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DNP Students Dive into Healthcare Policy

UL Online -- Wed, 02/19/2020 - 4:19pm

Advanced Practice Nurses enrolled in the University of Louisiana at Lafayette Doctor of Nursing Practice degree program go beyond clinical practice to impact healthcare.

Through the Ethics and Health Care Policy course, students identify key health care policy issues, take part in the state’s legislative process, and attend hearings at the state capitol.

“Sometimes we testify; sometimes we just attend the committee hearings,” Dr. Jennifer Lemoine, graduate coordinator, says. “We go there in hopes to change the way health care is delivered in the state; to improve outcomes for our patient population and providers, as well.”

In Spring 2019, Dr. Cynthia Suire began teaching the course, bringing decades of experience in public health.

Leading Evidence-Based Programs

Dr. Cynthia Suire, assistant professor for the College of Nursing and Health SciencesDr. Suire graduated from UL Lafayette in 1981 with a Bachelor of Science in Nursing and then began working for the Louisiana Department of Health. She was part of a team that introduced and implemented the Nurse-Family Partnership program to, “improve maternal health, improve child health, to improve the self-sufficiency of the family, and to get everybody started on the right track.”

Dr. Suire helped spread the program throughout Louisiana while she continued her education, earning a master of science in nursing and doctor of nursing practice.

Dr. Suire retired in 2015. In 2018, she began teaching within the College of Nursing and Health Sciences.

Teaching policy, she says, was a natural fit.

“When someone says ‘health policy’ to nursing students, it can be scary. You don’t go into nursing, and you don’t do clinical nursing, loving policy,” Dr. Suire says. “Being I had worked in state government for 33 years, it was natural for me.”

Humanizing Healthcare Policy

DNP students begin the course by assessing the way advanced practice nurses interact with health policy. Each student identifies a policy that’s important to them to work with throughout the semester. Among their assignments, students interview legislators and policymakers on key healthcare issues.

“They’re informing these policymakers about the subject, which is really empowering,” Dr. Suire says. “After the first couple of weeks, they realize we can’t function without policy, and policy can’t function without us. They really start to embrace it.”

Students also review healthcare-related bills for each legislative session. The cohort marks bills they’ll support, oppose, or monitor. Then students visit the capitol to better understand the process.

“Through their interview, the policy brief assignment, and the day at the capitol, they’re diving deep into an issue and really making it meaningful for them,” Dr. Suire says. “When they do that, they feel good enough to say, ‘I can make a difference here in policy,’ and they can.”

Pursuing APRN Autonomy

Historically, one of the key healthcare issues UL Lafayette cohorts follow is restrictions to family nurse practitioners. In Louisiana, nurse practitioners must have a collaborative practice agreement with a physician in order to practice.

UL Lafayette DNP students visit the state capitol during the legislative session.“This agreement doesn’t require the physician to be present at any time while you’re working,” Dr. Lemoine explains. “It merely says that if you need to consult someone, that physician is available.”

But if a physician collaborator moves, retires, passes away, or simply decides not to collaborate anymore, nurse practitioners are forced to shut down until they’re able to find a new collaborator and work through the physician approval process.

Dr. Samantha Lilley focused her attention on this issue while earning her Doctor of Nursing Practice degree online through UL Lafayette. As her synthesis project, she developed a white paper that could be used to educate state residents and lawmakers.

Dr. Lilley opened a clinic in Iowa, La., after earning her Master of Science in Nursing online at UL Lafayette in 2016.

“(My collaborator and business partner) could have pulled the plug on everything, and I wouldn’t have been able to continue to practice,” Dr. Lilley says. “After everything I worked for, it could have all been taken away by a very small disagreement.”

In that case, Dr. Lilley’s rural patients would be left without access to care and without access to crucial maintenance medications for chronic conditions.

Lilley’s white paper was adopted by the Louisiana Association of Nurse Practitioners and used during the 2016 legislative session, Dr. Lemoine says, “as a point of reference to educate legislators and providers about full practice authority — what it is, what it isn’t, why patients would benefit,” and more.

Dr. Suire says the class still uses the archive footage from the 2016 session as a teaching tool to understand legislative policies and politics. Efforts since then to grant full practice authority haven’t gained sufficient traction, says Dr. Lemoine.

Through these exercises, Dr. Suire says, students understand the logistics of healthcare policy and are empowered to influence the policies that guide their practice.

“With policy, you have to gauge what’s going on in the state and at the federal level. It takes some stepping back to assess stakeholders, their stance, and how to proceed,” Dr. Suire says. “You have to be mindful and deliberate about approaching people and issues. That’s a very important art that’s hard to teach.”

Create meaningful impacts through your practice, in healthcare systems, or in policy. Earn your Doctor of Nursing Practice online through the University of Louisiana at Lafayette. Request more information today.