MSN to DNP Programs: Discover the MSN vs DNP Difference

Nursing, unlike medicine, is something one can pursue incrementally and across decades. For many, that master’s is a step, though not the pinnacle. The pinnacle is the Doctor of Nursing Practice, or DNP; it is a practice doctorate.

A working nurse can take classes online. Clinical hours can sometimes be completed at the practitioner’s own workplace.

The DNP for Advanced Practice

Advanced practice nurses may enter the field with degrees at the master’s or doctoral level. Many of those educated at the master’s level are re-enrolling and pursuing the higher degree. It’s not because it will increase their official scope of practice. It’s not because they foresee a time when they will personally be required to hold it, though they may foresee a time when it will become very commonplace. They may do it to fulfill professional goals or to improve patient care. They may also recognize a potential for higher earnings.

The DNP as Preparation for Nursing Executives, Instructors, and Directors

The DNP can be useful for ‘systems’ or administrative positions, including high level executive ones.

It can also prove very useful for those who want to teach. It’s about having the doctoral degree and, in some cases, tailoring independent study to answer education-related questions. A nurse can teach at a high level with a DNP; the degree can also increase one’s chances of having a high-level position in basic RN education.

There are a lot of voices in support of that extra education, including some premier employers. University Hospitals Cleveland Medical Center, for example, encourages those in its Dermatology Post-Masters Training Program to pursue DNPs or other doctoral degrees if they wish to extend their professional development (https://www.uhhospitals.org/medical-education/dermatology-medical-education/dermatology-nurse-practitioners-post-masters-training-program/candidates).

The DNP is favored for some positions. Sometimes this indicates a situation where the employer is looking for more than just one-on-one patient care. DNP graduates have been characterized as being especially good at translating research into practice.

The bottom line is that there are many entering the field with the higher degree – and many more going back to get it. They do so for many reasons from commitment to their own practice to desire to be competitive in the market.

Higher Standards: What They Do and Don’t Mean

Standards for advanced practice nurses are set at the state level. Wheels are set into motion, though, at the national level. Accrediting agencies are major players. Even when they move accreditation to a higher level, it doesn’t follow that nurses without the higher degree will be unable to practice. For years stakeholders have come out in favor of the higher degree. The American Association of Colleges of Nursing (AACN) endorsed a position statement in 2004 that the doctorate should become the standard. Though the one time goal of 2015 was not met, the landscape has changed. There has been a sharp rise in doctoral programs with all states boasting at least one program.

One discipline, nurse anesthetist, is set to transition by 2025. New graduates will be entering the market with DNP in hand.

Comparing Master’s and Doctoral Standards: MSN vs DNP

The American Association of Colleges of Nursing has set standards for both master’s programs and doctoral programs. At first glance, the “essentials” may appear very similar. Both, for example, include clinical prevention and population health, interprofessional collaboration, and health care policy for advocacy across all specialties. However, expectations are higher for doctorally prepared nurses.

DNP programs includes clinical work. It may be very individualized and help meet the nurses’ own goals. Students of CCNE-accredited programs complete 1,000 post-BSN hours. They can expect to have some recognition for previous work. Nurses who have already met APRN standards for licensing will not be expected to meet the same competencies again.

DPN Candidates Meeting Professional Goals

Doctoral candidates complete an in-depth capstone. This is an opportunity to use research to solve a real-world problem – and to develop the skills to do it again and again.

Many nurses pursue the DPN because they have unrealized professional goals. They’re already assessing their patients and diagnosing them. They’re already prescribing medication. They want to do more. They have visions they want to enact.

Frontier University showcased a video question and answer session with three MSN to DNP nurses (https://npweek.fnudigitalsummit.com/moving-toward-clinical-leadership-dnp-student-stories/). Common threads included having a healthcare vision, wanting skills to enact the vision – and recognizing evidence-based practice as fundamental. One nurse described having become a medical director at a community health center because she was the most prepared candidate there, but still feeling she needed more preparation. One wanted to look at EKGs cardiac abnormalities through the lens of quality improvement. One had considerable experience with sports medicine and knew there were kids who needed to travel pretty far to have their needs met. Putting a program in place, she knew, would take breadth of skill.

The University of St. Francis, meanwhile, highlighted the DNP role in translational research in a story about a long-term home health nurse (https://www.stfrancis.edu/dnp-students-utilize-translational-research).

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