Catherine Gregg has been interested in women’s health care for as long as she can remember. This fall she’ll be one of eight Carlow University students to enroll in the school’s inaugural women’s health nurse practitioner program, switching her focus from family health.
She’s optimistic that when she graduates in 2018, she’ll find a job in Pittsburgh.
“I hope to make mother and baby my focus, but I’m excited to see where the program takes me,” says Gregg, who lives in Washington, Pa. “It is so exciting to participate in something new. Women’s health is an all-encompassing specialty, from newborns to the elderly.”
Pennsylvania’s 10,700 certified registered nurse practitioners are among more than 222,000 around the country—nurses who have advanced education and clinical training in a specialty area. The state requires them to work with a collaborating physician’s stamp of approval, though the nurses are pushing state legislators to grant them full practice authority licensure.
“We have many areas in the state of Pennsylvania where we do not have enough M.D. providers. Nurse practitioners specially trained in women’s health can work with OB/GYN providers in rural and underserved areas, allowing them to provide care for more women,” says Maribeth McLaughlin, vice president of operations at Magee-Womens Hospital of UPMC.
McLaughlin says Carlow is targeting an in-demand profession. The Association of American Medical Colleges estimates there will be a shortage of as many as 94,000 U.S. physicians by 2025, and about 1 million nurses are age 50 or older, nearing retirement in 10-15 years. Societal reasons add to the need: Women in the United States are more than twice as likely to die during childbirth than they were 30 years ago, and women are more likely than men to die within a year of suffering a first heart attack.
“Women are often the health care decision-makers and caretakers for their families, so keeping women healthy is a key strategy for overall population health,” McLaughlin says.
Lynn George, dean of Carlow’s College of Health and Wellness, says a women’s health nurse practitioner program is a good fit for the university’s mission “philosophically, as well as with talents we have.”
The school’s first nurse practitioner program, focusing on family health, has demonstrated success since it began in 1995. With 250 currently enrolled, the program has graduated 300 students over the past five years. All of them passed the national certification exam and obtained jobs, many in western Pennsylvania. Some graduates choose to pursue doctorate degrees.
“Employer satisfaction surveys among regional employers of our nurse practitioner graduates indicate they’re extremely satisfied with our graduates,” George says. “Women have unique health care needs, just like men have unique health care needs, but there’s plenty of evidence that women’s health care needs are not being met at the levels we’d expect in the United States . . . We spend more on health care than any other country but our [disease and death] outcomes are not where we need them to be.”
About six percent of nurse practitioners nationally focus on women’s health, George says, and many of them serve patients in underserved rural or urban settings. Carlow’s students have clinical practice sites at Pittsburgh Mercy Health System, Allegheny Health Network, Magee, and the VA Butler hospital.
“Nursing is a practice discipline, so they need to be practicing as they’re learning,” she says.
Deborah Mitchum, an assistant professor in the College of Health and Wellness, is director of its nurse practitioner programs. She became interested in women’s health care while working at the VA hospital in Pittsburgh for many years, where she noticed that “women didn’t receive the same level of care that men did.” In the VA system, women comprise about 15 percent of the patient population, she says.
“So often I felt like a suffragette, but it was necessary in that setting,” she says.
Her students learn to treat patients holistically. “They learn many things physicians do, but nurse practitioners’ education is more focused on health and wellness,” Mitchum says. “We focus on how it is that we can assist a person to maintain good health, and if they don’t, we also know how to manage a chronic disease or an acute episode of problems. The physician is focused more on dealing with disease or diagnosing rare diseases—they come from a disease model, whereas we come from a health model.”
Leaders from both AHN and UPMC confirmed for Carlow that there is a critical need for women’s health nurse practitioners to fill roles at their hospitals, George says. A recent review of employment websites found 43 non-duplicate advertisements for nurse practitioner positions in the Pittsburgh region, and 14 percent of those ads specified that national certification in women’s health was a requirement.
If nurse practitioners find it rewarding to care for women throughout their lifespan, it’s also a good-paying job, says Joyce Knestrick, president-elect of the American Association of Nurse Practitioners. Average salaries range from $93,000 to $109,000, she says. The AANP advocates for nurses to become equal partners in planning what the nation’s health care will look like in the future, she says.
“It’s important to have care at the right level, so that we’re not adding extra dollars to the health care system,” says Knestrick, who lives in Washington, Pa., and practices at a free clinic run by nurse practitioners in Wheeling, W.Va. “With my patients, I’m committed to working with them to achieve healthy, happy lifestyles. Prevention is a natural fit as we work with people to meet their needs.”