Healthcare as an Institution Is, of Course,

¶ … healthcare as an institution is, of course, the need to care for the sick and the injured. However, in the contemporary model of healthcare, effective communication during a crisis is not only important, but also vital. Communication by healthcare professionals takes the concern and worry out of the situation; offers a quicker resolution, makes better control of information possible, earns the trust of the public and individual families; and keeps the flow of information consistent and accurate, thus averting potential external problems. Based on my current experience in the nursing field, I realize that to advance my professional goals, as well as contribute soundly to the profession, I must expand my educational experience and am therefore seeking entrance into the Doctor of Nursing Practice (DNP) in Psychiatric Mental Health Nursing.

I believe I am well-qualified and motivated to undergo this program. Currently, I am a master's prepared Neonatal Nurse Practitioner (NNP) and a post-master's prepared Family Nurse Practitioner (FNP). My certifications are current, and I meet the yearly educational recruitments to maintain each certification. Recent changes in healthcare policy and the psychographics of the profession, however, indicate that it is wise both personally and professional to pursue doctoral level certification and I believe the DNP will allow me to broaden my scope of expertise as well as contribute to the advocacy and communication issues so needed in the profession.

In 1952 Hildegard Peplum wrote Relations in Nursing. In this text, Peplum focused on the client-nurse relationship as the basis for any foundation within the professional nursing template. While this seems logical today, the idea of compromise and advocacy of patients post-World War II was seen as both reactionary and upsetting of the hierarchical nature of patient-medical theory. Peplum believed that the partnership relationship between nurse and patient was essential to any means that would contribute to patient healing. I have chosen the Psychiatric Mental Health Program specialty specifically to enhance this theoretical basis. My clinical experience in the past few years has prepared me for even greater professional challenges. I have worked with high-risk premature babies, I provide acute and chronic direct medical management in neonatal ICU environments, I collaborate with neonatologists and other multidisciplinary professionals, I interact with the families during a time of stress and health crisis, and I am regularly called upon to act as a liaison between specialty disciplines. These experiences helped me realize just how stressful and debilitating health crises can be, and how many long-term effects may result from such early issues. I believe that a Psychiatric Mental Health specialization would enhance my skills in dealing with such issues, as well as increase my value to needy families and the profession.

My experience has shown me that the increased levels of diversity and change management are so rife in the modern healthcare culture that the idea of hope, optimism and finding relationship building opportunities are more than strategic plans -- they are tactical necessities. As an FNP, I worked in a rural clinic, in which I found that besides treating a number of physical disorders there were a number of clients with mental health issues (depression, anxiety, helplessness, substance abuse, etc.). Many of these clients eventually became so disabled they were unable to physically function. I referred these clients to other health care professionals, and worked with other specialists to provide an adequate treatment program, however, the DNP in a psychiatric specialty will allow me to provide not only a greater understanding of individual issues, but more important, the clinical knowledge and competence to actively help clients.

Based on my own personal view of lifelong learning, I realize when I review my career and experience that I am somewhat at a crossroads. To further my career and enhance my own personal level of expertise, I need to pursue advanced education. In reviewing a number of nursing theorists, I find that typically, at the heart of each ideology, is the basic notion that communication to all sides is integral. Client communication/advocacy is the application of skills, information, resources and action to speak out in favor of causes, ideas, or decisions to preserve and improve the quality of life for those who cannot effectively speak for themselves. I believe that the profession needs more professionals who have the clinical and personal skills to do just this, and a DNP in Psychiatric/Mental Health would assist these personal and professional goals.

Most importantly, I realize that the profession is at a critical juncture- healthcare costs, policies, patient needs, governmental oversight, patient expectations, changing demographics, and a more diverse population have all contributed to a more complex paradigm of care. We now have multiple horizontal priorities and challenges: to the work environment, the fiscal needs of the institution, patient advocacy, and balancing human needs with resources. . Acting both ethically and responsibly cultivates public trust and confidence, and allows a patient to put their faith in the profession. This very idea of beneficence -- to balance the benefits of treatment against the risk and costs, and to find the appropriate level of care, is really the central notion of modern medical philosophy, and therefore healthcare. What better way to encourage the ideas of ethics, advocacy and communication than teaching and reaching out to the next generation of nurses and medical professionals at all levels. The DNP will allow me to interact more in a pedagogical role, hopefully passing on my own passion and guidance to others.