Whether a nurse’s first degree came from a diploma, associate or baccalaureate program is irrelevant. Self-determination and a thirst for knowledge means more for academic success than a nurse’s entry point into the profession. Read how three local nurses overcame similar financial concerns, time constraints and other barriers as they pursued DNPs and achievements in their clinical and academic careers.
Diploma programRenee Liberty, RN
As a patient safety specialist in the quality management division at North Shore University Hospital in Manhasset, N.Y., Renee Liberty, RN, DNP, seized what she called a great opportunity to learn more about research and earn a terminal degree through a hospital collaboration with Case Western Reserve University in Cleveland, Ohio. North Shore-LIJ Health System paid for the degree up front.
The hospital made it easier for us, Liberty said. She attended full-day weekend classes in Greenwich, Conn., and at Case Westerns Cleveland campus for two courses and a presentation of her thesis, a formal program review of North Shore Universitys pressure ulcer prevention program.
Liberty completed the diploma program at Queens Hospital Center School of Nursing in 1977, in the schools last class. She worked in med/surg, step-down, intensive care, labor and delivery, and the ED at Jamaica Hospital Medical Center in Queens, N.Y. While there, in the early 1980s, she began working on her bachelors degree in community health education and graduated from York College/City University of New York in 1984. Liberty received a masters degree in nursing as a clinical nurse specialist from Long Island University C.W. Post Campus in Oyster Bay, N.Y.
Meanwhile, she moved to her current hospital North Shore University practicing as a dialysis nurse, then pediatric intensive care, and eventually became assistant head nurse on the post-partum unit. She transitioned to education and held that position for 19 years before switching to nursing performance improvement.
The diploma program provided Liberty with hands-on experience, but did not train her in nursing theory and evidence. Her non-nursing bachelors also didnt touch on these topics. Liberty was motivated to get a DNP because she said it would make her more knowledgeable about nursing theory and evidence. When her son left for college, the timing was right for her as a single parent to pursue a doctorate.
Things are just flying by so fast, you need to keep up, look at the research that is being done, look at all the new innovations nursing has, and without continuing on with reading and studying, you are not going to pick that up, Liberty said. In my position in nursing quality and performance improvement, it was essential for me to learn as much as I could.
While continuing to work full time, Liberty completed a DNP in January 2010. She said she uses the skills she learned in her doctoral program in her current position and plans to continue conducting research studies and advancing the professions knowledge base.
Nurses should never stop learning, Liberty said. They need to subscribe to magazines or go to the hospital library, and they should not be afraid of research and learning from what others have done before them.
Associates degreeMercedes Echevarria, RN
Although she describes herself as very clinical, Mercedes Echevarria, DNP, APN, director of the DNP program at the University of Medicine and Dentistry of New Jersey School of Nursing in Newark, N.J., knew she would eventually end up in academia.
Im self-motivated, Echevarria said. It was instilled in me by my parents to reach for the stars and achieve my full potential. The doctorate was something I wanted to accomplish my entire life.
Echevarria began her career with an associate degree from Middlesex County College in Edison, N.J. While working full time in a variety of positions acute, school nursing and ambulatory care she continued her studies, earning a BSN, an MSN, certification as both an adult and pediatric nurse practitioner, and in 2008, a DNP from UMDNJ. She found employers tuition reimbursement programs helpful in paying for her courses, but scheduling time off for classes still proved difficult. Nevertheless, she did not back away from her goal.
UMDNJ offers an executive-model DNP program, with weekend classes, which allowed her to work and go to school full time. She considers the intensity of the program, with completion of a capstone project while taking regular coursework, the greatest challenge. For her capstone project, Echevarria implemented a Spanish-language, school-based nutrition and physical activity educational intervention for Hispanic children and parents.
The American Association of Colleges of Nursing calling the DNP essential for nurse practitioners convinced Echevarria to return for her doctorate. She found the program valuable in terms of health policy, leadership and other topics not covered in a masters program.
The masters is probably sufficient for clinical practice, but adding the doctoral courses to it and being able to identify gaps in practice and translating that knowledge into practice is a tremendous added benefit [with a DNP], Echevarria said.
Echevarria said she could not have completed her degree without the support of her husband who advised her to keep her eye on the prize.
Now as director of UMDNJs DNP program, shes helping other nurses achieve that goal. She recently received a Health Resources and Services Administration grant to start a post-baccalaureate, pediatric DNP program, which will admit its first students next year.
She advises fellow nurses seeking a terminal degree to put your life on hold for a couple of years. You have to be driven and organized with good time management. Its doable but you have to stick to it.
Echevarria calls the DNP her biggest professional accomplishment. It was stressful going through it, but I wouldnt change anything, she said.
Bachelors degreeAnny Eusebio, RN
Family nurse practitioner Anny Eusebio, RN, DNP, FNP-BC, at NewYork-Presbyterian Hospitals primary care outpatient clinic at the Columbia campus and an adjunct professor at Pace University in New York, began her nursing career with a bachelors degree from Columbia University in New York City. She first received a bachelors in psychology but returned for a nursing degree. Then she practiced at The Mount Sinai Medical Center in Manhattan before transitioning to a school-based clinic as a special education substitute nurse.
Working per diem as a school nurse provided her time to return to Columbia University for her masters degree and a career as a nurse practitioner. She was not satisfied with stopping her education mid-level, so Eusebio began toying with the idea of returning for a DNP.
I saw changes in the healthcare environment and felt motivated to do it and to go for it, Eusebio said.
Wanting the flexibility of taking some Internet-based courses, so she could be home with her 3-year-old son sometimes, led her to Pace University. NewYork-Presbyterian allowed Eusebio to take Fridays off for in-person classes and reimbursed her tuition for the three-year DNP program. Even with family and employer support, she found the conflicting obligations a challenge.
Its quite a lot of multitasking, and you have to have organizational skills and prioritize, she said, adding that she reached out to student colleagues to help her stay focused. You get through it, and after you do, its such an accomplishment, a great feeling.
Eusebio was attracted to the research elements of a doctorate degree. I wanted to show how we quantify what we do, how we prove what we are doing is right or that we are doing excellent work, she said. I dont think that is well documented, and nursing is taken for granted. I wanted to be involved and learn how to improve the nursing profession.
Eusebio has used her new DNP knowledge to co-lead a nurse practitioner forum and is planning to collect data to demonstrate that NewYork-Presbyterians nurse practitioner-led anticoagulation clinic decreases patient complications and hospitalization readmissions.
Although she acknowledges a DNP degree is not for everyone, she said for her it made sense.
We need to be able to propel the profession, and [a doctoral degree] was the only way I saw that could happen, Eusebio said. I wanted to be part of that.