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A higher level of nursing proficiency


New doctorate-level program the first to upgrade nurse practitioners in the New North

Story by Amie J. Schaenzer

RIGHT NOW, JULIE SCHNEIDER IS A NURSE, but in a couple short years, she will also be a doctor.

Schneider, a family nurse practitioner for Agnesian Health Care in Fond du Lac, is enrolled in the University of Wisconsin-Oshkosh’s new Doctor of Nursing Practice program – or DNP, for short – which first started accepting students this past summer. If all goes as planned, she will be part of the first graduating class of students with their DNP in 2012. The program through the College of Nursing is the first doctoral degree program available at UW-Oshkosh.

“I got my master’s degree in 2004…so I have been in this field for awhile. I knew that this field was progressing and that I had to step it up to progress with the field,” Schneider said. “This ever-changing world of health care needs educated nurses at the highest level.”

Over the past three years, more DNP programs have been popping up nationwide, whereas before that, the program was much more scarce, said Kim Udlis, Ph.D., coordinator for the DNP program at UW-Oshkosh. The American Association of Colleges of Nursing (AACN) recently upped its requirements for entry-level advanced practice nurses, which includes nurse practitioners, clinical nurse specialists, nurse midwives or nurse anesthetists. The AACN set requirements for advanced practice nurses to have their DNP by 2015. In today’s current job market, most advanced practice nurses don’t pursue much more formal education beyond their master’s degree.

“This was important to UW-Oshkosh because we’ve been known for our stellar nurse practitioner program. With the AACN pulling for the DNP for entry-level for nursing practitioners, Oshkosh really needed to look to be on the edge of this advancement,” Udlis said.

The new program started this past summer and there are currently six students enrolled in the first cohort.

“It’s addressing a need for this area. We need nurses at that level and we also need nurses to train other nursing students at that level,” Udlis said.

The program should take two years to complete and goes year-round. Students take seven 4-credit classes for a total of 28 doctorate credits. The first four classes are online, Udlis said.

“Many of these nurse practitioners were working fulltime or were the sole bread winners for their family, so we knew we had to offer this in a user friendly way,” she said.

Currently, UW-Oshkosh offers a master’s degree to DNP track for students and will begin to offer a bachelor’s degree to DNP option in 2012.

Balancing act

THE SIX DNP STUDENTS enrolled at UW-Oshkosh have a background as nurse practitioners and administrators. Many plan to continue working in their same role after they graduate while others plan to use their degree to teach other nursing students.

For those remaining in their same jobs, there is no evidence at this point that the DNP degree translates to a higher salary, Udlis said. She also said accrediting bodies still accept master’s level degrees for advanced practice nurses.

“It’s a wave of change right now and this is how things are progressing,” Udlis said. “This is a new degree for our marketplace, especially in the Fox Valley. We know now that we have to advance the knowledge of our advance nursing to make them more systems aware and more health outcomes aware.”

Besides the requirements set by the AACN, nurse practitioners cite many other reasons for wanting to obtain their doctoral degree. Nurse practitioners and educators say the respect from peers that comes along with obtaining a doctorate degree, being able to more efficiently do their jobs and add more insight into their fields, as well as the ability to take on more leadership roles are all reasons for moving forward with their education.

“This is a practice doctorate. This is not a research doctorate. I am going to practice, I am going to do it better, I am going to do it with better efficiency,” said Schneider. “(DNP) nurses want to practice. We just want to be good at what we do.”

For Schneider, prior to enrolling in the program, she was already balancing fulltime work at a busy clinic and life as a mom for three children under the age of 8 years old. She said there are around 120 DNP programs nationwide, but UW-Oshkosh’s program was the only one located in the Fox Valley. Schneider added the program so far has been flexible, and she has been able to manage it despite her busy schedule.

“I can get it done at my leisure and my pace,” she said.

Making the time commitment was a hard decision initially, but Schneider said the changing atmosphere of medicine, wanting to stay current in her field, and the goal of doing the best job in the most efficient way were all reasons for her to enroll.

She also said more is expected of nurses than ever before. Clinics, such as the one in which she works, see more patients coming in with various conditions than ever before. In the past, such patients went to the hospital for care, but now seek treatment at a clinic because it’s more economical, more efficient, and they often can return home right after their visit.

“The patients we are seeing are just different. The guidelines are different. We have to keep up to date,” Schneider said.

Nurses with doctorates: Is it necessary?

NURSING SCHOOLS ARE EVENTUALLY LOOKING to have nurse practitioners graduating at the doctoral level for entry-level jobs by 2015. But no specific regulations or legislation to that effect is in place at this point, said Kristin Matthias, employment specialist for Theda Care in Appleton.

“We will follow suit with whatever the requirements might be,” she said.

In recent years, similar changes have occurred with physical therapy and pharmacists. While master’s degrees were sufficient education before, now ThedaCare is hiring professionals for those positions with doctorates.

Right now, the majority of entry-level nurse practitioners continue to be hired with a master’s degree, Matthias said. If the requirements do change in coming years, there is typically a gap in hiring as employers wait for medical professionals to obtain their doctorates, she said.

“We have had to adapt to that in the past,” Matthias said.

According to a 2009 survey by Advance for Nurse Practitioners, a medical journal for the field, critics of requiring a doctorate-level degree in nursing cite three primary issues. First, that such a requirement would mean too much time in a classroom for advanced practice nurses and not as much hands-on experience. Second, that money spent on tuition for a doctoral degree will not automatically relate to a higher salary. Lastly, critics argue a push for the DNP requirement is blurring the lines for patients between nurses and doctors and lessening the credibility of the actual doctors. Those responding to the survey also said such a mandate would add to the nursing shortage, by forcing more nurses to advance their education, and would also require more doctorate-educated nurses to teach DNP courses, taking them away from actual practice.

But for students, like Schneider, who have decided to go ahead with their DNP degree at this point, it’s all about preparing for the future of health care.

“I do think we are near a change,” she said.

Amie is a freelance writer who spent three years writing and reporting for daily newspapers in the Fox Valley, including the Oshkosh Northwestern and the Fond du Lac Reporter. Amie was born and raised in the Fox Valley area (Hortonville) and received her degree in journalism from UW-Oshkosh.