January was for reflection and honesty about the current state of Nurse Practitioner education; a plea to steer the ship in a different direction. Now, let's talk about what NP education is getting right. From community medicine collaborations with EMS to post-graduate fellowships, clinicians and institutions across the country are working to move our profession forward and better serve patients in an increasingly complex healthcare system.
In Georgia, a spike in non-emergent 911 calls was overwhelming the EMS systems and contributing to ED overcrowding. Grady Health System stepped in to help by launching a collaborative Mobile Integrated Health (MIH) program aimed at managing non-emergent issues in the field. Each MIH team paired an NP or PA with an advanced EMT or paramedic to respond to calls that were triaged as non-urgent.
The results? 66% of patients seen by the MIH team were treated on scene, avoiding unnecessary transport to the ED. This is a strong example of the value advanced practice providers (APPs) bring to an overburdened healthcare system, and a reminder of what multidisciplinary collaboration can achieve.
The thrill of graduating and passing boards can quickly become eclipsed by the overwhelming reality of starting clinical practice. All new graduates are prone to feeling some degree of “imposter syndrome.” A solid orientation program coupled with regular continuing education opportunities within a department is essential to helping new NPs reach their potential. Some organizations have taken this to a whole other level with the development of APP fellowship programs, geared towards taking new graduates and immersing them in didactics, clinicals, and labs to help them grow and develop in their chosen specialty.
You will find these programs at medical centers such as Stanford, Mayo Clinic, and Vanderbilt. APP fellowships provide an opportunity for new APPs to immerse themselves in robust and comprehensive training. APP fellowships offer mutual benefit: hospitals grow confident clinicians, and APPs gain the foundation they need to thrive. Programs like these are good for patient outcomes, professional development, and long-term retention.
Back in 2004, the American Association of Colleges of Nursing (AACN) endorsed a shift for all APRN programs to the DNP level by the year 2025. The Council on Accreditation of Nurse Anesthesia Education Programs (COA) mandated the change by 2025 for all CRNA programs.
For NP programs, the change to a DNP remains a recommendation instead of a mandate. While many programs encourage their students to pursue a DNP, this remains a personal decision that each nurse should have to make based on their particular situation and career aspirations.
It’s worth thinking ahead. Where are you currently in your nursing career? Are you 3-5 years in, and considering starting a family in the near future? If so, completing your terminal degree now might be far more convenient than trying to do so while balancing work and family life. And while the idea of working clinically at the bedside for the next 30 years sounds good now, your career goals and perspectives may rapidly change once you start to miss weekends and holidays with your family. Administrative or educational jobs may start to look more appealing, and having already completed your DNP will put those career changes within arm’s reach.
Or, you may be a veteran charge nurse who has seen just enough of administration to know that your calling is at the bedside. You don’t mind having students, but academics aren’t exactly calling your name. You also have a family and don’t want to be in school for any longer than necessary. In this case, an MSN program might perfectly fit your needs.
My point is that the program you choose should reflect your short and long-term career goals, and these are just a few of the several factors and scenarios that you should consider when looking at program options. A good friend of mine ended up getting his DNP for the sole reason that having a terminal degree was always a personal goal, and he wanted to set an example for his children.
Now, if you have decided to pursue your DNP, you also need to consider the different types of programs offered. Many schools offer a standard DNP that covers a broad curriculum, but there are also several nuanced options, such as neonatal, executive leadership, and informatics. Some online programs will boast a “fast track” experience to getting a DNP. This may seem like a good option on the surface, but in the long run, you will have a far more enriching experience if you pick a program with a long history and high standards, coupled with a concentration that interests you.
Whatever path best suits your professional interests and needs, choose a program that is regarded for its quality and standards. Shortcuts can easily masquerade as conveniences, until students are indebted of both time and money before they realize the mistake of choosing an “easy” program.
Think to yourself: would YOU want to be taken care of by an NP who went the route of shortcuts and convenience? Or would you rather your child or loved one be cared for by an NP that forged themselves in a program of uncompromising standards and excellence, an NP that embraced the harder road, and emerged a competent and confident provider?
Next month, we are going to get into the green and red flags when looking for a job as an NP, and the basics that you should expect when looking to accept a new position.
As always, please respond with any comments or questions to NP@hippoeducation.com.
See you at work!