Increasing numbers of bachelor’s and master’s-prepared nurses in Hawaii are earning a Doctor of Nursing Practice (DNP)—the highest clinical degree available in the nursing field. Bachelor’s-prepared RNs pursuing the degree are able to move into administration or obtain advanced practice certification as NPs, nurse-midwives, clinical nurse specialists, or nurse-anesthetists, while master’s-prepared advanced practice RNs seeking the degree cite benefits such as increased salary, more advanced employment opportunities both in and outside of direct patient care, and the ability to effect practical policy change from a clinical standpoint.
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The trend toward the DNP comes at a critical time when Hawaii is in desperate need of more primary care practitioners. According to the 2019 Hawaii Physician Workforce Assessment Project, 152 doctors left Hawaii in 2019, while another 91 physicians retired and 123 more decreased their work hours.
Advanced practice registered nurses (APRNs) are able to fill this void, and those with a DNP can assume high-level positions, both in an out of the clinical environment.
Earning a Doctor of Nursing Practice (DNP) In Hawaii
Both bachelor’s and master’s-prepared nurses in Hawaii are eligible to enroll in DNP programs, with specialized entry-points available to both:
- Nurses with a bachelor’s degree may enroll in BSN-DNP programs, which will allow them to focus first on master’s coursework before then moving into the doctorate program. Many nurses use this program as a path to APRN certification and licensure. Most BSN-DNP programs consist of about 90 credits and can be completed over 36-48 months of study. Programs are also available in an aggregate/systems/organizational focus in areas like administration, informatics, and healthcare policy.
- Nurses with a master’s degree may enroll in MSN-DNP programs, which launch straight into doctorate preparation. If the nurse is seeking a DNP degree in a focus different from their current APRN certification, the program will consist of additional credits on the master’s level. The MSN-DNP program is at least 36 credits long and usually takes about 18 months to complete. Programs are also available in an aggregate/systems/organizational focus in areas like administration, informatics, and healthcare policy.
Accredited programs may vary in number of required credits, specializations offered, and individual course offerings, but all programs must include at least 1,000 post-baccalaureate practice hours, 500 of which may be carried over from the master’s level. In addition, programs must offer students the ability to specialize in either an advanced practice nursing direct care focus or an aggregate/systems/organizational focus such as executive leadership or health policy.
Due to the extensive nature of clinical hours, many DNP students choose to log clinical hours independently of practicum requirements within the program.
Many DNP programs offer three broad program tracks to accommodate student needs:
- Traditional, about 18-24 months of study
- Accelerated, about 12 months of study
- Part-time, about 2 ½ years of study
DNP programs consist of three main components:
- DNP core: Core classes will cover topics of scientific foundations for nursing, epidemiology, and clinical scholarship, and will also prepare nurses for executive positions through the study of management in healthcare and leadership roles for nurses.
- Specialty courses in line with the chosen focus: Depending on whether the nurse has chosen an advanced practice focus or an aggregate/systems/organizational focus, specialty courses will delve into topics relevant to the focus.
- Final project: The final project, normally involves a final paper and presentation in the nurse’s area of focus.
Post-Bachelor’s BSN-to-DNP Programs for BSN-Prepared Nurses
As the most direct route to APRN licensure and doctorate credentials, many bachelor’s-prepared nurses choose to earn both their MSN and DNP in one comprehensive BSN-to-DNP program. Due to the extensive nature of the requirements, most BSN-DNP programs require three to four years of study.
Program requirements vary, but most BSN-DNP programs will require nurses to designate a focus for their master’s study, which may include an advanced nursing practice focus. The master’s track usually includes about 500 clinical hours, and nurses will be required to obtain national certification in their APRN role.
The MSN core will cover the following topics:
- Scientific Underpinnings for Practice
- Organizational and Systems Leadership for Quality Improvement and Systems Thinking
- Clinical Scholarship and Analytical Methods for Evidence-Based Practice
- Information Systems/Technology and Patient Care Technology
- Health Care Policy for Advocacy in Heath Care
- Interprofessional Collaboration for Improving Patient and Population Health Outcomes
- Clinical Prevention and Population Health for Improving the Nation’s Health
MSNs for APRNs would also include core classes that would cover:
- Advanced Practice Pathophysiology
- Advanced Practice Pharmacotherapeutics
- Advanced Practice Patient Population Outcomes
BSN-to-DNP and MSN-to-DNP Programs Available in Hawaii
As of 2016, the following DNP programs have been accredited by the Commission on Collegiate Nursing Education (CCNE). CCNE and ACEN-accredited online programs are also available to advanced nursing students in Washington, DC. Other DNP programs not shown here may hold regional accreditation or specialty accreditation through the Council on Accreditation of Nurse Anesthesia Educational Programs or the Accreditation Commission for Midwifery Education.
Hawaii Pacific University
Nursing Department
Honolulu
Accreditation: CCNE
MSN-DNP (online)
- Clinical Nursing Practice
University of Hawaii at Hilo
School of Nursing
Hilo
Accreditation: CCNE
BSN-DNP (campus)
- Family Nurse Practitioner
Post-Master’s-DNP (campus)
- Clinical Nursing Practice
University of Hawaii at Manoa
School of Nursing & Dental Hygiene
Honolulu
Accreditation: CCNE
Post-Bachelor’s-DNP (campus)
- Adult-Gerontology Primary Care Nurse Practitioner
- Family Nurse Practitioner
Post-Master’s-DNP (online)
- Organizational Leadership
Opportunities Available to DNP-Prepared Nurses in Hawaii
Doctorate-prepared nurses in Hawaii may seek advanced nursing positions in hospitals, clinics, and physician’s offices. The DNP also qualifies nurses to hold faculty positions in nursing education programs and to step into clinical leadership roles.
Hawaii is home to a number of hospitals and health systems that represent excellent opportunities for today’s DNP-prepared nurses:
- Queens Medical Center, Honolulu
- Straub Medical Center, Honolulu
- Adventist Health Castle, Kailua
- Hawaii State Hospital, Kaneohe
- Hilo Medical Center, Hilo
- Kaiser Permanente Moanalua Medical Center, Honolulu
- Kapiolani Medical Center for Women and Children, Honolulu
Examples of DNP nursing positions were taken from a survey of job listings in January 2020 and are shown for illustrative purposes only. These examples do not represent job offers or positions that are currently available.