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VOL. 128 | NO. 74 | Tuesday, April 16, 2013

Program Addresses Neonatologist Shortage

By Jennifer Johnson Backer

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Memphis hospitals face a shortage of physicians that care for critically ill and premature newborn infants.

While the rate is falling, premature births in Shelby County remain well above the national average, says Ramasubbareddy Dhanireddy, who is medical director of the Sheldon Korones Newborn Center at The Regional Medical Center at Memphis and the neonatal intensive care unit at Le Bonheur Children’s Hospital.

Dhanireddy says the high prematurity rates in Shelby County have led to increased demand for neonatologists. But changes in neonatology residency programs and rotations have led to a situation where neonatologists in training are no longer able to solely provide the continuity of care that premature and ill infants need.

Both newborn units Dhanireddy oversees are increasingly relying on neonatal nurse practitioners to fill that need. But even that can be a challenge, he says.

“It’s very hard to attract nurse practitioners from outside the region,” he said. “We have a lot of need between these two institutions to provide bedside care to newborns under the supervision of neonatologists.”

To address the shortage, the University of Tennessee Health Science Center’s College of Nursing has created a new advanced training option, the Pediatric Nurse Practitioner in the Doctor of Nursing Practice Program. The UTHSC College of Nursing also is reopening admissions for the Neonatal Nurse Practitioner program at the doctoral level.

“Everyone is recognizing the need for primary care providers, and with the complexities you face, you absolutely need to be prepared at the doctoral level,” said Susan Patton, an associate professor in the College of Nursing, who is coordinating both the pediatric nurse practitioner and neonatal nurse practitioner options.

Hospitals in Memphis and elsewhere in the state were influential in the creation of both advanced training options, Patton said.

It can take seven to 10 years of academic and clinical training before physicians are ready to practice. Nurses with doctoral degrees can be trained much faster, providing a faster pipeline to hospitals and other areas with shortages.

The new doctor of nursing practice program at the UTHSC is primarily an online program open to applicants with either a bachelor’s degree or master’s degree in nursing. Laura Talbot, dean of the College of Nursing, says many students will choose to study part-time, while continuing to work part-time.

The pediatric nurse practitioner program will accept up to eight students its first year, while the neonatal nurse practitioner option will admit about six. Students in both programs can graduate in four to six semesters, depending on whether they pursue full or part-time study, and whether they are already certified as an advanced practice nurse.

Patton says the new programs will help fill a shortage for a very difficult to recruit specialty.

“Neonatal is an extremely demanding type of practice,” Patton said. “They (nurse practitioners) are working 24 hours a day with the sickest infants. While we have some successes, most of your shift is going to be working around critically ill neonates with families who are often undergoing the greatest stress they will ever face.”

Demand for nurse practitioners and nurses is projected to grow as millions more Americans gain access to health insurance and medical care. By some estimates, the U.S. will face a shortage of nearly 30,000 primary care physicians by 2015 – a scenario that could play out inequitably in some cities.

“We are responding to the need of both Tennessee and the nation,” Talbot said. The new doctoral level programs also will address a shortage of nursing faculty, she said.

Dhanireddy says he’s thrilled the new programs will provide him with more qualified practitioners to staff the Sheldon Korones Newborn Center at The MED and the neonatal intensive care unit at Le Bonheur Children’s Hospital.

“There have been days when I had more than 100 babies between the two units,” he said. “That requires many physicians and nurse practitioners, which is a real challenge because of staffing shortages. It’s critical we have our own school for training talent.”

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