Emory University | Woodruff Health Sciences Center
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State of opportunity

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Kelly Wiltse Nicely (left) leads Emory's new DNP program for certified registered nurse anesthetists. The first 10 students enrolled this past fall.

Last August marked the official start of Emory's new DNP Nurse Anesthesia Program. The first cohort of students—10 in all—began the 36-month, full-time program in newly remodeled classroom space at the School of Nursing.

It was a happily hectic time for program director Kelly Wiltse Nicely PhD CRNA, who juggled moving her staff into new office space and moving her family into a new home in the same month.

She joined Emory last winter from the University of Pennsylvania, where she led the nurse anesthesia program during its transition from master's to DNP level. She planned to remain at Penn until Dean Linda McCauley recruited her to develop and lead a DNP-level CRNA (certified registered nurse anesthetist) program at Emory.

When Nicely flew to Atlanta to look the School of Nursing over, she wasn't looking for a big change since she and her husband had two young children. Once she visited the school, she was sold.

"I loved what the students and the faculty were doing," she says. "More than that, I loved the opportunity. I saw Atlanta as an urban center with abundant health care resources and an untapped market for CRNA education. When you look at other CRNA programs around us, they are geographically distant from us. The closest program in Georgia is at Augusta University. Other programs are in Alabama, North Carolina, and North Florida. So there was a hole here that needed to be filled."

By 2022, all students admitted to U.S. nurse anesthesia programs must graduate with a doctoral degree, as required by the Council on Accreditation of Nurse Anesthesia Educational Programs. Consequently, schools with master's programs in nurse anesthesia are now transitioning to DNP programs.

"We didn't have to do that here at Emory," says Nicely. "We had an opportunity to build a DNP program for CRNAs from the ground up."

Students spent their first semester in the classroom. During spring semester, they begin their simulation training in the high-fidelity operating room in the Center for Experiential Learning at Emory School of Medicine. They also will start clinical training later in the semester. Students will study and train year-round until they graduate in 2020.

Thus far, Emory's CRNA program has agreements with 16 sites in Georgia and one in Tennessee for clinical training, with plans to add more. The sites offer students inpatient and outpatient experiences in urban and rural settings. Typically, urban sites use the anesthesia care team model, with a physician anesthesiologist and one or more CRNAs, while rural sites use a CRNA-only practice model.

"Students will see everything from pediatrics, cardiology, and neurology to thoracic surgery," says Nicely. "They will be exposed to different populations in different settings."

Nationwide, approximately 55,000 CRNAs provide more than half of the anesthetics delivered yearly. Of those, 1,906 are licensed to practice in Georgia. With the graying of the nurse anesthesia workforce and the increasing demand for surgeries and other services, Georgia faces a significant provider shortage, especially in rural and underserved areas.

As the second nurse anesthesia program in the state, Emory is positioned to attract more nurses to train and practice in Georgia.

"In rural areas, the CRNA is often the only anesthesia provider," says Nicely. "Our program creates an opportunity to fill some of that need."—Pam Auchmutey

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