The nursing program at the University of Indianapolis introduced the first minor within nursing in the United States in 2019, the primary nursing care minor. UIndy received a Health Resources and Services Administration (HRSA) grant in partnership with Community Health Network in 2018 which was to be spent towards primary care in some manner. A team of nursing faculty partnered with Community Health Network to create the minor. Among the faculty was Assistant Professor of NursingJulie Blazek, who was hired as a faculty member in 2018 after having previously been an adjunct professor.
“I was hired specifically to help create this minor,” Blazek said. “I was an adjunct at the time and I was the only faculty … that had any experience in primary care or the outpatient side of things…”
Blazek said that the development of the minor began with a crosswalk process. These crosswalks include assessing objectives and topics within the pre-existing courses and comparing them with the objectives for the primary care minor and filling the gaps based on what is lacking, according to Blazek. The minor consists of four total courses, one pre-existing course and three courses created for the minor. The three courses include; NURE 300: Roles and Standards in Clinical and Professional Practice in Ambulatory Care Settings, NURE 310: Information Technology and Communication in Ambulatory Care Settings, NURE 320: Coordination of Care in Ambulatory Settings and NURB 440: Transitional Care in Primary Population Health.
“The big reason behind this push is because everything in the nursing school is geared towards inpatient, acute care, very little is talked about in the outpatient setting, or primary care. And that’s where most of the care actually takes place, is outside of the hospital,” Blazek said. “So forever the push has been to get nurses in hospitals, that’s where we need them. Well, now with the cost of custom medicine rising, they’re trying to get insurance companies’ patients in and out as quickly as they can. There is a big need now for those nurses to be on the outside, now caring for those patients that have come out of the hospital to keep them from having to be readmitted for the same thing…”
According to Blazek, each of the three courses include 50 hours of clinical training, totaling 150 additional clinical hours on top of the required major courses. She said that each student is placed with a preceptor, which is a registered nurse working in the primary care setting, with whom they shadow and work with throughout their coursework.
Assistant Professor and Undergraduate Program Director for the School of Nursing Karen Elsea was also on the team for the creation of the minor and said that when developing the minor, they used the American Association of Ambulatory Care nurses’ scope and standards to evaluate the current curriculum and its gaps.
“And we use their scope and standards to completely structure the classes that we have, three classes that we came up with,” Elsea said. “So it kind of mirrors what they say is important in their practice. We just use that as kind of the guide for the entire format of the minor.”
Elsea said one of the things that students gain from the minor is the ability to understand more about chronic illness outside of the acute environment. Be that a diabetic patient or a patient with congestive heart failure, seeing them in the outpatient setting is different, Elsea said.
“When they see them in this environment, they start to see what in their home environment is impacting them,” Elsea said. “What resources do they have or not have available to them in their community? What kinds of teaching do they really need long term? I mean, they’re in hospital for such a short amount of time. But in this environment, this is where you really make the difference, and keep someone out of the hospital or try to keep somebody as healthy as possible…”
Senior nursing major and primary nursing care minor Payton Kumpf will complete the four courses required for the minor this semester and plans to graduate in May 2022. Kumpf said that this minor opens up an opportunity to experience different clinical settings as well as more one on one education through their preceptors.
“One big thing is that [the minor] shows me how many options there are in nursing. There’s more than just inpatient nursing jobs. But also, at the clinics, we would get a lot of hands-on experience,” Kumpf said. “A lot of the time, this semester especially, I was running around in the office, rooming patients, giving injections and taking vitals, just getting that extra hands-on practice.”
According to Kumpf, she has worked in five different settings including Stop 11 Clinic, Reach North, Internal Medicine North, an infusion clinic as well as a vaccine clinic. Kumpf said that she chose to go into the field of nursing because she ultimately wants to help people. She said that her experience in the outpatient setting has been different from the inpatient setting because she gets to form connections with her patients as opposed to trying to treat as many patients as possible.
“Primary care is so, so important. We need people to go to their primary care visits so we can prevent them from having even worse illnesses where they end up in the hospital in the first place,” Kumpf said. “Primary care is very, very special, and important, and I think this minor is going to prove that as we continue forward.”