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Discussion

Degrees vs. Roles- Post RN Education Q's!

Hello all!

I'm currently clawing my way through my dual degree ADN/BSN program and I know it's a little early to be thinking so far ahead, but I can't help myself!

I'm thinking (way, way) ahead and every time I search the web, I seem to find more questions than answers to what is the day to day difference in the role of a post-bacc prepared nurse? What will be the difference in my case load, involvement in patient care, and day to day work as a nurse if I choose to pursue:

MSN

DNP

APRN

CNS

And any certification I choose to earn after whatever degree program I graduate from?

No, this is not to answer a homework assignment- I'm just way too curious and ahead of myself and I haven't received any clarity by asking around. It's still a bit too early for me to determine what I might want to specialize in, but I do think that I'll definitely want to continue to see patients rather than opt for a policy or office role. I haven't seen any critical care units yet, but I get a rush from the more unstable patients on med-surg. I love a challenge, and the idea of being behind a desk and off my feet all the time is less than savory.

So, in practice- what is the ballpark difference between higher and terminal degree nurses? It's apparent that the lines aren't necessarily clear cut and definitive, especially not across state lines - but generally speaking, why would I choose to earn a DNP over CNS etc

Thanks in advance and I hope that this post helps fellow nurses-to-be with the same questions!

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    • Expert

    CNS, NP (all the various "flavors"), CRNA, and CNM are professional roles. MSN and DNP are degrees that you take in order to be a CNS, NP, CRNA, or CNM (or nursing administrator, nurse educator, clinical nurse leader, etc., etc.) You become a CNS/NP/CRNA/CNM/etc. by completing an MSN or DNP degree with a specialization in the role of your choice. The four advanced practice roles (CNS, NP, CRNA, CNM) generally require that you have national certification (in that role), above and beyond the degree, in order to be licensed and employed. There are also national certifications for nurse executives/administrators, nursing informatics, nurse educators, clinical nurse leader, and lots of other roles. They are not mandatory for the other roles in the way that they are for advanced practice, but they are often expected or required by some employers.

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    • Author

    Thanks Elkpark,

    I think I might not have articulated what my question is though-

    MSN and DNP are degrees

    CNS, CNM, APRN etc are roles

    My question boils down to- when choosing a post-bacc degree program (DNP, MSN), what would be the reasoning to choose one over the other? Being that I want to take care of patients, get my hands dirty and be in the thick of it, what advanced degrees will allow me to do this instead of finding myself in an office or in every corner of the hospital not getting to know my patients or their families?

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    • Author

    I know that an MSN is masters and a DNP is doctorate and there is an option to go to either one following a baccalaureate degree.

    In writing, it sounds like a DNP is going to allow me to be caring for patients as compared to a Ph.D but at the same time, DNP program descriptions don't sound like they'll result in a career that allows for much bedside time

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    Usually, RNs care for patients at the bedside. Usually, NPs care for patients in an office setting. It's my understanding that there is no additional $ benefit for a DNP, but some people feel that NPs will be required to have DNPs before long, before they allow are to work as NPs. What many are saying is that, just like hospitals are going towards requiring that RNs have BSNs instead if simply ADNs, the same will be true for NPs (that they will be required to hold a degree higher than a Master's.

  • Quote
    • Expert
    Thanks Elkpark,

    I think I might not have articulated what my question is though-

    MSN and DNP are degrees

    CNS, CNM, APRN etc are roles

    My question boils down to- when choosing a post-bacc degree program (DNP, MSN), what would be the reasoning to choose one over the other? Being that I want to take care of patients, get my hands dirty and be in the thick of it, what advanced degrees will allow me to do this instead of finding myself in an office or in every corner of the hospital not getting to know my patients or their families?

    At this point (although, of course, things may change in the future), what matters is the role, not the degree. You can prepare for any of the advanced practice roles (NP, CNS, CRNA, or CNM) via either an MSN degree or a DNP degree. At this point, there is no difference in the scope of practice between any of those practictioners with MSNs vs. those with DNPs.

    The anesthesia community is the only group so far that has really embraced the DNP as a requirement -- all CRNA programs are converting (or already have converted) to DNAP programs, and all new applicants for CRNA certification will be required to have a DNAP starting in 2025. However, none of the other advanced practice groups have (so far) stated any interest in making the DNP the minimum for (new) certification. Plenty of educational programs have converted from MSN programs to DNP programs, and plenty of people are getting DNPS, but there is no difference in terms of scope of practice. So far, the difference is a matter of personal preference.

    At this point (and for the foreseeable future), whether or not you would "take care of patients, get my hands dirty and be in the thick of it" would be a function of what clinical role you choose to pursue, not whether you get an MSN or a DNP.

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    • Author

    No wonder there are no sure fire answers out there! Thanks for clearing it up for me!

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    I have a question out of curiosity, what this dual degree program you are doing and what is the advantage of gaining both at the same time? Like if you are getting a BSN why on earth is an ASN thrown in there? Isn't it just a BSN then?

    I was just wondering to be honest as I have never heard of it and was wondering what advantage there was or reasoning there.

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    • Author

    My program is an ASN program at a school that is part of the city's university system. After fundamentals, we are invited to apply to one of the other schools BSN programs as sort of a "sister" school, allowing us to earn both in slightly less time than if we were to apply to BSN programs on our own. I'm currently enrolled in two different programs, but I can't start taking BSN classes until after med surg (this summer). I will sit for the NCLEX after I complete the ADN next May.

    The advantage is being allowed to start my BSN program before graduation, condensing the time and allowing me to earn my BSN sooner.

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    Make sure your MSN or DNP is accredited to allow you to sit for the NP certification exam if you want to continue to take care of patients, get your hands dirty and be in the thick of it. CNS also work closely with patients and families.

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    • Expert
    CNS also work closely with patients and families.

    As do CNMs and CRNAs -- all four of the advanced practice roles work in direct, hands-on clinical practice.

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    • Author
    As do CNMs and CRNAs -- all four of the advanced practice roles work in direct, hands-on clinical practice.

    CNM is something I'll consider if I like my OB rotation down the line :)

    if I continue to have a penchant for critical care, what might the role differences be if I were to choose to pursue CRNA vs becoming an NP? Aside from administration of anesthetics and intubation? I am assuming that a role as a CRNA doesn't necessarily mean that I'm always in the OR (which I didn't enjoy in rotation)

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