Here at DUSON, nurse practitioners and NP education has a rich history. It was at Duke in 1992 that North Carolina’s first Master’s Geriatric Nurse Practitioner Program was launched. Shortly thereafter, pediatric, acute care and oncology programs were added. Today, DUSON is home to eight nurse practitioner majors with an additional eight specialty certificates. Five of these majors are ranked #1 in the country. 

As we celebrate National Nurse Practitioner Week, we wanted to share some thoughts and insights from a few DUSON Faculty who lead our nurse practitioner specialties. Their answers while very different, shared common themes…a deep compassion for those who they care for and a professionalism toward their roles. 

Making an Impact in the Lives of Others 

We asked our faculty to tell us about a time in their careers when they knew that they had made the right decision in becoming a nurse practitioner.  

“I knew I made the right decision to be an APRN when at about six months post-graduation, said Kathryn J. Trotter, DNP, CNM, FNP-C, CHSE, FAANP, FAAN, associate professor and director of Women's Health Nurse Practitioner Major, “a woman hugged me and thanked me for supporting her during her entire pregnancy and postpartum time, and so did her little 4-year-old.” 

For Mary Lou Affronti, DNP, MSHc, RN,ANP, FAAN, now assistant dean for the Doctor of Nursing Practice Program, it was a similar feeling when, “I made a significant impact on the patient/family quality of care through their trajectory of their oncology treatment and during the end of life of their loved one.” 

It’s oftentimes surprising to see the impact that a committed nurse practitioner can have on the lives of patients and their families, Allison Edie, DNP, APRN, FNP-BC, FAANP, associate professor and director, Family Nurse Practitioner Major and Carolina “Callie” Tennyson, DNP, ACNP-BC, AACC, CHSE, assistant professor and Director, Adult-Gerontology Nurse Practitioner Acute Care Major shared these perceptions.  

“As and FNP for 35 years, I’ve had many wonderful memories, said Edie. “But one stands out to me is when an 18-year-old woman “graduated” from my peds clinic to the adult clinic-she did not want to go. She trusted me and asked to stay with me.”  For Tennyson it was “One day I recognized that my interventions shortened a patient’s length of stay at the hospital. That is an important impact! When I realized how important my role was in patient experiences, I felt so proud and had a real sense of purpose.” 

Sometimes the circumstances are so dramatic that it leaves a lasting impression, “I was deployed to Port Au Prince, Haiti as part of a stabilization medical team following the devastating earthquake of 2010,” said Benjamin Smallheer, PhD, RN, ACNP-BC, FNP-BC, CCRN, CNE, FAANP, associate professor and assistant dean, Master of Science in Nursing Program. “After I arrived at the tent hospital, I reported to by duty area for the week The team alternated shifts to cover 23 hours a day for seven days, until the tent team arrived. Sitting there with medically fragile patients and their families was the moment I knew serving as a healthcare provider was my calling. I was able to prince peace to a challenging time, guide recover, and ease the pain of loss.” 

A Sense of Professionalism and Purpose 

When asked what they would say to nurses who are thinking about advancing their careers as nurse practitioners, our faculty members were both practical and professionally insightful.  

“Being an advance practice nurse carries a significant responsibility,” said Edie. “Nurses are the most trusted of professions and NPs are also valued for the time we spend with our patients and our dedication to our patients as the center of all health care decisions.” Affronti agrees, “Your prior nursing education and experience (on social determinants of health) will help lead quality personalized and interdisciplinary care while increasing the access of individualized health care especially for marginalized patients.” 

The selection of professional mentors and the environment that newly graduated nurse practitioners place themselves into are also important. Tennyson suggests that newly graduated NPs “Find a mentor and hold-on tight. They can do so many things as an NP.” In addition, Trotter believes that where a new NP begins their practice is equally important, “I would tell new graduates to look for their first position to be in a practice site with other NPs/APRNs for support as they continue to build their knowledge and skills.”  

Every nurse has high aspirations for themselves and their careers. For Smallheer, planning your career in stages can prevent a new nurse practitioner from being overwhelmed and help ensure a healthy, long-term career strategy.   

“You may want to change the world…and you may just do that. But I recommend looking at your career in 5-year increments. Each five years you can re-evaluate where you are at, and what you want to achieve in those next five years,” said Smallheer. “Leadership, clinical innovations, additional education, or training, even mentoring the next generations of NPs are all visions you may have. Pick one, focus on it, and do it well. Then move on to the next goal.” 

Sean Convoy, DNP, PMHNP-BC, associate professor and director, Psychiatric Mental Health Major offers self-care advice  for new nurse practitioners.  

“Evolving from RN to an APRN is predictable and natural in some ways and unpredictable and unnatural in other ways. It will feel predictable and natural progressing to the APRN level once you establish some degree of proficiency as a RN,” said Convoy. “It will feel unpredictable and unnatural during graduate training and for the first few years of APRN practice. In graduate school, you will have to both learn new things (higher levels of health, pathophysiology and pharmacology, differential diagnosis, etc.) and relearn other things (e.g. role function, etc.). Once you enter advanced nursing practice, you can anticipate a lingering sensation of imposter syndrome that subsumes all of this. When these thoughts and feeling surface, remember that there are more than 355,000 nurse practitioners that came before you who have made the journey from RN to APRN and so can you. 

We think that with this advice, the future of nurse practitioners is extremely bright. Thank you to all of the nurse practitioners here at Duke and across the nation.