Building the public health (PH) workforce: Doctor of nursing practice (DNP) in public health nursing (PHN) through distance learning

Background: Shortage of public health nurses (PHN) endangers the health of populations. Reasons for the shortage are complex, including aging nurse workforce and a shortage of graduate PHN prepared nursing faculty. In 2001, the University of Tennessee Health Science Center, College of Nursing admitted the first PHN practice doctorate student utilizing distance learning methodologies to respond to this need.

Methods: The curriculum incorporates Essentials of Doctoral Education for the advanced practice nurse and the PHN Competencies. Retrospective review of the PHN option curriculum and the students are included in this evaluation. Students are surveyed annually regarding activities, including the types of projects completed, employment, and post graduation scholarly activities.

Results: The distance learner graduates met the program goal to address disparity in health care delivery. Scholarly Capstone projects included evaluating homeless programs, programs targeting prevention of measles and HIV in Africa, implementation of PHN Competencies into graduate curricula, use of portable electronic medical records following disaster, community readiness for disaster, gaps in services for intellectually and physically challenged, prevention programs for the sexually victimized, and community-wide response to reports of violence against women. Graduates (12) teach advanced nursing practice in accredited PHN programs and at historically black colleges (2). Graduates are located in disadvantaged communities (9) and are working through local health departments (2). After examining student resources, disadvantaged PHN students were assisted financially with loaner computers. Overall, meeting the competencies through distance learning has resulted in five graduates stating plans to develop a PHN DNP program in their community.

Conclusions: Since the program's inception, 17 students have graduated; 5 more will graduate in 2008. Student choices to remain in education, public health departments and in communities where the disadvantaged can benefit from their expertise are building the PHN workforce. Capstone projects demonstrate that students evaluated health policy and implemented systematic change in complex health care delivery systems serving disparaged and disadvantaged populations. Students report graduating with skills necessary to teach PHN Competencies to the existing workforce in their communities where capstone projects, scholarly activities, and clinical experiences advanced their proficiency in PHN skills, knowledge, attitudes and clinical activities.