University of Minnesota Turns Out 'Doctor Nurses'

Sarah Gutknecht has been a nurse practitioner for years, but in she earned a new title, of sorts - doctor nurse - as one of the first graduates of the University of Minnesota's new doctorate of nursing practice program. The creation of these doctorate, or DNP, programs is a growing national trend. Nursing school leaders believe they will address a predicted shortage of doctors in the near future and more importantly empower nurse practitioners to be leaders and problem solvers when it comes to the nation's health care woes.

Physician leaders worry that calling them doctors will confuse patients. They also believe some doctor nurses will try to "creep" to a level of practice beyond their education level and skill.

Gutknecht said she wasn't looking for a title, just a new challenge. She was already a nurse practitioner specializing in orthopedics at Gillette when she enrolled in the U program's first class. All 23 graduates from that class had to complete meaningful reform projects. Gutknecht devised a screening tool to reduce complications among children needing spinal fusion surgeries.

Classmate Katherine Casey revised scheduling in Mayo Clinic's trauma unit so that nurse practitioners monitored recovering patients and surgeons were freed up for operations and other tasks. The result: Patients have been happier and leaving the hospital sooner.

Doctors concerned about DNPs said they aren't slighting nurse practitioners, who are vital to health care, but believe it would be deceptive to equate them to physicians who undergo more extensive classroom and clinical training.

The U's Edwardson said the debate is needless, because most nurses go by first names and because the marketplace will dictate the role for DNPs. One early question was whether doctor nurses would merit greater pay than traditional nurse practitioners. Edwardson said several of the first graduates already have received raises or promotions. "So far, the market is telling us that we're on the right track," she said.

The U's doctorate program requires a year of study for nurse practitioners who already have master's degrees. Courses cover health policy, evidence-based medicine and other subjects. Most students continue in their jobs, taking Web-based courses and intensive 12-hour classroom sessions on weekends.

The university plans to take the DNP program a step further - by offering a three-year course that will convert basic registered nurses into doctor nurses. U officials believe they will be the first in the nation to offer a doctorate program to RNs starting in fall 2009.

"The demand for advanced-practice nurses in our health care system is huge," said Connie Delaney, dean of the U's school of nursing. The anticipated physician shortage may have a bigger impact on Minnesota, where a higher-than-average life expectancy means greater demand for medical care. On the other hand, Minnesota has a high per-capita rate of doctors and the nation's lowest proportion of doctors 60 and older who are nearing retirements.

Source: Pioneer Press, Jeremy Olson, 6/22/8