AddressingChronic Health Conditions in Women

by the Nursing Workforce

Lucy Marion, PhD, RNDean, College of Nursing

Georgia Regents University soon to be

Augusta University

Determinants of Health in Women• Social• Economic• Behavioral• Environmental• Aging• Genetic• Epigenetic

• Heart Disease• Cancer- ovarian and breast malignancies• Obesity• Suffering– Pain: perimenstrual, breast, fibromyalgia– Bladder and gastrointestinal dysfunction– Fatigue– Depression and anxiety– Domestic violence

Chronic Health Conditions in Women

Nursing Workforce • ANA Scope and Standards of Practice (2015):

Levels of nurses– Registered Nurses: entry to nursing degrees– Advanced Nurses: graduate degrees– Advanced Practice Registered Nurses: advanced

practice graduate degrees• Types of healthcare “consumers”– Patients and families– Groups, communities, populations

Nursing Scope and Practice The nursing process for all nurses in all settings– Assessment– Diagnosis– Outcomes identification (expected)– Planning– Implementation of the plan• Care coordination• Health teaching and health promotion

– Evaluation of patient outcomes

Basic Nursing Care for Women• Nursing education to deliver basic care to all patients

and in all settings• Nursing process for health promotion and disease

prevention, screening, illness care, rehabilitation and facilitation of healing or dignified death

• Acute care: Labor and delivery, mental health, adult and children’s medical-surgical, emergency, and specialty units for women

• Community and primary care settings: schools, workplaces, homes, churches, clinics

Advanced Nursing for Women

• Graduate Degrees: MSN, DNP, PhD• Education• Administration• Research• Agents of quality and safety• Professional development• Program development• Policy development and advocacy

Advanced Practice• Basic Nursing• Advanced Nursing

PLUS• Advanced Practice– Expanded role, increasing access to primary and

acute care– Emphasis on population health– Can fulfill at least 85% of MD care with quality– Shorter and less costly education than MDs

Types of APRNs

• CRNA• CNS• CNM• CNP– Acute and Gerontological Acute Care NP– Family, women, children, geriatric nurse

practitioner– Mental Health NP

National Overview of APRN’s

• Changes in annual number of APRN graduates: from 2001 to 2011

– Nursing anesthesia: increased from 1,159 to 2,447 – Nurse midwifery: decreased from 422 to 392 – Nurse practitioner: increased from 7,261 to

12,273 • Nationally: 174, 826 NP’s licensed

AACN Georgia 2014 APRN Enrollments

3,593 studying to be APRN’s including • 3,499 in Nurse Practitioner programs, • 79 in Nursing Anesthesia programs, • 11 in Clinical Nurse Specialist programs, and • 4 in Nurse-Midwifery programs.

Georgia APRN Programs• Albany State University - PC• Armstrong Atlantic State University – PC, AC• Brenau University - PC• Chamberlain College of Nursing – PC• Columbus State University - PC• Emory University – PC, AC, NMW• Clayton State University – PC• Mercer University Georgia Baptist – PCPC-Primary Care AC-Acute Care MH-Mental Health NAP-Nursing Anesthesia NMW-Nurse Midwifery

Georgia APRN Programs• Georgia College and State University – PC, MH• Georgia Regents University – PC, AC, MH, NAP• Georgia Southern University – PC, MH• Georgia Southwestern State University - PC• Georgia State University – PC, AC, MH • Kennesaw State University – PC• University of North Georgia – PC• Valdosta State University -PC, MH• Others from distance programs

APRN Innovations in Women’s Healthcare

• Integrated mental and physical healthcare for women with major mental illness

• Reproductive healthcare for women with physical disabilities (e.g., quadriplegia)

• Telehealth to rural areas for emergency and specialty care (telestroke, teleheart)

• Network of small clinics in urban areas• Partnership clinics in schools, factories, youth

centers, shopping malls and mega stores

Recommendations for WH Nursing Workforce

• Adapt existing NP programs in Georgia to gain more expertise in Women’s Health

• Create new WHNP and Nurse Midwifery programs and consortia

• Increase faculty salaries to match market • Provide strong incentives for rural WHNPs• Scholarships, loan forgiveness, tax incentives

• Remove APRN practice barriers in Georgia (IOM Recommendation One)

Thank You