1. Warren, Joan Insalaco PhD, RN-BC, NEA-BC, FAAN

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Dr. Warren is an associate professor at the University of Maryland School of Nursing. She has advanced nursing education and built the capacity of nursing schools in the state of Maryland, established statewide nurse residency programs, and advocated for more than 125 million in statewide hospital and school of nursing funding. In her leadership roles as a professional development specialist and researcher, she improved hospital environments and nationally built structures and processes and completed research studies to advance the specialty of nursing professional development. Dr. Warren is a Past President of the Association for Nursing Professional Development.



I am proud of my contributions to nursing. However, I would be remiss not to acknowledge the many accomplished and dedicated nurses I have had an opportunity to work with who made these many accomplishments possible. When I think about expertise, I think about the unique contributions each individual brings to a team and how our contributions as members of the team vary based on the knowledge and expertise of others as we learn and grow together. I have had an opportunity to advance nursing education, research, and set policy as a leader and follower.


1. What are the significant professional milestones in your career journey?



J. I. W.: I could talk about many professional milestones in my career journey. Three come most readily to mind. The first milestone was as a newly licensed registered nurse (RN) working in a 20-bed open heart, trauma, and transplant surgical intensive care unit. As a new graduate, I was left to my own devices. Although I had received an excellent education, I was underprepared and lacked clinical reasoning skills, and had no preceptor or nurse residency program as supports. One disastrous night, a concerned RN took it upon himself to mentor and coach me. He instilled in me the importance of lifelong learning and belonging to professional nursing organizations. This work experience was the catalyst for me to join a specialty organization, obtain professional certification, and complete my master's degree in nursing as a trauma, critical care clinical nurse specialist. My next professional milestone was as the critical care clinical nurse specialist (civilian position) at the former National Naval Medical Center, now known as the Walter Reed National Military Medical Center. In this role, I had the opportunity to mentor nurses and staff and be mentored by senior leaders, who encouraged me to present and obtain my PhD. I was passionate about nursing professional development (NPD) and the advancement of professional nursing. Hence, the most significant professional milestone was obtaining my PhD, where professional nursing development became my passionate pursuit. My successful contributions to nursing I attribute to the knowledge I acquired during my doctoral studies, and mentorship and networking opportunities that came to me as I pursued my degree and professional career.


2. How have you seen the specialty of NPD grow/evolve/change during your career?



J. I. W.: In 1994, I attended the first solely sponsored annual convention for nursing professional development specialists in Chicago. What an experience to meet like-minded nurses with similar learning needs. Since this small beginning, the specialty has significantly grown and evolved. In 2016, the third edition of the NPD scope and standards was published, the fifth edition of the core curriculum is currently in press for release in the summer of 2017, and the Journal for Nurses in Professional Development celebrated its 33rd year of publication. The specialty organization has grown from the original 225 chartered members to more than 4,000 national and international members. The specialty is recognized by other professional nursing organizations, specialty leaders serve in key national positions, and its body of research is maturing.


3. What do you see as significant trends or gaps in NPD practice, from your perspective as an expert in NPD?



J. I. W.: NPD practitioners must become proactive, influential leaders to positively impact their healthcare organization. Proactive leadership starts with an understanding of the forces impacting health care and how these forces are impacting organization decision making and the work of NPD practitioners. NPD practitioners must be engaged with organizational goals and able to show how their work influences these goals. Becoming proactive, influential leaders can be uncomfortable and takes energy. It means making recommendations for change and accepting leadership roles in driving that change. It means asking to sit at the table and, more importantly, speaking up on issues and volunteering.


4. What insights can you share related to the value of NPD in healthcare organizations now and in the future?



J. I. W.: As described previously, in today's healthcare marketplace, essential skill sets require NPD practitioners to have a keen understanding of global, national, and local healthcare trends, knowledge of healthcare economics and policy, and insight into how these trends influence healthcare organization decision making and, ultimately, NPD work. If work of the NPD practitioner is aligned with organizational outcomes, leadership will perceive it as valuable.


For example, trends in the healthcare marketplace influencing NPD practitioners include the following:


* organizational mergers to expand the patient base and market share to mitigate risk;


* new healthcare delivery models and reshaping of the healthcare workforce to improve efficiencies and effectiveness and reduce cost;


* population health management, quality, safety, and patient experiences;


* disruptive technologies;


* aging population with chronic illness necessitating more healthcare services and increasing costs;


* healthcare worker attrition due to toxic work environments;


* unexpected infectious disease outbreaks with little knowledge of how to control;


* aging of the healthcare workforce creating geographical shortages of all healthcare providers including nurses; and


* national call for a well-educated nursing workforce.



In response to each of these trends, NPD practitioners must place greater emphasis on the following:


* working within and across healthcare systems;


* accepting leadership roles on teams designing innovative healthcare delivery models and placing an emphasis on educating new and experienced RNs in healthcare delivery model changes and actualization of new roles;


* educating and implementing high-quality, safe, effective, evidence-based practice for diverse patient populations across the healthcare continuum;


* educating and implementing best practices to support care of older adults using models such as Nurses Improving Care for Healthsystem Elders (NICHE) program;


* educating nurses and implementing best practices to create positive work environments;


* developing, implementing, evaluating, and disseminating "just in time" educational programs for healthcare emergencies;


* implementing transition into practice programs to improve retention of newly licensed RNs; and


* providing career counseling to nurses seeking advanced nursing degrees and offering certification courses to support nurses in obtaining professional certification.



Think about trends and how the role of the NPD practitioner can support the organization in growing and advancing. It is up to the NPD practitioner, as a proactive leader, to identify how his or her role and work fit into the organization's goals and make suggestions as to how he or she can support the goals through learning. If you wait to be asked, you may not be invited.


5. What advice do you have for NPD practitioners in the context of today's healthcare and learning environments?



J. I. W.: The NPD practitioner plays an essential role in creating safe, high-quality, healthcare environments, which require scientific knowledge. Sharing of scientific knowledge and advocating for practice change based on the best available evidence are qualities NPD practitioners should be role modeling and promoting. That means, NPD practitioners must have an understanding of research and be able to explain its importance in patient care. Gaining knowledge about using the best available evidence and how to most effectively and efficiently implement changes into daily nursing practice will strengthen the value our specialty contributes to health care. Finally, be adaptable, flexible, and resilient. Experiment with innovative practices to move beyond the rote work of orientation and competency assessment so you can focus on organizational goals and outcomes.