President's Point

NONPF Newsletter, Volume 11, Number 4, 2000

Academic Nursing Centers: Raising the Bar in Graduate Nursing Education

When a college of nursing owns and operates an academic nursing center (ANC), it raises the bar for the quality and quantity of learning options for students. This is true for not only nurse practitioner (NP) students but also students of community and clinical nursing specialties, administration, undergraduate students, and students from other disciplines. Watching the effort and creativity required to sustain such a center is a major learning in itself.

Students increasingly have the opportunity to learn in ANCs. In looking at AACN and NONPF data, I estimate that there are about 200 ANC sites in the nation. Have we reached the “tipping point¹” in which this “disruptive innovation²” is taking hold—will ANCs be here in the future, and will they make a difference in health care delivery? I think we have not yet reached the tipping point, but the potential for making a difference is real if ANCs have collective creativity and collective data systems, enabling a strong collective voice. Incrementally, through regional networks, we are joining forces. Now NONPF has the opportunity to take the leadership in networking at the national level among our members involved in ANCs. Joanne Pohl, Chair of our Faculty Practice Committee is exploring this idea now.

However, I digress.

Raising the bar in nursing education occurs naturally because nursing faculties are accountable for the entire system—health care delivery, education, and research in the context of community service. The ANC faculty, our contemporary nursing pioneers, are excellent role models. They are filled with a drive to provide the best possible care to a select clientele; they appreciate contributions of a multidisciplinary team, including physicians, pharmacists, professional social workers and lay case managers; they are outcomes-oriented and pragmatic; and they necessarily integrate practice, teaching and scholarship in a day’s work. The concept of clinician/manager is real life in ANCs—most of the clinicians help to manage some aspects of the practice for the center to survive, and the primary site manager is frequently an APN who also provides health services. If nothing else, many teacher/clinicians have had intensive training in charting and coding for billing. Such work can be energizing, intellectually stimulating, and satisfying, but it also can be exhausting.

The challenge of sustaining ANCs is enormous. We have all of the challenges facing traditional health care delivery systems: aging population and aging work force; inadequate health care technology, limiting quality, safety, and cost effectiveness of care; limited resources; and a growing uninsured population. Furthermore, ANCs must overcome inequitable reimbursement, significant legal restrictions, lack of practice management infrastructure even on academic health science campuses, and limited public awareness of our contributions. We are fortunate to have foundations and governmental agencies (especially the Division of Nursing) which have supported nurse-managed centers on the way to sustainability.

As nursing faculties address one ANC issue after another, our students are there, helping and learning about policy, systems, persistence, collaboration, independence, and other internal and external forces that can produce strong health care leaders. The faculty members wisely learn to incorporate students in almost every aspect of the practice. Therefore, the ANC students are likely to have had experience with managing not only health care but also with managing the business and system of health care. They make great employees. Yes, ANCs have definitely raised the bar in graduate nursing education.³

Ever onward,

Lucy Marion, PhD, APRN, BC, FAAN

References

¹ Gladwell, Macolm (2000). The tipping point: How little things can make a big difference. Little, Brown, and Company

² Christensen, C., Bohmer, R, & Kenagy, J (2000). Will disruptive innovations cure health care? Harvard Business Review, 102-112.

³ Taylor, D. & Marion, L. (2000). Innovative practice models: Uniting advanced nursing practice and education (Chapter 21). In A.B. Hamric, J.A. Spross, & C.M. Hanson (Eds.), Advanced Nursing Practice (2nd edition). Philadelphia: W.B. Saunders.