Since the 1960s, when the concept of expanded nursing education emerged as a means to provide primary care to the medically underserved, the roles of advanced practice registered nurses (APRNs) have become an essential part of healthcare in the United States.
The role of APRNs continues to grow, providing services that were previously offered by physicians and seen as the solution to a shortage of primary care providers. The need for Family Nurse Practitioners (FNPs) and Doctors of Nursing Practice (DNPs), which both fall under the umbrella of APRNs, is critical.
Both FNPs and DNPs can work in clinical settings to assist in primary, acute, and specialized healthcare. Either may work in clinical, administrative, or leadership roles. Both have the training to provide medical interventions similar to primary care physicians, making them uniquely qualified to fill a growing hole in the medical community.
Nurses who are considering an advanced degree as an FNP or DNP should weigh both options for their best choice. While the roles may appear similar, the education, duties, and functions widely differ. Duquesne University offers both advanced programs for nurses: an online Master of Science in Nursing (MSN) with a specialty in the Family (Individual Across the Lifespan) Nurse Practitioners field and an online Doctor of Nursing Practice degree program. Both give nurses the skills needed to excel in the field to provide high-quality healthcare.
The biggest differences between the FNP and DNP degrees are education, training, and experience. In a clinical setting, FNPs are known to take a patient-centered healthcare approach, while DNPs utilize technology, healthcare and business acumen for nursing best practices.
An FNP is a masters-level degree that prepares graduates to work in leadership and management roles, typically in clinical settings in primary healthcare practices. They work either autonomously or in collaboration with other medical professionals. They focus on diagnosing and treating patients. Other duties include managing acute and chronic conditions.
A DNP is a doctoral-level degree that focuses on the science, business, and management side of nursing. DNPs utilize evidence-based skills and practices to improve health outcomes for patients. The degree program gives DNPs the skills to examine healthcare trends and implement policy and clinical changes. Many also work in private practice to focus on patient care. DNPs are registered nurses with masters and doctoral degrees.
FNP degrees prepare nurses to be primary healthcare providers across a lifespan, from infant to adult. The lifespan-centered approach allows FNPs to care for families and individuals, including through pregnancy.
The FNP program is a master’s level course of study that prepares graduates to take the American Association of Nurse Practitioners Certification Program (AANPCP) exam or the American Nurses Credentialing Center (ANCC) Family Nurse Practitioner exam. Upon successful completion of a certification exam, graduates are eligible for FNP licensure. Graduates must also register with the boards of nursing in their states of employment.
An FNP program is a three-year program with a focus on topics that include disease symptomatology, pathophysiology, anatomy, and professional ethics. To be accepted into the advanced program, students must have a Bachelor of Science in Nursing (BSN) degree and passed the NCLEX-RN exam.
For the program, FNP students must complete hands-on clinical work in family care. At Duquesne University, students are required to take 670 clinical hours overseen by a nurse preceptor and 80 lab hours. The program prepares students for licensure as a Certified Registered Nurse Practitioner (CRNP)
After graduation, FNPs fill roles in hospitals, health clinics, and medical offices. Their scope of work varies by state. In some locations, state law allows FNPs to work independently of licensed physicians and open private practices. Some FNPs are legally permitted to prescribe medications and order diagnostic tests, depending on state law. In general, FNPs obtain health histories, perform physical exams, develop therapeutic care plans, order and interpret lab tests, provide patient education, and participate in research studies.
The DNP degree program is aimed at building on traditional master’s program training for an in-depth role in clinical work, leadership, healthcare delivery systems, and healthcare policy. Unlike a research-focused nursing Ph.D. program, the DNP program is a practice-focused degree concentrated on patient care and leadership training.
APRNs interested in earning a DNP degree typically must have an MSN. However, applicants with a non-nursing master’s degree may qualify for Duquesne University’s DNP program. DNP students must complete 500 practice hours and a residency to be eligible for graduation. The American Association of Colleges of Nursing (AACN) requires all DNP programs provide students with the following foundational principles in coursework:
DNP graduates work in clinical settings as well as administrative and leadership roles. They also work in public policy, public health, and education. The DNP is the highest professional degree in nursing, also called a terminal degree, and is considered the future of healthcare. Organizations that have endorsed the DNP position as transformative include the National Organization of Nurse Practitioner Faculties (NONPF), the Institute of Medicine (IOM), and the National Association of Clinical Nurse Specialists (NACNS).
“Considering the complex needs of patients and the future direction of nursing practice, we believe that DNP preparation for practice in the Clinical Nurse Specialists (CNS) role will better position the CNS to meet the demands of an evolving healthcare system,” the NACNS said in a position paper
Experts have been predicting healthcare professional shortages for decades, but more recent changes in federal legislation have hastened the shortfalls. By 2030, the United States will face a shortage of up to 43,000 primary care physicians, the Association of American Medical Colleges said. The American Nurses Association said about 500,000 RNs are expected to retire by 2022.
At the same time, new federal healthcare laws have increased the need for medical professionals. The Affordable Care Act (ACA), also called Obamacare, has increased the demand for medical services. The law requires nearly all Americans have health insurance and expanded Medicaid coverage to tens of thousands of people previously uninsured. Much of the expansion happened in rural areas, where few doctors and nurses practice.
FNPs and DNPs are qualified to fill the gaps left open by retiring physicians and APRNs. Changes in state and federal laws allow FNPs and DNPs to provide healthcare services to those who need it most.
Students working toward an online Master of Science in Family Nurse Practitioner degree or a Doctor of Nursing Practice degree are trained to manage the evolving and emerging roles in nursing. The programs build on skills to prepare graduates for a comprehensive understanding of the field and strong leadership and clinical skills.