What is the difference between NP and DNP?

llg, PhD, RN · Mar 3, 2010

NP is a certification, not a degree. People are eligible to take an exam and become an NP after they have completed an approved education program. In the beginning (back in the 1960's) you didn't even need a Bachelor's Degree to qualify for some NP exams. But then the profession raised the standards for beome certified as an NP and a Bachelor's Degree was required. Then, the standard was raised again and the NP educational program were moved to the Master's level. So, people got a Master's Degree in Nursing focuing on the NP role and then took the exam to get certified as an NP.

The profession is going through another period of transition. Many people want to see the educationl standard for NP's rise again. Many schools are converting the Master's Degree programs focused on preparing NP's to doctoral level programs. The DNP is a new academic degree (not a certification) focusing with a more clinical focus than traditional PhD's. There is a movement to require the DNP degree as the standard for taking the NP exam and becoming certified as an NP.

However ... that official change in standard has not happened yet -- and may or may not become official in the very near future. That's a political question that the profession is wrestling with now. Currently, some schools have closed their Master's levels NP preparation programs and opened DNP programs to prepare NP's. Some schools have not. The people actually providing the test are still accepting the Master's Degree NP programs as sufficient. It is expected that even if the official educational standard for taking the exam rises to the doctoral level, current NP's will be "grandfathered in" an retain their NP certification.

So ... in a nutshell:

"NP" is a certification one earns by taking an exam after completing an approved educational program. "DNP" is an academic degree offered by a school. The issue of what type of educational programs will be required to take the certification exam and maintain certification as an NP is a political issue that is currently being discussed. Historical trends are for the educational standards to rise, but that is no guarantee that the DNP will be required any time soon -- but then, it might if the political winds favor are blowing in that direction.

Whether or not graduates of DNP programs should use the title "Dr." in the clinical setting is another political question -- and one that is hotly debated. As holders of a doctoral degree, DNP graduates are entitled to use the "Dr." title. However, that could be confusing to patients and other staff members, causing some people to think that they should not use the "Dr." title. Other people think that educating the public about "different types of doctors" is the best long-term, healthy approach to the fact that we have many different staff members with different types of doctoral degrees in the clinical setting. There is no concensus on that issue.

ajhill00 · Mar 4, 2010

Thanks for the detailed reply! Since DNP is relatively new, are there any DNP graduates out there yet using the "Dr." title? If you earn a doctorate, I think you should be allowed to use the title.

llg, PhD, RN · Mar 4, 2010

Yes. The degree has been around for a couple of years.

dgenthusiast · Mar 5, 2010

Thanks for the detailed reply! Since DNP is relatively new, are there any DNP graduates out there yet using the "Dr." title? If you earn a doctorate, I think you should be allowed to use the title.

Well, the thing is, some people (myself included) question whether the DNP curriculum warrants the title of a doctorate. It's very watered down and pretty much has the same courses an MPH has. I don't see why a glorified MPH that can be done online deserves a doctorate.

In the end, the difference between an NP and a DNP, at least in my view, is several thousands of dollars in tuition. That's it.

Smitty08 · Mar 5, 2010

Hi all. As a DNP student in a rigorous program, I don't see DNP to be a watered down anything. I've learned a lot and it has been challenging. Its a different focus than a PhD and clinically oriented. Granted, there are probably programs that are a lot less rigorous than the one I attend - perhaps they will change in the future as this process evolves. And yes, I know some of my colleagues who have already graduated are using "Dr" as well they should, with the caveat that clients should always understand it's not an MD credential but from the nursing discipline! :)

reznurse · Mar 5, 2010

here, here Smitty! I am applying for the DNP instead of the PhD to become tenured faculty, and I certainly plan on using Dr.

efy2178 · Mar 5, 2010

I start the DNP program at the University of Iowa this summer. The curriculum does not look 'watered down' to me.

Disinherited · Mar 6, 2010

Yup, a DNP gives the holder the title of Doctor. Same as my sister in law, who has a PhD in creative writing. She is a Doctor as well. Al gore is also a Doctor - UT just gave him an 'honorary' doctorate. It doesn't matter whether you have a PhD, DbA, PsyD, DNP, EdD, DPA, MD, DO, DsC, DPT, DPAS, or DCh - each of these doctorate level degrees give the bearer the title of "doctor". Furthermore, it doesn't matter if you earned a doctorate online through Capella, UOP, or Walden, or if you earned it by attending the most rigorous of American medical schools, you have earned the right to be called "doctor".

Of course, my sister in law is smart enough not to use her title in inappropriate places - LIKE IN A MEDICAL SETTING!!! I mean, while she is a doctor, she is not a doctor. She wouldn't want to confuse anyone. Hopefully the DNPs will use the same common sense.

efy2178 · Mar 6, 2010

Yup, a DNP gives the holder the title of Doctor. Same as my sister in law, who has a PhD in creative writing. She is a Doctor as well. Al gore is also a Doctor - UT just gave him an 'honorary' doctorate. It doesn't matter whether you have a PhD, DbA, PsyD, DNP, EdD, DPA, MD, DO, DsC, DPT, DPAS, or DCh - each of these doctorate level degrees give the bearer the title of "doctor". Furthermore, it doesn't matter if you earned a doctorate online through Capella, UOP, or Walden, or if you earned it by attending the most rigorous of American medical schools, you have earned the right to be called "doctor".
Of course, my sister in law is smart enough not to use her title in inappropriate places - LIKE IN A MEDICAL SETTING!!! I mean, while she is a doctor, she is not a doctor. She wouldn't want to confuse anyone. Hopefully the DNPs will use the same common sense.

DNP is doctorate of clinical nursing practice. Doctorate being the key word. We don't say Physician Smith. We say Dr. Smith. Who says physicians have the right to rob the title only for themselves?

I make it clear to patients that I am a nurse. I will also make it clear I have a doctorate (in a few years). If they chose to call me Dr. I won't discourage that although I prefer to be called by my first name.

I think in the same token, nurses should call physicians by their first name.

reznurse · Mar 6, 2010

Several people in my family are optometrists, and they go by Dr. I also have a freind who is a dentist that goes by Dr. None of them went to med school, isn't this the same deal?

PICUPNP · Mar 6, 2010

There are several threads on this forum related to the use of "Dr" by NPs. This has been addressed ad nauseum! The use of the title "Dr" by NPs is ridiculous. This will only further current bad relations with physicians and make those using the title look bad. Nps are not doctors and the title shouldn't be used in a clinical setting.