1) Gaining New Ground: Creating A Unique Approach to NP Education, 2) What’s all the Fuss About? Discussing the Doctorate of Nursing Practice and 3) Innovative Independent Practice: Carving a New Path

Abstract

1) NP educational programs have evolved across the country attracting RNs eager for the challenge and professional growth that the new role can offer. In the relative infancy of this role comes the challenge of balancing the supply of qualified instructors with the demand of an ever-increasing student population. With a limited number of experienced Masters and Doctoral prepared NPs serving as faculty, creative strategies have been required to meet this need across the country. As NP faculty is significantly more difficult to recruit and retain, unique solutions were required to effectively meet program goals of our institution with faculty who understood the reality of the role. “As the nursing faculty shortage continues to increase, it will become more vital for schools to be able to promote their own faculty and assist in their education” (Hessler & Ritchie, 2006). One of ten suggestions for schools of nursing discussed in the literature is described as the ‘grow your own’ initiative. For one university this concept led to an invitation to select recent graduates to become sessional instructors/course facilitators.

To explore the transition experiences of this select group, the instructors were asked after one to two years of part time NP instructional experience to join with fulltime continuing faculty in inductive research development. The focus of the scholarly inquiry was the student to facilitator experiences of this select group of graduates.

For the small group who took this challenge, the transition from student to facilitator marked a milestone in their professional development, and their experiences will be summarized in four themes that highlight the unique nature of this undertaking as well as discuss the development of the core competencies of research and leadership required for advanced nursing practice.

2) Although there are currently no professional doctorate degrees in Nursing offered in Canada, our American colleagues have been slowly integrating this doctoral level nursing degree into the NP curricula structure for over 30 years. The Doctorate of Nursing Practice (DNP) is designed for nurses seeking a terminal degree in nursing practice and offers an alternative to traditional research-focused doctoral programs. The DNP, like practice doctorates in other disciplines, builds on science generated by research, translates it into practice, and provides feedback, thereby putting the theory-research-practice feedback loop that has been advocated for years into action.

With the US, in 2004 the American Academy of Colleges of Nurses (AACN) approved a milestone DNP position statement which describes a target implementation date of 2015, by which all entry NPs will be prepared with a professional doctorate such as the DNP. Given that as Canadians we are still struggling to define our minimum entry to practice level, it bears investigation what our more seasoned American NP Associations determine as essential for entry to practice.

This presentation will provide an overview of the evolution of the practice doctorate, describe the degree and its components, the current recommendations for its implementation, and will clarify ‘what the fuss is all about’. Lastly, the fundamental questions of how does the DNP differ from a Nursing PhD and what are the core competencies of a DNP gradate will be addressed.

3) There are few NPs in Canada employed in independent nurse owned practice. Traditionally NPs have gained employment by District/Regional Health Authority’s, First Nation’s Band Councils, or Government Funded Agencies such as Health Canada and First Nations Inuit Health Branch. Although many RNs enter advanced practice for the autonomy, a small number are actually employed in a truly independent and autonomous role outside of an established hierarchical organization.

Within a traditional academic appointment, there are three classic elements – Research, Teaching, and Community Service. In addition, for faculty teaching NPs, many believe that the scholarship of practice is required as the fourth element. The Boyer Model of Scholarship asserts that clinical practice is considered an essential component of exemplary faculty contribution.

Finding a way to include a part time component of NP practice was deemed essential for the author, although difficult to actualize. The innovative solution was to create a unique opportunity whereby the author opened a PHC NP company and created a business plan to petition a federal government service provider in response to an identified need. This allowed for the creation of a part time NP practice, where community health care needs are being met and there is realization of scholarship of practice within a tenure-track academic role. Demonstrating that it is possible to own and operate a small independent business and be funded through an untraditional mechanism.

This presentation will describe the steps required to own and operate a successful NP business, describing barriers and facilitators to this challenging undertaking and question current beliefs and traditions in NP reimbursement.