The Role of the APRN at Dartmouth-Hitchcock
Facilitating great care
"The number of Nurse Practitioners continues to grow in various departments at DHMC, because Dartmouth-Hitchcock has gone above and beyond in terms of recognizing us. Dartmouth-Hitchcock is really ahead of the game. However, the role still remains somewhat of a mystery to people," says Dorothy Mullaney, APRN, MHSc, Director of CHaD Neonatal Nurse Practitioners. Mullaney is one of more than 140 APRNs currently working at DHMC.
Mullaney first worked as a staff nurse at DHMC for nine years before deciding to further her education. "I thought I wanted to be a neonatologist, but then it dawned on me that what I really wanted to do was continue in direct patient care, which is a little more hands on," she says. "I loved being a nurse and I didn't want to lose that piece of my profession." So, Mullaney says, instead of focusing on becoming an MD, she turned her attention to the Nurse Practitioner degree (recently renamed APRN). "It was the perfect decision," she says.
Mullaney explains that an APRN is a Registered Nurse who has an advanced degree in a specific field of interest. "What's really interesting is that we are very specifically trained. Unlike physicians who can cross over certain fields, by profession, and by law, we practice only within our scope and expertise. I like to think of it as a bridge between Nursing and medicine. We are all nurses, but we are hired by medicine, so we have our foot in both arenas. And, we are able to help facilitate great care in that way," she says. "We very much value and view the work of physicians and nurses as collaborators and colleagues—and I don't think we could do our job without either. It's not an 'us' or 'them' thing. These are patients that we, as a team, share."
Many of DHMC's APRNs have authored papers and several have also contributed to book chapters. "It's a group that is extremely accomplished—beyond just the clinical world," she says. That expertise has not gone unnoticed. Mullaney says a number of nurse practitioner programs in Boston send their students to DHMC because they realize the on the job education and training they receive here is second to none. For example, interns in the neonatal unit are often times assigned to an APRN to precept, "and between the two of us, that baby will get the most incredible care possible," she says.
Moving forward
Currently, there isn't a formal organizational structure for the APRN group, which Mullaney chairs, but they do host quarterly sessions to get together and touch base on a wide variety of issues. "One of the goals we have is to provide consistency," she says. "We also want to be available to provide peer mentorship to APRNs in a section that may not have any others working within that department."
