New Doctoral Degree
for Nurses
words by Mary Ann Littell / photograph by John Emerson

Donna Cill, DNP, FNP-BC

By day, Donna Cill is director of continuing education at UMDNJ-School of Nursing (SN), where she organizes seminars and symposia for nurses throughout the state. By night, however, the cameras roll, and she’s the host of a health-themed cable TV program for adolescent girls. “Girl Talk” is Cill’s own creation, an idea she’s nurtured and developed during the last few years. “It’s one of the most rewarding things I’ve ever done professionally,” she says.

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ill is among the first group of students to graduate from a new doctoral program offered by SN. The Doctor of Nursing Practice (DNP) degree is a clinically-focused terminal degree designed to produce a more highly qualified nursing workforce. SN is the first New Jersey school to offer this degree, and graduated its first class this spring. The 21 graduates include a hospital president, nurse executives, a minister, nursing faculty members and nurse practitioners. While they’re a diverse group, they share common goals: to learn the clinical, leadership and management skills that will help them work more effectively and enhance their career opportunities.

Here, Cill and a few of her fellow graduates talk about what they’ve gained — and hope to gain — from the program.

New Skills Equal New Opportunities

With her sparkling personality and good looks, Donna Cill looks like a television star, and as a teenager, dreamed of having a career in broadcasting. That dream was back-burnered when she became a teen mother. “My mother was a nurse, and she encouraged me to become one too, saying it was a great career and I’d always have a job,” she says. “She was right.”

Cill, who also has a master’s degree in nursing from Columbia, has held a series of increasingly responsible positions in nursing education, first at Bloomfield College, then at UMDNJ. While she enjoyed her work, she felt something was missing. “I’ve always been interested in adolescent health but wasn’t sure how to take my career in that direction,” she says. “I attended the information session for the DNP program and decided to go for it. I thought it would help me achieve my goals.”

The two-year DNP program was “challenging, but exhilarating,” says Cill. She completed her capstone project on adolescent health risk behaviors, including drugs, alcohol and sexual activity. The project turned out to be the basis for “Girl Talk.”

Cill developed her proposal for a television show focusing on adolescent girls and health risk behaviors, and brought it to local cable station SOMACOM in the fall of 2007. She received an immediate go-ahead. One night a month, several episodes of “Girl Talk” are taped. Cill and a panel of girls discuss health and social issues, including self-image, peers, parental relationships, pregnancy, drugs, alcohol and other health issues. The show airs weekly throughout many parts of New Jersey.

Cill says the DNP degree gave her the knowledge and confidence to launch the show, which is now in its second year of production. In addition to her work at the nursing school, she’s continuing to find other opportunities in the area of teen health. Another item on her to-do list: organizing an adolescent health conference scheduled for spring of 2009.

A Lifelong Learner Thinks Outside the Box

As president and CEO of a large community hospital, Deborah Zastocki seeks practical solutions to problems and issues in healthcare. This accomplished administrator, nurse, teacher and author began her nursing career in 1974. She held a series of executive positions at a number of New Jersey hospitals before going to Chilton Memorial Hospital in Pompton Plains in 1990. She was named president of Chilton in 2004.

Why did Zastocki — who’s achieved great success, is a Fellow in the American College of Healthcare Executives and holds advanced certification as a nurse administrator — decide to go back to school? Describing herself as a “lifelong learner,” she says, “I’m totally committed to self-improvement and always wanted to get a terminal degree. While traditional PhD programs are geared for careers in research, the DNP had a more practical focus for someone in my position who has executive responsibility over a broad range of clinical programs.”

Zastocki, who attained a 4.0 grade point average and received the school’s DNP Student Excellence Award, wanted to learn how to become a better advocate for influencing the healthcare system through public policy. She is involved with the New Jersey Hospital Association, a nonprofit organization committed to helping the state’s hospitals provide accessible and affordable healthcare, serving on its board of directors as well as the American Hospital Association Regional Health Policy Board. She says, “What I’ve learned from this program will give me the tools to enact change.”

Other knowledge gained from the program will be applied to current and future initiatives at Chilton, says Zastocki. As part of her course work, she completed a special project examining the Intensive Care Unit (ICU) of the future, researching hospital design and studying ICU models from all over the world. “At some point we’re planning to create a new ICU at Chilton, and my research will help in our strategic planning,” she says.

Zastocki completed her capstone project on the low retention rate of acute-care nurse managers, which she describes as “a huge problem” facing hospitals and nursing administrators. She states, “As the current group of acute-care nurse managers is growing older, we’re not attracting younger nurses to take their place on the front lines of clinical care. We need to find ways to recruit and retain them.”

Left to right : Deborah Zastocki, DNP, EdM, FACHE, Nicole Goetz, MS, RN, FNP-C, Ray Scarpa, DNP, AOCN

Gaining Leadership Training

Nicole Goetz, a nurse practitioner in the Division of Upper GI and Endocrine Surgery at Columbia University Medical Center/New York Presbyterian Hospital, is the youngest graduate of SN’s DNP program. She says that when she attended the school’s information session and heard they would accept a class of no more than 20, “I was determined to be in that 20.”

Goetz, who works primarily with oncology patients, says her new skills have made her a better nurse and educator. She works in a practice where advanced practice nurses (APNs) are given a great deal of autonomy and administrative responsibility. On the job, she’s become involved in training and managing nurse practitioners, interviewing applicants and making hiring decisions. “By enhancing my leadership and administrative skills, I expanded my role as nurse practitioner even further,” she says.

Goetz’s capstone project was the launch of a Web site for patients with recurrent or metastatic pancreatic cancer: the Pancreatic Cancer Support Group Study site. Unlike other support groups where participants chat about whatever is on their minds, this group holds on-line discussions based on specific topics and readings.

“Participants are asked to complete short questionnaires online about depression and quality of life,” she says. “Our goal is to learn if a support group designed this way will positively affect patients with advanced pancreatic cancer.” Goetz, who recently gave birth to her first child, will defend her capstone project in December 2008.

No “Glass Ceiling”

As the nursing profession has evolved, so has Ray Scarpa, an APN in the Division of Otolaryngology-Head and Neck Surgery at UMDNJ-University Hospital (UH). He is one of three men in the first graduating class and the first UH nurse to receive the DNP degree. Throughout his 28-year career at UH, Scarpa has worked his way up the academic ladder, obtaining many degrees and certifications. He says, “I’m always looking for ways to develop, and it seems I’ll never hit the glass
ceiling.”

Scarpa’s career choice was influenced by his mother, who worked as a nurse in a nursing home. When he was a teenager, she got him a job as a nurse’s aide there. A self-described “rebellious kid,” he says, “I got tired of taking orders from nurses and decided to become one myself. I was impressed by how much autonomy the nurses had. The doctors made brief visits, but the nurses ran the show.”

At UH, Scarpa’s primary interest is patients with head and neck cancer, which comprise about 15 percent of all cancers treated at the hospital. A typical workday for him includes going on rounds, performing procedures, assisting in the operating room, seeing patients in the hospital and following them up in the outpatient clinic. Scarpa says he derives great satisfaction on providing outstanding healthcare for his patients, many of whom require a multidisciplinary approach to treatment. He recalls a recent patient, a man in his early 60s with a recurrence of cancer who had initially been treated in another hospital. The patient required a complex surgical procedure.

“I met with him and his family and explained the procedure and how long recovery would take. I said, ‘I’m going to help you get through this,’” says Scarpa. When his treatment was completed, the appreciative patient donated a $1,000 scholarship in Scarpa’s name to the New Jersey chapter of the National League of Nursing, an organization promoting excellence in nursing.

Says Scarpa: “It was nice to be recognized in this way, but I didn’t feel that I did anything special for him that I would not do for any other patient.”

Although the role of nurses has expanded, they still seek more autonomy. APNs in some states are required to work under the supervision of physicians, but often have their own practices. Several nursing associations, including the American Academy of Colleges of Nursing (AACN), advocate for nurses to work more independently, outside of physician-led teams. However, some physician groups, including the American Medical Association, oppose efforts to eliminate physician supervisory requirements for nurses.

Scarpa believes the DNP degree will improve the stature of APNs in the workplace. “Nursing has changed so much over the past few decades,” he says. “What has been slower to change is how APNs are perceived. As nursing and medicine are separate professions, we’d like to see APNs functioning as equal members of the healthcare team, reporting to their peers. This will lead to better patient care.”