For a lot of registered nurses, training to become a nurse practitioner is a logical next step in their careers. 

Nurse practitioners have greater autonomy over the care of their patients than nurses do and are often able to make decisions around care with minimal supervision. As you might expect, this increase in responsibility comes with an increase in remuneration. 

The level of autonomy depends on the state and on the institution, but it’s a prospect that is attractive to many. Some nurse practitioners even set up clinics of their own and transition to becoming business owners!

Choosing between qualifying as a nurse practitioner by getting your MSN or your DNP is a decision that is largely dependent on where you would like your career to progress to. Historically, the MSN has been much more focused on clinical experience and working with patients, and the DNP, while providing clinical experience, also equips graduates to work at management level and problem-solving on an organizational level.

What is a MSN?

If you want to study for a MSN (Master of Science in Nursing), you will first need to be a registered nurse and have attained your BSN (Bachelor of Science in Nursing). If you are a registered nurse with an ADN, you will need to take a conversion course.

You will usually choose your MSN based on the nurse practitioner track you wish to specialize in, for example, family nursing or cardiology. MSN courses can be studied remotely or in person, will take two years, and should focus on clinical experience. 

Once you have your MSN and the required amount of clinical experience, you can apply for licensure as a nurse practitioner by your state – licensure requirements differ by state.

What is a DNP?

It’s also possible to qualify as a nurse practitioner by undertaking a DNP program. As with the MSN, you will need to be a registered nurse and hold a BSN to qualify you for a DNP course. Or, if you already hold an MSN, you can choose to undertake a DNP.

Studying for a DNP if you have a BSN usually takes three years and two years if you have an MSN, so if you think that you might get a DNP one day, it can be more time-efficient to study for it straight away.

The DNP has a clinical focus like the MSN, but it also includes training that will prepare you for leadership positions, so it can be a good idea if this is where you see your career going in the future. DNP courses are focused on utilizing new and emerging technologies, understanding healthcare policy, and have a greater focus on the scientific underpinnings of nursing.

Salary expectations

In 2020 the average salary for a nurse practitioner was $117,670. The actual salary you make will vary depending on where in the country you are working and in what type of institution.

There isn’t a lot of information available regarding salary expectations for MSN vs. DNP qualified nurse practitioners. Often, when they first qualify, graduates will be working in similar nurse practitioner roles.

Some employers will look more favorably on a DNP qualified nurse practitioner, which could mean that you have a greater choice of employment options and can therefore leverage a higher salary. There are also opportunities for high-paying management-level jobs as you progress in your career if you are DNP qualified, and you may find everything you learn on a DNP level course advantageous if you have aspirations of opening your own practice in the future.

That being said, DNP courses do take more time and money to complete, so it’s important to weigh this cost against what your future career ambitions are to calculate whether the cost is worth it for you.

Nurse practitioner tracks

Nurse practitioners usually specialize in a particular medicine track, and the track you choose will determine your salary expectations and also what kind of environment you might work in.

Just some of the nurse practitioner tracks that are available are:

  • Acute care. This means working with people of any age who are critically or acutely ill. Generally, you will work as part of a large care team, and you will need to make quick decisions that drastically alter the outcome for your patients. This track is equally challenging and rewarding.
  • Family care. Family nurse practitioners take on a primary care role, looking after families throughout their lives. They will diagnose, assess, and treat illnesses as a primary care physician and focus on education and preventative treatments to help their patients lead healthy lives. For example, they might provide education on eating healthily and exercising or on vaccination.
  • Cardiac. Cardiac nurse practitioners specialize in the heart. They might order tests and assessments, interpret results and manage treatments. They will often work closely with doctors, caring for patients with heart disease or high cholesterol.
  • Neonatal. Neonatal nurse practitioners work with preterm infants who need critical care to ensure their health and wellbeing. They might have health conditions or be at high risk for a health condition. It’s a high-stress role that must be carried out as part of a team.

Roles for DNP holders

DNP holders can work as nurse practitioner specializations just like those mentioned above, but they can also work in management-level careers. 

A DNP qualified nurse practitioner might go on to work as a nurse educator, a chief nursing officer, or a clinical nurse specialist, for example. 

According to the BLS, the average pay for medical and health services managers was $104,280 in 2020, with the highest 10% being paid more than $195,630. The level of pay you could expect would depend on where you were working; for example, large teaching hospitals are more likely to have a big budget than small rural health centers.

The employment of health services managers is expected to grow by 32% between 2019 and 2029, which is a much faster growth than in other fields.