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IN KANSAS, the confusion is compounded by two things. First, WSU' program isn't a master's degree program, even though the graduates are called nurse clinicians.
University Dallv Kansan
Second, the nurse practitioner program at the Med Center graduates both nurse practitioners and nurse clinicians, depending on the educational background of the graduate. The nurse practitioner program from a baccalaureate or diploma nursing program, she is called a nurse practitioner at the end of the program, Barnard said. However, a nurse who enters the program after receiving a master's degree is called a nurse clinician upon graduation.
Carla A. Lee, project director of the WSU program, said it was called the nurse in 1970 and the internship grant in 1970 was given to the project under that name. Then in June 1974, the roles were officially defined by the ANA, and WSU's nurse in 1975 was the ANA's nurse clinician category. Lee said.
LEE SAID the WSU nurse clinician program was actually similar to the nurse programa, but the program had no training.
She said her program took registered nurses who were actively employed and sponsored by either a physician or commissioner. Priority is given to rural setting nurses.
"The whole idea of our program is to get nurses out into rural Kansas," she said, "but our intent isn't that they take the place of the doctor.
The first eight weeks of the nurse clinician program are used to teach four skills including clinical assessment, which includes medical history and physical assessment. The second area is psycho-social pathophysiology. The third is clinical pathophysiology.
"Our nurse clinicians are professionals in and of themselves, and they work collaboratively with physicians. They're not doctors. They're not dentists. They work interdependently."
"IN THIS AREA, we talk about the wellness-to-illness continuum, where they into growth and development and normal processes, we stress the identification of abnormal from normal, emphasizing that our students have to know normal first before they can
The last area taught in the eight weeks is the concept of the health care team. In this, the nurse learns to work in her expanded role as a primary physician or physician and other health team members.
Next, each nurse in the program goes on a ten-month preceptorship in a rural setting, to practice the skills learned during the first eight weeks. Lee said.
At the end of the program, graduates receive a certificate of completion. So far, the program has graduated 57 nurse clinicians, Lee said.
The program originated at the Med Center and then was transferred to the Hospital in 1918. It was later renamed
Related Professions, not part of the Med Center's branch at WSU. Lee said.
THE NURSE PRACTITIONER program at the Med Center is also a 12-month program that is designed to train the registered nurse for an expanded role in the medical service. In seven Med Center departments in 1971, the program currently has 48 graduates.
Edward C. Defo, director of the institute, presided over the nurse was ideal suited for an expurgator.
"The physician is medical disease oriented, but the nurse is more oriented to clinical practice. I am by dint of her background, has a broad social and psychological perspective. She should, with help, have much more to offer in terms of life experience with a daily environmental problems."
Defoe said the nurse practitioner had two roles. She is trained to do the job of a physician's assistant, and she also has a broader role as a health educator, he said.
FOR THE FIRST two weeks, the nurses learn how to take medical histories and do physical examinations. Then for 10 weeks, they do supervised clinical work with students, also送 them seminars and lectures. Deborah said they were then evaluated for proficiency.
The next step is a nine-month precepc-
hip with a physician in a community
setting. Defo said. During this period, the
physician met with the nurse at the
Med Center are put into practice.
According to Defo, the nurse practitioner can't write prescriptions or take care of medical disease problems on her behalf. The physician assume responsibility for these.
"An increasing number of physicians are enthusiastic, since they realize how the nurse practitioner can complement them," Defofe said.
There are many more applicants than there are openings in the program at the present time.
"We have 45 applicants now, without recruitment," he said. "Applicants have been from 14 states, with the majority from Kansas."
DEFOE SAID that 3,511 of the 12,655 registered nurses in Kansas were inactive. Recruitment of these inactive nurses would be stressed. he said.
Barnard said there was a 70 per cent
"Nurses must be bored," she said. "They're not using their heads. They're given a good college or junior college education, and then they're told to just follow orders, stay at the desk and do charts."
national turnover rate per year in nursing jobs.
Several graduates of the nurse practitioner program agreed that their new role was more satisfying and challenging than previous nursing jobs.
Training nurses to function in an expanded role is one way to lessen job dissatisfaction and the high turnover rate, Barnard said.
Georia Crouch, who formerly was the head nurse in pediatric outpatients at the Med Center, became a nurse practitioner when she was disillusioned with her aid job.
"What I was doing wasn't really nursing at all," she said. "There was no patient interaction or contact. All I did was put glove injections and give injection and do administrative work."
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Crouch now is part of a physician-nurse-patient group at the Pediatric Group at the Med Center. She said that she and her doctor teammate, Burton A. Dudding, chairman of pediatrics, did not know the patient's name.
"I handle most of the well-baby checks and minor illnesses, and if I feel I have reached my limit, I consult with Dr. Dudding and he intervenes," she said. "If he's seeing a patient that needs counseling, he refers the patient to me."
Crouch said that patient acceptance of Crouch had been good. While some patients want to see the doctor rather than her, other doctors say they see her instead of the doctor, she said.
One nurse practitioner who has worked in rural setting is Michele Craig, who had her doctorate from the University of Pennsylvania.
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"I wanted to bring primary health care to
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a community that hadn't had it and couldn't get it in other ways," she said. "I did a lot of teaching and counseling with expectant mothers to work with little babies and watch them grow."
CRAIG CONSULTED often with a doctor in Gardner and sent patients there if she couldn't provide the necessary care on her own.
"Eventually my patients learned to trust me, and they would call with questions they had," she said. "They could pick up the phone and get preventive information from me, which would keep small problems from turning into major ones."
Craig now wants to go in pediatric work at the Med Center. She said that later she might go back into a clinic on her own in a rural area away from Kansas City.
Virginia Hagemed, another nurse practitioner, was employed by a physician's group in Kansas City, Kan. before taking the nurse practitioner training. She said that she was in charge of the office and took blood pressure, temperature and pulse.
"A nurse practitioner student was seen from the Med Center, and the doctors put her on a trial basis." Hagedorn said. "She worked with them for a few months.
"I was at a standstill in what I was doing in the office," she said, "and maybe I was a little jesus of what the nurse practitioner should do. So I went into the program."
NOW HAGEDORN sees patients on her own, mainly pediatric cases, women wanting Pap smears, patients with sore throats or earaches, obese people, hypertensives and diabetics. A major facet of her job is patient education.
In Lawrence, a nurse clinician from the WSU program is employed by A.C. Mitchell, a family practice physician. Mitchell said that the nurse clinician, Dixie Sharp, saw patients more or less independently, and that he was for back-up advice.
"There are many patients she can attend to just as well, or perhaps better, than I can," he said.
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