Jana L. Pressler

The NNP/DNP shortage: transforming neonatal nurse practitioners into DNPs.

Neonatal nurse practitioners (NNPs) represent a high-demand specialty practice that is especially targeted for US secondary and tertiary care neonatal intensive care units (NICUs). NNPs make primary decisions about the caregiving of high-risk newborns at the time of admission, throughout hospitalization, at transfer, and at discharge that require an advanced knowledge base in neonatology as well as NICU clinical experience. NNPs prepared at the masters level are currently in very short supply, with some estimates suggesting that for each NNP who graduates, there are 80 positions open across the country. Even with the present shortage, due to the high cost of NNP education, NNP programs are diminishing and those that are remaining are not graduating a sufficient number of new NNPs each year to keep up with the demand. To add to the basic shortage problem, in 2004 the American Association of Colleges of Nursing decided that by 2015, the terminal degree for all nurse practitioners should move from the masters degree to the doctor of nursing practice (DNP) degree. That decision added a minimum of 12 months of full-time education to the advanced education requirements for nurse practitioners. What impact will the decision to require a DNP degree have on NNP specialty practice? Will even more NNP programs close because of faculty shortages of NNPs prepared at the DNP level? If a worse shortage occurs in the number of NNPs prepared to practice in NICUs, will physician assistants or other nonphysician clinicians who meet the need for advanced neonatal care providers replace NNPs? What steps, if any, can nursing take to ensure that NNP specialty practice is still needed and survives after supplementing the DNP requirement to NNP education?

Classification of major newborn birth injuries.

A classification system of various forms of major newborn birth injuries is clearly lacking in the literature. Currently, no scales exist for distinguishing degrees, extent, or distinctions of major birth injuries. The purpose of this study was to use published and online literature to explore the timing, prediction, and outcomes of major newborn birth injuries. Potential antecedents and causes were used in depicting what were reported to be major birth injuries. The outcome of this literature search was the development of a classification table synthesizing the most frequently reported (n = 20) major newborn birth injuries. This classification was developed according to (1) types of tissue involved in the primary injury, (2) how and when the injury occurred, and (3) the relationship of the injury to birth outcomes. A classification scheme is critically needed as the first step to achieving preventive interventions and plans for long-term recovery from birth injuries. Because major birth trauma contributes to increased neonatal morbidity and mortality, its occurrence requires careful study and preventive efforts to better promote newborn health.

Successfully climbing the academic leadership ladder.

Many new nursing leaders assuming deanship, assistant deanship, or interim deanship have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.

Interprofessional Dedicated Education Unit An Academic Practice Partnership

The need for the development of interprofessional education competencies is a significant topic in nursing education discussions today. The Institute of Medicine (IOM) called for common competencies in 2003 with use of interprofessional teams named as a core competency. However, teaching students from diverse health professions programs in joint core classes or constructing shared clinical experiences for multiple professions is challenging. Creating such a teaching-learning environment affords students opportunities to appreciate the knowledge/skills of various professionals in advancing quality patient care while learning as members of a team. The expectation is that students from multiple professions who are taught simultaneously will more easily work in teams upon graduation. Improving the quality of healthcare delivery continues to receive increased and ongoing attention. Evidence suggests that highly competent interprofessional teams result in better coordinated, higher-qualitypatient care, andbetter patient outcomes. This article describes how 1 academic-practice partnership and nursing leadership forged new territory by creating an interprofessional dedicated educational unit (IDEU) and used that unit to educate students from multiple professions, including nursing. APartnership as a Foundation for the IDEU A partnership refers to an arrangement where parties agree to cooperate to facilitatemutual interests. In nursing, academicservice partnerships are most often defined as strategic relationships established to advance their mutual practice, education, and research interests. One example of such a partnership is a dedicated education unit (DEU). A DEU refers to a unit within a hospital or other healthcare facilities dedicated to providing optimal patient care while simultaneously offering clinical education, such as nursing education. The national Veterans Administration (VA) system began explicitly encouraging partnership development between its healthcare systems and academic institutions through funding of VA Nursing Academy (VANA) across the United States. Despite not being federally funded as a VANA, the VA Boston Healthcare System(VABHS) forged a relationshipwith 6 schools of nursing in 2007 and called this the Northeast Region VA Nursing Alliance (NERVANA). Its mission, derived from the VA’s parent mission, is to ‘‘employ an innovative educational model to expand and enrich nursing students and faculty, to educate nursing students in the care of veterans, and to expose nursing students to the advancedmodel of medical informatics, patient safety, quality improvement, and integrated systems of care employed by the VA’s national healthcare system.’’ The academic partners comprising this partnership include Boston College, Northeastern University, Regis College, Simmons College, the University of Massachusetts–Boston, and the University of Massachusetts–Lowell. This partnership capitalizes on ‘‘economies of scale’’ for creating shared learning opportunities across partners (eg, preceptor workshops), allows individual schools to forward specific initiatives (eg, DEUs for clinical experiences), and creates new pedagogical models. The IDEU is one of the pedagogical projects contained within NERVANA. A long-term working relationship with NERVANA fostered discussions between Northeastern University’s School of Nursing and the VA BHS about how to build on experiences with DEUs to create an IDEU. With nursing taking the lead, department heads and division chairs at the VA BHS and Northeastern University’s Bouvé School of Health Sciences

When does outsourcing become a right source for academic excellence

Many new nursing leaders assuming deanships, assistant deanships, or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.

Supporting student success on the NCLEX-RN.

Many new nursing leaders assuming deanships, assistant, or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.

Neonatal Genetic Testing is More Than Screening

Newborn screening practices have changed since breakthroughs have occurred in genetics and mapping of the human genome. Although newborn screening has been in existence since the 1960s, todays newborn screening practices are subsumed primarily under the umbrella of genetic testing. Inclusion of the family history tool is another dimension of neonatal assessment. Technology allows many noninvasive tests to be run at a low cost but with this advance comes ethical and legal dilemmas. This article discusses neonatal genetic testing and some of the ethical dilemmas that arise.

New age literacy: Expectations for deans

Many new nursing leaders assuming deanships, assistant or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.

Closet skeletons that accompany all deanships.

Many new nursing leaders assuming deanships or assistant or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address the common issues, challenges, and opportunities that academic executive teams face, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.

Developing a culture of emergency preparedness education in nursing.

Many new nursing leaders assuming deanships, assistant, or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers.