Can the Institute of Medicine trump the dominant logic of nursing? Leading change in advanced practice education.

The Institute of Medicine (IOM; 2010) has called for a transformation of the nursing profession to lead the redesign of health care in the United States. It acknowledges the need for profound change in nursing education, particularly advanced practice education, to produce the next generation of leaders in sufficient quantity to expand access, improve quality, and reduce cost. Although the IOM provides welcome validation of nursing's significant role, most of the recommendations are not new and have been advocated by nurse educators for decades. What has prevented us from creating the nimble and responsive educational programs that would ensure a sufficient corpus of advanced practice nurses with the relevant knowledge and skill to transform our ailing health system? Conceptualizing nursing as a complex, adaptive system (J.W. Begun and K. White, 1997), this article explores three examples of the dominant logic, grounded in a historical legacy that has kept the nursing profession from realizing its promise as a potent force: (a) the continuing preference for experience over education, (b) the belief that only nurses can teach nurses, and (c) the hegemony of the research doctorate.

Innovative university partnership meets neonatal nurse practitioner program need amid faculty shortage.

This nation is facing a significant nursing faculty shortage not only at the undergraduate but also at the graduate level. As nursing faculty, we must be innovative in considering ways of consolidating resources in this time of demand for advanced practice nurses. With the apparent need for qualified neonatal nurse practitioners in Iowa, the University of Iowa understood the importance of starting a neonatal nurse practitioners program. The University of Iowa College of Nursing and the University of Missouri-Kansas City formed a partnership to educate neonatal nurse practitioners. Although this partnership concentrates on a specific subspecialty population, it can serve as a pilot project that could be adapted by those who care for other diverse populations. The nurse faculty shortage requires innovative solutions, and a model such as this one may provide solutions for other institutions.

Doctorate of nursing practice: blueprint for excellence.

A great deal of work has been done during the past several years since the American Association of Colleges of Nursing voted in October 2004 to move advanced practice nursing to the doctoral level by 2015. Following the approval, task forces were formed to address curriculum issues and the strategies for transitioning advanced practice nursing education from the master's level to the doctorate of nursing practice (DNP). The DNP curriculum contains content on leadership, management, and other topics that are needed to address some of the issues in the health care system that traditionally have not been included in most master of science in nursing curricula, as well as additional essential content and nurse practitioner competencies. As pediatric nurse practitioners and other advanced practice nurses go forward in their careers, the DNP may have an impact on their role. In this article, the background of the DNP movement, changes in advanced practice nursing education, and the concerns of currently practicing pediatric nurse practitioners prepared at the master's level will be addressed.

National agenda for advanced practice nursing: the practice doctorate.

The purpose of this article was to provide the background and rationale for the practice doctorate in nursing. The American Association of Colleges of Nursing's Position Statement on the Practice Doctorate in Nursing, approved in October 2004, will be discussed. Outlined are some of the changes that will be needed in education, regulation, and advanced practice. Common questions and concerns that advanced practice nurses have, including titling, salary, and transitioning to the doctor of nursing practice degree, will be addressed.

Facts and fallacies: the practice doctorate.

In the past year there has been continued discussion within professional organizations regarding the emergence of the practice doctorate. This in turn has caused concerns among some nurse practitioners. The purpose of this article is to provide an overview of the practice doctorate, current progress and development of the concept, and the potential impact on practicing pediatric and other nurse practitioners.

The trophic role of oligodendrocytes in the basal forebrain.

Traditionally, the primary function of oligodendrocytes (OLGs) in the CNS has been considered to be myelination. Here, we investigated whether OLGs may play a trophic role, particularly during development. Neurotrophin expression was assessed in postnatal day 7 basal forebrain (BF) OLGs, using in situ hybridization and detection of myelin basic protein. Nerve growth factor, brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) mRNAs were revealed in OLGs in vivo and in culture. To determine whether OLGs support nearby neurons, we examined the influence of OLGs on BF cholinergic neurons. Neuronal function was enhanced by cocultured OLGs and OLG conditioned medium. Moreover, trophic effects of OLG conditioned medium were partially blocked by K252a, a trk tyrosine kinase inhibitor, and by neutralizing anti-BDNF or anti-NT-3 antisera, indicating that neurotrophins may mediate these effects, perhaps in concert with other signals. Our studies support a novel role for OLGs in providing local trophic support for neurons in the CNS.