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Nursing’s Next Level

Whether at the bench or the bedside, in the classroom or the boardroom, the Doctor of Nursing Practice program promises advancements in patient care.

By Sandra L. Gray

Fall/Winter 2008 Vitae: The Magazine of the University of Massachusetts Medical School

It is five o’clock and they’ve already put in long days, but the four nurse practitioners are enthusiastic as they gather for an evening class. They are a dedicated and accomplished group: Dawn Carpenter, MS, RN, is the lead NP for the surgical intensive care units at the UMass Memorial Medical Center University and Memorial campuses; Vinetta M. McCann, MS, RN, splits her time between medical and surgical units; Robin M. Sommers is a medical oncology NP specializing in gastrointestinal cancers at the Dana-Farber Cancer Institute outpatient clinic; and Mary E. Sullivan, MS, RN, specializes in surgical oncology at UMass Memorial.

DNP nursingThe inaugural class of the Graduate School of Nursing’s Doctor of Nursing Practice (DNP) program, Carpenter, McCann, Sommers and Sullivan are excited to be pioneers on the newest frontier in advanced practice nursing education.

“I have always wanted a doctorate but the nurse scientist PhD did not necessarily support my goals,” said Sullivan. “The DNP offers the clinical niche I seek at the doctoral level.”

In response to the increasing complexity of health care and shortages of both primary care physicians and advanced practice nurses, in 2004 the American Association of Colleges of Nursing (AACN) issued an historic position statement with the charge to elevate educational preparation for advanced practice nursing from the master’s to doctoral level by the year 2015. With approval last spring from the University of Massachusetts Board of Trustees, the GSN joined nursing schools across the nation in preparing nurse practitioners to become leaders of interprofessional health care teams.

“The hallmark of the DNP is to improve quality and outcomes— the emphasis is on better health care for our patients,” said Kathleen H. Miller, EdD, RN, professor of nursing, associate dean for Advanced Practice Programs and director of the DNP program. Along with GSN Dean Paulette Seymour Route, PhD, RN, Dr. Miller and the DNP faculty, including Rosemary Theroux, PhD, RN, launched the program well in advance of the AACN’s 2015 target, putting the GSN at the vanguard of this significant transition.

The DNP prepares advanced practice nurses for leadership roles in clinical practice and education, distinct from the Doctor of Philosophy in Nursing which focuses on creating new knowledge through research. The GSN will continue to offer the PhD program for nurses interested in research-focused academic careers, while the DNP will be the degree for nurses interested in practice-focused careers with direct patient care that intersects with evidence-based practice, quality improvement, health care administration, program evaluation and clinical faculty roles. Both doctoral programs will share faculty and resources to enrich and inform each other.

 Beginning with the launch this fall of the DNP program for advanced practice nurses already possessing a master’s degree, the GSN will incrementally phase out the current master’s program for nurse practitioners over the next five years; the current Graduate Entry Pathway (GEP) program will become a GEP to DNP pathway. The GSN will further collaborate with DNP programs at other University of Massachusetts campuses. In 2006 Amherst was the first UMass campus to establish its DNP, and UMass Lowell and UMass Boston had theirs approved along with UMass Medical School’s this spring.

The GSN has added course work to its already rigorous foundational master’s curriculum to achieve AACN standards for DNP programs. Students will take seven new courses including research and theory, health care economics and systems leadership, and population health. They will refine leadership skills during their clinical residencies.
And they will complete a capstone project applying nursing science to measurably improve the quality of care and outcomes for patients in a particular setting. “As nurse practitioners we are already turned to as experts. We teach nursing students, and our colleagues, including physicians, come to us for advice,” said McCann. “A Doctor in Nursing Practice degree will make me a more effective leader by advancing my skills and knowledge in nursing as well as my ability to successfully interpret fundamental research findings.”

Indeed, applying research findings to improve patient care is an essential goal of DNP practice and of UMass Medical School at large. Already engaged in the development of a gastrointestinal cancer database and a Phase I solid tumor vaccine trial with principal investigator and Professor of Surgery Giles F. Whalen, MD, Sullivan said, “I am reading research articles with a different eye and a new understanding since completing the Statistical Analysis of Data course.”

Another new and essential component of the DNP curriculum is nursing informatics—the discipline that combines nursing skills with information technology to translate data into applicable knowledge that will improve patient care.
“Informatics skills differentiate doctorally prepared nurses from master’s-level nurses, with the ability to manage information that will affect not only care of individuals but care across patient populations,” noted Christine Curran, PhD, RN, associate chief nursing officer for professional and business development and nursing informatics officer for UMass Memorial Medical Center.

In addition to preparing advanced practice nurses with clinical, research translation and informatics skills, the DNP will train more doctorally prepared faculty who have the expertise to teach in clinical nursing programs. Noting that we are an aging society faced with a shortage of nurses and nursing faculty, Sommers said, “The DNP provides a great opportunity for mature, experienced advanced practice nurses to mentor a new generation of nurses. I will continue to precept students while in practice, with my goal to become a faculty member for an advanced nursing degree program.”

Nursing and physician leadership at UMass Memorial Health Care and UMass Medical School will ensure DNP students and faculty have the resources and access they need to put theory into practice. UMass Memorial will support the DNP across the spectrum from prospective students to graduates. “Doctorally prepared nurses will elevate the caliber of our health care workforce,” noted Curran. “We will encourage our advanced practice nurses to participate in the program and ultimately employ many of them.”

With the DNP program, as with the traditional Master of Nursing, PhD in Nursing and Graduate Entry Pathway, the Graduate School of Nursing maintains its tradition of responding to changing needs in health care. Whether at the bench or the bedside, in the classroom or the boardroom, the program promises to advance nursing practice, science and leadership to improve patient care. “The diversity of experiences with other disciplines, the level of faculty expertise and the rigor of the program will get us where we want to go,” said Carpenter.