“Doctor of Nursing Practice” From the Bedside to the Boardroom

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I believe we cannot improve the quality of healthcare in America without nurses in key management roles,” says UM President Donna Shalala, Chair of the Institute of Medicine and Robert Wood Johnson Foundation “Future of Nursing” Committee. There is a new breed of leader at the head of the table in healthcare boardrooms across the country: the nurse. The most extensive overhaul of healthcare in our nation’s history has resulted in a call for leaders with the advanced education, real-world experience, nursing expertise and organizational management skills required to help spearhead the process of healthcare reform. The University of Miami Doctor of Nursing Practice (DNP) program, launched in January 2009, is helping to meet this need.

For over 63 years the School of Nursing and Health Studies has prepared nursing professionals to excel in the provision of patient care.The current ambitious national healthcare reform agenda, together with The Institute of Medicine/Robert Wood Johnson Foundation’s groundbreaking “Future of Nursing” report, call for today’s nurse leaders to develop expertise beyond the bedside. To partner with physicians and other professionals in redesigning our nation’s healthcare system, nurses must also speak the language of fiscal planning, organizational leadership, health policy and translational science. The remarkable graduates of our DNP program are taking a leadership role in this arena. Emerging among the program’s alumni base are professionals at the helm of multiple care settings, with the business acumen to match their nursing skills.

“You are going to be seeing more DNPs in boardrooms across the country,” says Tom Hartley, (DNP ‘11), Director of Ambulatory Care Clinical Services at University of North Carolina Health Care. Hartley is the senior manager of over 111 clinics, responsible for 7500 daily patients and oversight of 2000 physicians/nurse practitioners. He explains, “Nurses are uniquely prepared as clinicians; they are the ones who touch the patients. Nurses have not only the patient’s perspective, but when you add the capacity to manage resources and fiscally sound principals; you have an executive who understands the patient’s needs and [the organization’s] business requirements.” It is precisely this combination of doctoral-level executive ability and advance practice nursing knowledge that the DNP program was designed to produce.

“If you had told me years ago that I would be in a senior leadership position at UMH as Chief Operating and Nursing Officer, I would never in a million years have believed it, but due to years of hard work and the professional growth I have experienced from the DNP, I am proof that with dedication, perseverance and the right education anything is possible,” says David Zambrana (DNP, ’09), DNP, MBA, RN, Chief Operating and Nursing Officer, University of Miami Hospital (UMH). Zambrana received his Doctor of Nursing Practice degree in the first graduating DNP class of 2009. Today, he oversees clinical operations and nearly one thousand employees at UMH, South Florida’s first university owned, multi-specialty, acute care hospital.

As DNPs, Zambrana and Hartley have the leadership ability that large healthcare boards are seeking, decades of clinical experience, the finance, management, and assessment skills required to triage and tackle problems, knowledge of how to translate evidence-based quality improvements into practical governance policies, and insight into the concerns of patients.

“I was a little reluctant at first when JoAnn Trybulski (Ph.D., ANP-BC, DPNAP, Associate Dean, DNP Programs) indicated I would be in class with clinicians, business professionals, and educators. However, putting all of us in the same class to discuss healthcare topics actually enhanced my understanding and perspective”, says Hartley. The DNP program’s partnerships with the University’s Schools of Business Administration and Education affords its students an interdisciplinary dialogue as a component of their education,. “I have talked with Dean Nilda (Nena) P. Peragallo Montano, DrPH, RN, FAAN and told her that I have encouraged all of my senior staff members who desire executive leadership roles to get their DNP,” says Zambrana.

Jacqueline Cereijo (DNP ’09), DNP, MBA, RN, Director of Satellite Practice for the UM Sylvester Cancer Center in the Kendall area of Miami, represents yet another member of UM’s DNP graduates heading up a sizeable healthcare operation. This is a class of leaders for whom it appears the sky is the limit. Cereijo is responsible for spearheading business growth and patient care for the Kendall facility, where she oversees nearly 100 nurses and physicians in more than 30 adult and pediatric subspecialties. “I never thought as a nurse I would be in a leadership position like this, but the DNP has given me the total package to optimize patient care while working under a solid business model; the doctoral degree has helped create opportunities that I could never have dreamed of,” says Cereijo.

Zambrana, Hartley and Cereijo all stress that “higher education is the key to success.” In fact, Zambrana is already working on his next degree, a PhD. As he explains it, “During the DNP program, I was very interested in the research component. There is so much that needs to be investigated and the PhD is the next chapter of my career.” Clearly, the University of Miami Doctor of Nursing Practice program represents an important advancement for the future of the nursing profession. Our DNP graduates are helping to lead the not-so-quiet revolution that is placing today’s nurse at the forefront of national healthcare leadership.


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