By Debra Wood, RN, contributor
September 16, 2011 - Nurses are increasingly returning to school for graduate degrees to gain more knowledge and skills to thrive as the country looks toward nurses to fulfill more primary care needs, implement new health information technologies and navigate changing reimbursement models.
Geraldine (Polly) Bednash, Ph.D., RN, FAAN, reports enrollment is up in RN-to-BSN, clinical nurse leader master’s programs, and DNP and Ph.D. programs.
“It is absolutely imperative that we move the educational preparation of the workforce,” said Geraldine (Polly) Bednash, Ph.D., RN, FAAN, executive director of the American Association of Colleges of Nursing in Washington, D.C. She reports tremendous growth in doctor of nursing practice (DNP) and Ph.D. programs.
Patrick R. Coonan, Ed.D., RN, NEA-BC, dean and professor of the Adelphi University School of Nursing, in Garden City, N.Y., reported an increase in applications to its master’s program.
“People are seeing the future of health care and trying to stay ahead of the curve,” Coonan said. “And with nursing practitioner [programs], people are seeing a future in extended primary care options.”
Additional education is absolutely a requirement if nurses want to change roles or move into new practice domains, Bednash said.
“The way to become the most competent professionals is to continue learning and moving our educational preparation up,” Bednash said. “And it certainly has the capacity to improve earning potential.”
Rose Sherman, Ed.D., RN, NEA-BC, CNL, FAAN, said additional education will open doors and lead to personal growth.
Rose Sherman, Ed.D., RN, NEA-BC, CNL, FAAN, director of the Nursing Leadership Institute at Florida Atlantic University in Boca Raton, agrees that education will offer new opportunities, but she cautioned that should not be the sole motivator.
“It is part of being a professional, and it empowers you as an individual,” Sherman said. “And doors will open that were previously closed. But the internal transformation is every bit as powerful as anything an organization asks of you.”
Lorna Gallogly, MSN, APN-BC, a clinical nurse specialist at Beaumont Health System in Royal Oak, Mich., considers it important for the bedside nurse to pursue further education.
“It improves patient safety and patient care, because they have a knowledge base with advanced degrees,” Gallogly said. “Patient outcomes improve as a nurse has more education.”
In addition, private industry is placing a greater emphasis on education. UnitedHealth Group in Minneapolis provides tuition reimbursement to nurses interested in advanced degrees related to their practice at the health plan, and many are pursuing graduate studies, said Dawn Bazarko, DNP, MPH, RN, senior vice president of UnitedHealth Group’s Center for Nursing Advancement. Many nurses employed by the insurer, including Bazarko, already have doctoral degrees and serve as role models.
“The world has found out that nurses with master’s and doctoral degrees have a lot of skills and are being recruited by insurance companies and other companies,” said Colleen Conway-Welch, Ph.D., RN, CNM, FAAN, FACNM, dean of Vanderbilt University School of Nursing in Nashville. Employers, even outside of health care, appreciate nurses’ critical thinking skills and their ability to apply the nursing process to a variety of problems.
Aiming to make it easier for busy nurses to obtain a graduate degree, Vanderbilt has developed blended distance learning, with master’s students coming for three or four weekends per semester and doctoral students coming for one week at the start of the semester. The rest of the coursework is completed electronically.
Western Governors University in Salt Lake City offers an online master’s program and an RN-to-MSN program for students with an associate or diploma degree. Upon completion, “they can teach, and leadership opportunities are much more abundant,” said Jan Jones-Schenk, RN, MNA, NE-BC, director of nursing programs at Western Governors University.
Up and coming specialties for master’s-prepared nurses
Conway-Welch reported more hospitals are employing acute care nurse practitioners as hospitalists, especially with the cutbacks in residents’ hours, creating a need for more NPs with this skill set. She said nurses also are finding opportunities in leading quality and safety initiatives.
Susan Salmond, Ed.D., RN, reported a need for master’s prepared nurse informatics professionals, clinical nurse leaders and primary care nurse practitioners.
Susan W. Salmond, Ed.D., RN, dean and professor at the University of Medicine and Dentistry of New Jersey (UMDNJ) School of Nursing in Newark, called nursing informatics a booming field, with federal regulations for an electronic medical record and meaningful use. The school’s master’s program prepares nurses with the knowledge to blend clinical and computer expertise.
Adelphi also has established a new master’s program in health information technology and a master’s in public health with a community-based focus. Both are pending state approval, but the school has noted an increased interest in both areas of academic study. The federal government has placed an emphasis on electronic health records, and more health care is moving into the community.
Coonan noted an interest in clinical nurse specialist education, particularly for nurses in critical and emergency care, and Adelphia will consider returning such a program to its offerings.
Salmond reported an increased interest in their clinical nurse leader (CNL) program, with Jersey City Medical Center hiring as many CNLs as UMDNJ can graduate.
“I’m devoted to the clinical nurse leader, because I believe it is a position that can turn many of the safety and quality issues around,” Salmond said.
Bednash indicated growth in the clinical nurse leader program; from 2009-2010, enrollment increased by 25 percent, and employers are hiring graduates.
Enrollment in doctoral programs also is increasing, with DNP up by 36 percent and traditional, research-focused Ph.D. up by 43 percent, according to Bednash. The IOM report also recommends doubling the number of doctorally prepared nurses by 2020.
June Marshall, far right, was one of four Texas Health Dallas nurses to recently earn a DNP at TCU’s Harris College of Nursing and Health Sciences, and said it prepares nurses for a wide variety of roles.
“Doctoral education prepares nurses for a wide variety of roles in service or academia, including nurse scientist, collegiate faculty, consultants and nurse executives,” said June Marshall, DNP, RN, NEA-BC, director of advancing professional nursing practice at Texas Health Presbyterian Hospital Dallas, who recently received her DNP.
Coonan reported increased interest in its two Ph.D. programs: research and health systems, with many nurses in administrative roles returning for doctoral degrees in health systems.
The UMDNJ’s DNP program allows students to opt for a master’s degree as well. The school’s dual-track offering enables students to become a women’s health NP and midwife or adult nurse practitioner in the same time frame.
“Recognizing the complexity of the health care system and clients we see, there is a need for more education,” Salmond said.
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