Robin Geiger, DNP, MSN, APRN, NP-C, FNP-BC, NEA-BC, is an accomplished, results-driven, board-certified nurse executive with over 20 years of hands-on clinical leadership experience. Dr. Geiger’s professional focus is on health equity and clinician advocacy. Through the ACT (Advocacy, Career, Tools) program for all clinicians within the Ingenovis Health brands, Dr. Geiger aims to increase resilience for healthcare providers, improve quality care, and create solid support systems. With a long-standing history of assembling impactful and forward-thinking teams emphasizing improving healthcare quality and increasing patient safety, Dr. Geiger’s vast experience includes accreditation and developing policies to support foundational programs through assessment and data analysis.
She previously served as associate dean of academic affairs for the National University School of Health Professions and focused on strategic planning, clinical program development, and academic operations.
Dr. Geiger is an important nursing leader, and Minority Nurse is pleased to profile her as part of the Champions of Nursing Diversity Series. The series highlights healthcare leaders who are prominent figures in their organizations and are making transformational impacts in nursing.
Meet Dr. Robin Geiger, senior vice president of clinician advocacy of Ingenovis Health.
Talk about your role in nursing.
As senior vice president of clinician advocacy for Ingenovis Health, I’m pleased to lead our ACT program, which is focused on clinician well-being, resilience, and support. I hold board certification as a nurse executive advanced (NEA-BC) and chair our Chief Nurse Advisory Board, an interdisciplinary advisory group focused on creating solutions for current frontline clinician challenges.
I support the nursing community as much as possible. I serve as an editor-in-chief for a medical publishing company, focusing on nurse practitioner certification and nursing ethics. I also remain current in clinical experience as a board-certified family nurse practitioner (FNP) and cofounder of an NP-owned concierge practice in North Florida.
How long have you worked in the nursing field?
I’m surprised to say that I have been working in this field for more than 23 years!
Why did you become a nurse?
My interest in nursing peaked at an early age. I would hear stories about my grandmother, who was a nurse midwife, stories of how she helped others heal, and stories of the need that would always exist for people to receive healthcare. I would stare at her nursing picture, in which she wore a white dress and cap. She was my earliest influence in nursing; she looked like me and was someone I could relate to.
I started with the goal of becoming a certified nursing assistant (CNA). I wanted to handle the humble and respectful connection of bedside care. I immediately loved it! It was important to me to be there for some nursing home patients with little to no family and support them in accomplishing daily tasks. I knew I could grow in nursing and pushed myself to do more.
What are the most important attributes of today’s nursing leaders?
Today’s critical attributes for nurse leaders should incorporate an empathetic, resourceful, and advocacy approach. Considering the social climate when engaging new and existing nurses is essential. External factors to keep in the forefront include mental health and bandwidth, which stem from work-life balance, something I like to refer to as a “work-life blend” when assigning and delivering care and being supportive means including flexible options for staffing that align with a nurse’s history and respect for years of service, as well as physical, social, and emotional support.
What does being a nursing leader mean to you, and what are you most proud of?
Being a nurse leader means factoring in previous personal experiences of my own and those around me. An excellent example would be the formation of Ingenovis Health’s interdisciplinary Chief Nurse Advisory Board (CNAB). Solid decisions involve a multidisciplinary approach to healthcare strategy and design. Multidisciplinary teams provide a more global lens of how decisions impact all, from the social worker to the clinician and all the people who serve the patient.
I am proud to give back to the community by cofounding a concierge health clinic for the under-served population, creating MSN and DNP programs that consider the working nurse, and developing a clinician well-being program to encourage improved work-life blend and foster resilience – the ACT program.
Tell us about your career path and how you ascended to that role.
I’ve touched almost every area of nursing through lived experience, either as faculty, clinician, or leader. My life in nursing began first as an intensive care unit (ICU) nurse, followed by staffing various ICUs, ER, and OR at a level-one trauma hospital. I became a family nurse practitioner in multiple areas, including as an RN, first assisting in plastics, orthopedics, and general surgery. I have always mentored nurses along the way, and opportunities to serve as lead faculty, director, and associate dean in academia provided me ample opportunity to do so. I received my most impactful leadership training at the Veterans Health Administration. My career has included national leadership roles as VP of clinical care at a non-profit organization and later as co-owner/ CEO of a concierge clinic. My current role as senior vice president of clinician advocacy for Ingenovis Health allows me to combine my previous experience to support all clinicians – I enjoy what I do!
What is the most significant challenge facing nursing today?
Recognizing the importance of self-care is always challenging for nurses. I’m also guilty of this from time to time. Nurses are natural givers, and we often neglect the importance of reflecting on challenges, trauma, and the losses we experience. We provide our best care when we reflect on our experiences and learn from them. Covid was challenging, but we didn’t experience initial trauma and burnout with the pandemic. Nurses are strong – we have constantly been challenged. I’m glad we are now focusing on better health for the nurse, something we have needed for quite some time.
As a nursing leader, how are you working to overcome this challenge?
I’m working daily to be an example of incorporating self-care and eliminating stress. Ingenovis Health supports the ability to grow support and enhance the lives of frontline clinicians through the ACT program. I’m proud to lead this program, which is focused on providing a voice of advocacy, career pathing/ support, and tools to foster better mental and physical health. I think of the program as an ongoing conditioning and strengthening program to ensure our clinicians are prepared to lend their best selves to caring in various areas within healthcare.
What nursing leader inspires you the most and why?
Dr. Hollier is one of the many nursing leaders that inspires me. I found her certification guidelines and manuals amazingly insightful and well-written from a practical point of view. She inspires my entrepreneurial spirit to create better ways of accomplishing milestones and mentoring others to greatness.
What inspirational message would you like to share with the next generation of nurses?
We are all capable of more. You’ll receive a new challenge when you think you’re comfortable and have it figured out. Grow from each challenge by adding it to your toolbox. You’ll soon have a nice box of tools/experiences to reach for and share with other nurses.
Allowing yourself to grow through mentorship will open ideas and create lifelong connections you didn’t know you needed. Participate in shared governance and nursing associations to strengthen the profession and lend your voice and support.
Finally, consider that one day, we will all become patients. You are influencing the future care for your family and yourself. Thinking this way is powerful; this forward-thinking always leads to positive and motivating actions.
Is there anything else you’d like to share with our readers?
There’s a personal quote I often use, “Everything revolves around the need to receive and deliver education.” This doesn’t apply to academia as it might seem but to life in general. Nurses are lifelong learners. We don’t teach emotional and social learning in every education program, but to continue shaping this profession, we must learn how and when to share our stories to inspire others. Editors Note: This month, Minority Nurse proudly shines a spotlight on the significance of DEI in nursing and honors the remarkable Champions of Nursing Diversity. These individuals are not just leaders but beacons of inspiration, guiding us toward a more diverse and inclusive future in healthcare. In 2023, we introduced the Champion of Diversity series, showcasing healthcare leaders driving positive change within their organizations and the nursing profession. In this edition, we applaud the top three profiles from this series. Nursing Diversity Champions embody a steadfast dedication to diversity and inclusion within accredited nursing programs and healthcare facilities throughout the United States. We commend their tireless efforts and unwavering commitment to these vital initiatives. Moving forward, we must not just prioritize, but champion DEI in nursing. This is not merely a call to action but a shared responsibility, a commitment to shape a more equitable and compassionate healthcare system for all. Let us not become complacent, but rather, let us be the catalysts for change.
Earning an advanced degree offers nurses immediate career benefits, including skills and knowledge they’ll apply to their work long before graduation. But advanced degrees, including the designation as a nurse practitioner (NP), also offer study nuances that propel careers forward and present opportunities that weren’t available before.
Nurses who pursue an NP with a master’s of nursing degree find, in particular, that the additional credential offers a level of autonomy leading to career paths that could include direct patient care, nurse leadership roles, research, business, academia, or the diverse potential in entrepreneurship.
As nurse practitioners branch out to explore entrepreneurial pursuits, new roles that blend bedside and leadership, or new research models, the beneficial impacts on public health and approaches to healthcare are widely visible.
“The NP workforce is in a constant state of growth
to keep up with the rising demands of the healthcare system,” says Paula Tucker, DNP, FNP-BC, ENP-C, FAANP Clinical Associate Professor and Interim Director of the Emergency Nurse Practitioner Program Nell Hodgson Woodruff School of Nursing, Emory University. “NPs frequently operate in regions where access to healthcare services is limited and providing care to vulnerable populations. This experience equips NPs with invaluable skills for providing care to diverse patient groups and addressing healthcare disparities.”
The COVID pandemic brought significant changes to the nursing practice and workforce and, in many ways, paved the way for NPs to expand their career paths. And because their experience and expertise were crucial to in-the-moment patient care scenarios, public awareness about nurse practitioners increased. “NPs have demonstrated their leadership capabilities by pioneering innovative care models that adapt to these changes,” says Tucker, who also holds a volunteer leadership position for the American Association of Nurse Practitioners. “This experience in healthcare innovation is an asset for nurses contemplating diverse career avenues.”
Miranda High MSN, APRN, FNP-C, works as a Certified Mobile Research Nurse/CMRN and a nurse practitioner for PCM Trials. When she started on a nursing path, High says becoming a nurse practitioner was her goal because it would allow her to work as a provider. Working as a mobile research nurse wasn’t a path she was initially aware of. “I thought this was a role where I could potentially help people have access to treatment options that they may not otherwise have due to several factors, including traveling restrictions and financial obstacles preventing people from making follow-up visits at the site,” says High. “I felt like being able to take ‘the site’ to them allowed them the ability to be a participant in a clinical trial to not only help themselves but to be part of something bigger than just themselves. Being part of something that could potentially help so many other people in the future was what led me to discover the excitement of this role.”
Tucker says that identifying goals, developing a passion for a specialty, and gaining new skills are all effectively leveraged in diverse roles. “The key is to find one’s passion in caring for patients and allowing that passion to drive creativity, giving back to the community, and fostering innovation as a change agent in healthcare,” she says.
Alita-Geri Carter, MSN, RN, CPNP-PC CEO and founder of The Commission for Health, LLC, says she decided to become an NP when she was 14, a path that began when her younger sister spent weeks in NICU. Carter’s entrepreneurial approach allows her to provide various nursing services rooted in her passion. “Nursing is a significant part of who I am, and my nursing perspective also plays a critical role in each decision I make,” she says. As a nurse entrepreneur, you must be able to pivot and meet the needs of your consumers to remain relevant.” Carter has shaped a career that lets her use her nursing skills to provide patient advocacy and resource coordination education, healthcare provider and school-based provider training, curriculum development, public speaking, communications and public relations consultant services, and legislative advocacy for children and youth with special healthcare needs.
For High, a mobile research nursing role brings her into the homes of subjects participating in a clinical trial, and needs follow-up data obtained as required in-home visits. “On these follow-up visits, any number of nursing tasks can be performed, including labs, EKG, obtaining information, reviewing logs, etc.,” she says. In High’s other role, as an NP with PCM, she is part of the clinical interview team conducting clinical interviews with potential NPs to discuss clinical competencies since the initial recruiters are not clinically trained. “We discuss their skills and abilities as they relate to the nurse practitioner’s scope of practice,” she says. “After the candidate interview, I help to determine if they are eligible for hire based on their clinical competencies.”
According to Tucker, the NP credential means nurses have experience with using advanced clinical skills, making complex medical decisions, and, particularly, developing effective communication with patients, which fosters teamwork and interprofessional collaboration. Both High and Carter say the NP expanded their career options. Because the NP background gave her an understanding of how to interpret the patient findings she was reporting to physicians as a registered nurse, High says being an NP has helped her expand on how she helps people and the number of kinds of people she can serve. “It gave me the opportunity to potentially be a provider to people to the underserved community who may not have access to care in any other way,” she says. “As an NP, I can help them with preventative and chronic health needs in a way that many MDs do not practice. I firmly believe that having my NP allows me to bridge the gap in healthcare disparities.”
Carter’s entrepreneurial approach relies on the NP’s experience as a provider with prescribing, diagnosing, and authorization responsibilities. “I can understand the healthcare system more intimately,” she says. “There is something to be said about the firsthand experience. I have the unique experience of working as a nursing assistant, registered nurse, nursing administrator, and nurse practitioner. It creates a well-rounded perspective of patient care, outcomes, provider scope, and access.”
Nurse practitioners can open doors they never knew existed, and that’s often a starting point to a meaningful career. “The NP path offers a gateway to a world of opportunities,” says Tucker. “Being part of a community of NPs who serve as catalysts for change within the healthcare system facilitates personal and professional growth, positively impacting the lives of patients, families, and communities. For nurses considering this path, being part of a trusted profession, the ability to adapt to various healthcare settings, experience in serving diverse populations, and contributing to innovative healthcare interventions makes it an immensely promising and fulfilling career choice.”
Nurse practitioners have been valuable members of the healthcare ecosystem for decades. As providers with increasing practice autonomy, NPs fill significant healthcare delivery gaps.
With a growing shortage of primary care physicians, the need for NPs could not be more dire. When NPs approach patient care innovatively, everyone benefits from their creativity.
NP Innovation is Here
Coming from a background steeped in nursing’s more holistic view of patient care
, nurse practitioners’ outlook can differ significantly from physicians’ perspectives.
“Nurse Practitioners do what nurses do best — educate and listen to their patients,” states Dr. Mykale Elbe, DNP, APRN, FNP-BC, Assistant Dean of Nursing and Associate Professor at the Catherine McAuley School of Nursing of Maryville University. “Patients report that nurse practitioners listen well and educate them more on their disease and treatment plan.”
She affirms that nurses are responding to the needs they perceive.
“Nurses are returning to obtain their NP degree to serve their communities due to the need for more providers. Most nurses write about the need for primary care or mental health services in admissions essays. With nurses being on the front lines and seeing the needs of their patients, they are being motivated to advance their education and make a difference.”
Claire Afua Ellerbrock, DNP, APRN, PMHNP-BC, is a psychiatric mental health nurse practitioner who supports other PMHNPs in managing their well-being. She sees the NP’s point of view as key to creating effective provider-patient collaboration.
“Nurse practitioners’ approach to the provider-patient relationship is unique, with its foundation rooted in compassion, collaboration, and trust,” states Dr. Ellerbrock. “As nurses first, NPs excel in building trust with patients, and this trust significantly enhances healthcare delivery.”
Dr. Ellerbrock elaborates on how NPs can provide quality care that matches or exceeds that of physicians. “A 2015 systematic review of ten randomized controlled trials found that NPs ‘demonstrated equal or better outcomes than physician groups for physiologic measures, patient satisfaction, and cost.’ Our ability to foster trust is the cornerstone of these positive outcomes.”
And in terms of innovation, Dr. Ellerbrock is enthused by what she sees.
I’m witnessing exciting innovations in NP entrepreneurship. Nurse practitioners are identifying unmet needs and creatively addressing them, whether it’s through innovative delivery models or educational initiatives for NPs. For example, Justin Allen from The Elite NP has developed a business that assists other NPs in establishing their practices and ensuring high-quality patient care.”
Dr. Ellerbrock continues, “Additionally, my online course business, Stress Free Psych NP, is dedicated to empowering psychiatric and family practice NPs to diagnose and treat mental health patients with greater confidence. I firmly believe that entrepreneurship is the driving force behind advancing healthcare.”
Other NP innovators dot the country with their unique practice models.
Dr. Joanne Patterson, DNP, PMHNP-BC, CIMHP of Atlanta, has created the first-ever tiny house psychiatric clinic on wheels. She can deliver on-site mental health care for businesses, corporations, and schools and reach patients who might otherwise lack the ability to get a fixed office location. Dr. Patterson’s innovation extends to being licensed to treat patients virtually in Maryland, Nevada, Florida, and Washington, D.C., which increases the number of patients who can benefit from her holistic orientation and broadens the market for her business.
Josie Tate, MSN, CRNP, FNP-C, is a nurse practitioner who provides career guidance for other NPs. She feels that NPs are thinking innovatively and creating careers that work for them.
“NPs are leveraging their skills to become intrapreneurs and entrepreneurs within the healthcare industry,” shares Ms. Tate.
“Healthcare organizations benefit from NPs being highly experienced personally and professionally, “adds Ms. Tate. “We’ve created blended and flexible schedules and salary structures that challenge the norms. Whether having two PRN roles, taking locum tenens assignments, or 1099 contract positions, we provide optimal care while living our vision of a liberated life.”
Turning the Tide for a Bright Future
When it comes to the future, many NPs see a limitless horizon. Nurse practitioners can focus on adult gerontology (AGNP), the entire lifespan (FNP), mental health (PMHNP), pediatrics (PNP), midwifery (CNM), and other specialties, and certain roles can be pursued through educational pathways focused on either acute care or primary care. NPs can also earn post-master certificates in other disciplines.
Additionally, full practice authority is slowly growing despite resistance by medical groups who may feel threatened by NPs’ success and growing market share.
Ms. Tate states, “I envision the future for nurse practitioners as the powerhouse of healthcare, especially with an increased number of states gaining full practice authority. Primary care for underserved populations will be accessible thanks largely in part to nurse practitioners.”
Dr. Ellerbrock concurs. “I see the future of the NP role expanding to encompass full practice authority in all states, effectively bridging gaps in primary care and reaching underserved populations.”
She continues, “These gaps in care are not only persisting but also expanding, both in the United States and globally. By 2030, the demand for healthcare workers worldwide is projected to rise to 80 million, while the supply of healthcare workers is expected to reach only 65 million over the same period. Granting NPs the authority to practice to their fullest extent across the country positions us well to meet these growing needs.”
When it comes to embracing this rising tide, Ms. Tate adds, “Nurse practitioners need an empowering mindset to guide and direct their career paths. This mindset will build on their strengths and open opportunities throughout healthcare.”
Dr. Elbe is encouraged by how today’s NPs are being educated. “We’re ensuring that we’re preparing NP students around access to care, understanding social determinants of health, and the role NPs can play in improving outcomes, promoting health, and preventing disease cost-effectively.”
There’s no denying that nurse practitioners are reaping the rewards of decades of hard work, advocacy, and professional advancement. From entrepreneurship and a business mindset to innovative patient care models, NPs will continue to be an essential cornerstone of keeping the American healthcare system serving patients with increased access to care and the compassionate, skilled providers to treat them.
The American Association of Nurse Practitioners (AANP) welcomed Stephen A. Ferrara, DNP, FNP-BC, FAANP, FAAN, as the organization’s new president, taking the reigns from former AANP President April Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN in late-June.
Ferrara is a busy man, wearing many hats.
He’s an actively practicing NP in New York and a member of the senior leadership team at Columbia University’s School of Nursing, serving as the associate dean of clinical affairs and assistant professor responsible for overseeing the NP primary care faculty practice located in New York City and teaches health policy in the DNP program.
Ferrara is passionate about health information technology and integrating evidence-based practice into daily nursing practice. His doctoral work examined the impact of
group medical visits for patients with Type 2 diabetes and whether this intervention led to better health outcomes. He’s been honored with the AANP New York State Award for Clinical Excellence and inducted as a Fellow of AANP, as well as into the American Academy of Nursing and the New York Academy of Medicine.
Meet Stephen Ferrara, the president of the AANP.
Congratulations on becoming the new president of AANP. What do you look forward to most at the helm of one of nursing’s most influential organizations?
It’s just great to be leading the largest NP organization that represents over 355,000 nurse practitioners across the U.S. I’m excited to continue to have nurse practitioners partner, care, and grow so we can build the NP workforce for the future. We do that through speaking with our policymakers and modernizing state and federal laws that will allow our patients greater access to NPs.
Talk about your early years in nursing and what inspired you to become a nurse.
I’ll start with what inspired me to become a nurse. I knew early on I wanted to be in a profession that helped people. I was unsure what that profession would be, but I always gravitated towards the help professions. I credit my aunt, a nurse, who all the while was saying consider nursing, and I did it. It took me a while to come to that decision on my own. Once I understood the role of nurses and patient advocacy, the ability to share health information and care for people and promote health and wellness, that was my epiphany.
Once that all came together, I said okay, this is what I want to do. So, I credit my aunt for putting me on the path to my career as a nurse practitioner. I knew I wanted to work as a nurse practitioner early on. I worked on a med-surg floor, which was a heavy orthopedic floor. And I give kudos to my colleagues who are on units in hospitals. But I knew that helped solidify that I did not want to be in that environment. I wanted to see patients on an ambulatory basis. And that’s where nurse practitioners became the natural fit for me. I’ve worked in some prior healthcare settings. I was associate director of student health services at Fordham University and loved working with college students. I also worked in retail health for a bit with MinuteClinic. Before joining the Columbia School of Nursing, I worked in occupational health. So, I was always connected to primary care. That’s where I wanted to be. That’s where I thought I could influence my patients and partner with them to reach our shared goals.
I’ve been incredibly fortunate to have these roles and fulfill what I wanted to do. Other than my presidency of AANP, I am the Associate Dean of Clinical Affairs at Columbia University School of Nursing. I oversee our primary care nurse practitioner practice as my everyday work, so I still do similar types of work, but more on a system scale than an individual patient basis. And I feel like I’m still contributing to the healthcare system through that NP lens.
When you were the executive director of the Nurse Practitioner Association of New York State (NPA), you were frustrated by “arbitrary limitations” in your practicer and successfully advocated for full practice authority (FPA). Can you talk about that?
I enjoyed my time at the Nurse Practitioner Association of New York State as a member of that organization and then ultimately as executive director. I was frustrated by things such as not being able to sign most medical orders of life-sustaining treatment forms or not being able to sign, believe it or not, a barber who needs a physical to be cleared to get their barber license in New York State. As a nurse practitioner, the law at the time prohibited NPs from signing this form. I’ve been performing physicals for hundreds of patients across the spectrum, and organizations accept my signature, except for this barber form. Some of those examples drove me to get involved at the policy level. And I thought that all we need to do is change these laws, and then you could do it, but it’s not an easy task. It’s certainly empowering to feel part of it, and my frustrations were not just mine. Once you speak to colleagues, they have the same frustrations. So, working with people who want the same things, ultimately taking care of the patients in front of us without those barriers, was very empowering.
In those ten years, nurse practitioners can now sign most forms in New York State, and we can sign the barber physicals. In April of 2022, New York Governor Kathy Hochul signed legislation that nurse practitioners with more than 3600 hours of clinical experience have full practice authority and are no longer mandated to have any contract with physicians to practice. So, what this means is increased access for patients. It means a more equitable healthcare system. We are improving those dynamics around us. I advocate for everyone to get involved in health policy because it affects us all personally or professionally. So, NPs have a crucial role in advocating. Nurses are the most trusted profession in the Gallup poll every year. And we need to continue using our voices outside patient rooms with our policymakers and lawmakers. So they need to hear the stories of the challenges we face that impact patients in their constituents and districts and then work together to solve them. I want to leave this profession better than when I found it. And it requires not just nurses and nurse practitioners to talk about these things, but collectively, we need to use our voices to escalate these issues. And we know as nurses, we’re leaders, we have no problem advocating for our patients. I would love to see us continue that advocacy beyond and to our lawmakers and policymakers.
You’ve worked with several national organizations. Can you talk about who they are, what motivated you to join them, and how nurses can become more involved?
I’ll use AANP as the first national organization. People need to join their membership organizations. They don’t necessarily consider joining an organization because information is out there, but our national organizations advocate for the profession. And they are looking out for us in ways we cannot do alone. So, join your national organization and your state organization. Sometimes, they’re not the same organization. And that’s somewhat confusing. So you have to be a member first and foremost. I recognize, and I’ve been through the ups and downs of a career, and sometimes you want to reach out to your organization and say, “I’m a volunteer, and I want to help you. I want to lend my talent.” And sometimes you are so busy with your work and personal life that you can’t possibly volunteer any more time, and that’s okay. But we want you to be a member. We want you to lend your time and talent and be part of the membership. That’s how we can band together and use our collective voices. Hopefully, that’s a loud voice with more people supporting the cause.
The other organization I’ve been involved with for two years is Jonas Nursing and Veterans Healthcare. I led that organization as executive director, and that was a fantastic opportunity to support nurses returning to school for their doctoral education in the form of scholarships. So, it was empowering to hear the stories of the applicants and what they wanted to do with their advanced education and plans. In every instance, it was about bringing increased access to care to their communities or studying underserved communities historically passed over. It was inspiring to me. It gives me hope for the profession’s future, knowing that such passionate people are in the pipeline and looking to finish their education to do the work they feel most impactful for their patients and their communities. So it’s been great.
You’ve worked in several nursing leadership positions. What advice do you have for nurses seeking leadership positions?
First, you need some experience. People should volunteer, whether volunteering their time or being a mentee, reaching out to individuals who might be out there who could help them. I support and endorse the idea of a mentor-and-mentee relationship. Finding the right mentor takes time. Sometimes, that mentor may not be available to you based on what’s going on in their lives. So there needs to be a plan, and you need to have a few people on your list that you identify that you can say, hey, I’m going reach out to them to see if they’ll give me some words of advice. I think that’s quite powerful.
The other thing to say to people is that once you have some experience, go ahead and apply for the job. You may not get that role, but going through the steps of submitting an application for interviews is always good. And it allows you to interview that organization as much as they’re interviewing you. That’s a key. As people mature in their careers and roles, I remember being in love with a job before it was offered. I’m like, “Oh, this would be the perfect job for me.” And then you go on the interviews, speak with people, and do your diligence. You’ve concluded that maybe that role is not the best for me. And I think that takes just having some experience, speaking with people, and making the best decision for yourself. Sometimes, we forget about that when we go on job interviews. We see a job description on paper, and it looks perfect. But the reality is no job is perfect. You have to look at the full pros and cons of any situation. Certainly, there are lots of opportunities for people to get involved. Nurses make great leaders, and I encourage people to seek those leadership positions.
Speaking of leadership, what was your motivation to run for president of the AANP?
I wanted to give back to my profession. I wanted to support the profession in ways I felt supported in the 20-plus years I’ve been a nurse practitioner. So I like working with people. I like making changes at the system level. And being the AANP President would allow me to continue doing those things at a national level. And so far, I am just still a few months into this. I officially became president at the end of June, but it’s been fun. It’s been so rewarding to me. Hearing and speaking with our members invigorates me and gives me the passion to continue creating positive change.
You are particularly interested in health information technology and integrating evidence-based practice into daily practice. How do you plan to make that a focus of nursing?
From a healthcare technology perspective, I think there’s a huge potential to allow us to care for patients better. The example I like to use is the electronic health record, which is sometimes challenging because it’s very structured and takes more time. But what we have accessible to us that we didn’t have before is just reams and reams of data. And it’s a lot of data points, and no human can look at all these data points and make sense out of them. And this is where I see the potential of artificial intelligence to look at information and summarize it. We have wearable technology like the Fitbit and Apple watches and things like that. We can get EKG readings every hour that can go to anyone. But that information isn’t helpful if it’s just recorded as a point in time. And that’s where technology can help us make better sense of the information and determine if this information that we’re getting is good and if it’s actionable. And that’s where a clinician’s expertise comes in to say yes; this is good information that I can make an educated decision for my patients. So that’s critically important.
My doctoral work focused on evidence-based practice to critically appraise data and ensure we’re doing things in healthcare because they are based on evidence and not just how we always did that. It’s vital for credibility; it’s essential to new treatments, and as we learn more about disease processes, it’s critical to keep incorporating these aspects into our daily practice. And then there’s the research piece. There are so many opportunities for research for nurse practitioners. At Columbia University, we’re working with our researchers on nurse practitioner and patient outcomes, but not just that. We’re also looking at nurse practitioner-led interventions and different studies aimed at taking better care of patients.
What is your vision for AANP under your tenure?
It will be working with our stakeholders and lawmakers at the federal and state levels. We want to remove barriers to practice that impede nurse practitioners from delivering healthcare to our patients. There are many outdated laws or policies, particularly Medicare and Medicaid. Medicaid is also legislated at the federal level, and there’s an opportunity there for us to make historic changes within those programs that will increase access to care. One of the items in the current bill in Congress, both in the House and in the Senate, is the ICAN Act, which aims to improve care and access to nurse practitioners. This bill will make many improvements and modernizations to laws, including a nurse practitioner’s ability to prescribe diabetic shoes for patients with Medicare insurance for cardiac rehab, inpatient cardiac rehab, and medical nutrition therapy. There’s a whole host of priorities that are included in this legislation. I was looking this up, and we only have 14 co-sponsors in the House right now for the ICAN legislation out of a possible 435 districts. On the Senate side, there is just one Senate co-sponsor. So, we have a lot of work to bring awareness to this bill and not have it lost in our society’s political discourse today. This means patients are prohibited from getting the care and access they need. The other thing we need to do is on the state level. We have 27 states that are full practice authority. We need to work with those 23 states that are not full practice authority. And we know that full practice authority leads to better outcomes. Most of the healthiest states in the nation are full practice authority states for nurse practitioners.
And conversely, the ones that are not healthy restrict NP practice. So there’s a lot of work to do. And it’s no one person’s responsibility to do all that work. But it’s truly working together and getting our lawmakers to listen to some of these challenges and hear the stories that everybody’s encountering on a daily basis.
You have a lot on your plate. What do you enjoy doing when you’re not working hard to elevate the role of NPs?
I put my family first and foremost. I enjoy being a father to my three children and a husband to my wife. My kids are involved in various sports and activities, so you’ll find me at the soccer or the football fields. I listen to music and exercise and try to have some sense of balance in my life. I also love things like sports and cars. I try to find a good mix of balancing everything, but sometimes it’s easier said than done.
Hospitals designated through the Magnet Recognition Program® live up to their name—they attract and keep nurses thanks to the nursing-focused strategies at the organization’s operations’ foundation.
Since the American Nurses Credentialing Center (ANCC) launched its inaugural Magnet pilot program in Seattle in 1994, the designation has become the highest recognition for a hospital’s nursing department. The rigorous application process comes only after organizations commit to the highest quality of nursing and patient care with established initiatives and programs.
Nurses who work in Magnet hospitals are supported throughout their careers and given the skills and opportunities needed to move up the career ladder, says Susan Fisher, DNP, APN-C, ACNS-BC, CNOR, NE-BC, and director of the Clinical Excellence & Magnet Program at Jefferson Health. “Magnet wants nurses
at the table,” she says. “It is not a top-down approach. They have to include bedside nurses at the project-planning level.”
Fisher says Magnet hospitals differ for many reasons, including an approach to nursing practice and standards that expect nurses at every level to practice at the full span of their licensure. With a nursing model that is based on both collaboration and autonomy, nurses find they work within a structure that lets them use their experience and education to assess and treat patients based on standing orders and provides an environment where peers and leadership model career advancement and lifelong learning. And it’s not a one-and-done approach—Magnet hospitals only hold the designation for four years, after which they need to reapply.
Once organizations are Magnet-designated, keeping the status is important because healthcare consumers and professionals recognize it. “A Magnet-recognized organization is one in which the continued education and development of its nurses is highly valued, leading to improved patient outcomes and care,” says Rebecca Graystone, vice president of the Magnet Recognition Program and Pathway to Excellence Program® at the ANCC. “Magnet recognition is not merely an award or a badge of honor. It is steadfast proof of a hard-earned commitment to excellence in healthcare, with contented, valued, and inspired nurses at its heart.”
With all the programs and initiatives necessary elements of Magnet recognition, nursing in these organizations is much more than a job. “Magnet-designated organizations are recognized for the phenomenal work their nurses are doing for the profession, clinical outcomes, and for their nursing practice,” says Angelina Fakhoury-Siverts, chief nursing officer at City of Hope, a hospital that received its third Magnet re-designation in January with exemplar status in 12 categories. “It’s not just some recognition that doesn’t mean anything. We don’t want people to strive to be Magnet; we want people to strive to do the work Magnet recognizes.”
Because Magnet encourages nurses in their immediate role and with an eye to their future potential, nurses are frequently expected to see how their work fits into the organization’s processes holistically. “Magnet lends itself to the ability to be innovative and not just task masters,” says Fakhoury-Siverts. “You start to think of nursing differently.”
Although Magnet organizations are known for having high hiring standards, including a standard practice of hiring nurses with a BSN, Fakhoury-Siverts says nurses without a BSN shouldn’t be discouraged from applying for positions in Magnet hospitals. Graystone agrees, saying, “The Magnet Recognition Program provides a framework and encourages organizations to have 80 percent of their nurses attain BSN registration, but a BSN is not a hiring requirement set by the Magnet Recognition Program; each organization decides that. Magnet’s 80 percent BSN goal aligns with the Institute of Medicine’s Future of Nursing Initiative.”
Because Magnet hospitals are focused on lifelong learning and continuing to improve a nurse’s knowledge and practice, supporting continuing education is part of the core Magnet approach and something nurses are encouraged to pursue. “The Magnet Recognition Program provides a roadmap to nursing excellence, which benefits the whole of an organization,” says Graystone, noting that only 10% of hospitals in the U.S. are Magnet-designated. “Every organization is unique and different, but what we can say about the culture of Magnet organizations is that there is a commitment to excellence and an accountability for improved patient outcomes that is embraced by the whole nursing body.”
The pathways to career advancement may look slightly different for every nurse, but at Magnet organizations, there is a roadmap for making that advancement a reality. The novice nurse is supported in a Magnet organization on all fronts—with residencies to help them transition to practice, educational opportunities, peer support, and role modeling that encourages their success. As a veteran nurse, earning an advanced degree, gaining certification, or moving into a leadership role are all encouraged and mapped out with planned pathways to help that happen. The mix of nursing experience brings a valuable perspective and ensures a diverse hiring practice.
Even if a nurse has never worked in a Magnet hospital, there are some ways to prepare and conduct a job interview that will show a personal investment in the nursing profession. Asking questions directly related to Magnet principles, including support for career-boosting continuing education or certification, will help the hiring managers see a candidate as someone already committed to the rigorous, evidence-based practices so important in their organization.
“Ask what the nursing care model is, if they have shared governance, and if they have opportunities to be part of a unit-based council. You should also ask how the organization supports evidence-based practice and how nurses impact key decisions,” says Fakhoury-Siverts. “Those kinds of questions will resonate highly at Magnet organizations.”
The supportive and forward-thinking model is critical to Magnet hospitals as it helps prevent burnout and increases job satisfaction, says Graystone. “Working in a Magnet organization is also different for nurses because these organizations are committed to a framework for excellence that sets goals and requires evidence-based measurements and outcomes,” she says.
Fisher advises nurses to look at any potential employer carefully, even if they don’t have a Magnet designation.
“Don’t just look at the money,” she says. “Look at what comes with the money. Will they support you?” Nurses can think about how a nursing practice can grow when they’re not just encouraged but expected to contribute experiences and opinions to the daily operation—no matter what the experience level. “As CNO, I can’t make decisions on nursing practice if I don’t know what is happening at the bedside,” says Fakhoury-Siverts. “That bedside nursing is front-line nursing.”
Magnet designation is more than recognition of a job well done. Fisher puts it simply, saying, “I would want nurses to know that coming to a Magnet hospital means they will be practicing nursing the way nursing is meant to be practiced.”
Read the October issue of Minority Nurse focusing on the MSN and Magnet Hospitals here.
We’ll be at the 2023 ANCC National Magnet Conference® October 12-14 at the at the McCormick Place Convention Center in Chicago, Illinois. Stop by booth #918. We look forward to seeing you there!
