Considering Advancing Your Nursing Degree?

By Deborah Small, DNP, MSN, BSN, RN, NE-BC

From its recently re-introduced Nurse Associate Extern program to its one-of-a-kind New Graduate Nurse Residency and generous tuition reimbursement offerings, Cleveland Clinic Nursing promotes lifelong learning and advanced education no matter where you are in your nursing career.

And new expectations for the role of the nurse coupled with today’s fast-paced nursing environment make advanced education imperative. The landmark 2010 Institute of Medicine report: The Future of Nursing: Leading Change, Advancing Health calls on nurses to have a greater role in America’s increasingly complex healthcare system. It offers various recommendations on the critical intersection between the health needs of diverse and changing patient populations, and the actions of the nursing workforce.

The report is centered on four main issues, with the second being: “Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.”

However, while many nurses understand the great importance of advancing their professional degrees, it can be viewed as a daunting challenge to which to commit. I can personally attest to these feelings as I had them myself. As the chief nursing officer of Cleveland Clinic Fairview Hospital, I, like most nurses working full-time with families, came up with many excuses to delay enrollment in school – from my busy schedule to role and responsibility changes—or simply lack of time. I can recall the exact moment one of my colleagues said to me: “Just enroll – you will be surprised at the time you will find.”

My colleague was right. I recently earned my Doctor of Nursing Practice (DNP) degree from Cleveland, Ohio-based Case Western Reserve University. I admit the journey was, at times, long and laborious, but no doubt one of the greatest personal achievements of my career.

As I worked to complete my doctorate, I noted a selection of helpful tips to aid me with the process of going back to school and the great benefits I realized as I stepped back into the role of a nursing student. I felt these could be of value to other nurses considering furthering their education.

Helpful tips to consider when going back to school

While thoughts, opinions and words of wisdom certainly vary from person-to-person, I found the following tips useful:

• Stand behind your choice to go back to school.
• Establish timeframes for completion of applications, and don’t let the application process overwhelm you.
• Understand the finances, including payment process, payment schedule, etc.
• Use available resources to help you with the enrollment process, such as EdAssistTM, which offers a wealth of information and career guidance.
• Find a buddy, friend or colleague with whom to share your education journey.
• Know that it is completely fine to take one course at time and go at your own pace.
• Set and establish goals and associated timelines for your education plan.
• Use available library resources.
• Meet with your advisor frequently to ensure you are staying on track with your plan.
• Share what you are learning with your nursing colleagues.
• Celebrate your accomplishments.

Notable benefits realized as a nursing student

Education feeds your passion for nursing

Education makes lasting changes in the lives of those who seek it. It provides opportunity, flexibility and critical thinking skills to navigate the ever-changing healthcare setting. Education changes people’s stories. Going back to school gave me the opportunity to feed my passion for nursing. While in school, I was immersed in networking with new colleagues and challenged by great nursing professors to think differently, transform my leadership style, to be more politically savvy and to manage with meaning – all of which have allowed me to lead more effectively today.

Education is a catalyst for future healthcare change

Education is one of the most powerful catalysts we have to encourage change in the future of healthcare. For example, while pursuing my degree, it became obvious to me that as nurses we have spent many years of our careers qualifying the educational level and competency for entry into practice and professional autonomy. As early as the 1960s, we have been working to establish core competencies and skills in the academic arenas. Understanding this history and continuing to work with various action coalitions and boards is important to influencing practice changes for the future – and having a place at the table with regard to political changes.

Education offers professional insight on the past, while pointing to opportunities for the future

During my DNP journey, I was exposed to many political venues and opinions that have shaped the practice of nursing into what it is today. My coursework included review of articles and leadership stories that were instrumental in establishing the nursing profession. The program emphasized the need to be politically informed and to educate, communicate and collaborate in providing nurses an understanding about legislative process, health policy issues and an awareness of the influential voice of nursing. As a result of my studies, I worked with my colleagues to start a Cleveland Clinic Nursing Legislative and Practice Council to better understand the political arena and encourage Cleveland Clinic nurses to have a more active voice in healthcare politics.

Education unveils successes and failures in nursing practice

As I was working toward my degree, I found I could apply much of the knowledge I was gaining to my own organization. Specifically, I was able to garner added insight into practices that were not being sustained on nursing units and create nurse-driven protocols that were evidenced-based and nursing owned. For example, using research methodology inclusive of surveys and focus groups, I found that staff did not understand the evidence behind many of the initiatives we implemented, such as bedside handoffs and fall prevention, both of which are nurse-driven practices.

Results of a bedside-handoff survey revealed a handoff to sometimes be considered stressful and inconsistent for each provider. To address these results, we initiated two unit-specific pilots that included a scripted toolkit to improve communications and alleviate handoff-related stress. To date, audited compliance is now at 90 percent and nurse communication is at an all-time high with results in the 90th percentile.

Additionally, as a nurse leader, role modeling, encouraging and supporting nursing staff members to seek higher degrees and further their knowledge is imperative. It is this furthering of education that will open the path to innovation for the future of our profession.

Deborah Small is Vice President of Patient Care Services and Chief Nursing Officer of Cleveland Clinic Fairview Hospital.

Photo credit:© Andrew Jordon Photography LLC