Why would you want a DNP?

I knew I wanted a doctorate in nursing. I knew enough about the Doctor of Philosophy (PhD) to know that it was not the right terminal degree for me. I had heard about the Doctor of Nursing Practice (DNP) but never took time to really find out how it was different until it was almost too late.

Why would you want a DNP?

I was asked that question many times. Everyone had heard of the Doctor of Philosophy, or PhD, but getting a PhD was not in my plans. The PhD program of study teaches you how to be a nurse scientist, someone who focuses on research. While I definitely enjoy doing research, I really wanted a doctoral degree that would allow me other options. So I did my homework, and let me tell you what I found out.

Today, there are basically two types of doctoral programs in nursing - the research-focused PhD, and the practice-focused Doctor of Nursing Practice, or DNP. The PhD prepares nurse scientists; these students present and defend their completed original research in a dissertation, while professional or practice doctorate candidates present their findings in a doctoral study or project. Both types of degrees are recognized equally by the U.S. Department of Education. While I knew that the PhD prepared nurse scientists, and that the focus was on scientific content and research methods, I learned that professional or practice-focused doctoral programs prepare experts in specialized advanced nursing practice. When I got to that point, I began to wonder if I 'qualified' for a DNP - you see, I'm not an advanced practice registered nurse (APRN).

Now, I was stuck. My Master of Science in Nursing had a nursing education focus, not an advanced practice focus. I had been teaching in a College of Nursing on a large medical sciences campus, and I loved it! But I wanted my doctorate - my 'terminal' degree - and the higher position of credibility, leadership, and influence, as well as the knowledge that came with it. But where was I going to get that? Would the DNP be a degree that promoted my nursing practice as a nurse educator in an academic institution? After some searching, I found The Essentials of Doctoral Education for Advanced Nursing Practice. The Essentials tell you what must be included in a DNP program - as well as what is not included. I was excited to read the following excerpt from that official document:

"In some instances, individuals who acquire the DNP will seek to fill roles as educators and will use their considerable practice expertise to educate the next generation of nurses. As in other disciplines (e.g., engineering, business, law), the major focus of the educational program must be on the area of practice specialization within the discipline, not the process of teaching. However, individuals who desire a role as an educator, whether that role is operationalized in a practice environment or the academy, should have additional preparation in the science of pedagogy to augment their ability to transmit the science of the profession they practice and teach. This additional preparation may occur in formal course work during the DNP program. ...the basic DNP curriculum does not prepare the graduate for a faculty teaching role any more than the PhD curriculum does."

While both the PhD and the DNP are necessary for the research knowledge obtained and utilized in evidence-based practice, I knew that choosing the DNP was the right track for me. I didn't want to spend the next 6 to 8 years working on a research project; I wanted to learn about how healthcare policies are developed, about nursing administration or government positions; and especially about academia in practice-based nursing programs. Searching the web I found that there were many programs that offered other options besides the APRN focus. The university I chose offered a focus in Executive Leadership. I knew then that I was headed in the right direction!

Before you pursue any nursing degree, but particularly before you embark on a doctorate, ask yourself some questions.

1. What do I ultimately want to do in my nursing future?

2. What are the differences in the programs of study; which universities offer the degree I want; are the programs accredited by CCNE or AACN?

3. What will be included in my course of study in each type of program?

4. Which of the two degrees will help me to reach my ultimate goal?

5. Does future income matter to me? (Nurses with PhDs tend to make slightly less than those with DNPs, with an average salary of $95,577 per year)

I graduated with my Doctor of Nursing Practice in 2014. I know I made the right decision for me. The knowledge I gained from my Executive Leadership focus has allowed me to become a more effective leader, a more confident person, and a better teacher. My advice to anyone thinking about earning his or her doctorate in nursing is to first decide what you really want to do. If your heart is in research, the PhD is for you. If you know you want to practice then choose the DNP. Both are complementary terminal degrees in nursing - one in practice and one in research - and both represent the highest level of educational preparation in nursing.

Resources:

Advance for Nurse Practitioners. (2012). 2012 NP & PA Salary by Academic Degree. Retrieved from 2012 NP & PA Salary By Academic Degree

American Association of Colleges of Nursing. (October, 2006). The Essentials of Doctoral

Education for Advanced Nursing Practice. Retrieved from http://www.aacn.nche.edu/dnp/Essentials.pdf

1
Up Vote Up Vote ×
Not just a nurse

About Not just a nurse, MSN, DNP, RN

Karen Davis, DNP, RN, CNE I am nursing faculty and I teach returning RNs who are completing their BSN and/or Masters.

1 Article   12 Posts

Share this post

Share on other sites
Specializes in Urology.

In my opinion the DNP doesnt delinate itself enough from the PhD in nursing. The DNP is supposed to be the "practice" doctorate but many APRN's feel it doesnt really augment their role as providers. The DNP is still heavy into research, statistics (which is part of research), theory, and ethics. Very little is spent on the actual "practice" portion. I'm not trying to discredit those who get the DNP, I'm just saying a lot of APRN's dont see that it offers them anything additinal than what they already do. Sure some will want it for the terminal degree and possibly the title (which you can't use in certain places) but I dont feel thats a good enough reason to attain it.

Now should they focus on working with a vulnerable population or provide some type of advanced clinical practicum related to scope then I feel it would offer much more. For example an ACNP could spend their doctorate learning a more in depth scope into acute medical management(like an in depth cardiology class, nephrology class, and pulmonary class), potentially even have a capstone focusing on an acute disease related process that is hospital related. I think APRN's want it to be more "practice" based and to squeeze more out of their everyday experience.

Up Vote Up Vote ×
Specializes in Nursing Education; Leadership/Management.

Dear Twozer0,

I think you and others might just need to check into more DNP programs to see what each offers. In my program, through Union University in Jackson, TN, we had to have 1000 clinical hours - literally - which far surpasses the hours we spent studying how politics related to nursing and why it was important for nurses to get involved; or about how to create a budget for a advanced practice partnership; or collecting data for a research project - which could be in any area of interest the student had. Our clinical hours could focus on any type of advanced practice - whatever the student's focus was, so you could make it your 'ideal' learning experience. Yes, we learn and do enough research to be familiar with it and be able to translate it into practice - evidence based practice. So I urge you to continue to search out a DNP program that fits what you and others want to experience...its out there.

Up Vote Up Vote ×
Specializes in Urology.
Dear Twozer0,

I think you and others might just need to check into more DNP programs to see what each offers. In my program, through Union University in Jackson, TN, we had to have 1000 clinical hours - literally - which far surpasses the hours we spent studying how politics related to nursing and why it was important for nurses to get involved; or about how to create a budget for a advanced practice partnership; or collecting data for a research project - which could be in any area of interest the student had. Our clinical hours could focus on any type of advanced practice - whatever the student's focus was, so you could make it your 'ideal' learning experience. Yes, we learn and do enough research to be familiar with it and be able to translate it into practice - evidence based practice. So I urge you to continue to search out a DNP program that fits what you and others want to experience...its out there.

I went to the Union University website to look at the requirements for the executive leadership program. It had 1060 hours of clinical time which is great but I want to stress that this is also masters AND doctorate clinical hours. The post MSN has 660 hours of clinical (which is typical for most DNP programs, post masters).

I feel this is where most advanced practice nurses feel the need to have a separate and more worthwhile degree. You have a doctorate in leadership but does this have parity with a doctorate for a nurse practitioner or CRNA? For example, CRNA's developed their own doctorate the DNAP because they knew that their practice guidelines should not be lumped into a general degree (and really no doctorate should, its supposed to be speacialized). They work in a highly specialized area, much like NP's and also like leadership. A lot of programs do little to distinguish the basis of the DNP from how it was originally created.

I also want to point out that the Doctoral program for post masters at the school you went for is the exact same between leadership and nurse practitioner. The only difference being where you spend clinical hours. How does this adequately prepare someone with drastically different educational and functional backgrounds for work related to their specific field. This is the big elephant in the room with the DNP.

See for yourself here (NP): Post-Master's Doctor of Nursing Practice - Nurse Practitioner Tracks | School of Nursing | Union University, a Christian College in Tennessee

and here for leadership: Post-Master's Doctor of Nursing Practice - Executive Leadership Track | School of Nursing | Union University, a Christian College in Tennessee

I am in no way trying to discredit you from getting your DNP, its quite the feat. I just feel there is a huge problem in the way its implemented and how it severly lacks several things for those who still work in patient care vs those who do not.

Up Vote Up Vote ×
Specializes in Nursing Education; Leadership/Management.

Hello again!

I totally understand what you are saying about specializing, such as the CRNA's. All I can add to what you said are these points:

1. I had 450+ masters clinical hours and still had to earn 1000 in the DNP program.

2. Yes, the basic core courses for the DNP are the same for all, just like in any other nursing program - BSN, MSN, etc, where core courses are taken by everyone. In my class there were 3 CRNA's and they did their clinicals at sites where they learned and experienced a higher degree of skill, as well as researched areas of interest in those fields; about half the remaining students were APRN's and they chose clinical experiences that would help them grow in knowledge and in skills for their particular license, and their interests; and the final half were faculty from various universities. The DNP is strictly a practice doctorate - the 'DNP Essentials' specifically say that it does not address the needs of the academic nurse educator. However, it does provide a leadership focus which works for most of us in academia.

3. The DNP is not the 'perfect' degree for me - but the problem is that there isn't one that is perfect for the nurse educator. There are currently only two doctoral degrees recognized in nursing - the PhD, which is research focused, and the DNP. I wanted my terminal degree, and being university faculty I also needed that degree. So it was either, not get a doctorate, or choose the one that would benefit me the most.

4. Both the PhD and the DNP are recognized as terminal degrees for nursing; obviously, the PhD is the oldest degree so people are more aware of it. But both are respected as the highest levels of nursing - one for practice and the other for research.

5. Nursing educators are hoping that at some point, some 'official' body will design a doctoral program specifically for academic nurse educators. But it would be too late for me...

So I guess what I'm saying is that for me, the DNP was my solution. It definitely is a practice degree (see the DNP Essentials) so it should be perfect for those who practice at the bedside and in remote areas as APRN's. You can make your clinical focus what you want or need it to be. You design it. So, would you mind explaining what you mean by "How does this adequately prepare someone with drastically different educational and functional backgrounds for work related to their specific field. This is the big elephant in the room with the DNP." I'm not sure where the 'disconnect' is...

Thanks so much for your comments. Maybe someone is reading this who can create a program that better meets your needs - and will totally meet the needs of educators, like me.

Up Vote Up Vote ×
Specializes in Urology.

Have you ever considered the Ed.D degree for your role as an educator? Just curious as to that degree versus the DNP.

So, would you mind explaining what you mean by "How does this adequately prepare someone with drastically different educational and functional backgrounds for work related to their specific field. This is the big elephant in the room with the DNP." I'm not sure where the 'disconnect' is...

Yes, i was referring to your post masters DNP. The program is the same for the nurse practitioner and the nurse educator. That is why I linked them to show that there is no difference in the program, they are all the same classes.

I bring this up because APRN's are providers whereas education is not. Should providers share the same advanced education as someone getting their nursing leadership or education focus? I don't think so. This is why anesthesia jumped ship and also why I think APRN's need their own focus (even outside of the DNP essentials).

Up Vote Up Vote ×

In my former academic institution, a DNP would be mildly accepted for educators. We had a couple- neither tenured or on track. The tenure track strongly favored the Ph.D. The major university here would not tenure track the DNP nor the Ed.d. I think it wise to look in the academic area you want to teach in. Sorry, but if you were already employed as a nursing professor, you should know which degree would be accepted at your site so no dilemma. Also depends on tenure or not, maybe some would be happy with an assistant professor or lecturer title, but seems rather stupid and unfair.

I'm advanced practice and if I went back, hands down the DNP. If I knew I wanted to teach forever, it would be the Ph.D (upper Midwest state. ) Here the Ed.d might be ok if you'd been in the field and tenured, but be careful.

Up Vote Up Vote ×
+ Add a Comment