The 348 alumni of the Doctor of Nursing Practice (DNP) program at Cizik School of Nursing at The University of Texas Health Science Center at Houston (UTHealth Houston) serve as chief nursing officers, informatics experts, nurse practitioners in various roles, deans of other nursing schools, and in a host of other leadership positions from the bedside to the boardroom. In the 15 years since its founding, the program has become so popular that the number of graduates will double within the next few years.
This is good news for health care systems across Texas and the nation.
“Professor Beth Ulrich [EdD, RN, FAAN] asked one of most recent classes to think about the number of patients whose care would be improved by their individual quality improvement projects. The number quickly added up to thousands,” said Assistant Professor Kathleen Siders, DNP, FNP-C, who co-directs the DNP program with Associate Professor Lisa Boss, PhD, RN, CNS, CEN, CNE.
“I’m not a Texan by birth, but I know what is important to Texans. They like to be the first, and they like to be the biggest,” said Professor Emerita Joanne Hickey, PhD, ACNP, FAAN, the architect and founding director of Cizik School of Nursing’s DNP program.
Then-dean Patricia L. Starck, DSN, RN, FAAN, had a vision for helping nurses reach the pinnacle of their practice potential. She had been part of a national working group promoting DNP degrees as an alternative to research-focused PhDs.
“We envisioned the DNP as being a scholarly focus on the highest level of clinical practice,” Starck said.
And, yes, she wanted UTHealth Houston’s program to be the first in Texas. Hickey described Starck’s skills at negotiation and persuasion as “incredible,” and the dean emerita herself acknowledged she may have wielded them more than usual in building support for the DNP program among the nursing school faculty and in Austin.
“We believed that nursing as a discipline has some characteristics and competencies that are unique within the health care field,” Hickey said. “Patients often tell things to nurses that they don’t tell to physicians.”
She and Starck worked together with a team of expert faculty and staff to design a program that would capitalize on and enhance the skills and abilities inherent to nursing and create greater opportunities for nurses to work collaboratively as indispensable members of health care teams and improve patient outcomes. They also pressed the then-novel idea of delivering most of courses via distance learning.
“Anything online 15 years ago was definitely a new thing,” Boss said. “Dr. Starck pioneered it in every way. Other DNP programs that came later really looked to her.”
The moment of truth came in April 2006, when Starck and Hickey presented their plan to the Texas Higher Education Coordinating Board. Success was far from certain, but the board approved most aspects of the proposal, enabling UTHealth Houston to create the first DNP program in the state.
“I remember sitting next to Dean Starck,” Hickey recalled. “She said, ‘Now Joanne, when are we going to start this? It could be next year, in January.’ I said, ‘We are doing it this fall! We’re going to do it before anyone changes their minds.’ ”
Over the next few months, creating the DNP program became Hickey’s full-time job. Her unusual background as a faculty member with a PhD who also maintained a clinical practice made her well qualified for the role.
One of the first people who joined her team was Senior Administrative Coordinator Candiance Duplessis, now a 32-year veteran of UTHealth Houston. The self-described “mother hen” of the DNP program prides herself on maintaining professional and personal relationships with students and graduates.
“We set the bar high,” Duplessis said. “Our students graduate not just with a DNP in hand, but with an education. They know where home is – here,” she added, ticking off a list of at least a dozen DNP graduates who are now members of the Cizik School of Nursing faculty, including Siders and Myron Arnaud, DNP, CRNA, director of the nurse anesthesia program.
Duplessis is a champion and advocate for the students. If RNs receive pins when they become nurses, so should nurses who earn terminal degrees, she reasoned. So, she designed DNP pins for graduates. “They are given a pin by their advisor, and they wear it proudly,” she said.
At first, only nurse practitioners (NPs) were admitted into the three-year, part-time program that was designed for working professionals and focused on nursing leadership. The first class of nine DNPs graduated in 2009. Within a few years, clinical nurse specialists became eligible, and several concentrations were added over time.
DNPs today and tomorrow
Demand for Cizik School of Nursing’s DNP program has soared, Boss noted.
“We just admitted 160 students, and we now have a total of about 300 in the program,” she said. Increased enrollment required significant updates to program and an infusion of resources – a huge project that faculty has undertaken with dedication and commitment.
Contributing to the growth are changes to national standards and requirements for NPs. Since more clinical hours are needed to become NPs, many students choose the BSN to DNP programs now available as an alternative to pursuing master’s degrees.
“NPs 20 years ago were taking care of easy things – cold, flu, coughs, blood pressure, etc.,” Siders said. “Today, we are taking care of complex diseases and complex patients. Our level of responsibility has risen, and with that, our education needed to as well.”
Cizik School of Nursing’s BSN-DNP Nurse Anesthesia program was established in 2014 and remains the only such program offered at a public university in Texas. It is accredited separately from the NP programs, which now offer BSN-DNP tracks for family NPs, adult/gerontology primary and acute care, and psychiatric/mental health nursing.
Cizik School of Nursing’s reputation for excellence plays no small part in its popularity. For example, the number of students enrolling from the Dallas area has grown substantially as graduates there spread the word among their colleagues, Boss said. In the past two years, the greatest number of remote students hailed from the Panhandle and the Rio Grande Valley, Duplessis added.
The fact that most work is done online makes it possible for nurses to advance their education from any corner of the state. However, the face-to-face element is also a critical component of Cizik School of Nursing’s DNP program. Normally, students would travel to Houston for a couple of days each semester to meet with faculty and collaborate with their cohort. Because of COVID-19, those interactions shifted to video conferencing, which may remain an option for students in far-flung locations as we emerge from the pandemic, Boss said.
After all, underserved rural communities arguably need DNPs most, Siders noted. “We are trying to recruit from rural areas and encourage our graduates to go back there,” she said.
Ultimately, it is an unwavering commitment to excellence that keeps Cizik School of Nursing’s DNP program in the top 5% nationally as ranked by U.S. News & World Reports.
“I just see it continuing to grow in terms of student admissions, faculty involvement, and continuous quality improvement,” Boss said. “Our alumni are going to be in a really good position when they graduate because of our reputation for excellence.”
“We always focus on quality,” Hickey said. “We are very concerned with high quality and high standards, and that shows up in the alumni who have come through the program and graduated. They continue to lead in phenomenal ways.”