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Updated May 31, 2024
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- Effect on Students and Grads
- Support for the Move
- Where to Practice and Get a Degree
Some nursing organizations propose requiring a DNP as the entry-level education for NPs. How could this affect graduates, and who supports the change?
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In our Ask a Nurse series, experienced nurses provide an insider look at the nursing profession by answering your questions about nursing careers, degrees, and resources.
Question: Hello! I have heard a lot about MSN programs possibly phasing out and becoming DNP programs by 2025. As someone who graduates in 2024 and is looking to pursue a career as an NP, what does this mean for me?
The American Association of Colleges of Nursing (AACN) and the National Organization of Nurse Practitioner Faculties (NONPF) have proposed that all new nurse practitioners (NPs) must hold a doctor of nursing practice (DNP) degree by 2025. There are indications, however, that this may require more time to implement.
In 2004, the AACN first announced the proposal to require a DNP degree for all NP candidates by 2018. In response, the number of DNP programs skyrocketed. At the time of the announcement, there were fewer than 50 DNP programs nationally. By 2022, the number of programs grew to 426, with 70 more in the planning stages.
In a 2018 position statement, the NONPF formally recommended a DNP entry-level education for all NPs by 2025 and reaffirmed that position in 2023. It is important to note that every state nursing board is an independent body free to decide the entry-level education required for practicing NPs.
How Does the Move Affect MSN Students and Graduates?
A doctoral degree is not currently required to become an NP.
While multiple nursing organizations have advocated for the move toward DNP-prepared NPs, the state nursing boards must ultimately take action to change recommendations into reality. To date, no state has announced any licensure changes related to NP education requirements. Many MSN programs, which also prepare NPs, continue to operate.
Implementing such a sweeping change requires a collaborative effort between state nursing boards, educational institutions, and state regulations. These processes can take time and contain many voices. Thus, current MSN students and graduates likely do not have to worry about any imminent changes to NP requirements.
Although the movement is slow, states will likely require a DNP for all NPs in the future. How states implement this move will likely vary between states. For example, a state may require all NPs to have their DNPs by a certain year or may require NPs to earn a DNP within 10 years of starting practice, much like New York passed the “BSN in 10” law.
This kind of transition is not without precedent. In 1965, the American Nurses Association recommended that the entry-level education for nursing should be a Bachelor of Science in Nursing (BSN) by 1985. In 2010, the federal organization, then known as the Institute of Medicine (now known as the National Academy of Medicine), recommended that 80% of practicing nursing staff be BSN-prepared. Over 50 decades later, the argument over the minimal preparation for professional practice continues.
The move to an entry-level DNP degree will impact nurses differently and depend on several factors. Each state board of nursing determines the entry-level education needed for an NP license. This can significantly impact an NP’s decision to move states. For example, if an MSN is the entry-level education required for an NP license in your home state, it could limit your ability to take on certain roles or responsibilities. This could also affect the scope of practice for NPs and make statewide decisions more complex.
MSN-prepared NPs may wish to pursue a DNP through an MSN-to-DNP program, many of which are sensitive to the time and energy demands of working students. These programs typically take 12-24 months and 500 clinical hours to complete when the student enters the program with 500 MSN NP clinical practice hours.
Given the current nursing shortage, it’s highly unlikely that states will begin to require practicing NPs to hold a DNP within a very short period. But, the topic of DNP-prepared NPs is still ongoing.
Support for the Move to DNP-Prepared NPs
Nurses who want to become NPs may consider a DNP program. Several online BSN-to-DNP programs allow you to finish the program within 3-4 years, which qualifies you to become a board-certified and licensed NP. (An MSN degree also allows you to become a board-certified and licensed NP).
The AACN lists several factors for its recommendation to require DNP-prepared NPs, including the rising complexity in the healthcare environment that necessitates the highest level of knowledge and expertise to ensure positive patient outcomes.
Other factors include:
- The rapid expansion of knowledge underlying practice
- Increased complexity of patient care
- National concerns about the quality of care and patient safety
- Shortages of nursing personnel, which demand a higher level of preparation for leaders who can design and assess care
- Shortages of doctorally prepared nursing faculty
- Increasing educational expectations for the preparation of other members of the healthcare team
Before releasing its 2018 position statement on the issue, the NONPF convened a summit in December 2017 in which nearly 20 national nursing organizations gathered to discuss changing entry-level education by 2025. Not all organizations agreed the move was wise.
For example, in a position statement released in October 2018, the National Association of Neonatal Nurses (NANN) agreed the DNP should be the highest nursing degree rather than a doctor of philosophy in nursing. However, they did not agree that a DNP should be the entry-level education for practicing NPs.
The association argued that there is a lack of evidence regarding the clinical impacts of a move to DNP-prepared NPs. The additional education would also extend the time it takes to become an NP, lower the number of applicants, increase the cost of education, and potentially contribute to the growing shortage of nurses, particularly advanced practice registered nurses (APRNs).
Where You Practice and Where You Get Your Degree
As you consider earning a DNP for NP licensure, there are several factors you should assess. The first is the state where you want to become licensed and certified. Based on how states are handling the move toward requiring BSN-prepared staff nurses, it’s likely states will give MSN-prepared NPs a long lead time to transition to a DNP.
This allows you to practice while you’re completing the DNP program. The program’s location is unimportant as long as it meets the necessary accreditation requirements. You can become licensed and certified in the state where you want to practice.
States that have not yet adopted full NP practice authority might be more willing to consider expanding the duties that NPs are legally allowed to take on. To date, 11 states have restricted and 12 have reduced NP practice authority.
While some nursing organizations are pushing for DNP-prepared NPs, not all organizations are convinced that it is the best move for the nursing profession and patient care. Ultimately, the proposal must be addressed by the licensing boards at the state level, which could be inevitable in the long term, even if 2025 is an ambitious goal. In the meantime, new and recent MSN grads looking to enter the NP profession should feel reassured that a move won’t come any time soon and in all likelihood, would come with a reasonable adjustment period.
In Summary:
- The 2018 position statement by the National Organization of Nurse Practitioner Faculties was reaffirmed in 2023 and calls for DNP-prepared NPs by 2025.
- While the American Association of Colleges of Nurses agrees, other nursing organizations argue there is a lack of evidence the move could improve patient care and will likely contribute to a growing shortage of NPs.
- Historically, the move to BSN entry-level nurses was proposed nearly 50 decades ago and is still being argued.
- The move to DNP entry-level education will impact nurses differently, depending on several factors, such as whether they are students or graduates, the state where they live, and the scope of NP practice in the state.
- Each state determines the required entry-level education for an NP license; different requirements across states could limit the ability to move.
- NP candidates should strongly consider a DNP degree, which can take a full-time student up to four years to complete in a BSN-to-DNP program.
- A second option is to complete an MSN NP program and enroll in an MSN-to-DNP program, which allows the student to work part-time while finishing their DNP degree.
Page last reviewed on May 28, 2024
