Indiana State University Newsroom

Doctor of nursing practice program aims to address health care shortage

February 10, 2011

When Kathy Miley's family of seven moved to Greensburg, Ind., she learned firsthand about the severity of the health care shortage facing rural America.

"I was like 278th on a waiting list for a primary care provider," said Miley. Yes, her family has health insurance, but the health care shortage affects even those with coverage, she was quick to point out.

While most families in such situations can do little more than wait, Miley is a nurse practitioner and can take action. She has set her sights on doing something about the problem by enrolling in the new doctor of nursing practice program at Indiana State University.

Miley hopes to someday open her own rural family clinic. For now, she works for a company that assists hospitals in 42 states with emergency room providers.

She completed a master's degree in nursing through an online program at Indiana State. The doctoral program is also online and is well-suited for working professionals, she said.

"I absolutely love it. It works for me," Miley said. "I have lots of kids and I like to do my school work between 9 p.m. and midnight. I don't know many professors who hold class between those times so online classes are perfect for me.

A Chicago native who has followed her military husband around the country to communities large and small, she said she loves "the small-town feel" and that "nurse practitioners can educate and be an integral part of a small-town community."

While Miley may not be ready to launch her own clinic just yet, she has another project in the works to meet requirements of her ISU course. She is working on a community-based program to provide medical education to adolescents in partnership with Decatur County Schools.

Doctor of nursing programs are still fairly new nationally and "exemplify the professional terminal degree" for nurse practitioners, said Susan Eley, assistant professor of nursing.

Accrediting and certifying bodies have indicated that by 2015 "doctoral preparation will be the expected degree for anyone seeking certification as a nurse practitioner or wanting to go into advanced practice," she said. Nurse practitioners are licensed and nationally certified to deliver primary care. In many rural areas, they can be the only local primary care provider.

ISU's online program is well-suited to meet the university's goals in addressing the shortage of rural health care providers, Eley said.

"An online program attracts students nationally, which adds a lot of diversity, and it also adds a lot of robust student collaboration," she explained. "Most of our applicants have significant years of provider experience. They are able to use those years of experience and knowledge to offer effective health promotion strategies and disease prevention care."

An emphasis on rural healthcare and the opportunity to research best practices in providing that health care helped attract another faculty member to Indiana State's advanced practice nursing department.

"We need well qualified and highly skilled health care providers no matter what their setting, but especially for those living in remote rural regions in medically underserved parts of the state," said Roseanne Fairchild, assistant professor of nursing and a native of the southern Indiana town of Haubstadt. "Our critical access hospitals that serve many rural areas are able to provide a very high level of care and we want to make sure they can continue to do that."

Fairchild surveyed 300 nurses and health care administrators in 11 western Indiana counties last year and found a need for improved communications and inter-professional training. She is now pursuing funding to adapt a national initiative called "Transforming Care at the Bedside," developed by the Robert Wood Johnson Foundation and the Institute for Healthcare Improvement" for medical and surgical units to meet the specific needs of rural health care facilities.

The DNP program currently serves 19 students - nine who enrolled in August and 10 who began part-time studies in January. While it is currently open only to those who have completed a master's degree and are nationally certified as family nurse practitioners, in 2013 it will be converted to serve students with a Bachelor of Science degree in nursing, Eley said.

Nurse practitioner Felicia Stewart, a Sullivan native who now lives in Indianapolis, is pursuing the DNP degree to enable her to teach nursing students and manage a student-run community clinic.

"I want to empower students to pursue their own educational goals and also want to facilitate communities becoming healthier," she said.

Stewart's student project is to integrate a health ministry into her church, Southport United Methodist. The idea for that project took root after both her parents were diagnosed with stage 4 cancer in 2008.

"The mental strain, confusion and feelings of purely being overwhelmed during a time like that is unbelievable," she said.

Having a system established for treatments, doctor appointments, tests and medications helped relieve some of the stress for her parents and other family members.

"It allowed my parents to truly be able to refocus their mindset on living, not dying - even in the face of such dismal, late-stage diagnoses," she said. "It kept cancer from completely taking over their lives."

Photos: - Roseanne Fairchild (left), assistant professor of advanced practice nursing at Indiana State University, compares notes with Stephanie Laws, research associate with the Richard G. Lugar Center for Rural Health. (ISU/Tony Campbell) - Kathy Miley

Contact: Susan Eley, assistant professor, advanced practice nursing, College of Nursing, Health, and Human Services, Indiana State University, 812-237-7918 or

Writer: Dave Taylor, media relations director, Office of Communications and Marketing, Indiana State University, 812-237-3743 or