Primary care shortage raises profile of nurses with advanced degrees

A Twin Cities foundation will invest $10 million in a University of Minnesota program that develops highly trained nurses.

By funding the U of M's Doctor of Nursing Practice program, the the Bentson Foundation aims to help supply Minnesota with more nurses who have doctorate-level training in family medicine, geriatrics and other specialties.

The Bentson Foundation will provide $20,000 scholarships, enough to pay for about a year of training in the three-year program. In exchange for the funding, the university has agreed to graduate an additional 500 advanced practice nurses over the next decade. Highly trained nurses are seen as a potentially cost-effective way to extend routine medical care to underserved patients.

Nurses with doctoral degrees are trained to diagnose and treat conditions, prescribe drugs, and could lead a primary care practice with some physician oversight.

Among those who have received the training is Alison Romstad, a 36-year-old traveling nurse. A recent trip took her to see Ruth Peterson at her small assisted living apartment in Wyoming, Minn.

Peterson, 83, took a tumble recently and Romstad went to check on her bruised knee. As it turned out, Peterson hasn't had any other falls, and her knee is fine.

But the visit illustrated the importance of nurses like Romstad, who recently completed additional nursing studies and earned a doctorate degree on top of her master's degree in nursing.

Nurse practitioners can't do everything that primary care doctors can do. Researchers estimate they can do 60 to 80 percent of what a family physician does for about half the pay.

To provide such training, nursing schools are changing their graduate-level training from a two year master's program to a three-year degree program that confers a Doctor of Nursing Practice.

Romstad, who returned to the University of Minnesota for the additional training a few years ago, said it helped her move the nurses in her department to an electronic medical record system.

"Within our department we historically were just doing paper notes and a lot of our employees didn't even know what 'right click' meant," she said. "They were phenomenal nurse practitioners but had no computer experience and had no idea how to operate an EMR."

A nurse who can harness the power of an electronic medical record can take better care of patients said Mary Chesney, director of U of M's Doctor of Nursing Practice program.

Those skills are especially important in today's health care environment where there's a lot of focus on controlling costs and improving care, especially for expensive chronic conditions such as diabetes and heart disease, Chesney said.

"They're learning how to pull data records so that they can track trends," she said. "They can track [health status] before you implement a quality improvement program and they can track patient outcomes after."

Chesney said research indicates that skilled use of electronic medical records can improve the health of a community.

That potential payoff was appealing to the Bentson Foundation. Executive Director Judi Dutcher said her organization considered giving scholarships to family practice physicians, but discovered it could help place many more nurses in the field.

"We just felt that we would have a bigger impact through the dollars we could give in terms of educating these really well-qualified nurses," Dutcher said. "And it just came down to economics."