With a chill haunting the air of October, a handful of nurses came together for two days in Spokane and learned how to be doctors.
OK, they’re not quite doctors, but maybe something even better: At the end of seven semesters, these nurses will have doctorates. It’s almost an origin story for Spokane’s first superhero: the Super Nurse.
“We can do pretty much the same thing [as doctors],” says Lorna Schumann, an associate professor at WSU Spokane’s College of Nursing. “We can set up an independent practice.”
“They’re able to do primary care and psych and [pediatric] care,” says Anne Hirsch, the senior associate dean of academic affairs at the college. She’s also a nurse practitioner. “We’re a gateway [to physicians]. We facilitate. … We’re holistic, we look at everything going on with the patient.”
While in Spokane, the students go to research inquiry classes, slog through statistics courses and, at the end of their more than two years of learning together, will be advanced registered nurse practitioners (ARNP). They’re, in other words, a registered nurse who is able to practice independently, without a physician. They’ll be able to make diagnoses and perform physical examinations.
They’ll be able to develop and carry out treatment programs. They’ll counsel patients and write prescriptions. They’ll do it all.
And — again — they’ll have learned all this in Spokane.
In 2004, the American Association of Colleges of Nursing ruled that a doctorate was required to become an advanced practice nurse. The start date for this new rule is 2015. That’s when all ARNPs will have to have three more letters behind their names: DNP. That stands for Doctor of Nursing Practice.
The doctoral program in Spokane began in 2007. The program currently has 22 students, three of whom have advanced to candidacy status (meaning they’re this close to being done). The students come to town four times a year, meet with each other and huddle with professors. Ninety of the 120 professors in WSU’s College of Nursing are located in Spokane. The rest are in Pullman, Vancouver, the Tri-Cities, Walla Walla and Yakima. But mainly, the students in Spokane do distance learning, and practice at one of the 1,047 clinical sites the college has around the state. Still, the time spent in Spokane is invaluable, says Hirsch.
“This is the health care mecca,” she says. “We have access to incredible medical facilities here. Pullman can’t do this.”
In addition to that, the nursing students work closely with Spokane students in the WWAMI program, which is the University of Washington’s medical school program that takes students out of Seattle for much of their medical education.
Ruth Bindler, the director of the College of Nursing’s Ph.D. program here in Spokane, explains that her students will have many choices coming out of the program. Most of them — some two-thirds by Bindler’s estimate — will became educators, training the next batch of nurses. Others will become nurse researchers or health care researchers, working for larger institutions such as the Veterans Hospital or a health care cooperative like Group Health, where they’ll comb through large amounts of data and extract findings, creating more efficiencies in health care delivery. Some will go into private practice.
Despite the differences in where they end up, the advanced practice nurses all have one thing in common that is different than a regular nurse: They’ve been thoroughly trained in evidence-based practice, a level of educational sophistication that allows for wider views of medicine.
Bindler is quick to point out that the advanced practice nurses who will go into practice with a doctor (even though they could go it alone) are partners in good medicine. There’s no usurping of authority or expertise here.
“They’re real partners,” she says. “The silos between professions get broken down in real life. … They’re working as a health care team.”
Hirsch agrees. “We’re not in competition with the physicians,” she says. “We collaborate [and] allow them to focus on the complex issues.”