
Many CNS functions align with the advanced content learned in a DNP degree program. For example, system leadership, quality improvement, and patient and population health outcomes are all foundational competencies in DNP curricula.
According to Salary.com, clinical nurse specialists earn a median annual salary of $113,814.
A chief nursing executive (CNE) or chief nursing officer (CNO) sits at the top of the nursing hierarchy. Nurse executives perform little to no direct patient care. Instead, they impact patient outcomes at a broader level behind the scenes through strategic planning and oversight. These executives perform daily functions such as:
CNOs and CNEs are responsible for their entire nursing department, which can prove challenging. However, chief nursing officers and executives enjoy a lucrative average salary of $248,000.
To effectively lead a nursing department, it is also beneficial to have clinical practice experience. Therefore, the career path for executives may consist of working as an RN, APRN, or charge nurse to gain clinical skills. In addition, executive roles could benefit the most from advanced education through a DNP program due to the magnitude of responsibilities.
Nurse educators or faculty can work in academic and hospital settings, with either a DNP or PhD. PhD holders focused on research commonly work in academia or research settings.DNP holders emphasize clinical practice and commonly work as faculty members in hospitals, hospital systems, or nursing degree programs.
Within accredited nursing programs, nurse educators perform the following duties:
Outside of the academic setting, some nurse educators work as nursing department supervisors in healthcare settings or as consultants providing professional development and training.
The average salary for nurse educators is $105,281. Many nurse educators have a master’s degree and a Certified Nurse Educator (CNE) credential. However, some accredited institutions now require nurse faculty to have a doctorate-level degree. For example, the AACN’s Special Survey on Vacant Faculty Positions, released in October 2022, showed an overall nurse faculty vacancy rate of 8.8 percent, with 84.9 percent of the vacancies due to faculty positions requiring or preferring a doctoral degree.
The US Bureau of Labor Statistics (BLS) categorizes nurse administrators as medical and health services managers. The average annual salary for this profession is $101,340, with the potential for higher earnings depending on the setting. For example, health service managers in hospital settings can earn a median wage of $119,450.
Nurse administrators (also known as nurse managers) juggle many tasks on the administrative side of nursing, including:
Most employers require at least a Bachelor of Science in Nursing (BSN) and five or more years of experience as an RN to work in management roles. In addition, many aspiring nurse administrators who want to transition from clinical practice to the management side pursue a Master of Science in Nursing (MSN) with a concentration in nursing leadership or nursing administration.
The nurse administrator role often serves as a gateway to higher-level administrative jobs for which a DNP is required or preferred.
Nursing education is shifting as more accrediting bodies, healthcare employers, and academic institutions support transitioning from graduate-level to doctorate-level nurse preparation. If you plan to pursue advanced practice or nurse leadership roles that pay generously and have greater responsibilities, know that some accreditation and certification bodies plan to implement the DNP requirement for entry into advanced roles. Fortunately, many top DNP programs offer BSN-to-DNP or MSN-to-DNP degree pathways and flexibility through hybrid learning to accommodate working nurses.
DNP programs have continued to grow over the years and are available in all 50 states and the District of Columbia. If you’re ready to address complex healthcare issues and practice at an advanced level through direct or indirect patient care, a DNP degree may benefit your career—and your salary.
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