The Value of the DNP; Job Market Outlook/Compensation

[Avery H.]

The DNP is primarily a practice degree and many of us work or are planning to work in clinical practice settings, where we might meet an APRN without a doctorate in the same or similar role as us, with the same or very similar salary or compensation. These instances have obviously caused for some discussion and lead some to conclude that it is unnecessary to obtain the DNP, which I can understand. But, is there more for DNP prepared APRNs, other than the title? The DNP is relatively new, so maybe with more time our value will increase. Maybe, as this health delivery system continues to change, the DNP will show its true worth? Maybe, we ought to compensate DNPs more than APRNs. Thoughts?

[Patricia Boyle]

Just like in any job setting it would be appropriate to compensate the advanced practice Nurse for education completed. As California turns toward independent nurse practitioners, and the public becomes more educated on their patient rights, I believe there will be more patients that pay attention and choose DNP‘s. This will increase the demand of doctorate prepared nurse practitioners thus increasing our salary or compensation. The reality is that no position as a nurse is 100% equal in salary to those around them whether in the same hospital or a different facility. I have learned over the years that typically higher pay is not always a compensation or reflection on work completed. Although it would be nice to be compensated monetarily for work completed we have chosen a profession where most of the days our payment is through the smile and health of our patients. It is necessary to continue to advocate for nurse practitioners to become doctorate prepared so that horizontal violence from other practitioners is a thing of the past. Personally speaking, now that California passed the bill that will allow nurse practitioners to be independent, our work will be compensated the same as a physician. As a mental health nurse practitioner I will be competing with other psychiatrists for patients and monetary compensation. Therefore there will be no need to compete or compare myself with other nurse practitioners, no matter their degree completed, because the consumer the patient will be deciding and paying me for service. I can guarantee that my services and care provider will be superior to that of a master degree Mental health nurse practitioner and I will continue to advocate to other practitioners to obtain a doctorate.

[Carolyn Ann Wilder]

The topic of salary and compensation for nursing professionals will continue to be a discussion of considerable interest. If we look at those employed in business or medicine in comparison to those in the nursing profession we see hierarchal patterns with increased income potential and benefits. For example, in business we have staff, supervisor, manager, director, vice president, president, and CEO. In the medical profession we have medical student, intern, resident, fellow, and attending. To some degree this is also the case for nursing yet the structure varies because nursing has a variety of degree levels from LVN, ADN, BSN, MSN, APN, and PhD. As with other professions, it only makes sense that as education and career advancements occur, so should the salary and benefits. Yet, perhaps the DNP is still in its infancy and so the value viewed by society, medical facilities, and the nursing profession is limited at this point and will continue to grow as more become educated on the benefits of the DNP as the terminal practice degree for nursing. Similarly, as education about what the DNP is and does will increase interest in the degree and as healthcare continues to evolve in the United States the demand for equality of care and access to care will increase the demand for DNP practice. These and other advancements will aid in increasing the presence of the DNP and therefore, salaries and benefits of the DNP.

[Chinegbonkpa Audrey Akanno]

The value of the DNP has been changing due to availability, time, and experience. The benefits of having the DNP consist of getting higher pay, being ahead of time (DNP is going to be the requirement in becoming an advanced registered nurse soon), open oneself to more opportunities, and to be on par with other healthcare professionals. However, the outlook of the DNP can also change by refining the educational requirements and standards within the DNP program and the clinical training provided. I believe changes to these things will give nurse practitioners the option to be independent practitioners in all states of the country. Furthermore, if the public considers to be cared by DNPs, the reputation will be better and the stigma will lessen leading more people to consider becoming a DNP or see a DNP primarily. Ultimately, I do believe that DNP’s should have the highest compensation due to the education and clinical training required in the nursing field.

[Alan]

The role and responsibilities of DNPs go beyond just functioning in a clinical practice setting. DNPs work in academia, administration, and conduct research to influence nursing practices based on evidence. Additionally, DNPs seek to improve quality care and healthcare delivery systems (Gaines, 2021). Appropriate compensation for DNPs is an important topic, and those who pursue higher education and have earned a terminal degree deserve higher salaries. If there is no significant difference in salary between APRNs with a Master’s or Doctorate degree, nurses would have no incentive to pursue a terminal degree in their specialty. DNP-prepared nurses undergo additional education and training, which allows the development of advanced clinical and leadership skills and a better understanding of systems thinking.

[Xochitl Torres]

The Doctor of Nursing Practice (DNP) helps prepare and qualifies nurses for advanced positions in the clinical setting and executive and director-level roles that deal with policy development and decision-making. Thus, compensation and recognition in the job market should move to reflect the difference of scope of work and responsibility when compared to other advance practice registered nursing professionals. Doctor of Nursing Practice professionals are becoming one of the most common positions under the umbrella of advanced practice registered nurses with benefits of greater autonomy. They are charged with not only helping to treat patients but also lead plan of care with diagnosing illness. Some states in the country permit DNPs work without an attending physician or practice semi-independent. According to the US Bureau of Labor Statistics, nurse practitioners make a median annual salary of 117,00 in 2020. However, up to date, no differentiation was made between the salary of Doctor of Nursing Practice and Nursing Practice health care professional. My hope is that as we move forward and the health care system continues to change and adapt, the market (patients, health institutions and insurance companies) see the benefits of leadership and autonomy in Doctors of Nursing Practices and compensation changes among these professions.

[Brittanee Dominick]

The Doctor of Nursing Practice (DNP) degree not only provides education for the APRN to function as an independent advanced care provider, but the education involved in the doctoral degree prepares the advanced practice practitioner to be a leader in their field, to make changes in policies and academia, and allows them the autonomy to be change agents in the field of nursing as a whole. This increases the fortitude and value of the DNP in healthcare. With practice-led education, the DNP graduate not only can independently diagnose and treat a patient from start to finish, the DNP graduate can also participate in other aspects of healthcare, and contribute to positive changes through evidence-based practice. Overall, the terminal degree for the APRN, the DNP not only provides more autonomy for the advanced practitioner, but creates safer working environments for patients, with motivated and educated healthcare practitioners working with the public. In regards to compensation, the DNP graduate should be compensated appropriately based on their education and contribution to the healthcare world, which is tremendous.

[Steven Watson]

Hi Avery,

I like your question because it is one I asked myself a lot before deciding to go back to school. I think everyone should do an honest cost-benefit analysis for the options in their situation. This topic is not limited to advanced practice either as nurses starting out have many options. For example, my sister once found a job as a licensed nursing assistant which paid only $3/hr less than my Bachelor’s degree with 5-6 years experience, granted our scope of practice was quite different.

I found an interesting comparison on Michigan State University’s website between their MSN & DNP programs. Both curriculums take the same core classes and 4 classes in diagnosis & management with the DNP track adding a 5th class in diagnosis and management and 3 classes for the DNP project. The written description of the DNP track included the statement “The program develops practitioners who design, implement and evaluate high quality and cost-effective health care services for diverse populations including the disadvantaged and underserved.” If I am reading between the lines correctly, that means the MSN track does not include all aspects of design, implementation, and evaluation. This leads me to believe that MSN-prepared APRNs may be restricted in their role to implementing the evidence-based practices which the DNP’s design and evaluate, based on the research of Ph.D. prepared nurses. If this is right MSN prepared APRNs may have difficulty when seeking positions that require program development and evaluation.
As for the pay…

[Dannielle Ivey]

Hi Avery,
I think you raise a good point about compensation, for DNP graduates. In my opinion, those with the DNP that have passed their national certification exam should be competitively compensated. A Doctoral prepared APRN is the terminal degree in nursing so in my mind they should have a higher rate of pay than a masters prepared (MSN) APRN performing in the same roll. However most institutions I believe do not acknowledge the distinction and will offer the same compensation for a DNP and MSN because if the role can be filled by either graduate. This is unfortunate but the reality of institutions trying to save a buck. In most cases the DNP graduate brings more clinical experience, along with systems assessment skills, policy and practice ability and evidence based practice knowledge to a role than what a MSN- prepared APRN would bring. Another observation I have in favor of the DNP receiving higher wages is that their may be less motivation for graduate nursing students to complete a DNP over an MSN degree if there is no difference in compensation.

[Ernst Uychocde]

The value of the DNP is not limited to job market outlook/compensation, but it is a vital aspect to note when pursuing the degree. I believe that APRNs with a doctoral degree should have a higher rate of pay than masters prepared APRNs. As mentioned above, hospitals will probably hire a master prepared APRN over a doctoral prepared one because of the cost. However, being a doctoral-prepared advanced practice nurse in the field can be competitive when it comes to taking jobs in magnet hospitals, as well as becoming faculty at a university.

Although we pursued/are pursuing a higher level degree of nursing because we want to make advancements in healthcare, we should be compensated for the hard work we do. Using your education and experience as leverage to help you advance in your career should not be frowned upon and competitive compensation should be encouraged.

Lastly, I encourage DNP students to advocate for new positions at their current place of work when they graduate. Sometimes there are positions that do not exist, especially in smaller organizations, that may be created for the DNP graduate that will both benefit the organization, patients, and the APRN.

[YuJin]

For now, the entry-level of nurse practitioners is a master’s degree. From a cost-effectiveness perspective, the hiring hospitals or clinics will seek a person who is confident about the work but at the same time, lower labor costs. So, it does make sense that there are no differences in compensation standpoint between DNP and NP. However, when the law changes the nurse practitioner entry level to DNP, I think the pay scale should compensate for the extra educational cost. For now, getting DNP is more like being competitive in the nurse practitioner labor market and advancing nursing professions for a higher educational standard which helps to provide quality care for the patients.

[Samuel]

Hi Avery,

The DNP certainly goes through more rigor than other graduate nursing degrees. However, there is not a big enough gap in practical terms as to what a DNP could do compared to an MS-NP. Now, a DNP should definitely receive compensation for roles that a master’s level nursing degree cannot achieve like leadership positions, but I do not think most DNPs are too concerned about the money. There is also a trend right now, in 2023, of professional nursing organizations moving away from master’s prepared NPsl; similar to how hospitals have a preference for BSN new graduates over ADN new graduates. I think MS-NP will eventually phase out of most major hospitals. DNPs will have more value by that time and should be compensated accordingly.

[Anonymous]

I recently talked with a DNP practicing in the clinical setting amongst other MSN-prepared nurse practitioners, and she told me that her compensation is comparable, if not the same to her colleagues. I believe DNPs do not pursue their degree for compensation or the title, but DNPs pursue this track to make a difference in healthcare. However, DNPs should be competitively compensated for the degree earned. RNs with a BSN are compensated more than their colleagues with an ADN. This is because RNs with a BSN have received more rigorous educational training to prepare them for their nursing roles. Similarly, DNPs receive rigorous education and training to achieve high-level systems thinking and competencies and should be adequately compensated.

One reason that DNPs may not be compensated to the extent of their degree is due to the newness of the degree. While the DNP degree has been around for some time, patients, colleagues, and the public still do not clearly understand the DNP role. As such, DNPs may not be utilized to their full potential when hired. DNPs are responsible for educating their patients, colleagues, and the public about their credentials. DNPs practicing in the clinical setting have been trained with mastery of numerous valuable competencies: leadership, evidence-based practice, and advanced assessments. In addition, DNPs practice in various settings: academia, administration, and clinical. For years, it has been said that the DNP will be the new entry to practice for NPs, but this transition has yet to occur fully. Perhaps when this transition does fully occur, DNPs will start to be fairly compensated for the value they bring to the healthcare team. In the meantime, I encourage DNPs to advocate for their value and deserved compensation in the healthcare field.

[Christina]

I believe since the time that this forum topic was originally posted, the value of the DNP has increased. A DNP is the highest level of nursing education and expertise within the nursing profession. Just like APRNs, DNPs can work in nursing administration or direct patient care as an advanced practice registered nurse. DNPs are valuable because they can also implement health policy and influence healthcare outcomes as they can be utilized as health care system leaders.

With regards to advancement, A DNP is a terminal degree. This means that it is the highest degree that can be earned in that specialty. An MSN is NOT a terminal degree. Therefore, it gives a sense of value knowing that you have reached the highest level in your career. With regards to compensation, according to Payscale, nurses with a Doctor of Nursing Practice (DNP) degree earned an average base salary of $107K as of June 2022. Nurses with a Master of Science in Nursing (MSN) degree, on the other hand, earned an average salary of $98k, $9k less per year than the DNP degree.

The American Association of Colleges of Nursing (AACN), states that transitioning from advanced practice NP degrees to the doctoral level is a “…response to changes in health care delivery and emerging healthcare needs, additional knowledge or content areas have been identified by practicing nurses. In addition, the knowledge required to provide leadership in the discipline of nursing is so complex and rapidly changing that additional or doctoral level education is needed.” Essentially, DNP graduates are leaders in advanced nursing practice that bring evidence-based knowledge into the clinical setting to help improve healthcare outcomes and strengthen the leadership role of nurses in both the clinical and academic setting.

To conclude, yes, I do believe that with time the value of the DNP will continue to increase substantially, just as it has within these past few years as more educational institutions are offering the program and more APRNs are seeking the advanced degree.

[Jeffrey]

Hi Avery,

The issue of compensation for DNPs is one that often discourages bachelors-trained nurses from pursuing an advanced practice nursing degree. One coworker completed her DNP degree; however, she still works bedside because she can make more money working four to five days a week than she could as an APRN. Similar to many other professions with doctoral terminal degrees, payment does not necessarily correspond to the amount of education required for that position. However, one of the most significant differences is that APRNs with a DNP are more competitive and may find more opportunities in leadership positions.

Another issue related to compensation is independent practice. In states with restricted and reduced practice, APRNs are paid less than in states with full or independent practice. Currently, in California, APRNs have reduced practice authority; however, starting in 2026, they will finally be able to practice independently. Under the current practice standards, nurse practitioners work under the supervision of a physician who is compensated much more, even though the physician may not see patients. Full practice authority will allow facilities to spend much less because physician oversight will no longer be required by law, so nurse practitioners will have more bargaining power when negotiating salary.

[Soh]

Hello Avery,

This is a valid topic to discuss about so thank you for bringing this up. A doctorate in nursing is the highest degree available. However, most of the master degree nurse practitioners get paid on the same scale as doctorate nurse practitioners. There are some states that have nurse practitioners practice independently and in this case they can earn more. The idea behind this is similar to the fact that there aren’t wage difference between ADN and BSN nurses. Obtaining a BSN only allows more opportunities for higher earning such as being involved with management or working as an educator. By obtaining a doctorate, the APRN has many opportunities to be involved with research, policy changes and provide leadership in both clinical and academic setting. I do think that doctorate should be paid more but it is more dependent on the area they work in and the expertise they carry through experience. Another factor to consider is that NPs get paid more in rural areas where the need is greater. Also in more developed areas, there can be a saturation of NPs that causes many NPs to work as a bedside RN until they are able to find NP positions. As more DNPs are arising, I hope that we can influence more changes to health policies and that the value of the DNP will increase.

[Aiden]

Hello Avery,

Thank you for bringing up this topic. It is exciting to know about my future job market and compensation. Even though DNP is the highest degree in nursing, it is still relatively new. According to the information from the Payscale, the most up-to-date salary for a DNP in California is approximately $121,000. However, location, specialty, and experience significantly determine the actual salary. The Bureau of Labor and Statistics projects an approximately 46% occupational growth rate in 10 years between 2021 and 2031. In addition, the job growth can be attributed to an aging population living longer with a wide range of comorbidities. Many nurses are also retiring. The shortage means the opportunities for DNP will grow even more. Likely, the salary for future DNP graduates will be higher along with demand. The salary is not significantly different between DNP and MSN degrees. However, the DNP degree may have more leadership and career research opportunities.

[Sudi]

Hi, Avery; thanks for bringing up this topic. DNPs should receive the highest compensation due to their education and clinical training. A DNP is a terminal degree for advanced practice nurses. The American Association of Colleges of Nursing (AACN) states that transitioning from advanced practice NP degrees to the doctoral level is a “…response to changes in healthcare delivery and emerging healthcare needs; additional knowledge or content areas have been identified by practicing nurses. In addition, the knowledge required to provide leadership in the discipline of nursing is so complex and rapidly changing that additional or doctoral level education is needed.” It implies that DNP graduates are leaders in advanced nursing practice who bring evidence-based knowledge into the clinical setting to help improve healthcare outcomes and strengthen the leadership role of nurses in both clinical and academic settings.

Appropriate compensation for DNPs is an important topic, and those who pursue higher education and have earned a terminal degree deserve higher salaries. If there is no significant difference in salary between APRNs with a Master’s or Doctorate, nurses would have no incentive to pursue a terminal degree in their specialty. According to Payscale, nurses with a Doctor of Nursing Practice (DNP) degree earned an average base salary of $107K as of June 2022. Nurses with a Master of Science in Nursing (MSN) degree, on the other hand, earned an average salary of $98k, $9k less per year than those with a DNP degree.

The DNP is still in its infancy, so the value viewed by society, medical facilities, and the nursing profession is limited and will continue to grow. The demand for equality of care and access to care will increase the demand for DNP practice, which will aid in increasing the DNP’s presence and, thus, the salaries and benefits of the DNP. Thanks for sharing.

[Jennifer]

I think you are exactly right, as time goes on more and more people will obtain their DNP and the value of having one will be important. It is also interesting that you bring up that a difference between the Masters and the DNP (from the outside) is the title. I think people you are working with will know you have a DNP, but patients may never know. Especially because we couldn’t actually use the title “doctor”. On this forum, you can also read about the new bill (AB-765) and issues with using the title “doctor” in the clinical setting. I interviewed my advisor at school, and he said that both MSN and DNP nurses work and practice together seamlessly. He believes what sets you aside is the way you think about things, and how you are able to ask deeper questions. I also definitely agree we should be compensated more for having our doctorate. It makes sense with more education the salary would be higher. Not sure this is happening yet, but one day.

[Anonymous]

DNP-prepared APRNs stand out because it is a terminal degree. I have interviewed A DNP FNP who initially had her master’s. She shared that going through a DNP program allowed her to go even more in-depth with research and her research skills. Just this alone brings so much value to the DNP-prepared APRN because we see that the IOM’s report addresses current healthcare-related illnesses or injuries. Injuries in healthcare are 100% preventable if one is prepared with the experience and the knowledge to combat current and evolving healthcare complexities. A DNP program allows the already experienced nurses to take their education and knowledge to the ultimate step. This will not only prepare the APRN, but it will also allow for safe practice. In addition, there is a new bill in California, where I currently practice as a registered nurse, AB890. This bill will allow APRNs to practice independently and even open their practice. I do not know how it is in other states where this is already the case, but in California it is new. With this being said, I believe DNP-APRNs should have better compensation as independent providers.

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