Caring for our children: The University of Hartford's MSN program in Advanced Practice Community Health Nursing

Connecticut Nursing News, Jun-Aug 1999 by Hall, Marlene

The MSN Program in Advanced Practice Community Health Nursing prepares practitioners to provide front-line basic health care to children from birth to 21 years. The intent of the curriculum is to combine the skills of the practitioner with the vision of the community health nurse. It prepares graduates for ANCC certification as school nurse practitioners. There are 23 nurses enrolled and the first students will graduate in May. One of them, Pat Adams, likes the experience to being the oldest child in the family. You must forge new ground. Like a new parent, the Division of Nursing is learning from raising its first practitioner program. Students and faculty agree that the experience is a valuable one.

All of the nurses in the APCHN track hold professional nursing positions. -JAu2LRd=, an elementary school nurse, describes the program as designed for the nurse who wishes to continue working while completing the degree. Students enroll in one or two courses each semester and during the summer session. Most courses meet once a week in the late afternoon or evening. Practitioner preparation, however, requires the incorporation of a specified number of clinical hours. Faculty weave clinical experiences into assignments in many courses but three courses are clinically based. A summer course requires a six week, full-time commitment in a primary care collaborative practice setting. The other two clinical courses require a commitment of one day per week. One of these experiences is in a school setting and the other is the choice of the student in consultation with her academic advisor. At each clinical site the student works with a nurse practitioner as preceptor. Faculty member, B. Grace Sullivan PNP, is the advisor for all APCHN students and responsible for the ongoing development of the program.

An ideal place to address the individual and aggregate health needs of our children is in the schools. Over the past twenty years, Mary Schulze Acting Chairperson of the Division of Nursing, has arranged many clinical opportunities for both BSN and MSN students to promote wellness within the inner-city schools. The APCHN program is the culmination of her efforts. It was designed with the school nurse in mind. According to Pat Krin- President of the Association of School Nurses in Connecticut, and Coordinator of Health Services in Thomaston, CT, Schoold need nurse practitioners. Krin explains, There are school nurses who take it upon themselves to address issues at the communitey level, but many do not have the time nor the preparation. The nurse practitioner in a school-based clinic is expected to do this and so her time is more readily available for in-depth assessment of the individual child, consultation with family, and intervention on a larger scale. The scope of practice is more inclusive. I believe that each school system should have at least one nurse practitioner. Ideally, the school-based clinic is that setting; but in reality much could be done by a practitioner within the school health system.

The students point to their clinical experiences as most valuable. Cray and Adams spent their summer clinical in the peidatric clinic at Saint Francis Hospital. According to Cray, We saw a real give and take. Collaboration between doctors and practitioners was excellent. This fall both nurses worked with nurse practitioners in school-based clinics. Cray will work with a nurse practitioner in a pediatrician's office this spring and Adams will return to the clinic at Saint Francis. Antoninette Towle, who manages a rest home and instructs nurse aides for the city of Waterbury, came into the APCHN track to explore "something different" in her nursing career. Her clinical experience in the pediatric clinic at St. Mary's Hospital gave her that opportunity. Antoinette explains, The clinic operates in the inner city of Waterbury. It is like an ER ... all types of health problems come through the door. In the intensive six-week clinical, Bernadette Hirst worked at Kaiser Permanente where pediatric care compromises half of the East Hartford clinic's business. Hirst has decided to extend her fall clinical ,into spring as she is impressed with the management of the University of Hartford Health, Clini..-by her preceptor, NP Paula Chevrier The:UT&ersity will soon have another clinical site toe@i APCHN students. An interdistrict magnet school will be built on campus and open its doors in the year 2001. Students will practice in its wellness/health center.

Clinical practice provides the laboratory for the application of the curriculum. Students also combine theory and practice in the design of their research project. Adams iEr comparing stress levels in parents of children with ADHD to determine the effectiveness of interventions such as joining a support group. Combining a strong interest in cardiac care and adolescents, Hirst's research project is creating a great deal of awareness about teenage smoking in herr,community. Towle is looking at Connecticut school nurses' perceptions of their role in the care- of students with learning disabilities. The Similac Corporation is supporting Karen Tolman in her study of parental compliance in the timely administration of an antibiotic to a child. Cray is investing the effect of an educational program called Violence is Preventable on fourth and fifth grade elementary students. The program explores peer mediation, and conflic resolution. She is measuring impact using a tool developed by the Center for Conflict Dispute in New Mexico.