SON: Connections - Spring 2005

Headlines | Briefly | From the Deans Desk
Educational Evolution - Faculty Vote
to Offer a Doctor of Nursing Degree
By Lia Unrau

Nurse practitioner Marie-Annette Brown, who led the task force to study a doctor of nursing degree at the UW, talks with a woman about healthy nutrition and exercise at UW Women's Health Care Center.

When Karen Gilbert, fresh from graduation last summer, stepped into her new role as the only oncology nurse practitioner in a three-county area, she found herself facing many challenges. She wanted significant expertise to better care for her patients in rural Washington. "As a nurse practitioner [NP], I needed in-depth knowledge and experience to function independently," says Gilbert '04 MN. "I wish I had the option to either continue school for a time or to return to gain a greater sense of mastery."

For now, as a new NP, her learning curve is steep. Gilbert represents the reality of advanced nursing practice today. Many nurses are eager for additional knowledge, technology skills and practice experience as they begin their advanced practice roles.

That may be because nurse practitioners are stepping up to meet the growing national need for primary care providers and caring for increasingly complex patients with multiple chronic conditions. As they take on more responsibility, they are finding that they need additional preparation to manage resources and patients across care settings, to exert their leadership to shape the future of our national health care system, and to document the effectiveness of their practice.

Dean Nancy Woods has discussed this trend with other national nurse leaders in recent years. In 2004, she appointed a UW School of Nursing task force to look at creating a new doctoral degree at the UW focused on nursing practice.

"We have a tremendous opportunity to enhance nurses' ability to lead in our increasingly complex health care system and to improve our nation's health," Woods says.

At a meeting in January, faculty members voted to offer a new doctor of nursing (DN) degree-the first time in more than 25 years that the school has created a new degree. The UW School of Nursing is among the first schools to approve such a doctoral program, part of a trend that is expected to grow. In October 2004, the American Association of Colleges of Nurses recommended that the practice doctorate be the entry level into advanced practice by 2015.

In the 1970s, the UW School of Nursing was one of the first schools to adopt the master's degree to prepare nurse practitioners. "The practice-oriented doctor of nursing is another opportunity to prepare for the future and build interdisciplinary collaboration," says Susan Woods, associate dean for academic services.

The thumbs-up faculty vote is only the first step in the process of establishing a new degree at the UW. Because the DN is a new degree, the school must first get permission from the UW Graduate School and the state Higher Education Coordinating Board. If all goes smoothly, the earliest entry for non-master's prepared graduate students is likely to be fall 2007.

"Our task force identified three major components of a DN degree: first and foremost, advanced clinical practice, with additional emphasis on enhanced leadership skills and practice inquiry skills," says Phyllis Zimmer, lecturer in psychosocial and community health (PCH).

PRACTICE

If approved, the three-year program will feature greater exposure to simulated and hands-on clinical learning experiences, as well as a clinical residency that is individually tailored for students' chosen specialties. The school is also exploring ways to address practice at a collective level for potential students interested in community health nursing.

Advanced practice nurses (APNs) of the future will provide care to clinical groups of patients, such as those with chronic health conditions like diabetes or obesity. "We are going to need nurses who understand how to engage in partnerships with patients and families to address lifestyle changes and disease management," says Mary Ann Draye, assistant professor of PCH.

LEADERSHIP

Bachelor's and master's students learn leadership skills in their programs, but the DN would deepen and hone sophisticated leadership abilities, as well as knowledge of how health systems work so that APNs can participate in key decisions and shape policy making.

"They would not only deliver care, but would also participate in health care decision making with our colleagues who already have practice-oriented doctoral degrees-medicine, pharmacy, dentistry, physical therapy," says Marie-Annette Brown, co-chair of the dean's task force and professor of family and child nursing. "Whether in a small practice, large medical center or public health department, APNs will take a lead role in improving delivery systems and clinical practices."

PRACTICE INQUIRY

The third component, practice inquiry, will focus on investigative skills so that advanced practice nurses can improve the effectiveness of their practices. For example, APNs will collect data and evaluate various approaches to patient management to determine the best systems and methods.

"We need to better understand why some types of interventions work best for some types of patients and not for others, and how to adapt accordingly," says Diane Magyary, professor of PCH and task force co-chair. "How to motivate the entire family to take responsibility for their health care and sustain lifelong healthy habits across generations remains a mystery waiting to be solved."

Many decisions about the nascent DN program are yet to be made, but student interest is growing. Both bachelor's and master's prepared students will be able to enter the program. The School of Nursing is inviting stakeholders to express their thoughts and interests, knowing that community-based partnerships will be a key for a successful DN program, Brown says.

"At the time I received my MN, that degree was the standard of clinical excellence," says Deborah Smith '81 MN, a family nurse practitioner and assistant professor at Gonzaga University in Spokane, Wash. "The DN will now occupy that space. To stand still in the health care explosion of information is to deny potential options and growth, for both patients and students."

Doctor of Nursing Facts for Currently Licensed ARNPs

According to the Washington State Nursing Care Quality Assurance Commission, the master's degree meets the requirement for licensure as an ARNP. The practice doctorate is also expected to meet the requirement for licensure as an ARNP.
The School of Nursing plans to develop strategies for interested master's prepared ARNPs to earn the practice doctorate in a timely way, taking into consideration their background and expertise.
See www.son.washington.edu/eo/pd.asp for ongoing updates and to be added to the list of potential program applicants.

UW Doctor of Nursing Task Force

Marie-Annette Brown, co-chair, professor of family and child nursing (FCN); Diane Magyary, co-chair, professor of psychosocial and community health (PCH); Michelle Acker, senior lecturer in FCN; Eleanor Bond, professor of biobehavioral nursing and health systems (BNHS); Mary Ann Draye, assistant professor of PCH; Carol Schroeder, associate professor of PCH; JoAnne Whitney, professor of BNHS; Susan Woods, associate dean for academic services and professor of BNHS; and Phyllis Zimmer, lecturer in PCH.

Return to Headlines
Headlines | Briefly | From the Deans Desk