Elaina Hall, DNP(c), MSN, RN, MBA, NEA-BC, FACHE, is the chief quality officer of SnapCare, formerly SnapNurse, and an experienced healthcare executive in the areas of healthcare system operations, performance improvement, nursing practice, and leadership consulting. Hall’s passion is consistently delivering the ‘best and brightest’ for SnapCare clients. With a focus on opportunities for the clinician corps working with SnapCare, Hall has expertise in health system quality improvement and supporting clinicians in their journey to reskill and upskill for professional growth.
Hall graduated from Clemson University and extended her education in nursing, earning an MBA and MSN. She is currently pursuing her DNP. She also leads the Ventura/Santa Barbara Chapter of the Association of California Nurse Leaders. She is a Board-Certified Advanced Nurse Executive by the ANCC and an American College of Healthcare Executives Fellow.
Hall’s significant contributions to the nursing field have been recognized in the prestigious Champions of Nursing Diversity Series 2024. This series is a platform that showcases healthcare leaders who are prominent figures in their organizations and are making substantial changes in the nursing field. Hall’s inclusion in this series is a testament to her impactful work and her status as a leader in promoting diversity and inclusion in nursing.
Meet Elaina Hall, DNP(c), MSN, RN, MBA, NEA-BC, FACHE, the chief quality officer of SnapCare.
Talk about your role in nursing.
As the Chief Quality Officer at SnapCare, I play a crucial role in driving performance improvement initiatives to optimize the efficiency and effectiveness of our staffing and workforce management processes. This involves analyzing data, identifying opportunities for improvement, and collaborating with cross-functional teams to implement solutions that enhance the overall quality of our services. In addition to clinical quality, I am also tasked with ensuring that SnapCare complies with all regulatory requirements and accreditation standards
How long have you worked in the nursing field?
26 years.
Why did you become a nurse?
I became a nurse because of my passion for caring for people and my deep-seated empathy for those in need. From a young age, I found fulfillment in providing comfort and support to others during times of vulnerability. Nursing allowed me to turn this passion into a meaningful career where I could make a positive difference in people’s lives every day.
Furthermore, as an advocate for diversity in healthcare, I recognized the importance of ensuring that all individuals receive equitable and compassionate care regardless of their background. Nursing allows me to advocate for inclusivity and cultural competence in healthcare delivery, ensuring that every patient is treated with dignity and respect, regardless of race, ethnicity, gender identity, or socioeconomic status.
In essence, becoming a nurse was not just a career choice for me but a calling driven by a desire to care for others, empathize with their struggles, and champion diversity and inclusivity in healthcare. It is a privilege to serve as a nurse, and I am committed to upholding the values of compassion, empathy, and advocacy throughout my nursing career.
What are the most important attributes of today’s nursing leaders?
Visionary and innovative thinking to navigate the evolving healthcare landscape.
Strong communication and collaboration skills to foster teamwork and interdisciplinary approaches.
Emotional intelligence and empathy to support both patients and staff members.
Adaptability and resilience in the face of challenges.
Commitment to continuous learning and professional development.
Advocacy for patient-centered care and healthcare equity.
Tell us about your career path and how you ascended to that role.
Before obtaining my nursing degree, I began my journey in healthcare as a certified nursing assistant and patient care technician. These early roles provided me with invaluable experience in direct patient care and laid the groundwork for my future in nursing.
After earning my nursing degree, I embarked on a career as a bedside nurse, specializing in challenging areas such as Burn, trauma, ICU, and ED. I thrived in these high-intensity environments, gaining expertise and honing my skills while providing critical care to patients in need.
Throughout my career, I embraced opportunities for growth and development, working in various departments and even joining the float pool to broaden my experience. This flexibility and willingness to adapt allowed me to excel in different clinical settings and expand my knowledge base.
In 2006, I took a significant step forward by transitioning into my first manager role. This marked the beginning of my leadership journey, where I was entrusted with overseeing operations and guiding my team to deliver exceptional patient care. I embraced the challenge, using my clinical expertise and communication skills to drive positive outcomes and foster a collaborative work environment.
As the years passed, I continued to take on progressively complex roles within healthcare organizations, moving from community hospitals to academic health systems. Each new role presented its own challenges and opportunities for growth, and I approached them with determination and a commitment to excellence.
Today, I am proud to serve as the Chief Quality Officer of SnapCare, an AI-enabled workforce marketplace that serves the entire continuum of care. I can make a meaningful impact on healthcare delivery and champion a culture of continuous improvement.
My career path has been filled with challenges and triumphs, but through it all, I have remained dedicated to providing the best possible care to those in need. Reflecting on my journey, I am grateful for the experiences that have shaped me into the nursing leader I am today.
What is the most significant challenge facing nursing today?
One of the most significant challenges facing nursing today is the ongoing shortage of nurses, exacerbated by factors such as an aging population, increased demand for healthcare services, and burnout among healthcare professionals.
As a nursing leader, how are you working to overcome this challenge?
As a nursing leader, I am acutely aware of the significant challenges posed by the ongoing shortage of nurses, compounded by factors such as an aging population, increased demand for healthcare services, and burnout among healthcare professionals. Recognizing the critical need to address these challenges, I have been actively involved in implementing a clinician reskilling program to mitigate the effects of the nursing shortage and promote sustainability within our healthcare system.
The clinician reskilling program empowers healthcare professionals, including nurses, to expand their skill sets and take on new roles that align with emerging healthcare needs. By providing training and resources for upskilling and reskilling, we aim to optimize the utilization of existing clinical talent and alleviate some of the pressure caused by the nursing shortage.
Through this program, we offer opportunities for nurses to acquire additional certifications, pursue advanced training in specialized areas, and transition into roles that complement their existing skill sets. This helps address staffing shortages in critical areas and enhances the overall quality of patient care by ensuring that healthcare professionals are equipped with the necessary skills and expertise to meet evolving patient needs.
What nursing leader inspires you the most and why?
Beverly Malone, Ph. D., inspires me the most and stands as a beacon of inspiration in nursing leadership. As the CEO of the National League for Nursing and a former president of the American Nurses Association, Dr. Malone has dedicated her career to advocating for nurses and ensuring culturally competent care for diverse patient populations.
Her impact extends beyond the borders of the United States. As the first Black general secretary of the Royal College of Nursing in the United Kingdom, she broke barriers and paved the way for diversity and inclusion within the profession. Her global achievements include representing the U.K. delegation at the World Health Assembly, where she advocated for nursing and healthcare on an international platform.
Dr. Malone’s dedication, innovation, and unwavering commitment to advancing the nursing profession inspire nurses worldwide. Her tireless advocacy for equitable and compassionate care has left an indelible mark on the healthcare landscape, and her legacy will continue to inspire future generations of nurses to strive for excellence in their practice.
What inspirational message would you like to share with the next generation of nurses?
You are the heart and soul of healthcare, the guardians of healing, and the champions of hope. Embrace the privilege and responsibility of caring for others with humility and empathy. Your journey will be filled with moments of joy, challenges, and triumphs. Stay true to your values, never stop learning, and remember that every interaction is an opportunity to make a difference. Your passion and dedication will transform lives and leave a lasting legacy. Dream big, work hard, and always believe in the power of nursing to change the world!
Along with their trauma and flight nursing colleagues, burn nurses are now privileged to demonstrate their expertise in burn care with the new Certified Burn Registered Nurse (CBRN) exam from the Board of Certification for Emergency Nursing (BCEN). Introduced in the fall of 2023, CBRN certification spans the entire burn care continuum including prehospital care and initial management, acute and critical care, post-acute rehabilitation, outpatient and community care, and aftercare and reintegration, as well as injury prevention, education, and psychosocial patient and family support.
With this new certification, burn nurses are uniquely positioned to highlight the important role burn nurses play in the care of traditionally underserved communities. As burn injuries are often associated with several social determinants of health, including poverty (Patel, 2018), food insecurity (Elsey, 2016), and living in under-resourced neighborhoods (Alnabantah, 2016), burn nurses play a crucial role in caring for some of the patients most in need of care.
Burn nurses’ work is similar to that of critical care specialties like trauma and emergency nursing. However, burn nurses are also responsible for complex wound care, often requiring hours-long procedures in patient rooms. This affords burn nurses one-on-one time with their patients, allowing them prolonged individual time to assess individual socio-demographic risk factors better. This individual time also provides an expanded role for the burn nurse, often taking on the caretaker and trusted confidant role. In this role, burn nurses can better assess the needs of their patients post-discharge, anticipating potential problems like lack of transportation, living conditions without heat or electricity, or unstable food resources.
The ability of burn nurses to anticipate these needs post-discharge is such a crucial aspect of their role that it is a component of the CBRN exam. The CBRN exam tests burn nurses for diversity, equity, inclusion, community outreach, and interprofessional collaboration knowledge. In addition to acknowledging the unique role these nurses play in recognizing and intervening when necessary, the CBRN exam also acknowledges the difference in the presentation of both burn injuries and skin disorders like Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN). Given the recent acknowledgment of the lack of diversity in medical education training (Louie & Wilkes, 2018), it is vital for all nurses. However, burn nurses should know the differences in presentation for full-thickness burns and skin injuries in light versus dark-complected patients. In addition to including DEI as a testable item, CBRN item writers and exam construction review committee (ECRC) members made a concerted effort to include depictions of all skin tones to test this knowledge.
As a burn nurse of almost 13 years, I have seen the profound difference providing culturally sensitive care has made to patients in our burn center. When I started caring for patients with burns, for example, we used one type of shampoo and one type of lotion for all of our patients. While it seems like a small piece of care, providing products designed to work with the patient’s hair and skin demonstrates a commitment to culturally competent care. I profoundly hope that as we continue to make strides in educating burn nurses, we find new ways to provide the best care possible to all our patients.
REFERENCES
Louie P, Wilkes R. Representations of race and skin tone in medical textbook imagery. Soc Sci Med. 2018 Apr;202:38-42. doi: 10.1016/j.socscimed.2018.02.023. Epub 2018 Feb 23. PMID: 29501717.
Elsey H, Manandah S, Sah D, Khanal S, MacGuire F, King R, et al. (2016). Public Health Risks in Urban Slums: Findings of the Qualitative’‘Healthy Kitchens Healthy Cities’ Study in Kathmandu, Nepal. PLoS ONE 11(9): e0163798 Doi: 10.1371/journal.pone.0163798
Alnababtah K, Khan S, Ashford R. Socio-demographic Factors and the Prevalence of Burns in Children: An Overview of the Literature. Paediatrics and International Child Health (2016). 10.1179/2046905514Y.0000000157 [PubMed] [CrossRef] [Google Scholar]
Patel DD, Rosenberg M, Rosenberg L, Foncerrada G, Andersen CR, Capek KD, Leal J, Lee JO, Jimenez C, Branski L, Meyer WJ 3rd, Herndon DN. Poverty, population density, and the epidemiology of burns in young children from Mexico treated at a U.S. pediatric burn facility. Burns. 2018 Aug;44(5):1269-1278. doi: 10.1016/j.burns.2018.02.003. Epub 2018 Mar 7. PMID: 29551448; PMCID: PMC6453533.
Nurses Week occurs every year during the second week of May, and much fanfare is made of the pizza parties, tote bags, water bottles, and signs proclaiming “heroes work here.”
If we want to be more thoughtful and reflective about the phenomenon of National Nurses Week, there’s much more to this annual moment of recognition than these familiar superficial trappings.
And since Nurses Week is built around the celebration of Florence Nightingale’s birthday (May 12, 1820), it’s appropriate to wonder what the veritable godmother of modern nursing would think of how we do (or don’t) celebrate our profession.
What Would Florence Think?
The American Nurses Association (ANA) has chosen the theme “Nurses Make the Difference” for the 2024 celebration. While not altogether original or overly inspiring, we can all agree that nurses make a difference in patient care, research, entrepreneurship, academia, technology, and other areas of endeavor.
Would Ms. Nightingale agree that nurses make a difference? She certainly would, and I would venture that she would have much to say about how that statement rings true. In her time, nurses were purveyors of comfort, cleanliness in the form of improved sanitation and hygiene, and the carrying out of physicians’’ orders in caring for the infirm, the injured, and the dying.
In Nightingale’s theory, nurses aimed to ensure that patients were cared for in a manner that allowed nature to intervene in the interest of their health (e.g., the healing of wounds, the resolution of infection, etc.). If she saw nursing as “the activities that promote health which occurs in any caregiving situation,” nurses make a difference by assuring patients are cared for in a way that maximizes their healing potential. And if, as can be asserted, Nightingale’s theory sees illness as “the absence of comfort,” nurses’ ability to provide comfort can make all the difference in the world.
There’s no doubt that Ms. Nightingale would agree that nurses’ ability to provide positive interventions in the interest of patients’ healing is a central mission of the profession. However, what would she think of how we recognize nurses for their efforts during the annual celebration of her birthday?
In Nightingale’s day, there were no tote bags or water bottles bearing the hospital logo, nor were there pizza parties, greeting cards, and banners hung over hospital entrances. While it’s all conjecture on our part, one might hope she would look down upon such superficial acknowledgments of nurses’ worth.
Even though Nightingale was a revolutionary, out-of-the-box thinker as a Victorian woman, she might still be significantly shocked at the wages nurses command in the 21st century. She would also likely be shocked by the salaries earned by hospital CEOs, let alone the power of the insurance industry.
As a brilliant and forward-thinking woman, Nightingale would be likely quick to understand that women’s place in 21st-century post-industrial society has dramatically evolved since her time, and one could imagine that she would be wholly supportive of nurses receiving increases in salary, benefits, and other forms of recognition that demonstrate acknowledgment of their value as healthcare professionals. Plainly stated, Nightingale might be heard to remark, “Give those nurses a substantial raise — they deserve it.”
Reflecting on Nurses Week
Some hard-working nurses will likely appreciate an employer’s gestures during Nurses Week through food, gifts, and banners expressing gratitude for their contributions.
That said, salary increases, improved benefits, tuition and certification reimbursement, and other support for nurse professional development would likely be much more well-received. Improvements in staffing, protections against workplace violence, and updated technologies that truly make our work easier would also likely be much more well-received.
Nurses make a difference, and the satisfaction of a job well done can go far in creating one’s personal sense of self-worth, especially when coupled with patients’ and colleagues’ respect.
Nurses Week is a moment to pause for the cause and reflect on our value in the scheme of things. Tote bags and pizza aside, our work’s true value provides meaning, and Nightingale knew this too well.
What would Nightingale think? She would think that 21st-century nurses have greatly advanced the profession. She might also remind us that what we feel in our hearts—and the thoughts we have about who we are and what we do—always matter most in the larger scheme of things.
So, you’ve decided it’s time to further your education? Or maybe you haven’t decided yet because you are unsure what to do. So many questions are swimming through your mind: Are all FNP programs the same? How much will it cost? Can I still work as an RN while I’m in school? How will I know which program is right for me? Well, never fear; you may find the answers you need here.
Are All FNP Programs the Same?
The short answer is no, and that can be a good thing. All accredited FNP programs in the United States must follow the standards of their accrediting bodies, both for nursing and their university at large, governmental regulations, licensure standards, and other guidelines. However, the standards can be arranged in several different ways. This allows nursing colleges to offer programs that fit various student needs.
The FNP curriculum is typically offered in three different formats: online, traditional face-to-face, or a hybrid of online and traditional. Online programs have made educational experiences more accessible to students who would not otherwise have the opportunity to further their education or who prefer the flexibility of online learning. When considering online learning, ask whether the classes are presented in synchronous, asynchronous, or a combination of formats.
Synchronous delivery typically means having online classes with a live instructor at specific times, discussions with other students, and opportunities to ask questions and receive feedback. Asynchronous classes usually consist of recorded content, allowing students to access their learning experiences at any time of the day or night, with scheduled opportunities to interact with instructors. Combination formats are just that, a combination of the two.
Traditional programs provide face-to-face learning with an experienced instructor, and hybrid programs offer a taste of both in-person and online learning. So, determining which of the program types is right for you may take some self-evaluation. Some students need the structure of being required to show up in person at a specific date and time, and some are more self-regulated. Neither is right, and neither is wrong. Just make sure to think it through to set yourself up for success.
Another similarity between FNP programs is the requirement for hands-on patient care in clinical settings with properly vetted preceptors. Make sure to inquire about preceptor policies when considering a program. Some programs arrange clinical experiences for their students. However, the vast majority of programs require students to arrange their own clinical experiences. So, the time to start networking with FNPs in your area is now. Most programs allow students to learn from physicians for some required hours.
However, the majority of hours should be spent learning from an experienced nurse practitioner. Because the FNP scope of practice encompasses patients across the lifespan, students will likely be required to have preceptors in differing specialties: pediatrics, women’s health, primary care, and urgent care. Many programs also allow preceptorships within sub-specialties such as aesthetics, dermatology, podiatry, cardiology, urology, etc. Think outside the box. It never hurts to ask whether your favorite practitioner could be approved for a clinical experience.
A couple of words to the wise concerning preceptorships:
Some preceptors require payment for their services, and some do not. Some colleges allow paid preceptors, and some do not. Make sure to ask about this before you enroll in a class that requires a preceptor.
Contact your state’s Board of Nursing (BON) to ensure they allow clinical experiences while you learn from another location. The college you apply to should provide this information, but it always helps to check it out yourself.
How Much Will an FNP Program Cost?
According to Nurse.org, the range for graduate credit hours is approximately $500 to $2000. Required credits usually range from 46 to 54, but there are variations. So, look at the program curriculum and do the math. Also, don’t forget to ask about fees, books, supplies, etc., and start thinking about scholarships, grants, and financial aid now.
Please consider your time cost as well. Colleges and universities must calculate in-class time, expected out-of-class work time, clinical time, lab time, etc. So, think of solutions ahead of time for things like childcare, vacations, practice, and life in general. While graduate school is temporary, it will likely mean change for the whole family. So, make sure to talk it through with all of those important people in your life. After all, people can do just about anything for a while, as my Nana always told me.
Can I Still Work as an RN While I’m in School?
Most people do work while in graduate school. However, this may factor into your decision about the type of program you want to attend. An asynchronous program may work better if your practice site requirements conflict with traditional or synchronous course requirements. Or your practice site may be willing to accommodate the changes you need. It never hurts to ask. Just remember, a practice site is a great place to make contacts for clinical preceptors.
How Will I Know Which Program is Right for Me?
Consider the things above and talk to people that you trust. Ask them to tell you about their experiences. Then, consider what they say with your perspective in mind. Ask good questions and do your homework in examining available programs. You must consider your learning style, non-negotiable responsibilities, resources, and your family’s willingness to be flexible for a little while. When considering a program, you need to know about the format, the college’s accreditation status, the program’s success in licensure pass rates and graduate placements, the length of the program, the cost in money and time, the program’s preceptor requirements, and whether your BON allows learning from the college’s state. Then, choose wisely and GO FOR IT!
Nurse practitioners (NPs) are essential healthcare providers who are excellent, skilled clinical resources for newborns and elderly patients. While there are many available NP career choices, the family nurse practitioner (FNP) is a trendy option among nurses seeking to become primary care providers with the authority to diagnose illnesses, order diagnostic tests, prescribe medications, and manage the care of patients across the lifespan.
If you’re a nurse who wants to become a family nurse practitioner, what does that avenue look like, and what hoops do you need to jump through to achieve your goal? And if you’re not a nurse, what additional work must be done to get there? Let’s examine the landmarks along the way to becoming an FNP.
Why Become an FNP?
Becoming an FNP has pros and cons, so considering the many possibilities available in advanced practice nursing, it’s prudent to do your due diligence.
PROS:
Earning power: According to the U.S. Bureau of Labor Statistics (BLS), nurse practitioners, nurse midwives (CNMs), and nurse anesthetists (CRNAs) earned a median annual salary of $125,900 in 2022, with a mean hourly wage of $60.53. While the much higher salaries of CRNAs may admittedly skew the numbers higher, there’s no arguing that NPs are doing well for themselves.
Job growth: As another incentive for those considering the NP path, the BLS projects 38% job growth for NPs through 2032. When weighed against projected job growth of 6% for RNs and 3% for MDs, the attractiveness of a career as an NP can appear exceptionally bright.
Full practice authority: The state practice environment for NPs is improving slowly. The American Association of Nurse Practitioners (AANP) reports that in the states where full practice authority has been granted, “state practice and licensure laws permit all NPs to evaluate patients; diagnose, order and interpret diagnostic tests; and initiate and manage treatments, including prescribing medications and controlled substances, under the exclusive licensure authority of the state board of nursing. This is the model recommended by the National Academy of Medicine, formerly called the Institute of Medicine, and the National Council of State Boards of Nursing.”
CONS:
Future license portability: At some point in the future, the APRN Compact will become a reality like it is for millions of registered nurses. However, more states still need to sign on to begin implementing even a fraction of a potential compact.
Stress and burnout: Recent statistics show a high level of burnout, depression, and anxiety among NPs, primarily due to workplace stress, overwork, perceptions of lack of respect from colleagues and patients, and insufficient salaries.
The 15-minute visit: Since most FNPs work in a clinic or office setting, the now common 15-minute office visit can starkly contrast with the relational aspects of bedside nursing that many nurses enjoy as RNs.
The FNP Career Pathway
For Non-nurses:
For non-nurses wanting to secure their future by becoming a family nurse practitioner, the first step is to become an RN through an associate degree in nursing (ADN) program or a bachelor of science in nursing (BSN) program.
Alternatively, a non-nurse can also pursue a direct-entry MSN program, an accelerated path where the student simultaneously earns a BSN and an MSN. Specific direct-entry programs bypass the BSN entirely. Most of these programs will require the completion of prerequisites that will likely include some combination of anatomy and physiology, biology, chemistry, nutrition, sociology, psychology, statistics, and microbiology.
For Registered Nurses:
Registered nurses with an ADN who want to pursue a career as an FNP will want to complete an RN-to-BSN bridge program and then apply to an MSN program with an FNP track. Registered nurses can also consider an RN-to-MSN program, which allows students to take core BSN courses while completing their MSN.
Potential MSN and FNP students should know there is a strong movement afoot to make the Doctorate of Nursing Practice (DNP) degree the entry-level requirement for becoming a nurse practitioner. While a goal of 2025 has been set, this change has yet to be codified as an absolute requirement, but the day for such a requirement is fast approaching.
Students can expect to be tested regarding aspects of assessment, diagnosis, planning, and evaluation of patients across the lifespan in areas of knowledge that include:
Health assessment
Pathophysiology
Therapeutics
Evidence-Informed Practice
The Life of the FNP
Licensed and certified family nurse practitioners can work in a wide variety of settings, including but not limited to:
FNPs can earn additional postgraduate certifications in areas like psychiatric/mental health. APRNs can also become eligible for leadership positions in many clinical settings.
While those considering FNP certification may be worried about the limits of the increasingly common 15-minute patient visit, FNPs can find plenty of practice areas with other types of structures for patient interaction.
With predictions for astronomical job growth and opportunity in the years to come, family nurse practitioners will undoubtedly be in great demand nationwide. Pursuing the career path of the FNP is not for everyone, but the plethora of potential opportunities will attract students from all walks of life far into the foreseeable future.
