Health is determined by many different factors. Physiology in only one aspect determining who gets sick and how illnesses progress. Knowing nurses have always taken a holistic view of patients, the University of Southern California the takes it a step further with its new Family Nurse Practitioner program housed within the School of Social Work.
“Our vision is to combine science of social work and science of nursing,” said Ellen Olshansky, PhD, RN, WHNP-BC, FAAN, chair of department of nursing at USC School of Social Work.
Students must already have a BSN and a minimum one year of clinical experience to enroll in the online program. In an unusual twist for online, distance education, students will come to the USC campus twice during their enrollment period. Faculty will observe the students during hands-on simulation training. “We can make sure they will be successful as they graduate and become nurse practitioners,” noted Olshansky.
The proposed curriculum will follow the current competencies for NP education. This program is not creating social workers; rather core concepts of social work will be integrated into the nursing curriculum. In addition to the standard FNP courses, all students must take a social work course in Human Behavior as well as a second social work course of their choice. “They will have balanced preparation where they look at health from a different perspective,” Olshansky explained.
The program is following the current push for more interprofessional healthcare education. To create the curriculum, USC brought in nurse consultants and also went through the curriculum committee at the School of Social Work. “There was a lot of collaboration,” remarked Olshansky.
“Each course has concepts woven through it. When we talk about pharmacology, we talk about why people are not taking their medications. Is it they don’t like the side effects? Is it the cost?” explained Sharon O’Neill, JD, DNP, FNP, PNP, MSN, Clinical Associate Professor and Vice Chair, Nursing Department and Director, Family Nurse Practitioner Program.
O’Neill said, “We put concepts related to social work into courses so our graduates will have better understanding of the care provided.”
Social Determinants of Health
She continued, “This fits into what nursing is already doing.” The American Nurses Association has announced a renewed focus on social determinants of health. That organization’s Code of Ethics, Provision 8 states: “Nurses must address the context of 27 health, including social determinants of health such as poverty, hunger, access to 28 clean water and sanitation, human rights violations, and healthcare disparities.”1
O’Neill said, “You can diagnose and treat but if people don’t have other needs met, they won’t be full participants in their healthcare.
Olshansky remarked, “I am confident nursing as a profession is interested in social determinants of health.” A family nurse practitioner encounters a patient in a primary care clinic presenting with vague headache and stomachache complaints. Focusing on social determinants of health reminds the NP to ask questions beyond the physical symptoms. Is the patient stressed? How are their relationships? “If we only take a narrow focus, we can’t help people,” noted Olshansky.
Clinicians should consider factors that may impede the patient from being compliant. Can they afford their medications? There is a connection between zip codes and health care with where live you playing a part in your health.
Creating Healthy Communities
Community health has been a big focus of healthcare since the Affordable Care Act. “We plan to work actively with community organizations to have clinical sites where nurses work in the community for clinicals,” O’Neill remarked. An emphasis on health promotion and prevention will be a priority for the new FNP program. What decisions are people making about their health? Nurse practitioners are important players in increasing access to healthcare for marginalized groups. “Nurses are key to identifying patient needs and educating patients in terms of managing their disease,” she said.
Olshansky said, “We envision our students to be involved in health policy.” The program will teach the nurses about policy. Nurse Practitioners have the experience to make health policy recommendations and speak out against the policies that have caused the health inequalities.
The students will also learn the value of collaborative healthcare. Clinicians should not practice in silos. When do you bring in social workers or other agencies to meet the patient’s needs? “It’s going to change how they approach a patient,” said O’Neill.
She explained, “We can’t do it all, which is why we need our partners in social work and other disciplines. The goal is to improve outcomes.”
The first cohort of the new Family Nurse Practitioner program at the USC School of Social Work will start classes in September 2016.
Danielle Bullen is on staff at ADVANCE. Email her at: [email protected]
1. American Nurses Association. Code of Ethics for Nurses with Interpretive Statements. http://nursingworld.org/DocumentVault/Ethics-1/Code/Code-Provision-8.pdf. Accessibility verified May 23, 2016.