September 10, 2012

Nursing programs train change agents

Lynn Babington

Q&A talks about the future of nursing education with Lynn Babington, dean and professor, School of Nursing, Fairfield University.

Q: Maybe this is too broad a question, but what's new in the field of nursing education? What's different from, say, even 10 years ago for students entering the field?

A: The newest innovation in nursing education is the introduction of the doctorate of nursing practice (DNP) degree. The DNP is a new practice-oriented doctoral degree designed to prepare advanced practice nurses at the highest level. This change was driven by evolving nursing roles in an increasing complex health care system, new scientific knowledge and ongoing concerns about the quality and outcomes of patient care. Keeping pace with the demands of today's changing health care environment requires clinical experts who have the knowledge and skills to be effective and practical change agents. Graduates of DNP programs across the country are assuming clinical and leadership positions as advanced practice nurses in a variety or roles, including expert clinician, faculty, nurse executive and community leader.

Q: Fairfield University recently received a grant to launch a revised innovative master's of science in nursing program based on an inter-professional educational model aimed at producing nurses with skills in system management, business, information technology and communication. Are nurses required to be much more than caregivers?

A: The short answer is that in order for nurses to provide high quality, cost-effective evidence-based care to patients and their families, they need the knowledge and skills to be able to use research (evidence) to guide their practice, communication skills to be effective patient advocates and critical thinking skills to navigate the health care system. Globally, there is a strong call for developing models of inter-professional collaboration in education and practice. Research supports the ideas that these models will lead to improvements in health care delivery and health outcomes. For those nurses who do not have an interest in becoming an advance practice nurse or expert clinician, there needs to be other avenues of master's education that provide nurses with the knowledge and skills to take a leadership role in the provision of health care. Nurses who are able to use a systems approach to solving problems and have the business and communication skills to develop and launch new programs and initiatives will lead change in health care delivery in this country.

Q: You are working on independent and collaborative research projects focused on education of nurses toward the care of older adults. Is that where the greatest demand is going to be for nurses in the immediate future? How does the educational model have to change to meet that need?

A: People 65+ represented 12.4 percent of the population in the year 2000 but are expected to grow to be 19 percent of the population by 2030. Fairfield University, particularly the School of Nursing, has a strong commitment to understanding and improving the health of an aging population. Nursing faculty research around the area of aging includes a focus on clinical care, quality outcomes, care of veterans and palliative care.

Q: What is the most common field of nursing being pursued currently? What is attracting young people to the nursing?

A: I do not think there is a "most common field of nursing" today. At the entry level, most nurses begin their careers working in an acute care setting (hospital) caring for patients and their families. Once they return to obtain their graduate degrees, the majority of nurses go into one of the APRN roles. The nurse practitioner role is probably the most common. There are multiple specialties including family, pediatric, adult/older adult, geriatric, women's health, psychiatric/mental health, and neonatal. These NPs primarily work in the primary care setting and are viewed by some to be the answer to the growing shortage of primary care physicians.

Q: At one point there was a shortage of nurses. Is that still a problem? Are we still dependent on foreign nurses to meet our demands?

A: There continues to be a shortage of nurses and this shortage will grow as nurses retire. The average age of the registered nurse in this country is 48 years old. As the population ages and continues to live longer and chronic health conditions increase, there is a growing demand for nurses in all care settings. One of the major impediments to increasing the supply of nurses is the lack of qualified nursing faculty. There are a shortage of doctorally prepared nurses and an aging faculty workforce. The average age of nursing faculty in the U.S. is 57 years old. There is considerable effort nationwide to increase the numbers of doctorally prepared nurses and improve the salaries of nursing faculty. The U.S. primarily relies on nurses educated in the U.S., although foreign nurses have alleviated some workforce shortages in some places in the country. The challenge before the nursing profession is to increase the pipeline by introducing the career early on in childhood. We need to recruit nurses who represent the patients we care for; we need more men and underrepresented groups to enter the nursing professions.

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