Inside USD

Nursing School Prescribes Education, Advocacy

Friday, March 25, 2011

Health care is on just about everyone’s mind. It’s inescapable, really. Rising costs, obtaining quality care and accessibility, are just a few reasons to think about it. The passing of the Patient Protection and Affordable Healthcare Act, signed into law a year ago, remains a hot-button issue.

At USD, specifically in the Hahn School of Nursing and Health Science, health care certainly has the attention of administrators and faculty. They’re doing their part to inform federal and state officials connected to budgets and legislation to consider the impact that would result from cutting funding for nurse education programs, training, retention and more, especially when a nursing shortage already exists.

“If you cut funding, that’s less advanced practice nurses that will be available,” said Sally Hardin, USD’s nursing dean. “We produce these nurses, but we need the funds to hire faculty, for our laboratory and to buy supplies. We’re not looking for an increase, we’re hoping they don’t cut funding.”

The nursing shortage in California has been a sore spot for some time. In an August 2010 report, the California Board of Registered Nursing estimated the state’s Registered Nurse (RN) shortage was between 10,294 and 59,027 full-time positions. In December 2009, workforce analysts from the Bureau of Labor Statistics projected that more than 581,500 new RN positions will be created through 2018. The latter is a positive, but not if there is a key component missing.

“There’s a nursing shortage because of a lack of qualified faculty,” said Karen Macauley, director of USD’s Simulation and Standardized Patient Nursing Laboratory and clinical associate professor. “There aren’t enough spots for California, public school nurses or private universities to train all of these nurses. There has to be a bigger effort like what we’re doing at USD to train faculty. We’ve provided faculty for other area schools like San Diego State University, California State University, San Marcos and Point Loma Nazarene. UCSD (University of California, San Diego) uses our lab to train re-entry nurses. We outsource our lab for that. The program’s huge.”

USD, strictly a graduate nursing school, is doing its part. The school offers strong PhD and Doctor of Nursing Practice (DNP) programs as well as its Master of Science program. There’s also a fast-track program, the Master’s Entry Program in Nursing (MEPN), where students already possessing a bachelor’s degree can obtain a Master’s degree. The MEPN program opened in 2002 with a cap of 30 students. That cap is now at 50 students. Because these students have a BA, their knowledge, say in business or engineering or something else, enhances their abilities. It opens the door to obtaining a PhD and, potentially, to a nurse faculty position. International programs and research grants provide students opportunities to strengthen their skills set.

Hardin said there are 465 full-time equivalent nursing students in an assortment of advance degree programs at USD. The school graduates 15-19 PhD students each year and the number of applicants for its PhD program exceeds the 15 open spots available each year. She said USD’s PhD program has a 98 percent completion rate, demonstrating the quality of a nursing student that emerges from USD.

Maintaining funding so that students can attend USD and other nursing programs, however, is crucial to that success. Hardin, Macauley and others are involved in local and national organizations and stay current on policy matters.

Macauley attended the American College of Nurse Practitioners’ National Summit and Leadership Conference in Washington D.C. in late February. She learned about current legislation and issues facing nurse practitioners’ scope of practice and education funding. She spoke to health care liaisons for U.S. House Minority Leader Nancy Pelosi (D-CA), Senator Barbara Boxer (D-CA) and Rep. Darrell Issa (R-CA). Macauley’s meeting with Issa’s deputy chief of staff, Veronica Wong, was particularly positive. Issa has an office in Vista, Calif., and Macauley’s interaction could increase USD’s visibility with Issa’s office for input on legislation affecting nursing education.

“Any time that I or any of our faculty members can make contact, explain things and offer our point of view, it cannot hurt,” Hardin said. “It’s important that they know they have us as a resource.”

Making students fully aware and encouraging their diligence with health care policy has a place within the curriculum.

“We encourage our students to get involved at the health policy level, to get involved in local chapters of associations to promote nurse practitioners and nursing issues in general,” Macauley said. “We try to light a fire under them. Yes, they can take care of their patients and do a really good job, be cost-effective, reduce costs and look at new legalities of treating patients, but we need to look at more global responses to advocate for our practice.”

Last year, Hardin went to Washington D.C. for an American Association of Colleges of Nursing Health Care Policy Summit, taking USD PhD students, Amy Carney ’10 and Dale Todicheeney ‘11. The students learned about federal structures and processes that impact nursing research. Carney, who landed a full-time, tenure-track nursing professor at California State University, San Marcos, upon getting her PhD from USD, said the trip demonstrated the kind of investment USD makes in its students.

“Given the current economy in California, funding for nursing education is never far from our minds,” Carney said. “During the D.C. conference we were taught to speak about what was important to us and to ask for the resources we need and to be able to articulate why we need them. That’s important every day when thinking about health care dollars.”

— Ryan T. Blystone

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