The 21st Century Nurse

by LeeAnne Carson ‘02

From routine vaccinations to chaotic emergency rooms, medical scenarios can be stressful experiences. Soothing aches, ailments, emotions, and spiritual pain, nurses bridge the gap between doctor and patient, serving as liaison and advocate. Often it is this unique relationship, rather than bandages and medications, that brings the most comfort.

But these multi-tasking medical marvels face a nationwide crisis. Aging baby boomers and large numbers of retiring clinical nurses have caused an alarming nursing shortage. Contributing to the problem, new California legislation governing nurse-patient ratios, heavily fines health care institutions with an insufficient number of nurses for their patient population, causing many hospitals to close beds. According to projections from the U.S. Bureau of Labor Statistics, more than 1 million new and replacement nurses will be needed by 2012, making registered nursing the top occupation for job growth over the next eight years.

Nursing colleges and universities across the nation struggle to keep enrollment levels commensurate with the demand for nursing care. Even the 16.6 percent increase in baccalaureate program enrollment in 2003 falls short of the need. Regardless of enrollment increases, schools’ inability to accommodate the influx poses its own obstacles. In 2003, nearly 13,000 qualified applicants were turned away due to insufficient faculty, facilities, and money. According to the American Nurses Association, less than one percent of faculty hold a doctoral degree.

Before sufficient numbers of nursing students can step up to answer their call, the number of nursing faculty must also increase. APU's School of Nursing, known for producing exemplary nurses, awards an average of 85 bachelor's degrees each year, with another 100 graduates of the master's program working toward special certifications. Beginning this fall, the school will also concentrate on producing excellent nurse educators by offering APU's first doctoral program in nursing. Whereas a bachelor's or master's degree prepares nurses for clinical and specialty care, a doctorate is necessary for academic work. With 52 units of course work and 12 units of dissertation research, the Doctor of Philosophy in Nursing addresses the nursing shortage by preparing nurses as leaders, mentors, and teachers in their profession.

The Ph.D. in Nursing offers two areas of concentration – health of the family and community, and international health – with a sub-specialization in nursing education for graduates interested in an academic position. With classes offered weekly or bi-weekly, the program accommodates working adults. The program enrolls no more than 10 students each term, and can be completed in four years.

Plans for the Ph.D. in Nursing began in 1998 when the faculty examined the feasibility and timeliness of offering a nursing doctorate at APU. After three years of research and evaluation, the school submitted a proposal to the Western Association of Schools and Colleges (WASC) for approval. The team's November 2003 campus visit resulted in a positive report. "The Evaluation Team commends the president and the provost for creating an exceptional institutional transformation in a very short period of time," it stated. "The Substantive Change Committee's evaluation team members have never witnessed such rapid dramatic change in any other institution. The Evaluation Team firmly believes that the university is ready to offer the proposed Ph.D. in Nursing with distinction." The program received full accreditation on February 24, 2004. Azusa Pacific University stands as the only Christian college west of the Mississippi to offer a Ph.D. in Nursing.

According to chair Marianne Hattar, DNSc, FAAN, RN, the program was "developed with the intent to meet and exceed the standards for a quality Ph.D. in Nursing Program." And although the program is still in infancy, the faculty expects that APU's graduates will not only be on par with counterparts from other programs, but will also have a distinctive edge.

"For many of our graduates, nursing is not just an occupation or business; it's a calling," says Aja Tulleners Lesh, Ph.D., interim dean of the School of Nursing. "Their commitment to this calling and the ability to keep God First in their lives sets them apart from other nurses. It is our hope that the Ph.D. in Nursing will create that very same distinction: this time in nurse leaders."

APU's nursing philosophy is "whole person" care. Health is defined and understood as totality or completeness and can never be separated from spirituality. Student nurses are taught to not only address patients' physical needs, but also their emotional and spiritual concerns, whether that is obvious in conversation or subtle in care.

"Our graduates have a unique perspective on human spirituality, and a moral and ethical conduct that are inseparable. They view their chosen profession as a calling from God," said Rose Liegler, Ph.D., MSN, RN, former dean, and current professor and vice provost for graduate and adult programs. "The Cornerstones of this university – Christ, transformational scholarship, life-giving community, and selfless service – support the values and Christian caring emphasis of the nursing profession."

For further inquiry, please contact the School of Nursing at

LeeAnne Carson '02 is the research editor at Diablo magazine and a freelance writer and designer in the San Francisco Bay area.