Nurse practitioners are the most senior and highest-qualified members of the nursing profession. These nurses have studied a postgraduate nursing program and earned the right to be advanced practice nurses. Until relatively recently, it was common for people to earn the nurse practitioner title by studying for a master’s degree. As the demands placed on APRN and Nurse Practitioner-level staff have increased, so too have the qualification requirements. Today, it’s more common for nurses to earn a DNP as a part of their training.
DNP stands for Doctor of Nursing Practice. A DNP degree is a doctoral-level qualification, making it about the same as a Ph.D. in other subjects. A DNP prepared nurse has a strong understanding of day-to-day nursing plus a deep knowledge of the area of nursing practice they’ve chosen to specialize in.
Common specializations for DPN graduate nurses include:
- Nurse midwife
- Nurse anesthetists
- Psychiatric nurse practitioner
- Family nurse practitioner
- Pediatric nurse practitioner
It takes around four years of study to go from being a registered nurse to passing a DNP program. Many nurses study for a master’s degree and earn a specialization before starting a DNP. It is possible to enroll on a DNP without doing a master’s degree first, but nurses who do this will find they have to take some extra catch-up courses to ensure they have covered the content that an MSN-holding nurse has already seen.
Nurse practitioners earn a higher salary than those who hold the title of registered nurse, and they enjoy good job security too. Demand for nurses at all skill levels is increasing as the population of the United States increases and the average age of the population gets higher. The increasing average age of the population means there are more people placing demands on the health care system for primary care and care for acute or chronic conditions. In addition, as many of the people who are trained to nurse practitioner level today approach retirement age, there’s a need to replace them.
The length of time it takes to train as a nurse practitioner means demand is likely to stay high for many years. Entry requirements for nurse practitioner programs are high, and not all people who enter the nursing profession have the academic skills or the willingness to invest that much time in study. This means for those who are willing to complete the extensive training, the rewards can be lucrative.
Salary expectations of a Doctorate of Nursing Practice (DNP) nurses compared to a nurse practitioner (NP)
The average salary of a nurse who is trained to postgraduate level is $115,800 per year or $55.67 per hour, according to the Bureau of Labor Statistics. This figure is the average across a variety of doctoral-level nurses, including nurse practitioners, nurse anesthetists, and nurse midwives.
The average salary of a nurse who is trained to the registered nurse level, holding just a bachelor’s degree, is $73,300 per year or $35.24 per hour. To hold the title of Registered Nurse, a person must have passed the NCLEX-RN certification. Not all RNs hold a bachelor’s degree. It’s possible to take the test and practice after completing an associate’s degree, and many young nurses do this. An RN with the ADN qualification instead of the BSN will have far lower earning potential than an RN who is BSN-prepared.
What does the DNP mean?
It’s important to note that there’s no such thing as a DNP nurse. The Doctor of Nursing Practice is an academic qualification, not a nursing license. Nurses who hold the qualification of DNP have the ability to train to be Nurse Practitioners (NP), Certified Registered Nurse Anesthetists (CRNA), nurse midwives, and many other specializations. However, not all NPs or CRNAs have a DNP. Many are only qualified to the Master of Science in Nursing (MSN) level. In addition, not all DNPs choose the same specialization.
The certifications that allow nurses to specialize usually expire after a set period of time such as five years and nurses are required to either retake them or demonstrate they’re still qualified through a program of continuing education and active practice. The DNP, however, is just like any other postgraduate qualification. If the nurse retires or switches career, they still hold claim to their academic title.
What is the typical career path of a DNP nurse?
Most nurses start their careers by pursuing a degree in nursing at the associate’s degree or bachelor’s degree level, before taking the RN licensing examination. After this, they’ll have the opportunity to earn some clinical experience working in hospitals, doctors’ offices, or other settings. The scope of practice of a registered nurse is limited. Registered nurses do a mixture of practical nursing tasks and provide skilled nursing care, but they’re not able to diagnose and prescribe and the work they do must be supervised.
Many nurses are happy doing these hands-on jobs and chose the profession because they want to work in a ward or frontline clinical setting. Some nurses want to take on a more senior role, however, and training to postgraduate degree level allows them to do this.
There are several potential routes to the DNP:
- A BSN-holding nurse can take the MSN, then pursue their DNP
- Some institutions offer BSN to DNP courses that cover the essential modules from the MSN along the way
- An RN with only an ADN could pursue an RN-to-MSN program, then pursue the DNP
In total, it takes around eight years of full-time study to go from deciding to become a nurse to earning the DNP. Some academically gifted people may be able to enroll in accelerated programs and complete their studies more quickly, but in most cases, nurses choose to work and gain clinical experience while completing their studies part time, which makes the progress much slower.
There are benefits to studying part-time. Because the DNP is an academic qualification, it doesn’t confer any extra rights to practice by itself. Nurses need to hold specializations such as the Family Nurse Practitioner Certification (FNP-BC) to be able to practice at an advanced level. There are strict requirements for these certifications.
Using the FNP-BC as an example, to be eligible to take the exam and hold that title, a nurse needs more than just a postgraduate qualification. They will also need to have a valid RN license and a minimum of 500 hours of supervised clinical practice in family nursing. Most DNP and MSN programs offer lots of clinical practice hours as a part of the studies, but it’s a lot easier to build up the practice time required to hold and maintain certifications if you’re working while studying part-time.
What benefits can you expect as a DNP nurse?
Completing a DNP program offers a lot of benefits for those who are interested in pursuing a career in nursing to the highest level. A DNP nurse enjoys a lot of respect from other health care professionals. They have a far wider scope of practice than a nurse that is trained to BSN level. In fact, in some states, a nurse practitioner is allowed to diagnose, prescribe and even run their own practice without the supervision of a doctor.
A DNP nurse is able to provide a higher standard of care than a registered nurse, and they can move into specializations that are not open to nurses with a lower level of education, such as nurse anesthetist or clinical nurse specialist. These positions mean a nurse can work in settings that they have a special interest in, deliver more sophisticated health care services, and work with specific demographics.
DNP-prepared nurses earn higher salaries than their less-qualified counterparts, and they also get to choose the environment they work in. The day-to-day working environment and caseload of a Psychiatric-mental Health Nurse Practitioner would be very different from that of a nurse working on a more general ward in a hospital, for example.
Many DNP nurses opt to move into educator or managerial roles, allowing them to work more stable and predictable hours. While younger nurses might be happy with the hustle and bustle of a clinic or the 12-hour shifts that are seen in a hospital, nurses who are further on in their careers and who have families or other obligations may prefer eight-hour shifts and a little extra time to work with the patients they see.
Why pursue a DNP over an MSN?
If you already have a master’s degree, or you’ve got a bachelor’s degree and are considering your next step in your nursing education, you may be wondering why you would want to become a DNP student. After all, a DNP program takes longer than an MSN and costs more. Plus, if you already have an MSN and a specialization, why spend more time and money on education?
Well, the Doctor of Nursing Practice qualification can future-proof your career as an advanced practice registered nurse or a nurse practitioner. Many nurses who are already qualified to those levels have a master’s degree but no DNP, and they can keep their titles, but the ANCC’s position on DNP programs is that the Doctor of Nursing Practice qualification fills an important role in higher-level nursing care.
It’s still possible for someone to become a nurse practitioner with a master’s degree, but that may change in the future. Today’s nurse practitioners often serve in roles very similar to that of doctors. They’re the first health care professionals that people see when they walk into a clinic and they may even diagnose and prescribe for minor ailments, or order tests for more serious ones.
If you’re interested in being a family nurse practitioner or working in another advanced practice role, then it makes sense to study a DNP. Not only will this future-proof your career and keep open as many options as possible for advancement in the future, but it will also demonstrate that you care about giving your patients the highest quality care possible.
The average salary for a DNP-educated nurses
The Bureau of Labor Statistics lists the average salary of an advanced practice nurse as $115,800 per year, but that figure covers a variety of job titles. Not all nurses will earn the same amount. Job titles, experience, and even which state you work in can all impact your salary.
What is the average starting salary of a DNP nurse?
Salaries vary depending on the role, but nurses who are focused on diagnosis and treatment have an average salary of $82,300. This is lower than that of some more senior nurses in highly specialized positions, but still more than most registered nurses earn, and more than double the national average salary of $39,810.
Where are the highest-paid jobs for DNP nurses?
The nurses with the highest average salary are nurse anesthetists, whom the Bureau of Labor Statistics reports have an average salary of $174,790. Nurse practitioners are the next-highest earners, with an average salary of $109,820. A nurse midwife can expect to earn around $105,030 per year.
The setting in which you work can make a significant difference to your earnings. In general, DNP-educated nurses who work in hospitals earn more than those who work in outpatient care centers or in a physician’s office.
There are exceptions to this, however. A family nurse practitioner could choose to open their own practice if they are in one of the states that grant full practice authority for Nurse Practitioners. This may allow them to earn far more than a staff nurse in a hospital.
There are currently 28 states that offer full practice for nurse practitioners. This means a nurse with a DNP and nurse practitioner licensure has full authority to treat and prescribe without the supervision of a medical doctor. The following states grant full practice to nurse practitioners as soon as they are licensed:
- District of Columbia
- New Hampshire
- New Mexico
- North Dakota
- Rhode Island
In addition to the states listed above, there are several states that grant full practice authority to nurse practitioners after they have been practicing for a set period of time. Whether that time is measured by calendar years or practice hours varies between states:
- Colorado (1,000 clinical practice hours)
- Connecticut (2,000 clinical practice hours over 3 years)
- Delaware (4,000 clinical practice hours over 2 years)
- Illinois (4,000 hours)
- Kentucky (4 years)
- Maine (2 years)
- Maryland (18 months)
- Minnesota (2,080 hours)
- Nebraska (2,000 hours)
- Nevada (2 years post-licensure or 2,000 hours of practice)
- South Dakota (1,040 hours of clinical practice)
- Vermont (2,400 hours of clinical practice over 2 years)
- Virginia (9,000 hours of clinical practice over 5 years)
- West Virginia (3 years)
Why do DNP nurses’ salaries vary by state?
Salaries for nurses, at all levels, can vary significantly from state to state. There are many reasons for the difference in earnings. A part of the disparity can be put down to the cost of living in various states. For example, nurses in California are some of the highest-paid in the country, and nurses in Alabama are among the lowest earners in the profession.
The cost of living in Los Angeles, California is 133.9% more than that of living in Birmingham, Alabama. It makes sense that someone working in Los Angeles would receive a higher salary than someone in Birmingham for the same occupation, just because they need more money to maintain a similar standard of living.
Comparing two extremes is only part of the picture, however. There are other reasons for nursing salaries to vary. Population density, number of hospitals, local funding policies, and localized skills shortages can all make a difference to how much a DNP graduate can earn in a given geographic area. A nurse practitioner or nurse anesthetist who is willing to relocate and chooses their new location wisely could enjoy a significant increase in their standard of living and total disposable income by choosing the right state.
States that pay their DNP-educated nurses the most
A DNP degree is a very highly rated qualification, and because of this DNP graduates can command high salaries. Even nurses in the lowest-paying states can earn almost double the national average salary for all professions. The disparity between the highest-paying states and the lowest-paying states is significant, however.
The top-paying states for nurse practitioners, one of the most common jobs for a DNP graduate are:
- California: $133,780
- Alaska: $122,880
- Massachusetts: $122,740
- New Jersey: $122,100
- New York: $120,570
Hawaii, Minnesota, Connecticut, Washington, and Wyoming round out the top-ten highest paying states for nurse practitioners. In all of these states, a nurse practitioner has the opportunity to earn more than $115,000 per year. Many of these states have a high overall cost of living, but the higher rate of pay will often more than compensate for any increased living costs.
What are the pros and cons of moving for a DNP nursing job?
If you’re looking to maximize your earnings after you graduate from a DNP and start a job in advanced nursing practice, it may make sense to move to a different state. However, there are some challenges associated with this.
Not only does moving mean leaving friends and family behind and facing the practical issues around relocating your home, but it also poses some professional challenges too. The NCLEX-RN examination usually grants you a license to practice as a nurse in a specific state. If you move to another state, you may need to get a license to practice in that state too.
This isn’t always the case. The Nursing Licensure Compact (NLC) is an agreement between several states that allows nurses with licenses from other states that are a part of the compact to practice there. Currently, 30 states are enrolled in the compact and many others are working towards joining it. There are still some states that have not joined the NLC, however. So, before you consider relocating check whether your nursing license will be valid in the state you’re planning to move to.
If you’re looking to move to or from a state that isn’t part of the NLC, you’ll need to apply for a license in that state. Demand for nurses is high in almost every part of the country, and for most nurses earning a second license is a mere formality. It can take some time for applications to be processed, however, so you’ll need to factor that in to any plans for seeking employment.
Salaries of different DNP specialties
A nurse with a DNP can move into almost any career they wish. All of the advanced practice nursing specializations pay more than the average salary of a registered nurse, but some specializations offer much higher than average salaries.
What are the different DNP specialties?
Career options open to a nurse with a doctoral degree include:
- Certified Registered Nurse Anesthetist
- Family Nurse Practitioner
- Psychiatric-mental health nurse practitioner
- Oncology nurse practitioner
- Pediatric nurse practitioner
- Nurse midwife
- Cardiac nurse practitioner
- Clinical nurse specialist
- Nurse researcher
- Pain management nurse
There are many other specializations. A nurse with a doctoral degree who is looking to move out of patient care, for example, could become a nurse educator or an informatics nurse. Alternatively, they might want to consider working in public health at a public policy level, or moving into the back office and working in an administrative role.
The qualifications and experience a doctoral degree holding nurse has make it possible for them to pursue any role that interests them.
What are the highest-paid DNP specialties?
The highest-paid nursing specialty is that of the Certified Registered Nurse Anesthetist. These nurses can earn an average salary of $181,040 per year. Other nurse practitioners and advanced practice nurses can also command high salaries. The top paying nursing specializations include:
- Certified Registered Nurse Anesthetist: $181,040
- Neonatal Nurse Practitioner: $126,486
- Cardiac Nurse Practitioner: $115,260
- Certified Nurse Midwife: $111,958
- Nurse Practitioner: $111,840
- Clinical nurse specialist: $108,475
Why do some DNP specialties command higher salaries?
The pay disparity between different specializations can be attributed to many factors. Firstly, the complexity of the work being done. CRNAs are responsible for preparing patients for surgery, managing anesthetics, and monitoring the well-being of patients during surgery and as they recover from anesthesia. This is a highly skilled job where mistakes can have serious consequences.
These nurses work in a high-pressure environment and are expected to pay attention to detail and follow complex procedures. The pay they receive reflects the work they do. The same can be said for neonatal nurse practitioners who work with newborns who may have been born prematurely or have serious health conditions.
CRNAs may work in clinics that perform scheduled surgeries or they may be attached to an emergency room. Scheduled surgeries are booked for normal working hours but not all surgeries go smoothly. This means these nurses may be expected to work long hours, do overtime, or be on call for emergencies. Neonatal nurse practitioners are needed round-the-clock to provide care.
The working hours of nurse midwives and cardiac nurse practitioners are similar. These nurses provide care when it is needed, which could be on evenings, weekends, or public holidays. Because these specializations require so much training and study time, hospitals may have only a limited number of nurses qualified in that specialization. The few nurses that are trained to that level may be on-call regularly and have to respond to emergencies.
A nurse practitioner who works in a primary health care role in a doctor’s office may earn slightly less than an advanced practice nurse with a hospital-focused specialty. This is not because they’re less qualified or providing less important work. Primary care nurses are the frontline of the medical profession and see patients with a variety of complaints. Sometimes those complaints are relatively minor, but sometimes those patients present with serious medical conditions and the nurse practitioner must use their training to assess and triage the patient and send them for appropriate care.
When you’re choosing your specialization for your DNP, you’ll need to think about what sort of environment you want to work in. If you like the rapidly-changing environment of critical care, becoming a clinical nurse specialist makes sense. If you love babies and are happy with being on call, a neonatal nurse practitioner role could suit you. Don’t forget that once you’ve completed the Advanced Practitioner Essentials once, you won’t have to repeat them to earn a new specialization. The beauty of the nursing profession is that there are many options, and it’s not considered unusual for nurses to move departments throughout their careers.