DNP or PhD: Which One is for Me?

NurseWriter_AJP, PhD, RN

In 2018, 18% of nurses in the United States held a graduate degree and about 1% of nurses had a doctoral degree. Many of the classes taught in nursing school focus on nurses effectively managing problems that may require patients to be hospitalized; in fact, the NCLEX exam is mostly weighted on the management of care for patients, interventions (ie: pharmacological or parenteral therapies), and safety and infection control for the patient. Few classes will touch on managing others in the healthcare setting, providing care in clinics or on the street, and nursing research or teaching. Even less time is spent discussing advanced degrees for nurses.

As the workforce continues to age, there is significant concern about the well-being of the nursing profession. Nursing education is more often taught emphasizing patient care, which is very important. However, there is a nurse faculty shortage, and many nurses don’t realize that teaching is a viable option for those choosing to move from the bedside before reaching retirement.

The DNP

In 2004, the American Association of Colleges of Nursing decided it was time to make the DNP degree the standard for advanced practice nursing. The DNP is designed to be a practice doctorate, meaning the focus is on nursing practice. The primary focus of a DNP-prepared nurse is to work on interdisciplinary teams and provide nurses with skillsets that can be used to treat patients most effectively and safely. Evidence-based practice is often the focal point, which allows nurses to translate research findings into practice. The DNP program can take 2-3 years to complete, depending on degree requirements and whether attendance is full-time or part-time. Some DNP nurses will have advanced practice degree options included in the DNP coursework, such as a nurse practitioner track, but this is not required to be a DNP-prepared nurse. Nurses with DNPs can be found working primarily in hospital settings and teaching at universities and colleges.

The PhD

The PhD track has been around longer than the DNP track, and is considered the standard route for attaining tenure-track positions at academic institutions. The PhD prepares nurses to become nurse scientists, developing new and unfound knowledge in nursing and other disciplines, and expanding on evidence-based practice. PhD-prepared nurses often lead research teams and teach at academic institutions; some may still provide some direct patient care, but this is not common practice. The PhD program typically takes 4-5 years to complete, but can take more or less time, depending on the priorities of the student.

Which degree may be right for me?

If you’re thinking about going back to school for either of these degrees, consider this:

1- What is your priority for obtaining the advanced degree?

If your priority is to create new knowledge through research, the PhD may be for you. If your priority is to lead the implementation of the newest evidence-based practice in primary care settings, then the DNP option may be best. Keep in mind, DNP-prepared nurses can, and often do, conduct research. But this is typically not their primary focus.

2- How much time can you dedicate to completing the degree?

Whether you find a two-year DNP program or a four-year PhD program, they will both require much of your time over that time period. Many nurses juggle time between work, family and friends. You must consider how long you are willing to put most other priorities to the side to obtain either degree.

3- Do you want to teach?

Nurse faculty are in high demand, as there is a shortage of nurse instructors at all levels of nursing education. Both the DNP and PhD programs may be tailored to lead into a teaching position upon graduation. You can always negotiate how much time you spend teaching; however, each degree will prepare you to teach at least a course or two per year, as this is standard practice if pursuing a position in academia. For those who decide to work in a hospital or clinical setting less teaching may be required, but this depends on the institution.

4- Do you still want to touch patients?

There will always be many opportunities to continue to provide direct patient care. Many nurses and advanced practice nurses still provide direct patient care after obtaining their doctoral degrees. Keep in mind, doctorate degrees are designed for less direct patient care and more management of research or clinical teams. It will be up to you to decide how much time you allocate to each responsibility.

5- Do you want to manage others?

Oftentimes, those with doctoral degrees will spend a good deal of time managing a team of people. You’ll likely be responsible for managing a department or team of people in a variety of settings. It’s a good idea to determine how comfortable you are managing others and developing the skills to be an effective manager.

6- Are you prepared to move?

PhD-prepared nurses, and anyone choosing to enter academia as a profession, must consider whether moving for the right opportunity is an option. Mentors and job opportunities may not be in the city you currently live in. Additionally, faculty at academic institutions do not always retire at the same institution at which they took their first job.

These terminal degrees complement each other and allow nurses to impact public health and nursing practice in many ways. But each degree requires a great deal of time. Before making a choice, consider talking to nurses who have obtained either of these degrees and ask them for insight into life as a PhD- or DNP-prepared nurse. Whatever you choose, make sure the decision makes the most sense for you.

References

Difficult Professional Choices: Deciding Between the PhD and the DNP in Nursing

Test Plan for the National Council Licensure Examination for Registered Nurses

Advancing Scholarship through Translational Research: The Role of PhD and DNP Prepared Nurses