$125 Million for Nursing Education

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Participants in the Leonard A. Lauder Community Care Nurse Practitioner Program will receive free graduate school tuition at Penn.

In February, Penn Nursing announced a gift of $125 million from trustee emeritus Leonard A. Lauder W’54, chairman emeritus of the Estée Lauder Companies, to create a program offering free tuition to graduate students preparing to become nurse practitioners who commit to working in an underserved community for two years. When fully implemented, the Leonard A. Lauder Community Care Nurse Practitioner Program will fund 40 fellows annually, covering tuition and fees, plus a stipend for those with financial need.

In endowing the program—believed to be the first of its kind in the country—Penn and Lauder “hope to send a signal that a sustained commitment to the education of nurse practitioners is possible and necessary,” says Antonia M. Villarruel GNu’82, the Margaret Bond Simon Dean of Nursing.

Becoming a nurse practitioner requires a graduate degree and advanced clinical training. NPs, who are qualified to diagnose and treat common and chronic illnesses, work in a variety of settings, including community clinics and private doctors’ offices. About 10 times as many NPs graduate from primary care programs each year as do medical students who enter primary care residencies.

Increasing the supply is key to closing a looming gap in the overstressed and understaffed US healthcare system. Pandemic burnout and longer-term trends—including an aging physician workforce and projected US population growth of 35 million or so over the next decade—will combine to create a shortage of 17,800 to 48,000 primary care providers by 2034, the Association of American Medical Colleges (AAMC) estimates.

Newly graduated NPs earn between $90,000 and $120,000, according to Susan Renz Nu’84 GNu’87, Penn Nursing’s primary care program director and practice associate professor. But the estimated cost for full-time graduate study at the school was $75,222 in 2021–22, including tuition and fees of $52,508. “Many applicants are interested in Penn Nursing because they know that our clinical practices work with marginalized populations,” Renz says. “The idea of assuming debt while leaving the job they already have, though, can hold them back.”

Villarruel remembers “being one of those people who couldn’t work in an underserved community as I really wanted to” because her debt obligations meant she needed to pursue a higher salary. “This endowment makes it possible for us to find students who really have a desire to do this kind of work and help them achieve that goal,” she says.

Starting this fall, an initial cohort of 10 fellows selected among students who are enrolled in any of three nurse practitioner areas—adult gerontology, family nurse practitioner, and psychiatric mental health—will kick off the program. The enrollment will expand by 10 fellows each year until it reaches an annual target of 40 fellows, continuing in perpetuity. Tuition and fees will be covered for all participants, allowing them to enter the workforce free of graduate school debt; fellows with greater financial need will also receive stipends to help with living expenses. To oversee the program, Penn Nursing will soon name the first endowed Leonard A. Lauder Community Care Nurse Practitioner Professor, charged with managing the curriculum, support of community sites, and program implementation.

“We’re developing an application process and have already been getting tons of emails from prospective students and alums who are interested in applying to the program,” Renz says. “We are also hearing from health systems and federally qualified health centers that want to partner to train these students.”

Since finding experienced staff to guide students—known as preceptors—at such institutions can be another barrier to advanced nursing education, the Lauder grant includes provisions to better support community partner sites, which provide clinical education to the fellows. Initially the program will engage with two such sites, with plans to expand to 10 partners by 2026. “We really wanted to think about that end of things,” says Villarruel. “We need to make sure that we’d have enough community placements. Now our financial support can offer the staff professional development and networking opportunities while our students benefit from their expertise.”

While this mutual investment in community health partners may be new, “in many ways, this gift expands on what we’ve been doing to serve overlooked patient populations in the region,” adds Villarruel. For example, through Penn’s Eidos LGBT+ Health Initiative at the School of Nursing, announced last fall as part of a $750 million investment to advance various research priorities [“Gazetteer,” Jan|Feb 2022], nursing students can receive mentored training and work opportunities in LGBT+ healthcare, including accessing how providers interact with clients from the LGBT+ community. Another collaboration, with Penn Engineering, is funding pilot grants for three to four research and educational projects each year that foster community engagement and outreach on issues related to inequities and social justice.

The school has also sought ways to ease the path of those interested in pursuing careers in nursing education. It recently participated in a $200 million demonstration project to test whether Medicare funding could help boost the number of clinical educators, advanced degree nursing students, and ultimately the NP population. The results were encouraging, according to Regina Cunningham Gr’03, chief executive officer of the Hospital of the University of Pennsylvania, coauthor of a report on the project. “Working together in Philadelphia across health systems, public clinics, private medical practices, and schools of nursing, we were able to recruit a larger number of practicing physicians and nurse practitioners to mentor NP students to help them meet their clinical training requirements of 500 or more hours, thus enabling nursing schools to accept more student NPs,” she said when the report was released.

“Fulfilling the needs for primary care physicians is going to continue to be a daunting task,” says Villarruel. “It’s all hands on deck, and we believe that fostering nurse practitioners isn’t about substituting for doctors but preparing for a level of care that works to give patients the care they need. Lifting the financial burdens that nursing students face gets them out into the workforce more quickly.”

JoAnn Greco

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