Doctoral Degrees in Nursing


Career Paths for Nurses with a DNP

Whether you’re looking for a hands-on clinical role or a role that leads or creates policy, there are many career paths for nurses with a DNP.

male administrator talking to colleagues

As a “terminal” degree, the Doctor of Nursing Practice (DNP) is the pinnacle of education in nursing practice. It also can put you at the forefront of nursing with skills that can take you in many directions.

Many of your career opportunities won’t necessarily have to do with hands-on nursing, and the type of doctorate you earn will factor into the work you do. For example, a nurse with a DNP might work as a nurse executive in a hospital or clinic, while a nurse with a Doctor of Nursing Philosophy (PhD) usually focuses on scholarly research.

“DNP graduates can consider advanced roles that perhaps they didn’t think they could pursue before,” says Daria L. Waszak, DNP, RN, CNE, COHN-S, CEN, associate dean and assistant professor at the Department of Graduate Nursing at Felician University in New Jersey. “They can become a leader, entrepreneur, consultant, policymaker, researcher, peer reviewer, writer, expert clinician, speaker, or educator. In many cases, it will be more than (one role) at the same time. The sky is the limit.”

Here’s a primer on some of the DNP career paths you can take.

Types of Jobs

Many nurses with DNPs continue to build their careers as advanced practice registered nurses (APRNs). Others move out of direct care and into nonclinical roles.

All DNP programs provide a core curriculum, and an opportunity to pursue your passion through specialized coursework.

All DNP programs provide a core curriculum, plus an opportunity to pursue your passion through specialized coursework. As part of the core, you’ll learn to evaluate evidence-based research to improve patient outcomes. Then you’ll choose one of two paths:

Clinical roles

in which advanced practice registered nurses (APRN) continue to work directly with patients but with a specialty in assessing, diagnosing, and managing a specific type of patient care

Nonclinical roles

in which advanced practice nurses use their expertise to lead and improve care at the institutional level

“I think that if someone is interested in the advanced clinical practice degree [DNP], whatever flavor that is, from there go into what you want to do whether it’s administration, academia, research, informatics, or patient care,” says David G. Campbell-O’Dell, DNP, APRN, FNP-BC, FAANP, president of the professional association Doctors of Nursing Practice Inc. “I think that those who do not get the advanced clinical practice degree are going to be limited in the long run.”

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Clinical Career Paths

DNP programs with a clinical focus include:

  • Certified nurse practitioner (CNP)
  • Certified nurse midwife (CNM)
  • Certified registered nurse anesthetist (CRNA)
  • Clinical nurse specialist (CNS)

Advanced practice nurses in these clinical roles can have their own private practice, depending on the state. Otherwise, they generally work in:

  • Physicians’ offices
  • Medical and surgical hospitals
  • Outpatient care centers

Depending on their expertise, nurses with DNPs in clinical roles also may work in other settings. Here’s a look at clinical roles and additional workplaces.

Certified Nurse Practitioner (CNP)

  • Provides primary, acute, and specialty patient care as an independent practitioner or in collaboration with other healthcare providers
  • Specializes in at least one patient population

Additional Workplaces

  • Offices of providers other than physicians (chiropractors, podiatrists, etc.)
  • Colleges, universities, and professional schools
  • Hospice care
  • School or university clinics

Certified Registered Nurse Anesthetist (CRNA)

  • Administers general, regional, and local anesthesia
  • Works as part of healthcare teams in surgery, diagnostic tests, newborn deliveries, pain management, and trauma stabilization

Additional Workplaces

  • Offices of health practitioners other than physicians (podiatrists, dentists, etc.)
  • Colleges, universities, and professional schools
  • Specialty hospitals

Clinical Nurse Specialist (CNS)

  • Applies evidence-based research to a specialty
  • Diagnoses and cares for patients
  • Serves as an educator, researcher, and consultant to interdisciplinary colleagues
  • Provides expert support to bedside nurses to improve care systems and patient outcomes

Additional Workplaces

  • Nursing care facilities
  • Home health care services
  • Emergency rooms
  • Laboratories

Certified Nurse Midwife (CNM)

  • Cares for pregnant women
  • Educates expectant parents on newborn care
  • Attends births
  • Provides primary care for women

Additional Workplaces

  • Birth centers
  • In-home birth services
  • Specialty hospitals
  • Colleges, universities, and professional schools

Clinical Specialty Areas

While certified nurse midwives and certified registered nurse anesthetists are specialties in themselves, nurse practitioners and clinical nurse specialists select a specialty to pursue.

Nurse practitioners specialize in one of the following patient populations:

  • Family/individual across the lifespan
  • Adult-gerontology
  • Neonatal
  • Pediatrics
  • Women’s health/gender-related
  • Psych/mental health

Clinical nurse specialists focus on specialties defined by:

  • Patient population (neonatal, pediatrics, adult, etc.)
  • Medical setting (critical care, emergency room, medical/surgical units, etc.)
  • Disease (oncology, diabetes, etc.)
  • Patient care needed (rehabilitation, psychiatric, etc.)
  • Problem (stress pain, wounds, etc.)

The different ways of describing practice areas for nurse practitioners and clinical nurse specialists reflect the subtle difference between these roles:

  • Generally, certified nurse practitioners provide direct care to a specific patient population.
  • Clinical nurse specialists can provide patient care, but they also manage the care of complex patient populations, work for improvements in healthcare systems and patient outcomes, and serve as expert consultants.

Top NP Specialties

nurse anesthetist in operating room administering anesthesia

An APRN’s specialty will determine what certification exam they will need to take to be licensed. Here’s a look at the top specialties for nurse practitioners and required certification.

Family Nurse Practitioner (FNP)

Specialty Information

  • Provides preventive care and treatment for patients from infants to senior adults
  • Diagnoses and treats patients with acute, and chronic health issues
  • Can further specialize in areas such as diabetes, pain management, or obesity management  
  • Together, represent about 67% of all NPs, according to the AANP

Certification

One of the following, depending on state requirements:

  • Family Nurse Practitioner—Board Certified (FNP-BC) from the American Nurses Credentialing Center (ANCC)
  • Family Nurse Practitioner—Certified (FNP-C) from the American Academy of Nurse Practitioners (AANP)

Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP)

Specialty Information

  • Provides care for adults into advanced age
  • Diagnoses and treats patients
  • Educates patients about managing illnesses and acute and chronic conditions
  • Works with families and caregivers to facilitate patient care

Certification

One of the following, depending on state requirements:

  • Adult-Gerontology Primary Care Nurse Practitioner—Board Certified (AGPCNP-BC) from the ANCC
  • Adult-Gerontology Primary Care Nurse Practitioner (A-GNP) from the AANP

Pediatric—Primary Care Nurse Practitioner (PNP)

Specialty Information

  • Cares for children from birth through adolescence
  • Interacts with family members more than other NP specialties
  • Focuses on preventive care and managing acute and chronic pediatric illnesses
  • Educates patients and families about care

Certification

  • Primary Care Certified Pediatric Nurse Practitioner (CPNP-PC) from the Pediatric Nursing Certification Board (PNCB)

Top Specialties for Clinical Nurse Specialists

As you’ll see, the names of the top specialties for CNSs might sound similar to the names of NP specialties, but the job descriptions and required certification are very different.

Adult-Gerontology Clinical Nurse Specialist (AGCNS)

Specialty Information

  • Applies evidence-based research to nursing practice related to young adults through advanced age
  • Diagnose and care for adult patients
  • Serves as an educator, researcher, and consultant to interdisciplinary colleagues
  • Provides expert consultation on system improvements and patient outcomes

Certification

One of the following, depending on state requirements:

  • Adult-Gerontology Clinical Nurse Specialist Certification (AGCNS-BC) from ANCC
  • Acute Care Clinical Nurse Specialist—Adult Gerontology (ACCNS-AG) from the American Association of Critical-Care Nurses (AACN)

Pediatric Clinical Nurse Specialist (PCNS)

Specialty Information

  • Applies evidence-based research to nursing practice related to infants and children
  • Cares for pediatric patients
  • Serves as an educator, researcher, and consultant to interdisciplinary colleagues
  • Provides expert consultation on system improvements and patient outcomes

Certification

  • Acute Clinical Care Nurse Specialist—Pediatric (ACCNS-P) from AACN

Neonatal Clinical Nurse Specialist (NCNS)

Specialty Information

  • Applies evidence-based research to nursing practice related sick or premature newborns in intensive care
  • Cares for these newborns
  • Serves as an educator, researcher, and consultant to interdisciplinary colleagues
  • Provides expert consultation on system improvements and patient outcomes

Certification

  • Acute Clinical Care Nurse Specialist – Neonatal (AACNS-N) from AACN

Common Nonclinical Roles and Workplaces

Nonclinical DNP programs that emphasize leadership, management, policymaking, and other areas away from the bedside include:

Populations

Organizational management

Systems (including information systems)

State or national healthcare policy

Nurses with DNPs who pursue nonclinical roles may work in general medical hospitals, but they can work in many other settings as well.

Executive Nurse Leader

Role information:

  • Designs and manages patient care processes
  • Develops organizational policies and procedures
  • Creates facility-wide budgets
  • Collaborates with other healthcare professionals on organizational issues

Also works in:

  • Outpatient care centers
  • Nursing care centers
  • Nursing schools
  • Independent consulting practice

Nurse Manager

Role information:

  • Oversees nursing staff in a healthcare facility
  • Creates employee schedules
  • Interviews and hires new nurses
  • Manages budgets
  • Collaborates with medical staff and other healthcare professionals

Also works in:

  • Urgent care clinics
  • Physicians’ offices
  • Home health care services
  • Nursing care centers

Nurse Informaticist

Role information:

  • Integrates nursing science, computer science, and information science to improve the health of populations, communities, families, and individuals
  • Analyses data to improve patient systems and outcomes
  • Researches, manages, and shares health information and data

Also works in:

  • Healthcare facilities
  • Healthcare consulting firms
  • Colleges and universities
  • Healthcare product manufacturers
  • Long-term care facilities

Clinical Trainer

Role information:

  • Educates future and practicing nurses about theory and skills related to evidence-based practice
  • Designs curriculum for clinical training
  • Uses research on nursing practice to design course models

Also works in:

  • Colleges, universities, and professional schools
  • Junior colleges
  • Technical and trade schools
  • Educational support services

Certification for nonclinical roles like these can vary based on experience, a nurse’s specific position and workplace. Here are three common certifications for nonclinical roles:

Nurse Manager/Nurse Administrator

Certified Nurse Manager and Leader (CNML) from American Organization for Nursing Leadership (AONL)


Nurse Informaticist

Informatics Nursing Certification (RN-BC) from ANCC


Clinical Trainer

Certified Nurse Educator (CNE) from National League for Nursing (NLN)

Certified Academic Clinical Nurse Educator (CNEcl) from NLN

What Can I Expect to Earn?

Salary data from the U.S. Bureau of Labor Statistics (BLS) doesn’t report nursing salaries by degree, so it can be difficult to determine specific salaries for nurses with a DNP.  However, chances of earning a higher salary with a DNP can be a good bet.

Typically, the higher your education and the more certifications you have, the better your job opportunities and salary, says Campbell-O’Dell. For instance, the BLS reports that RNs, a category that includes nurses with all levels of education, earn an average annual salary of $77,460, while CRNAs earn an average of $181,040.

$77,460
Average Annual Salary for RNs

$181,040
Average Annual Salary for CRNAs

With a DNP, you can land on the higher end of the salary spectrum for a position. Surveys indicate that a DNP nurse makes more than nurses without DNPs in the same role, says Campbell-O’Dell.

Advancing Your Career

Even with a DNP, there can still be room to push your career ahead. For instance, you can add more specialty certifications or narrow your practice focus with certification in a subspecialty. If you decide to do this, consider where there’s demand and room for growth in nursing.

Two areas where a post-DNP certificate may be especially useful are education and executive leadership.

Two areas where a post-DNP certificate may be especially useful are education and executive leadership.

“I think we will continue to see a demand for DNP-prepared professionals who are skilled in nursing practice but especially in leadership,” Waszak says. “We are also seeing more and more nurse faculty with a DNP degree.”

Whether you decide to earn your DNP or you already have one and want to add a certification, you’ll find many options for online doctoral education. While you’ll have to complete clinical hours at an approved site and may have some onsite class requirements, online learning can allow you some flexibility to achieve your educational goals.


anna giorgi

Written and reported by:

Anna Giorgi

Contributing Writer

With professional insight from:

David Campbell-O’Dell, DNP, APRN, FNP-BC, FAANP

President, Doctors of Nursing Practice, Inc.

Daria Waszak, DNP, RN, CNE, COHN-S, CEN

Associate Dean and Assistant Professor, Department of Graduate Nursing, Felician University


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