4: HOW DOCTORAL-LEVEL ADVANCED PRACTICE ROLES DIFFER ■ 129health care landscape, the DNP can assist advance practice nurses to increase their respec-
tive knowledge and skills in many areas already noted within this chapter. Having a DNP
seems to “level the playing field” or create parity with other practice disciplines when
working on multidisciplinary projects within health care settings. It is also a degree that
is embraced by administrators as in many instances the DNP- prepared APRN has knowl-
edge of organizational and systems thinking that can be applied to quality improvement
projects or evidence- based practice initiatives that ultimately lead to improved patient
care outcomes. Thus, in many instances the DNP- prepared APRN makes the institution,
department, or program “look good” in the eyes of accreditors, patients, and other stake-
holders. There has been concern raised about who will hire NPs with a practice doctorate
and whether the pay they receive would be worth the additional education. A most recent
2014 salary survey conducted by Advance Healthcare Network (2015) estimated that NPs
with a DNP are receiving an average salary of $113,618. This is approximately $13,000
more than the average salary of a master’s-prepared NP. This is also close to a $4,500 gain
since the same organization’s 2011 salary survey. What will happen in the future across a
larger geographic landscape, increased number of DNP- prepared graduates entering the
profession and an influx health care system remain to be seen.
■ SUMMARY
The evolution of APRN education from the master’s to the doctorate level appears to be
here to stay. As Dreher (2005) stated: “Has this train left the station? If so, just where is it
going?” (p. 17). The issues surrounding this transition will most likely continue to be de-
bated for some time, and the ultimate direction of the DNP degree is still unfolding. We
think that active, practicing DNP graduates can actually shape the future of this degree
with our critical mass. We absolutely want more outcome data on what these graduates
are accomplishing. We even welcome any constructive criticism, especially if there are
DNP programs that proliferate that are not rigorous or that aim to create an easy path to
the title “Dr.” Weak DNP programs will harm us all and not advance the nation’s health.
We also call for the DNP graduate to advance “practice knowledge development” as
has been advocated by Dreher (2010) who also contends the DNP graduate should be
the leader in creating practice- based evidence for the discipline. DNP- prepared APRNs
have quickly positioned themselves to become an integral part of our discipline’s fu-
ture. They not only carry with them a unique preparation for diverse health care roles,
but a plethora of opportunities for advancement in the arenas of practice, leadership,
education, and applied research awaits them.
So, exactly how is the MSN different from the DNP? Why take the leap into
obtaining a practice doctorate in nursing? The answers to these questions will be dif-
ferent for every nurse practicing in the clinical arena. You will decide if you want
more. However, one fact is clear: The MSN degree allows you to be part of the change
to improve the quality of patient care you provide, while the DNP equips you to col-
laborate more inter- professionally (and with more confidence) to be the change and
advance the discipline. This degree opens your professional world to a myriad of new
lenses, new options, and new agendas with which to advance nursing and make a true
impact on the patients you serve and to the larger aggregate through your disseminated
clinical scholarship. To reiterate our warning at the beginning of the chapter, proceed
with caution! When you obtain the DNP, you will be different. Your professional eyes
will be open more widely to many more challenges. Your metamorphosis, we attest,
will be profound.