NP to a Higher Degree

Amanda Rumpke did not realize she was already doing doctorate-level work at her job until a UC Nursing faculty and mentor told her so. That was when she started to consider earning a Doctor of Nursing Practice (DNP).

“I was talking to her a little bit about a system-wide project I was leading and how I thought it was going to impact not only overall care outcomes but also care access and elevation of advanced practice clinicians to the top of their scope of practice,” Rumpke, DNP, APRN-CNP, says.

Her mentor Christine Colella, DNP, APRN-CNP, FAAP, who has since retired from UC College of Nursing, told Rumpke that her work sounded like a project required of the college’s DNP program, which involves planning, implementing and evaluating an initiative that impacts health outcomes on a systems or population level.

“So, she helped frame it for me,” says Rumpke, who also earned her Bachelor and Master of Science in Nursing from UC.

When she entered the Post-Master’s DNP online program, she found her job closely aligned with the coursework. Rumpke serves as the system director of advanced practice clinicians for Bon Secours Mercy Health, one of the largest health systems in the U.S. and where she supports 1,200 advanced practice registered nurses (APRNs) and physician assistants (PAs) across four states: Ohio, Kentucky, Virginia and South Carolina.

Rumpke’s DNP project focused on a key finding within the health system: APRNs and PAs, especially those in hospitals, were underutilized — not because of legal limitations, but due to internal privileges, which are the services a health worker is permitted to perform based on their credentials and previous performance. To complicate the matter, the system’s rules and privileges varied widely among its hospitals and other sites.

All of this translated to reduced patient care access. It saddled advanced practitioners with undue or burdensome physician oversight and prevented them from performing to the full extent of their licensure. It also made the health system incapable of flexing to critical staff shortages brought on by emergencies like, say, a global pandemic.

So, Rumpke and colleagues set out to standardize rules across the system. They took hundreds of documents and condensed them into 11 templates that align with APRN and PA national certification standards and developed best practices for qualifications, core privileges and specialty privileges.

Outside of her full-time job, Rumpke advocates for APRN autonomy. She has served as the co-director of the southwest region for the Ohio Association of Advanced Practice Nurses (OAAPN) and, for the past year, as president-elect. This fall, she began a yearlong term as president and will continue to support full-practice authority for all Ohio’s APRNs.

“We’ll work hard with our legal team, with our lobbyists, with our legislators in the state of Ohio to grow autonomy for Ohio APRNs because it matters to the health of Ohioans,” she says.

Mandi Cafasso, DNP, APRN, CPNP, assistant professor and director of the college’s DNP program, says Rumpke’s project is a model of how doctorate-level students and nurses can drive change in health care.

“[Rumpke] is an amazing leader and the impact of her project on the facility where she works will serve as an example for other health care systems,” says Cafasso, who also works with Rumpke through the OAAPN, calling attention to the benefits of APRNs providing care to the full extent of their education and training.