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Signature Pregenta. And today we are joined by
Reagan Tawney. Hello everybody.
And she is a third year Women's Health DNP student who is
passionate about advancing Women's Health through evidence
based care, mentorship and advocacy.
She is on social media really into changing the landscape of
Women's Health, using her platform to educate, empower and
connect fellow MPs, future nurses and nurse practitioners.
And we are so happy to have you on the podcast today.
Reagan, I just think your name is super cute.
The way you sound you. I've already been like crushing
on your ring. If you're watching this on
YouTube, it'll flash by just in paying attention.
And so we are so happy to have you on today.
I'm so excited to be here. This is just such an incredible
opportunity. I'm so excited to just chat with
you today and let's. Yeah, I'm excited to be here.
That's all I'm saying. Let's go ahead and talk a little
bit about what kind of your nursing career and how you know
where you are in your in your DMP program.
Yeah so I'm currently in 3rd year WHNP student.
I graduate in May who's counting down.
I'm so excited to be done and finally be able to practice.
But I am a solo WHNP student right now and my background is
funky because I feel like when people are in a Women's Health
program, but like my experience is all Women's Health, but mine
is a little different. I have been my primary nursing
experience in the NICU actually. So I was working in the NICU for
about 3 1/2 years and I it was more so just based off of
curiosity. Like in nursing school we didn't
have much experience really in Women's Health or the NICU
Women's Health. You have your LND rotation, but
like my rotation wasn't that great.
So I was curious about the NICU. I got a nursing assistant
position in the NICU and I just fell in love with it.
So I took that and I ran with it after I got my BSN.
But all throughout my time the NICU, there's just like
lingering thoughts of like Women's Health.
And I really thought that I was going to become a midwife.
That was my goal. But I just ultimately was like,
hospital life is not for me. And I just, I didn't need to be
the one delivering the babies. So that's when I started looking
into Women's Health programs because I really like you
mentioned, like I love just educating about Women's Health
and the relationships that you develop with our patients and
focusing on Wellness, Women's Health, Wellness throughout all
aspects of life. So that's really what led me to
my program today. And like, I've always known that
I've wanted to be a nurse practitioner.
I've always known that I wanted to advance my career and be able
to practice independently. But honestly, it's like I love
spending time with my patients and again, educating them and
really being a part of their long term reproductive and
sexual health goes. And I think that's what truly
inspired me to get to where I am today because I've seen just how
much of an impact a good quality provider in Women's Health has.
Being compassionate and knowledgeable can really make a
difference of Women's Health. So that's what I that's why I'm
here today and that's my goal in the future is just be someone
that my patients trust and makes them feel heard and empower.
I love that. I love that.
And so in your DNP program, what are you dealing with?
Where's your snapshot for where you are right now in your DNP
program? That is the question of the past
couple months. I am in the thick of my DNP
project. So something that does yes, that
is the that's the reaction I get to everyone.
I tell us about the main difference between Ms. and the
masters level, a doctor, the doctoral level is really this
big capstone project, the DNP project.
I am in the thick of it. It actually it went live a
couple weeks ago. And for those who don't know,
it's really like a quality improvement project where you
kind of design and implement and then evaluate some sort of
quality improvement in a field of study.
And I, because my passion is really been like menopause, I've
been focusing it on testosterone therapy and creating like a
standardized prescribing process for my providers.
And I'm so excited about it. I'm so passionate about this
topic. But as the DMP project comes
with so many hurdles to jump over and I it's and I feel like
we'll get into this a little bit later, but it's ruined my
passion for quality improvement. I'm not going to lie.
Yeah, we. Got to go ahead, figure out what
it is. So are you working on IRB
approval? Are you working on like protocol
and getting that approved so that you can then implement it?
Because I remember I had to do IRB approval and get them to say
it's OK, you can go and do this. Is that what the stage of your
inner, have you moved past that hurdle you're trying to
implement it and get the data back?
It's a lot. It is a lot.
And luckily, I did not have to
go through the IRB process because I'm not doing anything
with patients. I wanted to avoid that at all
costs just because I've heard just horror stories of people
not getting IRB approval, then they have to change their entire
project. So I really wanted to avoid
that. So I'm only focusing in on
providers. I'm not doing anything with
patient information or patient surveys, anything.
So I am currently I'm basically developing like a protocol for
lack of better terms of standardizing testosterone
prescriptions specifically for postmenopausal woman with low
libido or hypoactive sexual desire disorder.
So I'm finalizing my protocol and my toolkit and all these
resources to hopefully actually be implemented into practice
next week if everything right. OK.
And then are you going to be surveying the providers and
asking them like, how do you feel about it?
Do you feel like the process is easier?
Or is it like an algorithm where like you created if then and
then do this and treat that and creating because there really
isn't a protocol, like you're just making it up.
There's certain things you need to be aware of, but what is it
that you are hoping to measure? Yeah.
And I think you nailed the head on that one.
I am. My main goal is to just improve
provider confidence and knowledge surrounding
testosterone prescribing because there is evidence out there,
right? It's newer evidence and there's
a lot of compounding factors in the United States with
testosterone prescription specifically for women.
So my main goal is just to improve access to resources and
improve provider confidence and knowledge surrounding the
prescribing practices. But then it's also with my tool
kit and with my protocols that I'm developing is to assess the
usability and feasibility a bit just to see if this is something
that could continue to be used in the future.
So it is primarily I'm surveying my providers right now, getting
a Capri implementation understanding and then after
implementation I'll be doing a post survey as well as looking
at like number of testosterone prescriptions or how many times
the tool kit was used and stuff like that.
Amazing wow again, that is what's so special about the DNP
project is that really start getting into the nitty gritty
and I know where you are. It's almost like a when you're
planning a wedding, it's like at some phase of the wedding you're
also like let's look like this with so much to be just took a
plane to Ireland, got on a Cliff to got married with a
photographer. That just sounds great because
you're just so in the thick of it.
And then when you look back like right now, hearing you talk
about it, it just I just teleported back to that time
where I was collecting patient data like putting it into
stress. If I wasn't going to get IRB
approval, there was a nurse practitioner that was very good
at like writing things a certain way.
So we got approval super fast. So I can dig in the charts and
find this data. And now looking back, I'm like,
Oh my gosh, I missed that. It was.
It's like a sickness. This is the worst thing ever.
And then now looking back, I'm like that was.
Cool, like I. Was involved in making something
better where I was. And so just to give you maybe a
little bit of hope that at some point you're going to look back
and just be like, that was cool and I enjoyed it, even though in
the moment I hated. It and I think it's like exactly
what I needed to hear right now because I just it, like you
said, like I'm in the thick of it and I think there's so many
little tiny things that goes on with ADMP project and there's
like nitty gritty picky kind of things that you have to do it
one specific way. So, well, you're the one like
implementing these projects and developing these projects.
You're almost like doing it in a specific way for others
satisfaction. So you lose control in the sense
that you're not doing it the way that you really want to do it.
But it is really, really helpful to hear that you look back at
your project and you're like, wait, that was actually like,
cool, because I don't feel that way right now.
I just want to get this thing done.
Yeah, no, I completely hear where you're where you are, like
see where you are. I was there too.
And so I just again, Burnett DMP student out there that's
thinking about or in the same spot that's Oh my gosh, this is
the worst. You are going to look back at it
like you do at your wedding day and think, Oh my God, it all
came together so beautifully. But right now I'm just not
enjoying planning this thing and so I just want to look.
I think now the wedding is like, absolutely perfect.
That's exactly how it feels. Yeah, there's.
Some stages of grief. Oh my God, I just want to look.
So that's how you know you're on the right path.
Just keep going. You're almost there.
Yeah. You're going to look back and
just, I don't know, I just feel like the hurdles that you have
to jump over to for the DNP project really do prepare you
mentally to be a very resilient envy.
And so that is one thing that I will say about the DNP that I
look back with fondness on. And one of the things that you
and I were talking about before the podcast is just the MSN
versus the DNP. So I'm actually unique.
I don't know if this is your story, but I had my master's
degree and I was a nurse practitioner done.
And then I went back for the DNP.
So I did not have to do the DNPI was already a master's prepared.
MPI went back and did it. And you and I were talking a
little bit on about this behind behind the scenes.
How do you feel about the DNP versus getting a master's
degree? What was your, your course?
Did you get a master's degree and then go back, or did you
just get enrolled to the DNP program?
So I went to a direct BSN to DNP program, obviously working in
between getting my BSN and DNP like we already mentioned.
And you know what I will say is I did that because that's what
everyone told me to do. Everyone.
When I was starting to think about going back to school, the
only thing I heard was MSN nurses are being pushed out.
Everyone's focusing on DNP nurses.
Every employer wants a doctorally prepared nurse
practitioner. So I was like say no more twist
my arm, sign me up for ADNP program.
I didn't do my due diligence and I think this is like one of my
biggest regrets. It's like I didn't do my due
diligence to educate myself on really what the difference is
between MSN and DNPI. Just heard DNP.
It's a doctoral level and yeah, it's called getting.
I'm a doctorate of nursing practice.
It's like a cool term to in like name to call yourself, but like
I wish that I would have just done an MSN, I'm not going to
lie. And it's in when I was searching
for schools and everything. The unfortunate thing is there's
not many WHNP master's level programs anymore because they
are being pushed out for lack of better terms and being
transitioned into ADNP programs. I'm here, I graduate in six
months, and I'll be able to be an independent practitioner
regardless, but I do think that an MSN probably would have just
been enough for me. Yeah.
So what makes you, what made you come to that decision you've
you're finishing up in six months.
Why are you just is it because it's this DNC comes to a project
or is it because or is it because you actually are like I
don't know if this is necessary for what we need to do in our
jobs. I think it's both.
It's both. It's probably because I'm in the
thick of ADMP project. I'm just like, what am I doing
with my life? This has this is just whatever.
I will say just to kind of preface this conversation, in my
job in the NICU, I was involved in some quality improvement
projects and I really loved the whole idea of translating like
research into practice and like using the evidence based
research that is found and translating that into practice
to improve the quality of care for our patients and improve
provider practices and everything.
Like I love the idea of that. So that's where like the DNP did
make sense for me, right? So I was like, I love this.
I could see myself doing this in the future and I always want to
improve the way that we practice, but I also now
learning more about it and going through the DNP project process.
It's more so just I've come to the realization that even as a
master, as a masters level prepared nurse practitioner, you
can still do quality improvement.
No one's going to be like, sorry you don't have DNP after your
name. You cannot do anything
associated with translating evidence based into practice.
So I've just started questioning like why is there so much push
to get ADNPU? Hey.
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Now let's get back to the conversation.
Why can't we just do an MSN? Like it's 18 to 24 months for an
MSN for most programs compared to three years.
And like that actual year for ADNP is very expensive.
So that's where I've just been like really, what is the point
to do a whole extra year of school, do this DNP project when
I could have just done it post grad as a master's level nurse
practitioner? Yes, exactly.
And then I also feel like I agree with everything you just
said. I think everything you just said
is spot on. I've been very vocal on this
podcast and feeling like. I'm proud of my.
Work as a DNPI, do not believe that.
My work for the DNP was 100% fruitful in the fact that it
created no additional opportunities for me in my
workplace. And I don't really think that
people are talking about that and they're just doing what
you're saying. They're going to shop masters
prepared nurses. I've seen this many masters
prepared nurses pushed out of their jobs because they had a
master's, not one. And so I don't and I meet
fabulous nurse practitioners that have master's degree and
they don't have a doctorate and they do excellent autonomous
practice care as providers. So I don't believe the DNP is
necessarily facilitating any additional opportunities in the
clinical setting, especially because our job at that time is
to take care of patients. Now what you just said is key.
We want to deliver the best quality care that we can for our
patients. But you were already doing that
as a nurse like you are involved in that with ABN.
So getting ADNP and then not having a part of my practice
even being a section of. Hey, we have a doctorally
preparing nurse practitioner. She's going to see patients
three days a week and then she's going to go around the practice
and identify ways to improve quality.
That's not how my job has been split up.
It's been just 100% patient care.
So this CMP and this focus on the quality improvement doesn't
actually end up translating into something I do in practice.
And so it just feels a little bit like a waste of time and a
waste of money because like you said, now I've got to pay this
back at an interest rate that is compounding and it's crazy.
And so that extra year, I could have been working and paying
down my debt faster and becoming financially free, which is
another thing I talk about all the time on this podcast, that
nurse practitioners, just because you choose to become a
nurse practitioner doesn't mean you're going to run away from
burnout because our jobs are equally as demanding and
stressful. And now you've got the extra
debt that's compounding that you need to pay off so that you can
then create different opportunities for yourself.
Yeah. And I that like you're just
taking all of my thoughts that I've had over the past 2 1/2
years and just like spewing them out.
And I think just a circle back on what you said, ADNP adopt
horribly prepared nurse practitioners not paid any
different from an MSN. So it's, that's where it's
challenging to be like, hey, you're signing up for ADNP
program, which is great. You're signing yourself up for
another year of schooling, but your pay is not different from
anyone who has a master's level, but you're going to have that
much more debt. And I think that it's like even
in, I mean, granted, I think you can speak more on to this, but
what I'm assuming with the master's level program as well
is like what you are taught is still evidence based practice.
You are taught to be an evidence based practice provider to be
like taking the evidence and translating that into practice.
I just, that's where I also agree with you.
It's like, what is truly what is the point of ADNP if masters
level providers are also being taught evidence based practice
and translating that evidence into practice?
Like what is the point of take doing an entire extra year of
school to translate evidence into practice when masters level
masters prepared nurses are also doing that right?
It's really. Having your focus, it just
requires you to do this super tedious project that to a
certain extent too, may or may not even play into what you do
when you go into work. If the if the quality
improvement does change something, great.
But then if you go to another facility, are they going to take
the work that you did and actually implement it?
Like what happens to that work that I just did?
Does that actually equate to change?
And so I think that DNP students need to maybe push back a little
bit on faculty and ask these questions of the faculty.
Faculty just ask what is what are we doing with this?
Because I think that there might need to be either an opt in or
an opt out type thing that you can create.
I don't understand why we have to pigeonhole nurses into you
need the DNP when we were practicing as MSNS without it
just fine. And now we've created this extra
work. And one of the things that I
even have even shared when I found out when I was in my DNP
program, they had actually shortened it.
I was shocked. I've never, I don't think I've
ever spoken about this. They had cut a bunch of classes
from because it was like brand new the DNP back when I got I
was starting to go through it and they cut a bunch of
programs, like two or three semesters worth of curriculum.
They were like, oh, these aren't needed and they cut them.
Problem is I had already done that.
So I was like, wait a minute, you just now made these
curriculum obsolete? For the other.
NPS but I did them so I have a longer DNP.
Are you kidding me? And I just remember being so
enraged. I'm like 27, no 28 years old
again. Like I'm working, going to
school. I wasn't married.
And I remember just shouting at the I put advisor, you stole my
youth. That's all I said.
Like I just said it like it came out.
Yeah, it's like. It came out.
I couldn't even get the work. Like it was like, just stop my
youth. And then like I was like, Oh my
God, she's me. No, but you learned extra.
And I was like, no. Don't.
Like this was like, what is this a PhD level work?
Like I don't understand. And so I think what we're
talking about is when we create sometimes in nursing these extra
requirements, I just want to know that it's purposeful and
it's meaningful and that it's going to actually change the
landscape of nursing, especially for nurse practitioners because
we're in a tough spot already. We're not in these, we're not
nurses anymore. We're in this hybrid role.
And then they're creating all these extra hoops to get there
and do these hoops to really equate to better providers
because that I think is what we're doing.
We're providing care. I don't know if these extra
hoops necessarily make us better.
And one of the things we were talking about before the podcast
too, was about the use of the doctor just said it.
You said it was you were talking, you're like something
about it. Like they tell you like you're
going to be a doctor and you can say that you're a doctor.
And yet just recently rolled in California, there was a nurse
practitioner, I think it was 3 nurse practitioners or three
providers that had sued the state of California for freedom
of speech. They felt like they were should
be allowed to call themselves doctors.
And I don't know all the details of the case, but you and I were
talking before that you pursue the doctorate and then you come
out, you get no additional pay for it, especially in the
clinical setting, maybe in the academic setting, but you're in
the clinical setting. We're not seeing that.
And then you can't even use the title that you spent an extra
year, quote UN quote. She's not here.
Go and then you and paper nothing like try to use it.
We're going to sue you. It's oh, oh, OK.
So what's your thoughts on that as you're in the DNP
programming, you're seeing this play out?
Yeah, I think it just all comes back to then again, what's the
point? What's the point of doing all
this school, paying all this money and doing all these extra
classes and projects and everything to get a title that
we're not even able to use? And then coming from me in the
state that I live in, Like I haven't had that come through
yet, but I feel like it's a domino effect.
Once one state does it, all the states follow in suit as well.
But what I see is DNP prepared nurse practitioners just don't
use the term doctorate just because of the pushback from
those above us who are actual doctors, who are the MD's or
DO's and have that doctoral like doctor title because they don't
want to confuse the patients. And in some aspects, yes, I can.
Like I understand that perspective.
Like absolutely I don't want to. I'm not posing as an MD, right?
But I do push back at that because it's one I have hard
earned that title of doctor. But also the nurse practitioners
who are using the term doctor, I will say most of them of the DNP
prepared nurse practitioners who are using doctor so and so in
their name, they are not posing as MD or DO doctors.
They are explicitly stating I am doctor so and so I'm ADNP
prepared nurse practitioner. They're not using that term to
pose as anyone. They are not.
So that's where I'm just confused of why there's so much
pushback now that we're not able to use the title that we earned
with her blood, sweat and tears. Exactly.
Thanks for tuning into another episode of Success and P.
We hope today's discussion has shed some light on the diverse
career options or taught you how to improve your clinical
practice as a nurse practitioner.
Remember, whether you're considering a specialization,
pursuing advanced certifications, or exploring non
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Bye for now.