MSN vs. DNP

Blog: MSN vs. DNP

Should preparation at the DNP level be a requirement of entry into nursing advanced practice roles?

For years there has been the debate and the push for the BSN to be the entry level of education for nursing which has never come to fruition. While there are many hospitals and healthcare organizations that prefer to employee the bachelor’s prepared nurse with evidence supporting this decision there is still a need for ADNs to fill an ever-increasing nursing shortage. Some schools who abandoned their ADN programs in favor of BSN preparation have reverted and reopened their ADN pathway to supply the number of nurses that are being required by local hospitals supporting a need for nurses to enter the field prepared at this level. Other ADN programs are aligning with BSN programs and offering students a concurrent enrollment program where students are enrolled in an ADN prelicensure program at the same time they are taking courses in the BSN program. This approach is gaining wide attention and is aimed at increasing the number of BSN prepared nurses as well as providing a seamless transition from ADN to BSN.
Yet another debate among the education preparation among the nursing professionals lies with the academic preparation of the APRN, and whether a DNP should be required for entry into practice. The recommendation is that all APRN should hold a DNP as opposed to an MSN as is currently required, the CRNA has been the first of the APRNs to require the terminal degree. The projected goal is that by 2025 all NPs entering practice will be prepared at the doctoral level. I see this much like the BSN as entry level into practice for the RN as being something that may not come to be attained within the outlined time frame. While I see the importance of the terminal degree in nursing and its importance in personal as well as professional growth and leadership possibilities, I am on the fence on requiring the DNP for all NPs. The NP degree fills a void that is present in a lack of access to health care that is predicted to get worse with a decline in primary care physicians, often providing care in areas with low income and obstacles to care such as rural communities. While a DNP is advanced training beyond an MSN is it necessary to provide quality care to patients? For many practicing NPs across the country educated at the master’s level the answer might be a resounding no. Perhaps it would be better to allow it to remain as is meaning the MSN is required for the entry NP and of course there is the path to increase their education and achieve a terminal degree depending on the professional or personal goals of the nurse. I see an important place in the profession as well as a need for NPs who hold an MSN and those that hold a DNP. Evidence supports that NPs have a positive effect on healthcare on healthcare and patient outcomes but there is no data that suggests that an NP prepared at the doctoral level would provide better care. Of course, when considering an APRN holding a leadership position or being involved in healthcare issues beyond provision of direct patient care the additional educational training of the DNP is essential.