When Sarah Mobley neared the end of her master’s program, she was bombarded with so many calls and emails about potential jobs that she unsubscribed from employment websites.
“I got 12 calls in one day alone,” says Mobley, who completed a psychiatric nurse practitioner program at the University of Colorado–Denver in December. She ultimately lined up a job at a hospital in Columbus, Ohio, that pays $100,000 a year. “It blows my mind,” says Mobley, 27, that she was so marketable.
Mobley’s experience is not uncommon these days. The competition for advanced practice registered nurses, or APRNs — including clinical nurse specialists, certified nurse midwives, nurse practitioners and nurse anesthetists — is growing exponentially. Studies have consistently shown that a more educated work force translates into better care, says Linda Burnes Bolton, vice president for nursing at Cedars-Sinai Medical Center in Los Angeles and vice chair of a 2010 Institute of Medicine study on the future of nursing.
Indeed, people seeking to attain advanced-practice positions soon are apt to be required or strongly encouraged to obtain doctorates. In a decade, newly minted nurse anesthetists will have to have a doctorate, and the IOM has called for a doubling of the number of doctorate-level nurses by 2020.
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For now, a master’s is the main route, though experts expect stiffer credentialing requirements will eventually apply in more areas, as they already do for pharmacists and physical therapists; new entrants to both fields need doctorates. More than 250 schools offer a doctor of nursing practice degree, a 2014 RAND Corp . survey showed.
Several factors are fueling the demand, but none more so than the epidemics of diabetes and obesity and the aging of the population. Tending to people with chronic and often multiple conditions, in the home or in outpatient facilities, will account for the lion’s share of health care in the 21st century, according to the IOM.
Meanwhile, health reform has swept tens of millions of under- and uninsured Americans into a system already strained by a scarcity of family doctors, expected to reach 52,000 vacancies by 2025. Little wonder nurses are increasingly “being given responsibilities that normally flowed to physicians,” says Jacqueline Dunbar-Jacob, dean of the school of nursing at the University of Pittsburgh.
Nurses deliver care outside of hospitals that’s comparable in quality to a physician’s care, according to multiple studies conducted at the University of Pennsylvania and George Washington University, among other research centers, and often at a fraction of the cost. In 2014, British researchers concluded that it’s actually safer for healthy women with uncomplicated pregnancies to give birth aided by midwives than by doctors, who are more inclined to use interventions — forceps deliveries or C-sections, say — that can cause complications.
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Nurse anesthetists — who have been ministering to wounded soldiers since the Civil War — are the sole providers of analgesics in about one-third of all hospitals and close to 100 percent of rural hospitals, assisting in all sorts of surgical and other procedures and providing chronic pain management and emergency care. “If not for them, many of these hospitals in smaller areas couldn’t be there,” says James Walker, who directs the graduate program for nurse anesthesia at Baylor College of Medicine in Houston. Currently, nurse anesthetists make an average of $150,000 a year.
Nurse practitioners operate in settings from hospitals and HMOs to nursing homes and schools, as well as in private practice. They treat relatively uncomplicated medical problems, provide preventive care and write prescriptions. In 19 states, including Arizona, Colorado and Washington, plus the District of Columbia, nurse practitioners can work without a supervising physician; about a dozen other states, such as Pennsylvania and California, are considering giving them full independence.
Clinical nurse specialists work mainly in hospitals, providing specialized care in such areas as geriatrics, cardiac or cancer care. Nurse midwives not only deliver babies but also provide gynecological exams, family planning advice and neonatal care.
Typically, a master’s requires 18 to 30 months, while a DNP can take up to three years full time. Some schools, like the University of Colorado and the University of Pittsburgh, offer Ph.D. programs in nursing, too. The Ph.D., which requires original research and a dissertation, prepares students to become scientists and professors; the DNP, by contrast, emphasizes clinical skills and involves a so-called practice project but no dissertation.
At Pittsburgh, for instance, DNP students complete about 1,000 hours of mentored clinical practice similar to med school rotations and a capstone project that applies what they’ve learned. A student might work on upgrading safety in neonatal nursing care, for example, or come up with strategies for helping troubled adolescents in a mental health facility.
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When choosing a program, experts recommend looking at graduates’ pass rates on licensing exams and where they end up. “Placement rates of 94 percent or above are good, and [graduates] should have at least a 90 percent pass rate on exams,” suggests Dunbar-Jacob.
A bachelor’s in nursing is required to enter a regular master’s program. But there are also more than 60 accelerated programs for people with an undergrad degree in another field who want both a nursing license and an advanced degree.
This story is excerpted from the U.S. News “Best Graduate Schools 2016” guidebook, which features in-depth articles, rankings and data.
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