The DNP Advantage
They live and work across the U.S. — some in bustling cities, others in scenic mountain settings. Their backgrounds range from surgical nursing to labor and delivery. Some of them have decades of experience and others have less. One characteristic all these nurses have in common, however, is they knew that obtaining their doctor of nursing practice (DNP) degree would help them personally and professionally to be change agents in evidence-based nursing practice and leadership on all levels.
Meet eight of Vanderbilt University School of Nursing’s more than 250 DNP graduates as they share how the DNP advantage has shaped their lives and careers.
When Vanderbilt University School of Nursing launched its Doctor of Nursing Practice (DNP) degree program in 2008, school leaders hoped that, in addition to bringing valuable evidence-based knowledge to clinical settings, the degree program would also help many of its graduates move into significant roles of health care leadership.
The infusion of DNP-level nurses into leadership teams, the program’s developers believed, would positively fuel transformative change as the national health care landscape shifted toward better access to care, better quality of care and more affordable care.
Just 10 years later, Vanderbilt DNP alumni have overwhelmingly borne that out.
Among the School of Nursing’s 269 current DNP alumni are chief nursing officers, chief nursing informatics officers, academic deans, corporate leaders and advanced practice nurses at major health care networks. These individuals are earning well-deserved reputations as passionate change agents through their advocacy and adoption of evidence-based management practices and clinical care.
“In 2004, the American Association of Colleges of Nursing (AACN) called for an educational framework to provide nurses with clinical care preparedness at the doctorate level,” said Linda D. Norman, DSN, FAAN, dean of the Vanderbilt University School of Nursing and Valere Potter Menefee Professor of Nursing. She was the school’s senior associate academic dean at the time and oversaw the launch of VUSN’s DNP program just four years later in 2008.
“The DNP is a practice-focused degree that prepares advanced practice nurses to apply evidence-based knowledge to clinical practice and improve health outcomes for patients,” she said. “A DNP degree strengthens the authority of nurses with advanced degrees whether they lead complex care delivery or nursing education.”
Think at the systems’ level
Although nurse executives and leaders are nothing new, DNP nurses have blazed new territory by developing and advocating innovative and evidence-based approaches to complex problems.
Terri Allison, DNP, ACNP-BC, FAANP, directs VUSN’s DNP program. She said that DNP-educated nurses have a reputation for being able to explore novel technologies and strategies to support safe and efficient patient care, all while maintaining a keen eye on the business aspect of health care — the cost.
According to the AACN, there are 303 DNP programs currently enrolling students at schools of nursing nationwide, and an additional 124 new DNP programs are in the planning stages. Vanderbilt’s DNP program is the No. 11- ranked DNP program in the United States by U.S. News & World Report. VUSN’s inaugural class in 2008 registered 32 students. Today, the program has more than doubled, with incoming classes enrolling more than 70 students.
Vanderbilt DNP alumni — some already working in health care leadership roles or on a trajectory to their current positions when they enrolled in the program — overwhelmingly credit the completion of their DNP degrees for expanding their vision, deepening their knowledge, and giving them an undisputed seat at the table when it comes to making big picture decisions in health care.
“A doctorate is a thinking degree, so it changes how you think and how you view the world,” Allison said. “As a nurse practitioner, you know how to take care of patients, but completing a DNP program teaches a nurse to think at the systems’ level. You learn where all the parts fit together, what the resources are and what is needed to execute a plan.
“We’re seeing our graduates being hired for key leadership positions because executives at health care institutions throughout the United States clearly recognize the value of a DNP graduate, and the reputation of Vanderbilt University School of Nursing is well established,” she said. “When someone hires one of our graduates, they know they’re getting a quality individual, well-versed in applying the evidence to make positive change happen.”
Lydia Rotondo had no idea just how transformative earning nursing’s top degree would be for her career. She had previously worked in many nursing roles, including surgical critical care staff nurse, nurse manager, nursing supervisor, nurse consultant, administrator, clinical nurse specialist and nursing faculty. But the DNP would add another dimension entirely.“If luck is what happens when preparation meets opportunity, then I am indeed incredibly fortunate to have the opportunity to utilize the exceptional academic preparation I received at Vanderbilt in my professional work at the University of Rochester School of Nursing (URSON),” she said. “Following completion of the DNP program in 2013, I moved to Rochester, New York, and joined the UR School of Nursing faculty, teaching in the DNP program. Six months later, I became DNP program director and worked closely with faculty colleagues to review and revise the curriculum in response to emerging national trends in DNP education.“Based on my experience at Vanderbilt, I arrived with a keen appreciation for educational excellence, a vision for DNP practice and a passion to contribute to the DNP program at URSON — an institution with a rich history of transformative nursing education that began with founding dean, Loretta Ford, the co-developer of nurse practitioner education,” Rotondo said.Rotondo’s transformation did not stop there.
In June 2015, she was asked by URSON’s Dean Kathy Rideout, EdD, to serve as the interim associate dean for Education and Student Affairs; she assumed the position permanently a year later.
“Today, I maintain both roles as DNP program director and academic dean,” she said. “I believe these two leadership roles provide an ideal platform to advocate for DNP preparation and roles in diverse health care and organizational settings at the local and state level.” Rotondo is also a prominent voice in the national dialogue promoting DNP scholarship.
“I encourage nurses to consider that tomorrow’s nursing practice will depend on the actions of today’s nurses, and that by pursuing their DNP now, they have a unique opportunity to set the standard for future DNPs as practice leaders, clinical scholars and change agents,” she said. “Moreover, as practice pioneers, they will be uniquely positioned to respond to the challenges and opportunities of health care’s new frontier.”
Policy and partnership
Charleen Tachibana had been the chief nursing officer for Virginia Mason Medical Center in Seattle for more than a decade when she decided to return to nursing school. She wanted to polish certain skills she realized were necessary to lead others who had been immersed more recently in didactic learning environments.Another driver of her decision was the landmark Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health, which underscored the need for nurses with advanced degrees in leadership roles and issued the call to action to double the number of nurses with doctoral degrees by 2020.“First, as a nurse leader, I needed to lean into this with the same expectations that I held for the nurses who work at Virginia Mason. Lead by example,” Tachibana said. “Second, it had been many years since I had been in school, and I needed to up my game. My focus on advocacy, evidence-based practice and a few other areas were not as strong as I would like, and the DNP program addressed that. And third, I have a passion for school, learning and being in a cohort of people on a journey together. I had just come out of the Robert Wood Johnson Fellowship, and the timing was right. The DNP degree is a degree that matched my interest and the role that I hold.”
Now she wears two hats as senior vice president for quality and safety and CNO for Virginia Mason Health System, one of the top health care organizations in the Pacific Northwest. It has nine clinic locations, a research institute and two hospitals, including an acute care facility in Seattle.
Tachibana said her DNP degree also has opened her eyes to partnership opportunities with other medical professionals.
“It has allowed me to expand my focus on quality and safety to be more collaborative outside of nursing, and to be more actively involved with leading this work,” she said. “Prior to completion of my DNP, I was more focused on nursing than on other professions. The program’s emphasis on policy, advocacy, inter-collaborative work, evidence-based practice, quality improvement, population health and measurement all better help me address the health care issues we face with greater skill and knowledge.”
DNP to dream job
“I really started to see the value of what he was learning,” she said. “I was only 23 or so when I graduated with my master’s. I knew I was really young and that I had my entire career ahead. To be competitive, even in a clinical world, I saw the importance of going back to get the terminal degree.”
Broyhill was familiar with the learning culture at Vanderbilt University, having graduated from the College of Arts and Science with a bachelor’s degree in neuroscience and psychology, then going directly into the VUSN PreSpecialty Program to earn her Master of Science in Nursing in acute care in 2008. Choosing VUSN for her DNP was easy.
When she finished her DNP degree in 2013, she was quickly pulled into organizational and administrative projects for Atrium Health, one of the Southeast’s most comprehensive nonprofit health care systems (then known as Carolinas HealthCare System). She was involved in redesigning the system’s compensation plan and streamlining the onboarding of clinicians for more than 900 care locations. Broyhill was also asked to join a group that reviewed and updated institutional policies.
When her employer decided to create a new Center for Advanced Practice in spring 2013, Broyhill was selected as director of a new nurse practitioner fellowship program. She helped to grow the program quickly from five specialties to 22, making it the largest program of its type in the country. The fellowship program now graduates 50-70 NPs annually.
When Atrium Health reorganized their operational structure with multiple service-based committees that interact with each other as well as with a senior leadership team, Broyhill was asked to chair a new advanced clinical practice committee.
That work led to her selection for the newly created position of senior director of Advanced Practice, a role she calls “her dream job.” Now she works closely with Atrium Health’s senior physician leader and senior nursing officer to guide the practice of more than 1,000 advanced clinical providers.
“Once you get your DNP, I feel you have a professional obligation to do something with it,” Broyhill said. “Having your terminal degree gives you a lot of credibility, and when employers see that degree comes from Vanderbilt, that helps open a lot of doors. It’s up to you what you do with that opportunity. For me, personally, it’s helped me achieve success in a leadership position.”
Part of the national dialogue
Mary Kate FitzPatrick wanted to build leadership skills while also becoming an advocate and influencer of better patient care delivery on a broad scale. Her exploration led her to Vanderbilt’s DNP curriculum. Its focus on evidence-based practice, translation, quality, informatics and epidemiology aligned perfectly with her goals.Today FitzPatrick is the senior vice president and chief nursing officer for the University of Vermont Medical Center. She is the executive leader of 1,800 nursing full-time equivalent (FTEs) employees, as well as associate dean for academic and practice integration at the University of Vermont College of Nursing and Health Sciences.“I’ve drawn upon knowledge and skills I gained from my DNP program in countless ways, from leading a failure modes and effects analysis on two inpatient units, to working on a national project to expand awareness and knowledge of the impact of mindfulness for health care clinicians,” she said. “I have always considered myself a lifelong learner, and my DNP experience provided immense personal enrichment.”
The impact of earning her DNP reached far beyond her own institution’s walls.
“There’s an implicit credibility that comes with having doctoral preparation,” FitzPatrick said. “This credential has empowered me to be at tables and supporting important dialogue that is shaping health care locally, regionally and nationally. In 2014, I was very lucky to be selected to be part of the legacy Robert Wood Johnson Executive Nurse Fellowship, a three-year, funded program. I am confident that my experience at Vanderbilt and the development I experienced during my DNP program helped me earn a place in that incredible program.”
Thinking like a leader
As associate chief nursing officer for Advanced Practice, April Kapu, DNP, oversees an extensive program that includes more than 1,000 advanced practice professionals at Vanderbilt Health — one of the largest such groups in the United States.These professionals provide care, education and leadership at clinical sites across the entire Vanderbilt medical enterprise. Those include the adult, children’s and psychiatric areas (both inpatient and outpatient) and collaborative relationships throughout the Vanderbilt Health Affiliated Network, which contains more than 60 hospitals and 12 health systems.
Without knowledge she gained while earning her DNP, Kapu said she doubts she could be as effective a leader today.
As she began expanding her career from working as an acute care nurse practitioner, largely in cardiovascular surgery, into greater leadership roles, Kapu wanted more formal training to better understand areas such as financial data and reporting, strategic planning, negotiation skills and professional relationship building.
Kapu had earned her master’s degree in nursing from Vanderbilt in 2005, so familiarity with the faculty and the caliber of education made the school’s DNP program a natural choice.
“Without the DNP, I would have had a much harder time figuring out how to navigate executive waters and manage large groups of clinicians,” Kapu said. “The DNP changed my thinking. I think about everything in leadership differently now. I go about assessment, team dynamics and solving organizational issues differently.”
Better-rounded and equipped
As chief operating officer for WellStar Atlanta Medical Center, a 762-bed Level I trauma center with two campuses in Atlanta, Stuart Downs draws upon his DNP education continually. In this role, as in his previous one as WellStar’s chief nursing officer, he works alongside other members of the executive management team, collaborates with more than 50 nurse leaders, and guides the clinical practice of 1,100 FTEs.“The DNP program elevated me to be better-rounded in my approach as an executive leader,” Downs said, adding that the program’s foundational elements equipped him with advanced knowledge to lead in a manner that produces optimal outcomes. “Today, I realize how each of the foundational competencies in the doctor of nursing practice curriculum has bridged my clinical and leadership experiences over a river of practice-based theory, practice inquiry and clinical research (evidence).”Though he was already working in nursing leadership when he began the DNP program, having the highest clinical nursing degree designation behind his name has definitely opened doors for additional professional growth and inspired his leadership, Downs said.
“When I hear colleagues refer to me as ‘Dr. Downs,’ a certain sense of pride builds within, and I’m grateful for the opportunity of being doctorally prepared,” he said. “The DNP journey was worth it, and included challenges coupled with joyous victories. I’m truly thankful for the hours of knowledge, lecture, coaching, teaching and guidance imparted to me by the School of Nursing faculty. They will forever be my heroes because they empowered me to be my best self throughout my academic preparation.”
Building from Vanderbilt’s informatics strength
Vanderbilt University School of Nursing has a reputation for educating nurses to both develop and apply informatics to improve patient care, and that was just one reason Sheila Ochylski decided to pursue her doctoral degree in Nashville.“I needed to take my career to the next level in nursing informatics, and Vanderbilt is a known leader in advanced nursing practice,” said Ochylski, who was named chief nursing informatics officer for Veterans Health Affairs (VHA) in April 2017. “I saw the need to translate sound scientific evidence into the health care setting, and a DNP from Vanderbilt allows me to accomplish this.“Having a doctorate in nursing and attending Vanderbilt has given me an edge and opened the door. Of course, I had to be brave enough to walk through that door, and now, it is my privilege to encourage others to follow my lead.”
Ochylski’s background includes emergency room, intensive care and labor and delivery nursing, as well as owning and operating a large private duty and staffing company. Before joining the VHA, she led a complex electronic medical record implementation for a national nonprofit health care organization operating 92 hospitals in 22 states. As part of her VHA role, she continually looks for ways to use data and technology to provide evidence-based, patient-centered care to veterans. One of her first projects successfully established a governance structure for Nursing Infor-matics to engage stakeholders to work through critical decisions and ensure that changes in policy, technology and workflow are mitigated to improve quality of care. “The Nursing Informatics council establishes the voice of the staff nurse in decision-making to promote autonomy, foster accountability and encourage innovation,” Ochylski said.
“Today, I have the honor and privilege to lead the practice of nursing informatics for the largest integrated health care system in the United States,” she said. “The VHA provides care to 9 million veterans in over 1,000 facilities across the U.S. Over 90,000 nurses in this country work for the VHA. The leadership tools I gained at Vanderbilt allow me to lead teams who guide providers to improve health care for our nation’s veterans and their families.
“VA is an innovative organization and I am excited to work with the experts in the field to plan cutting-edge technology for those who gave so much,” she said. Ochylski also recommends the organization as providing fulfilling and progressive roles for nurses, noting that it is the nation’s largest employer of nurses, with opportunities for health care professionals at all levels. https://www.vacareers.va.gov/careers/nurses/index.asp
Leading during critical response
Nancye R. Feistritzer, DNP, was in a leadership role at Vanderbilt University Medical Center, serving as an associate hospital director and associate chief nursing officer over the Surgical Patient Care Center when she decided to pursue a DNP at Vanderbilt.She had spent much of her four-decade nursing career working in and directing perioperative areas. During her more than 20 years at VUMC, Feistritzer led areas beyond the operating room, including inpatient and critical care units; clinics; radiology; and the clinical laboratory. But even with her expansive training and experience, she thought something was missing from her skill set.
“I felt a need to be better prepared to assess and develop evidence about nursing best practice,” Feistritzer said. “I wanted to think differently about old problems in order to seek fresh solutions. The VUSN program was perfectly tailored to meet that need, and I often say that pursuing my DNP was the best gift I have ever given myself professionally.”
In 2014 Feistritzer was recruited to become the vice president of Patient Care Services and chief nursing officer for Emory University Hospital, a 733-bed academic medical center hospital, and Emory Wesley Woods Hospital, the inpatient behavioral health hospital for Emory Healthcare. She is also the interim vice president for the Emory Healthcare Perioperative Enterprise while a national search is underway for that position.
“In my current role I’m accountable for overseeing and enabling the practice environment for more than 1,300 nursing staff,” she said. “I’m actively engaged in representing the voice of the nurse in whatever forum I attend. I utilize professional governance, active leader rounding and interactive communication tools to ensure I am in touch with frontline nurses.”
One rewarding experience of her post-DNP journey — and an experience that tapped into her newfound skills — was being part of a quick-thinking leadership team on the frontline of the 2014 Ebola virus disease outbreak. Feistritzer was just beginning her third week as CNO when the hospital received the first of four patients with Ebola. The four were successfully treated in Emory’s Serious Communicable Disease Unit.
“It has been one of the miracle moments of my career to be associated with this team and the wonderful work being done nationally and around the world to ensure ongoing readiness for serious communicable novel agents,” she said. “Now more than ever, nurses are full-fledged members of the interprofessional team. The DNP program is well-positioned to support leaders as we continue to convey the impact of nurses on patient outcomes, satisfaction and the need for increased resilience and joy in practice for the health care team.”