Being a nurse is a varied profession with lots of scope for progression in many different directions. Most people start their career ‘at the bottom’ as a Certified Nursing Assistant, a Licensed Practical/Vocational Nurse, or a Registered Nurse. They might then go back to studying—often while continuing to work—and obtain a Master of Science in Nursing, which opens the door for promotion to Advanced Practice Registered Nurse, such as a nurse practitioner, a certified nurse-midwife, a certified nurse anesthetist, or a clinical nurse specialist.
If you have got this far in your career and worked as an advanced practice registered nurse for a few years, you might be feeling the itch to progress again and try to land an even more advanced nursing role. As nursing is a heavily regulated profession, you are probably already aware that you will most likely need a doctoral-level degree in order to progress to the next step in your nursing career. The two types of doctoral degrees available in nursing are a Doctor of Nursing Practice (DNP) degree or a PhD in nursing. Here is a guide to help you understand the difference between the two types of programs and decide which one is best for you.
Why two terminal degrees?
Unfortunately, in past decades, some universities were reluctant to create PhD programs for nurses because they did not believe there was such a thing as ‘nursing science’. This led to individual schools of nursing within said universities creating their own alternative terminal degrees, which led to titles such as Doctor of Nursing Science and Doctor of Science in Nursing. Once there were enough nurses with doctorates working in a particular school of nursing’s faculty to prove to the university’s administrators that the school had a solid research training program in place, these degrees became PhD programs.
Over the past couple of decades, however, many nursing schools and organizations have come to the conclusion that it would be beneficial to the expansion and improvement of the nursing profession to have two terminal degrees available to nurses: a research-focused one (the PhD) and a practice-focused one (what became the DNP). Proponents of the DNP argued that a practice-focused terminal degree in nursing would lead to changes in nursing practice born from the student’s immersion in clinical practice itself, as opposed to the lab environment which most Nursing PhD students work in. Thus, the Doctor of Nursing Practice degree was born.
What are the differences between a DNP and a Nursing PhD?
A PhD in Nursing, like one in any other discipline, is focused primarily on training students to become competent researchers in their field. As a Nursing PhD student, you will take classes, especially in the first part of your degree, that will teach you how to carry out scientific research; these may include courses on statistics, putting together a funding application and how to conduct research ethically. You will also do lab rotations, which means working in a research lab for a few weeks or months at a time and then moving on to a different one, in order to get a feel for how different labs work and to experience doing research in different subjects and with different instruments. Finally, you will work with your supervisor to design an original research project, which you will complete in your ‘thesis lab’.
On the other hand, a DNP degree exists to train nursing leaders. Nurses will come to a DNP having spent years working in clinical practice, they will be required to complete several hours of clinical work during the program, and they will leave the program prepared to work as leaders within clinical settings, in roles such as nurse manager, nursing director, and vice president of nursing (see below for more details on each of these jobs). While many DNP programs require students to complete a research project, the focus of this type of degree is not on the expansion of scientific knowledge as such, but rather on the application of both existing and new scientific knowledge to clinical practice.
On a practical level, DNP and Nursing PhD programs often share similar characteristics:
- they usually take at least two to three years to complete;
- they can sometimes be completed online, with clinical placements (for a DNP) or lab rotations (for a PhD) organized in a setting close to where you live;
- they can often be pursued part-time while continuing to work, although you are unlikely to be able to manage more than a part-time job while studying for such an intensive program.
What will my career look like with either degree?
A Ph.D. in Nursing will prepare you to work as a nurse researcher (also known as a research nurse). This job is similar to that of a research doctor or another research scientist, especially those who work in the various fields of human biology, such as immunology or human biochemistry. As a nurse researcher you will:
- design and conduct clinical trials, usually as part of a team of researchers;
- submit funding applications and update your funders on the progress of your research;
- analyze your findings, create graphs, and write up your research into journal articles;
- submit your articles to scientific journals;
- attend scientific conferences and present your findings there;
- teach and supervise nursing students, either in the lecture hall, in the lab, or in a clinical setting.
A DNP degree, on the other hand, is a way to advance your clinical practice career and help you achieve the highest nursing management positions available. Here are some of the most common job roles that DNP graduates go on to:
- Nurse Manager: this is a step up from positions such as Charge Nurse, Unit Manager, or RN Supervisor. As a nurse manager, you will be responsible for leading a whole nursing unit, which will include tasks such as supervising the unit’s care delivery systems to ensure that best practices are followed, liaising with the nursing director to set goals for the department, and ensuring compliance with local, state, and federal regulations. Nurse managers typically have few hands-on clinical duties.
- Nursing Director, or Director of Nursing: this role is the next step up from being a nurse manager, and it involves a bigger focus on long-term, strategic goals. In this job, you will develop, review, and update policies for all nursing personnel in your workplace to follow, as well as maintain the nursing department’s budget, set goals for the department to achieve, and oversee all processes in which nurses are involved. By this point in your career, you will have no clinical duties, as you will be required to focus on ‘the big picture.’
- Vice President of Nursing, also known as Chief Nursing Officer or Chief Nurse Executive: is the highest position in the nursing management hierarchy. As the Vice President of Nursing, you will work with the other board members to set the vision and strategy for the entire healthcare setting. You will also develop and implement new approaches to the delivery of nursing services, set the tone for the organizational culture of the nursing department and of the wider workplace, and liaise with funders and other external parties.
Which degree should I choose?
It hopefully goes without saying that there is no better or worse choice to be made between a DNP and a PhD in Nursing. You should choose one or the other based on your career aspirations, your skillset, and your personality.
You should choose a DNP if:
- you are a good leader;
- you enjoy taking the initiative;
- you enjoy working in busy clinical settings;
- you are comfortable liaising with stakeholders;
- you want to prioritize improving healthcare outcomes by applying knowledge and research to real-life clinical settings.
By contrast, you should choose a Nursing Ph.D. if:
- you are good at analyzing problems and coming up with new solutions;
- you enjoy discovering how things work;
- you enjoy working in a lab environment;
- you are comfortable writing up and presenting your research;
- you want to prioritize improving healthcare outcomes by expanding our existing knowledge of nursing science.
What qualities do I need in order to succeed in a DNP or a Ph.D.?
Hopefully, if you are considering applying for a terminal degree in nursing, you have had significant experience both in higher education and in the world of work, and have had time to realize what your strengths and weaknesses are. If you’re still not sure, ask your manager and your colleagues to give you an honest opinion, and make it clear that you will not be offended when they point out the things you are not good at. You could also take a skills test, though make sure you are using one developed by a reputable career advisor, as the internet is filled with personality quizzes made purely for entertainment purposes!
Here are some of the qualities you need to have to succeed in a DNP program and in the careers it will prepare you for:
- team leadership
- oral communication
- project management
- analytical skills
- confident decision-making
- a clear vision for improving nursing practice and patient outcomes
You will need most of these same skills in order to successfully complete a PhD and work as a nurse researcher or as a lecturer in Nursing. There are, however, some differences:
- as a researcher you will need excellent written communication skills because a key part of your job will be to write up your research findings;
- you will also need to have excellent analytical skills, even more so than DNP students;
- you will need to be at least somewhat of a visual thinker in order to produce good-quality graphs to illustrate your findings;
- you will need to have an aptitude for teaching if you are planning to become a lecturer in Nursing;
- finally, you will need to be excellent at creative thinking, as your research might not go the way you thought it would, which will require you to adapt the rest of your research plan accordingly.
Top tips for surviving a Ph.D. or a DNP
Schedule at least one day each week when you are not going to do any work whatsoever, be that work related to your course or another job. Everyone needs one day a week when they can rest.
- Prioritize sleep as much as you can. Do not feel guilty for sleeping—it’s essential to your wellbeing!
- Eat as healthily as you can and make sure you eat plenty of protein and slow-release carbs, such as those found in whole grains, which will keep you fueled for longer and avoid sending you into a sugar crash.
- Make a schedule for yourself and stick to it as closely as you can, while also allowing enough flexibility to take care of yourself.
- Plan in advance how you are going to fund your studies, which includes tuition fees, the cost of textbooks, transport, food, rent or mortgage and bills.
- Do not be afraid to ask for help, whether you are struggling with your mental health, your finances, your relationships, your studies, or something else entirely. Your college will have a mental health support service, and it’s there to be used.
Choosing to expand your career prospects by enrolling in a DNP degree or a PhD is a big decision, which should not be taken lightly. You will need plenty of time, energy, and money—whether through savings, ongoing work, scholarships or a combination of all three—to get through a terminal nursing degree. However, the career opportunities which will be open to you once you get your qualification will hopefully make it all worth it.
Remember that a DNP and a PhD in Nursing are both advanced degrees that people work extremely hard to gain. Don’t be swayed by those who think one qualification is worth more than the other—they are equivalent degrees that just focus on teaching you different skills, the same as a Bachelor of Art, a Bachelor of Science, and a Bachelor of Music. Choose the one that works best for you!