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The Doctor of Nursing Practice (DNP) is an academic degree — and the highest level of nursing education — not a license. Therefore, the DNP degree does not, by itself, grant prescriptive authority.
Nurses on Sermo often debate whether the DNP degree is worth the investment for their specific career goals. According to recent Sermo polls in the Sermo APP community, as well as peer-to-peer discussions, nurses and nurse practitioners find that the DNP may be worth pursuing when their career goals extend beyond prescribing. It’s important to determine your own career goals — and understand what a DNP allows and requires — before deciding whether you want to pursue this pathway.
Prescribing authority comes from the Advanced Practice Registered Nurse (APRN) license, which is regulated separately at the state level. This includes four roles:
- Nurse Practitioner (NP)
- Certified Nurse-Midwife (CNM)
- Certified Registered Nurse Anesthetist (CRNA)
- Clinical Nurse Specialist (CNS)
That means a DNP-prepared nurse practitioner can prescribe medications. However, a DNP-prepared nurse executive cannot, because the executive concentration does not include APRN preparation. These distinctions between degrees and licenses are important so that you can evaluate your own career pathways with clear expectations.
According to a recent poll in the Sermo APP community, only 18% of respondents have a DNP, while 13% plan to get one. Of those with a DNP, just 4% said it was extremely helpful to their career; 5% said it was very helpful; and 8% said it was “not helpful at all”. When asked whether getting a DNP is worth the money, opinions were diverse. 9% of respondents said absolutely: the long-term benefits and personal satisfaction outweigh the costs; 45% said it’s not worth it at all because the cost exceeds any potential career benefits; and 33% said it depends on each individual’s career goals.
“This has to be a personal choice, but one should not hinge all career decisions on acquiring a DNP. Very few jobs require this degree and the cost in time, money and emotional strain may not be worth it to you in the end,” shared one nurse practitioner in the Sermo APP community.
Degree vs. license: the distinction that matters
There are distinct differences between an NP and a DNP, including whether you can prescribe medications. If prescribing is your goal, it is imperative to understand that only certain DNP concentrations can prescribe medication. A nurse pursuing an APRN role completes graduate education (MSN or DNP), clinical training, board certification, and state APRN licensure. The license is what enables prescribing, not the degree. The DNP is an academic degree, while NP is a role. Treating them as the same thing is the most common source of confusion around this topic.
Sermo members have differing opinions about whether it’s worth the time and financial investment for nurses to pursue a DNP degree. While the degree offers advanced skills and the potential for career growth, it also requires significant commitment. NPs in the Sermo APP community have debated the costs versus benefits of pursuing a DNP, and many say the Return on Investment (ROI) depends on each person’s specific career goals. Notably, not every DNP program leads to APRN licensure.
Which DNP concentrations lead to prescribing eligibility?
DNP programs with APRN preparation can lead to APRN licensure eligibility, such as FNP, PMHNP, AGACNP, PNP, CNM, CRNA, or CNS pathways. Prescribing authority then depends on the APRN role, board certification, state laws, and any controlled-substance registration requirements.
Nurses on Sermo often ask: can a DNP prescribe medication? The answer is: Yes, certain DNP concentrations lead to prescribing authority. These include:
- DNP-Family Nurse Practitioner (DNP-FNP)
- DNP-Psychiatric Mental Health Nurse Practitioner (DNP-PMHNP)
- DNP-Adult-Gerontology Acute Care Nurse Practitioner (DNP-AGACNP)
- DNP-Pediatric Nurse Practitioner (DNP-PNP)
- DNP-Certified Nurse-Midwife (DNP-CNM)
- DNP-Certified Registered Nurse Anesthetist (DNP-CRNA)
- DNP-Clinical Nurse Specialist (DNP-CNS) — prescribing varies by state
On the other hand, some DNP concentrations do NOT lead to DNP prescribing medication, including:
- DNP-Executive Leadership
- DNP-Nursing Administration
- DNP-Nursing Education
- DNP-Health Policy
- DNP-Nursing Informatics
- DNP-Systems Leadership
If your primary goal is prescribing, choose a DNP concentration that leads to APRN licensure. If your primary goal is leadership, education, or policy, understand that a DNP in those areas does not authorize prescribing.
How state law determines what APRNs can prescribe
Nurses with APRN licensure can prescribe non-controlled substances, like antibiotics, antidepressants, blood pressure and diabetic medications in all 50 states. Prescribing controlled substances, however, varies by state. Controlled substances are divided into five categories, based on how potentially addictive and harmful these medications may be:
- Schedule I drugs, such as heroin and marijuana, have no officially accepted medical use and a high potential for addiction.
- Schedule II medications, such as adderall, fentanyl, amphetamine, have high potential for harmful use and severe dependence.
- Schedule III controlled substances, including Vicodin and Tylenol with codeine, have some risk of dependency or harm.
- Schedule IV medications, like alprazolam, clonazepam, and diazepam, have lower risks of harm or dependence.
- Schedule V drugs, such as Lomotil, Motofen, and Lyrica, are considered to have the lowest risk of harm or dependency.
While NPs can prescribe in all 50 states, the specifics around what and how they can prescribe vary by state practice authority category. In other words, each state separately dictates whether NPs can prescribe controlled substances and, if so, which categories. These fall into full, reduced, and restricted categories, mirroring the broader practice authority framework:
- In full practice authority states, APRNs prescribe independently, including controlled substances.
- In reduced practice states, APRNs prescribe with a collaborative agreement, typically required for controlled substances.
- In restricted practice states, APRNs prescribe under physician supervision or a formal Prescriptive Authority Agreement (PAA).
NPs who meet state requirements can prescribe Schedule II-V controlled substances in all states except Georgia and Oklahoma, which restrict NPs to Schedule III-V. DEA registration and, in many states, separate state controlled substance registration are additional steps beyond APRN licensure.
Does the doctorate change anything? Sermo members weigh in
Other questions that come up in Sermo’s nursing communities include: How does a DNP compare to an MSN?
Sermo members debate whether the doctorate changes anything. MSN-prepared NPs and DNP-prepared NPs have the same scope of practice, same prescribing authority, and both hold the same APRN license. A peer-reviewed study of more than 1,000 primary care NPs found no statistically significant difference in patient outcomes between MSN-prepared and DNP-prepared NPs.
However, the DNP can add career mobility, preparing nurses for executive roles, academic positions, and CRNA entry-to-practice compliance. If your primary goal is clinical practice and prescribing, an MSN with an APRN concentration is typically sufficient.
“I have an earned DNP degree. I truly valued the learning experience and the effect it has had on my practice. It has not helped in terms of salary in practice, but it has helped me in academia,” explained a nurse practitioner on Sermo.
So, if you can’t prescribe with a DNP, is it still worth it?
In a recent Sermo APP poll, participants were divided on whether a DNP is beneficial for job opportunities and salary boosts. Results should be interpreted with caution, as nearly half of respondents said the question was not relevant to their experience because they do not have a DNP degree. Among those who expressed an opinion, just 7% of respondents said a DNP is extremely beneficial, opening up many job opportunities; 5% said it’s highly beneficial, with noticeable improvements in opportunities; 14% said it was moderately beneficial, while 13% said it was not beneficial at all. Respondents also had mixed opinions on whether the DNP resulted in higher salaries. Only 3% said it was extremely beneficial, with a significant salary increase; 4% said it was highly beneficial; and 25% said it was not beneficial at all.
When a Sermo member questioned whether the long-term benefits outweigh the sacrifices, the answers from peers were varied.
Many Sermo members felt it wasn’t worth it to get a DNP degree.
“In my opinion, no. You are only looking at a minimal increase in pay, no real increase in your practice scope, and a nearly 100% in out of pocket cost in loans compared to a master’s degree, plus the hassle and torture of having to do the doctoral thesis and further research (which to me personally is nails on a chalkboard) to maintain the doctorate,” said a family practice nurse on Sermo.
“I’m currently in a DNP-FNP program that’s very intense, and even though I work only part time, my schedule has gotten really overwhelming,” added a general nurse.
Others felt the DNP’s benefits make it worthwhile.
“Personally, I think it’s only a matter of time before DNP is required as entry to practice, like what’s happening with CRNAs. Hopefully those of us without DNP yet will be grandfathered in, but will likely be starting a DNP program within the next year just to get ahead of the game,” a nurse practitioner posted on Sermo.
“Getting a DNP is worth it. I was able to negotiate a higher salary than master’s-level APNs and [am] now teaching an online class,” a nurse practitioner explained.
Another nurse practitioner on Sermo summed it up well by saying, “Depending on your career goals, if you just plan on being a clinician in a clinic setting, then it likely does not advance your opportunities. However, if you plan on doing any research, medical liaison, sales, teaching, then it is very helpful.”
Determine whether a DNP is right for you
Understand the differences between degrees and licenses to determine what you’ll need for your preferred career pathway as a nurse or nurse practitioner. The DNP degree on its own does not authorize prescribing, so if that’s your ultimate goal, pursue the APRN pathway instead. Prescribing comes from the APRN license, along with APRN or MSN preparation. Your state’s practice authority category then determines what any APRN, MSN, or DNP-prepared professional can actually prescribe in practice.
For many nurses, the decision to pursue a DNP comes down to broader career ambitions beyond the exam room.
“Pursuing my DNP is about retirement considerations and possibly teaching one day. I also work for the state, so my tuition is covered, which is the primary reason I was willing to pursue it. It doesn’t enhance my current practicing career,” according to a nurse practitioner in a recent Sermo post.
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