2020 Nursing Page Update

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Doctor of Nursing Practice degree graduate praises York College program

Christopher Smith, a CRNA, says the program gave him a “higher-level view” of healthcare.

Christopher Smith has been a nurse for nearly three decades with more than 20 years of experience as a certified registered nurse anesthetist (CRNA). He always figured he’d go back to school and get a doctorate one day, but he could never find the money for it. 

A few years back, one of his colleagues at Anesthesia Associates of York made an off-hand comment about a new program at York College of Pennsylvania’s Stabler Department of Nursing: the Doctor of Nursing Practice. The registration deadline was coming up, so without overthinking it, Chris applied. 

The Doctor of Nursing Practice is a two-year, 37-credit program, during which students complete a scholarly project. 

Chris liked that the degree was a practice doctorate. Rather than getting a designation for teaching or research, he’d be in the trenches of a clinical setting, using evidence-based practice to solve real problems. 

Opportunity for practicing nurse

Oftentimes, in a clinical environment, practitioners might notice trends or benchmarks for quality that aren’t being reached or observe practices that could be done better, Chris says. They’ll delve into the medical literature to explore the questions and find other people’s research that’s addressed the problem and found fixes for them. The trouble is, it might take years or decades for something to go from the research phase to the practice phase.

The Doctor of Nursing Practice was created to shorten the length of time it takes for research evidence to be put into practice. 

This degree program gives a practicing nurse like Chris the opportunity to read research, tease it apart, determine whether it’s applicable in a clinical setting, and then coordinate and lead its adoption in practice. 

“I cannot say enough positive things about the DNP program and the professors who teach it,” Chris says. “They are really among the top tier of professors because they care and put as much work into the classes as the students.” 

Putting scholarly research into practice

For his scholarly project, Chris decided to look at reducing the rate of postoperative nausea and vomiting in patients (PONV). 

Using data collected from patients at York Hospital, he found that 54 percent reported feeling sick or throwing up after surgery. Through his review of literature, Chris found an article published in 1999 with a pre-screening tool developed in Germany that assessed each patient’s risk for nausea and vomiting. 

With that discovery, Chris piloted a survey of 1,139 patients who were divided into three PONV risk categories, which determined the number of antiemetic medications that should be administered prophylactically. In just three months, the pre-screening process helped reduce the rate of post-operative nausea and vomiting from 54 percent to just 12.6 percent. 

“That was great,” Chris says. “I could identify a problem, identify a solution and pilot change. Now comes the hard part: How do you sustain the change?” 

Earning recognition

That’s where the DNP program came in. He learned what he needed to do to increase compliance and get support from the hospital. Two years following implementation of his protocol, Chris is proud that the rates of nausea and vomiting have been reduced even further – to 8.5 percent. 

“I’ve always been able to give above average, stellar care,” Chris says. “But through this process and degree, I’ve been able to affect positive outcomes for more patients than I could possibly take care of myself, which is extremely rewarding for me.” 

What’s more, professional organizations took notice of Chris’ work. 

An article Chris wrote based on his DNP scholarly project netted him a journalism award from the American Society of PeriAnesthesia Nurses, and he was honored by the American Association of Nurse Anesthetists with the Alice Magaw Outstanding Clinical Anesthesia Practitioner Award. 

Critical, attentive professors

Today, Chris is continuing his work on post-operative nausea and vomiting – hoping to improve rates among bariatric patients who are still experiencing high incidence of nausea. He’s working with a PhD researcher on a grant that would allow them to do a study on different techniques that could help these patients. 

Chris attributes his success to the one-on-one attention he received from professors and the ability to collaborate with the five other students in his program – who challenged each other the same way a sparring partner might do in martial arts.  

“You might not know anyone in your class, but by the time you’re done, it’s another extended family,” he says. “You’re close, experiencing similar trials and tribulations.” 

The program was rigorous. Not just because Chris was working full time while completing the program, but also because of the demands of the scholarly project and the high standards set by the professors. 

While working on his project, Chris says his instructors were critical. They sought out weaknesses in their students’ assertions and would never let them skate by on generalities. They’re aggressive in their critiques not because they want to prove how much smarter they are than their students Chris says, but because they want their students to succeed. 

“These professors push you. They support you, but they push you to drive through and succeed beyond what they think you can do.”

A higher-level view

The program helped Chris achieve a more holistic view of healthcare. 

No longer does he only view his work through a nurse’s eyes – he can now look at it through that of an educator, an administrator and even a legislator. 

“It gives you a higher-level view of all the problems and intricacies of what healthcare is and what patient care is,” he says.