New Hampshire is working hard to see to it residents have access to high-skilled nursing care amid a shortage of qualified healthcare providers in the state. A December 2015 article in Dover’s Foster’s Daily Democrat revealed that New Hampshire’s home-based pediatric nursing shortage is so severe that families with children with complex medical issues sometimes wait months to receive care. This isn’t the only example of how the shortage of qualified healthcare providers has been limiting access to care in the state. A March 2016 WMUR Manchester report found that a new crisis unit at New Hampshire Hospital established to alleviate the overload of acute mental health patients in other institutions was completed in July 2015, but has been unable to take on any patients due to a lack of nurses to staff the unit.
With a focus on meeting the Institute of Medicine’s goal of achieving a more educated workforce, many New Hampshire institutions are not only seeking to recruit nurses, but are more often looking to retain RNs and APRNs with advanced degrees like the Doctor of Nursing Practice (DNP). Now more than ever, DNP-prepared nurses are needed to fill clinical leadership roles, administrative positions, and clinical faculty positions throughout New Hampshire.
New Hampshire’s DNP-prepared nurses serve as leaders in the clinical environment and hold important positions where they have an opportunity to influence healthcare policy:
- Marilyn Daley, DNP, APRN, CHFN, Clinical Director Cardiomyopathy Clinic, New England Heart Institute: Manchester
- Sherrie Palmieri, NP, MBA, RN, CPHQ, New Hampshire Action Coalition, Future of Nursing Campaign for Action
Earning a Doctor of Nursing Practice (DNP) in New Hampshire
Accredited DNP programs provide focus areas in at least one of the following:
- An advanced practice nursing direct care focus (nurse practitioner, nurse midwife, nurse anesthetist, clinical nurse specialist)
- An aggregate/systems/organizational focus
Unlike PhD nursing programs, which prepare nurses for research-based careers, DNP programs are designed for nurses with an interest in holding leadership positions in clinical practice, administrative positions, or clinical nursing education positions.
A host of institutions across the U.S. offer online DNP programs, with specializations in advanced practice and leadership roles. Students of these programs complete all didactic requirements through online courses then complete the clinical component of the program at partner sites close to home. It is also commonplace for colleges and universities with online programs to require students to attend an on-campus immersion experience, which provides them with an opportunity to network with their peers, professors, and leaders in the industry.
Depending on the institution’s offerings, students may focus their DNP program on areas such as:
- An advanced practice registered nursing (APRN) role (nurse practitioner, clinical nurse specialist, nurse anesthetist, and nurse-midwife)
- Nurse leadership/management/administration
- Clinical nurse education
- Health policy
Post Master’s MSN-to-DNP Programs for MSN-Prepared RNs and APRNs
Full-time MSN-DNP programs are between 18 and 24 months in duration, consisting of about 35 credits. A number of colleges and universities offer accelerated programs, which take about 12 months to complete, as well as part-time programs, which take about 2 ½ years to complete.
The core of a DNP program includes courses such as:
- Scientific Foundations for Practice Doctorate
- Ethics, Policy, and Advocacy or Population Health
- Applied statistics for evidence-based practice
- Quality Improvement and Patient Safety
The DNP also includes courses in the chosen specialty. A couple examples include:
Adult-Gerontology Acute Care
- Differential diagnosis clinical
- Diagnostic physical exam across the lifespan
- Differential diagnosis theory across the lifespan
- Management of adult episodic/chronic health problems in acute care theory
- Leadership in complex systems
- Evidence-based quality improvement
- Clinical systems analysis and design
CCNE-accredited programs must include a clinical component of at least 1,000 hours, 500 of which may be transferred from the student’s MSN program. Furthermore, most programs include a DNP project, designed to encapsulate the student’s academic experience.
Post-Bachelor’s BSN-to-DNP Programs for BSN-Prepared Nurses
DNP programs aren’t just reserved for MSN candidates anymore. In fact, many institutions now offer BSN-DNP programs for the BSN-prepared RN. These programs combine the components of both the MSN and the DNP, allowing students to seamlessly transition to the DNP upon the successful completion of all MSN components. In many cases, these programs result in both an MSN and DNP.
Depending on the chosen concentration, students of these programs may be required to earn national certification in their chosen APRN role and population focus before transitioning to the DNP component of the program.
The core of an MSN includes study in:
- Clinical prevention/population health
- Evidence-based practice
- Interprofessional collaboration
- Organizational and systems leadership
- Policy and advocacy
- Program evaluation for improving patient and population outcomes
- Quality and safety
Additional coursework in an MSN focuses on the chosen MSN specialty. BSN-DNP programs consist of anywhere between 75 and 94 credits, and take three-four years of full-time study, depending on the chosen focus.
Opportunities Available to DNP-Prepared Nurses in New Hampshire
Today’s DNP nurses are well prepared to meet the complex challenges facing our nation’s healthcare systems, whether working in a clinical specialty or in the leadership or management of healthcare delivery systems. Nurses who have earned their DNP often enjoy an array of benefits, including advancement with their current employer and expanded job opportunities.
Just a few of the leading healthcare institutions in New Hampshire where DNP graduates serve as valuable members of the healthcare team include:
- Concord Hospital, Concord
- Dartmouth-Hitchcock Medical Center, Lebanon
- Exeter Hospital, Exeter
- Joseph Hospital, Nashua