Doctor of Nursing Practice

Grandfather exception

The future Doctor of Nursing Practice requirement will apply only to those who are not yet licensed and practicing as APNs. Those currently licensed as Advanced Practice Nurses will be permitted to maintain their current level of education and certification. Some APNs who have been in the profession for many years have been grandfathered into continuing APN practice and licensure even without a master's degree. For example, the first Nurse Practitioner program was created by a nurse educator, Loretta Ford, Ed.D, RN, PNP and a physician, Henry Silver, MD, in 1965 at the University of Colorado as a non-degree certificate program, and all the early NP programs were initially established as these type of certificate programs before transitioning them to master's degrees in the 1980s.

Every state has different laws, rules, regulations, licensing and certification requirements for Advanced Practice Registered Nurses, thus some states may not have a grandfather clause in their State Board of Nursing laws, in particular as it may relate to transferring a license from one State to another. The US National Counsel of State Boards of Nursing (NCSBN) continues to work on a collaborative muti-state compact licensure agreement for advanced practice nurses to be able to work in multiple US States with a singular active home State license. there are on-going discussions on expanding that type of licensure nationally similar to the existing Nurse Compact for recognition of RN and LPN licenses.

Terminal degrees

An Advanced Practice Nurse may earn a terminal degree in several ways. A terminal degree is generally a doctorate. In some fields, especially those linked to a profession (e.g. medicine, nursing, dentistry, law, optometry, architecture, pharmacy, social work, religious ministry, engineering, accounting, education, etc.), a distinction is to be drawn between a first professional degree, an advanced professional degree, and a terminal academic degree. A first professional degree is generally required by law or custom to practice the profession without limitation. An advanced professional degree provides further training in a specialized area of the profession. A first professional degree is an academic degree designed to prepare the holder for a particular career or profession, fields where scholarly research and academic activity are not the work, but rather the practice of a profession. In many cases, the first professional degree is also the terminal degree because usually no further advanced degree is required for practice in that field even though more advanced professional degrees may exist.

Examples of terminal degrees in research are:

    Doctor of Philosophy (Ph.D.)
    Doctor of Education (Ed.D.)
    Doctor of Science (D.Sc.)
    Doctor of Nursing Science (D.N.Sc., DNS)

Examples of terminal professional degrees in nursing are:

    Doctor of Nursing Practice (DNP)
    Doctor of Nurse Anesthesia Practice (DNAP)

Post-Nominal Initials

The specific titles, credentials, post-nominal initials, and so on, Advanced Practice Nurses utilize will vary greatly by country, state, license-type, academic degrees, and board certifications. A list of post-nominal initials include, but are not limited to:

  • ACNP - Acute Care Nurse Practitioner
  • ANP - Adult Nurse Practitioner
  • APRN - Advanced Practice Registered Nurse (Same as Advanced Practice Nurse)
  • APN - Advanced Practice Nurse (Refers to the four recognized general areas of advanced professional specialization: CRNA, NP, CNM, and CNS)
  • ARNP - Advanced Registered Nurse Practitioner (Refers to Nurse Practitioners in some US States)
  • C or BC following a title - Certified or Board Certified (i.e., APRN-BC, WHNP-BC, PNP-BC, FNP-C, GNP-C, ANP-BC)
  • CNM - Certified Nurse Midwife
  • CNS - Clinical Nurse Specialist
  • CRNP - Certified Registered Nurse Practitioner
  • CS - Clinical Specialist
  • CRNA - Certified Registered Nurse Anesthetist
  • DNP - Doctor of Nursing Practice (the terminal professional degree for APNs)
  • FNP - Family Nurse Practitioner
  • GNP - Gerontological Nurse Practitioner
  • NNP - Neonatal Nurse Practitioner
  • NP - Nurse Practitioner
  • ONP - Oncology Nurse Practitioner
  • PMHCNS - Psychiatric & Mental Health Clinical Nurse Specialist
  • PMHNP - Psychiatric & Mental Health Nurse Practitioner
  • PNP - Pediatric Nurse Practitioner
  • PsyNP - Psychiatric Nurse Practitioner
  • WHNP - Women's Health Nurse Practitioner