Family nurse practitioner students
Luke Miltenberger, right, and fellow nursing student Jesse Stubbs practice examination techniques during a class at the UNM College of Nursing. Berger and Stubbs are enrolled in the college's advanced practice registered nurse programs.
Credit: John Arnold

Erin Stopani couldn’t seem to get enough of a good thing when she finished the certified nurse midwifery program in the University of New Mexico College of Nursing last May.

“I graduated on Friday and started school again on Monday for the family nurse practitioner program,” Stopani says matter-of-factly. When she graduates next spring she will have a master’s of nursing as a nurse midwife and a post-master’s certificate as a family nurse practitioner – and a job waiting for her at Presbyterian Healthcare.

The extensive clinical experience she has gained in her training has given her a first-rate preparation for the demands of the workplace, Stopani believes. “That was one of the main reasons I chose UNM,” she says. “The amount of clinical experience was above what most other programs expected. I really think that is the best way to learn.”

Stopani’s experience is typical for many graduates from UNM’s trio of advanced practice registered nurse programs. Soon, thanks to an infusion of new state funding, more students will have an opportunity to pursue this career track.

In a bid to boost the ranks of primary care providers in the state, Gov. Susana Martinez and the 2014 New Mexico Legislature included a nearly $1.7 million recurring appropriation to grow the total number enrolling in UNM’s pediatric nurse practitioner, family nurse practitioner and certified nurse midwife programs from 24 to 40.

While the enrollment deadline for the certified nurse midwife program has passed,  prospective students have until Nov. 1 to apply for the pediatric and family nurse practitioner tracks. The first expanded classes will start in the Summer 2015 semester next spring and graduate in 2017.

“We’re trying really hard to get the word out,” says Carolyn Montoya, PhD, a certified pediatric nurse practitioner, associate professor and interim director of the College of Nursing practice team. “The Legislature is making a commitment. I am trying to be sure that we spend this money appropriately and we have sufficient students.”

The three APRN programs each begin with online courses in pathophysiology, research, nursing theory and health policy, Montoya says. Then the training shifts to clinical courses on block schedules in which students alternate between the classroom and hands-on training in clinics.

“We send students all over the state,” Montoya says. “We can’t have you in a class on Monday and expect you to do a three-hour drive to Las Cruces to do your clinical. If you are from a rural community, we will try as much as possible to place you for your clinical experience in your hometown.”

The trio of programs are a good fit for RNs looking to expand their skillset and greater autonomy in their practice, Montoya says, pointing out that New Mexico is one of 16 states in which nurse practitioners and certified midwives practice independently and with their own prescriptive authority.

“One of our selling points is that we’re not a massive program,” Montoya says. “There are some that take a hundred or more students. We don’t do that. Our students receive individualized faculty instruction.”

The fact that 100 percent of the students who have graduated from the program in the past five years have passed their certification exams is another plus, she says. Students also benefit from close supervision from faculty and preceptors while getting their clinical training, she says.

Stopani, a Chapparal, N.M., native who started out as a licensed midwife before earning her BSN at Texas Tech University, had more than 800 patient interactions in the certified nurse midwifery program. “It’s incredible that we have preceptors who share their clientele with us,” she says. “They’re so invested in our learning that they’re willing to share those experiences.”

Kendall Brown, who earned his BSN at UNM, is enrolled in the family nurse practitioner program. A Gallup, N.M., native who is also a member of the Navajo Nation, Brown wants to make primary care available where it’s most needed.

“There’s not that many health care providers out there,” says Brown, who hopes to work for the Indian Health Service after he graduates. The need is great: Many Native American patients cope with conditions like diabetes, high blood pressure, depression and anxiety, he says.

“What I’m learning in school is how to manage these illnesses,” he says, adding that the extensive classroom and clinical training he’s received so far has been “worth it,” because it has improved his skills as an RN.

Diana Sanchez-Gallegos, who earned her undergraduate, master’s in nursing and post-master’s certificate from UNM, has worked at Presbyterian’s family practice in Belen, N.M., for 21 years. Board-certified as both a family nurse practitioner and a pediatric nurse practitioner, she remembers well the bumpy transition between RN and nurse practitioner.

“All of a sudden, you’re in a role where you’re making all the decisions and you’re writing them down,” she says. “It’s a whole different ballgame when you’re signing your name to those orders. It’s a real responsibility, a real role change.”

Sanchez-Gallegos says that these days she learns a lot from serving as a preceptor to young APRN students from UNM. “You sometimes get stuck in your old ways,” she says. “They get a student who says, ‘Here’s a new way to do it, and there’s evidence for it.’”

She’s “excited” to hear about the expanded APRN program, because it will help improve access to care. “Overall, we can’t meet the demands right now,” Sanchez-Gallegos says, adding that the extension of health insurance and Medicaid coverage under the Affordable Care Act means that increasing numbers of people will be seeking health care.

Carolyn Montoya, who continues to treat pediatric patients in addition to meeting her busy administrative responsibilities in the College of Nursing, says becoming a nurse practitioner “is the best decision I ever made.”

She hopes that as more students graduate from the APRN program many of them will choose to remain in New Mexico to practice in rural and underserved communities, where the need is the greatest.

In small towns, she says, practitioners get to know their patients outside of the clinic. “It’s a very unique relationship,” she says, “very different from an urban setting.”

But for Montoya and others, the work is its own reward. “My mind is engaged 110 percent when I’m in clinical,” she says. “When I’ve had a tough day here, I go and see my little babies. You are totally engaged in that encounter, and it’s challenging and satisfying.”