D.N.P. Leadership: Skills and Roles

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Nurse leader smiling and holding a tablet in a well-lit hallway.

The challenges that our health care system faces are significant. According to the American Hospital Association, by 2032 the U.S. will face a shortage of about 122,000 physicians. On top of that, health care providers will need to hire about 200,000 nurses each year to keep pace with rising demand, address the growing complexity of health care and fill vacancies created by nurse retirements.

Addressing our health care challenges will require dedicated professionals who have the skills to rise to the occasion. As they always have, nurses will play an integral role in bolstering the health care system against these challenges. In particular, nurses who have leadership skills will be critical in ensuring that patients receive high-quality and efficiently delivered health care.

One of the best ways for nurses to acquire strong leadership skills is by earning a Doctor of Nursing Practice (D.N.P.) degree. Equipped with D.N.P. leadership skills, nurses can move into a variety of leadership roles. Those roles enable nurses to make valuable and lasting contributions to the quality of health care delivery and promote a positive working environment for all health care professionals.

Nurses who want to develop strong leadership skills and may be considering enrolling in a Post-Master’s Doctor of Nursing Practice program should learn more about D.N.P. degrees, essential skills and possible career paths.

The Importance of D.N.P. Nursing Leadership

To have a full understanding of D.N.P. nursing leadership and its significance, it’s important to understand why there is a need for the D.N.P. degree and how it helps nurses become leaders in addressing some of the biggest issues in health care.

The Need for the D.N.P. Degree

As more nurses earn D.N.P. degrees, the growth in D.N.P. leadership can mitigate many of the issues our health care system faces. For example, as the AACN has noted, nurses equipped with D.N.P. degrees are able to assess patients’ health and create treatment plans, which can help to address shortages in health care professionals. In addition, nurses who have the experience and scientific knowledge acquired through a D.N.P. program will be better able to meet the growing demands of our changing health care system while continuing to ensure positive health care outcomes.

D.N.P.-trained nurses also can:

  • Serve as clinical educators, sharing their experience and expertise with new nurses and helping to address a shortage of nursing faculty
  • Use their leadership expertise to promote evidence-based management practices to improve efficiency in health care
  • Apply their expertise and leadership skills to bring greater attention to a range of health care issues and promote health care policies that address those issues

How D.N.P. Advanced Nursing Skills Prepare Nurses for Leadership Roles

In earning their D.N.P. degree, nurses acquire advanced nursing skills that can position them well for a variety of roles in health care leadership.

Advanced Nursing Skills Acquired Through D.N.P. Programs

The AACN’s core competencies for advanced-level nursing education provide a framework for D.N.P. programs. These D.N.P. leadership skills enable nurses to make significant contributions to health care.

For example, through D.N.P. programs, nurses develop leadership skills in areas such as:

  • Knowledge of nursing practice.N.P. programs equip nurses with in-depth knowledge of nursing practice that enables them to use ethical decision-making to evaluate nursing care. Nurses also use that knowledge to demonstrate socially responsible leadership.
  • Person-centered care. N.P. programs train nurses in advanced communication skills that enable them to use a variety of modalities that they can adjust depending on the audience. Nurses also learn to design patient engagement materials that are person centered and evidence-based.
  • Safety and quality. After completing a D.N.P. program, nurses have the skills necessary to monitor the safety and quality of health care delivery by establishing data-driven benchmarks for system performance. They also can lead reviews of errors that could affect safety and promote a culture in which health care professionals feel comfortable reporting incidents related to safety and quality of care.

D.N.P. programs can help nurses offer leadership in improving health care systems and health care partnerships in areas such as:

  • Systems-based practice.N.P. programs provide nurses with the skills necessary to contribute to organizational planning and analyze the effects of systemwide policies. For example, D.N.P.-prepared nurses can design practices that improve the cost-effectiveness and quality of health care delivery. They also can create policies that improve access to care and health equity within health care systems.
  • After completing a D.N.P. program, nurses can assess practices and policies in an ethical context and have the skills necessary to model ethical behaviors in leadership roles.
  • Interprofessional partnering. Nurses who earn a D.N.P. degree are well prepared to direct initiatives that create teams of professionals who can work together to meet health care needs and promote interprofessional learning.

In addition, nurses can apply D.N.P. leadership skills in many other aspects of health care such as: 

  • Population health. The skills that nurses gain when they earn a D.N.P. degree enable them to assess the capability of a health care system to meet the needs of a target population. They also can identify population-focused health care priorities and collaborate with stakeholders to implement appropriate intervention plans.
  • Informatics and technology. The valuable informatics and technology skills that nurses acquire in a D.N.P. program enable them to evaluate information technology and determine its effects on health care outcomes and workflows.
  • Nursing scholarship. The research skills that nurses gain through a D.N.P. program equip them to advance health care by directly engaging in further learning, collaborating to advance health care and evaluating the outcomes and effects of new health care practices.
  • Personal, professional and leadership development. Nurses who have earned a D.N.P. are excellent candidates for the work of evaluating workplace environments in terms of health and well-being, promoting cognitive flexibility and mentoring other health care professionals who are seeking professional growth.

Where Nurses with a D.N.P. Degree Can Apply Leadership Skills

Nurses who earn D.N.P. degrees can work in any of a number of areas, some of which involve direct patient care and some of which do not. Following are general areas for possible employment of nurses who have earned a D.N.P. degree:

  • Advanced practice nursing. Working in positions such as nurse practitioner, nurse midwife, nurse anesthetist or clinical nurse specialist enables D.N.P.-trained nurses to apply their leadership skills in a patient care setting. While working in these roles, nurses who have earned a D.N.P. degree have an opportunity to enhance both health care delivery and health care outcomes.
  • Health care administration. Combining a D.N.P. degree with nursing experience makes nurses highly qualified candidates for leadership positions in health care administration. Nurses can apply their N.P. leadership expertise and clinical knowledge to implement management practices that can lead to positive changes in health care efficiency and effectiveness.
  • Health care policy. Equipped with a D.N.P. degree, nurses can choose to focus on influencing health care policy. Using their skills in collaboration, for example, nurses can elucidate the challenges in health care and work to promote policies to address those challenges.
  • Clinical education. Nurses who have earned their D.N.P. degree can play a significant role in educating the next generation of nurses. They can rely on their scientific knowledge of nursing research to educate new nurses; they also can develop curricula that provide new nurses with the skills they will need to provide optimum health care.

Putting Skills into Action: D.N.P. Leadership Roles

The examples of D.N.P. leadership roles discussed below demonstrate the wide range of positions that nurses may pursue.

Chief Nursing Officer

A 2019 report in American Nurse Journal regarding health care reliability placed the position of chief nursing officer (CNO) at the forefront of safety improvement and leadership. According to the report, approximately 60% to 80% of a hospital’s clinical staff report to CNOs, which is a reflection of the responsibility that comes with the position.

D.N.P. leadership skills can be invaluable in the CNO role. CNOs have a duty to engage their staff and motivate them to achieve the highest levels of clinical care. To fulfill that duty, CNOs use their expertise in leadership to maintain a positive working environment, build an atmosphere of trust and encourage open communication.

CNOs also work closely with other leaders in health care organizations in areas such as developing strategy, making high-level decisions, budgeting, promoting safety and encouraging patient engagement. In addition, CNOs can be called upon to communicate with and give presentations to the public and community leaders.

Patient Care Director

Patient care directors use their leadership skills to supervise employees and lead programs that are focused on patient care and welfare. They help to ensure that health care staff strive to provide quality health care; they also work with patients and their families to verify that patients receive the health care they need.

Patient care directors also can have administrative responsibilities in areas such as hiring, budgeting and training. In addition, they need to remain up to date on medical laws and regulations, and build processes to maintain compliance with those requirements.

Given their responsibilities, patient care directors need to be able to address a wide variety of issues that can arise in patient care and have good communication and interpersonal skills. They also must have the ability to oversee care in the dynamic and challenging work environment of a health care setting.

Health Care Lobbyist

Nurses with a passion for health care policy can put their D.N.P. leadership skills to use as health care lobbyists. They can use their health care expertise to collect health information data, synthesize how it relates to and potentially affects current policies, and then report the information to their clients. Employed by private consulting organizations or professional organizations, health care lobbyists develop an understanding of political strategy and work to build relationships with lawmakers and other decision-makers.

Health care lobbyists can use their analytical skills to help address issues in both health care and public health. They can be called upon to perform very detailed policy analysis, and they need to develop an understanding of the complicated processes involved in policy creation.

Earning a D.N.P. can help nurses gain in-depth knowledge of health care systems and policies, making them great candidates for analyzing and addressing public health policy challenges.

Professor of Nursing

Nurses who earn their D.N.P. degrees are in a great position to help alleviate the ongoing shortage of nursing school faculty. According to the AACN, in 2019 nursing schools had to turn away more than 80,000 applicants due in part to a shortage of qualified faculty. Nurses can put their scientific expertise and D.N.P. leadership skills to use in educating the next generation of nurses.

The D.N.P. degree has enabled nursing schools to increase the number of faculty members who hold a doctoral degree and, therefore, has helped to address the nursing faculty shortage. Nurse educators are in high demand not only in traditional nursing schools but also in settings such as public health agencies and hospitals.

The AACN advises D.N.P.-trained nurses who want to pursue working full time in a faculty role to seek additional teaching preparation in areas such as pedagogy, assessing students and developing curriculum.

D.N.P. Executive Leadership: Nurses Leading the Charge

Nurses who aspire to D.N.P. executive leadership roles have an opportunity to lead health care into the future. Earning a D.N.P. degree is a substantial step in the right direction for nurses who aspire to use their clinical and leadership expertise in executive roles.

Nurses can move into executive roles by relying on an interdisciplinary approach and employing their expertise in areas such as:

  • Accountability
  • Clinical leadership quality improvement
  • Ethics
  • Evidence-based practice
  • Influencing behavior
  • Mentoring
  • Strategic management
  • Teamwork

Responsibilities of Nurses in Executive Leadership

The day-to-day responsibilities of nurses who work in executive leadership depend on the type of organizations or divisions they lead. Some examples of the general responsibilities of a nurse executive are:

  • Creating budgets
  • Managing finances
  • Developing operational objectives and strategies
  • Developing educational programs to support staff development goals

Health care executives also need to take responsibility for succession planning and leadership development to help ensure continuity in the nurse manager and nurse leader roles. Focusing on challenges such as succession planning is critical in securing organizational stability, and D.N.P.-trained nurses are a natural fit for fulfilling that responsibility.

Nurse Executive Competencies

D.N.P. leadership at the executive level encompasses a wide range of skills. The American Organization for Nursing Leadership’s nurse executive competencies provides a good overview of the types of nurse executive leadership skills that enable nurses to succeed in executive roles. Categorized into five groups, the competencies are:

  • Communication and relationship building. Competencies in this area include communicating effectively, influencing behaviors, promoting diversity, participating in the community and building relationships with staff and academic professionals.
  • Knowledge of the health care environment. This area includes knowledge and skills in clinical practice, delivery models, work design, health care economics, policy, governance, evidence-based practice, outcome measurement and research, patient safety, risk management, and performance improvement and metrics.
  • Competencies in leadership include foundational thinking, personal journey disciplines (i.e., learning from both success and failure), systems thinking, succession planning and change management.
  • In the area of professionalism, competencies include personal and professional accountability, career planning, ethics and advocacy.
  • Business skills. Competencies in business include financial management, human resource management, strategic management, information management and technology.

The D.N.P. Degree: A Pathway to Leadership

The leadership skills of nurses who earn a D.N.P. degree offer a pathway to career growth. Using their D.N.P. leadership skills, nurses have an opportunity to make invaluable improvements to health care. If you aspire to advance in your nursing career and move into a position of leadership, explore the University of North Dakota’s online Post-Master’s Doctor of Nursing Practice program to see how it can help you pursue your professional goals. Start working toward a career in nursing leadership today.


Recommended Readings

How Long Is a DNP Program?

What Can You Do with a DNP?

What Is the Difference Between a DNP and a PhD in Nursing?


American Association of Colleges of Nursing, DNP Education

American Association of Colleges of Nursing, DNP Fact Sheet

American Association of Colleges of Nursing, The Essentials: Core Competencies for Professional Nursing Education

American Association of Colleges of Nursing, Nursing Faculty Shortage

American Hospital Association, Fact Sheet: Strengthening the Health Care Workforce

American Nurse Journal, “DNPs: Healthcare Change Agents”

American Nurse Journal, “High Reliability in Healthcare: The Chief Nursing Officer’s Critical Role”

American Organization for Nursing Leadership, CENP Examination and Program Handbook

ANA Enterprise, Chief Nursing Officer/Chief Nurse Executive

Daily Nurse, Health Policy Analyst/Lobbyist

Houston Chronicle, “Education Needed for a Patient Care Director”

Nursing Management, “Succession Planning for Organizational Stability”

Nursing Outlook, “Doctor of Nursing Practice (DNP) Degree in the United States: Reflecting, Readjusting, and Getting Back on Track”

U.S. Bureau of Labor Statistics, Medical and Health Services Managers