Laura Dawn McRee

Laura Dawn McRee , DNP, ACNP-BC, LMT, RNFA

Clinical Associate Professor, Nursing

Laura McRee DNP, ACNP-BC, RNFA, LMT have served as faculty for  the College of Nursing faculty fo 20 years. lt is a privileged to follow my “bliss”.  Embracing the philosophy of Joseph Campbell, who was an American mythologist, writer and lecturer, I guide my students with my passion and enthusiasm for creative innovation and positive motivation. I instill this same philosophy in all my teaching/learning, research/scholarship, and service/practice activities. In this statement I will describe my accomplishments in each area and my contributions as a faculty member in the University Of Arizona College Of Nursing.

 

Teaching and Philosophy of Education

My philosophy of nursing education recognizes that nursing knowledge begins with knowledge of the individual as self, health, behaviors and practice. It is important to follow evidence based science and discovery in teaching and practice. During my career in academia and practice I teach by example, role modeling and mentoring students to use the best evidence for self-care and patient care. I served as the AGACNP Coordinator for 5 years and chaired/co-chaired the Adult-Gerontology Acute Care nurse practitioner (AGACNP) specialty courses: NURS 615 Adult-Gerontology Diagnosis and Management of Chronic and Acute Illness-I, NURS 616 Adult- Gerontology Diagnosis and Management of Chronic and Acute Illness-II, NURS 693a Clinical Residency, and NURS 574 Pharmacology in Acute Care. I have developed innovative teaching strategies to apply content to complex health care situations for these adult learners.

In addition to the standard revision of courses each year to reflect updated knowledge and current standards of practice, I have incorporated smart phone/tablet resources and applications to review medical diagnosis and differential diagnosis. I also created a study guide for NURS 615 and NURS 616 midterm and final exam review using Collaborate and WebEx platforms to support interactive review sessions. I am working with our learning and healthcare technology department to develop an electronic medical record simulation to be implemented in the core AGACNP courses next year. I will test in the AGACNP courses and if the simulation is found to be successful; there are plans are to use it in other specialty courses (e.g., Family Nurse Practitioner (FNP) core courses).

Through my collaboration with Barkley, a company that provides professional practice exam courses for national certification, I introduced the Barkley Nurse Practitioner certification practice exam opportunity for all four NP specialties. Students can take a practice certification exam without cost provided by one of the leading certification exam preparation companies.  I have created simulations and videos that allow for advanced learning and application. For example, the challenges the advanced practice DNP student encounters is the role change to becoming a provider in health care responsible for end of life discussions with families regarding a loved one’s wishes and treatment planning and Two Videos (Modeling effective and Ineffective Communication) to distinguish between effective and ineffective nonverbal communication behaviors in the provider. I was invited by Sandy Severson BSN, MBA, CPHQ, CPPS, CENP, FACHE Vice President, Care Improvement Arizona Hospital and Healthcare Association [AzHHA] as a committee member to contribute Thoughtful Life Conversation (TLC) committee.  The committee’s missions are to development and disseminate teaching resources to health care providers including nurse practitioner on how to have end of life conversations with patients and families.  I developed Professional Role Power-point Presentation Criteria for NURS 615 (see teaching portfolio) and found recorded presentations for peer review have been effective in encouraging professional presentation communication skills and dissemination.

Due to my expertise, I have also contributed to other doctoral courses, such as NURS 681 Issues in Geriatric Health, to contribute expertise in gerontology and end-of-life care. I developed an AGACNP High Acuity Assessment and Professional Role Guideline for NURS 616 and shared this guideline with other faculty who decided to adopt it. This guideline has been incorporated into NURS 609a Advanced Health Assessment for use by students as part of any high acuity assessment of a patient. I regularly lend my expertise to assist in teaching students high acuity assessment in NURS 609a, above and beyond my regular teaching assignment.

Given my passion for practice based on the best evidence and patient preference, I taught in NURS 752 Evaluation Methods for Patient Safety and Quality, as a core Doctorate of Nursing Practice (DNP) course.  In this course, I am able to teach all DNP students, regardless of specialty, important knowledge critical to successful role enactment as a doctorally prepared advanced practice nurse. My TCES have been above satisfactory to excellent (>4.0 out of 5) (see supporting evidence in teaching portfolio) attesting to my commitment to providing high quality education to the next generation of advanced practice nurses. 

In addition to my online didactic teaching, I have provided clinical supervision to students within the clinical setting, mentoring NP students to provide the best care of their patients.  Due to my expertise as an AGACNP, I coordinated the clinical skills intensive, which is a 4-day on-site event that all nursing students must take to learn advanced nursing skills (e.g., suturing, x-rays, oral endotracheal intubation, chest tube insertion, central line insertion)  for the past five years.  I have obtained additional resources (funding from CMS Graduate Nursing Education grant, PI: Terry Badger) for this intensive to provide state-of-the-art simulation experiences for our students.  I also introduced the first ‘White Coat’ ceremony for DNP students which occur during this on-site clinical intensive (CSI) program .  This ceremony, modeled after the White Coat ceremony of physicians, welcomes the advanced practice nursing student into the role of advanced practitioner and provides a psychological contract to the role and responsibilities of an advanced practice nurse.

As AGACNP Specialty Coordinator, I have been involved in curriculum changes and revision of all specialty courses, development of policies and procedures in the Doctorate of Nursing Practice program, and mentoring of all AGACNP students and all new faculty. For the past five years (2012-2017), I have advised and mentored all first year AGACNP students (averages 38 per year).  I currently advise 19 DNP students who have selected the AGACNP specialty.  I have developed an advising/ mentoring worksheet to enable me to facilitate their progression through the program.  This document has been shared and adopted by other faculty.  I am chairing three DNP projects, and am a member of another 15 DNP projects.  

            As part of my ongoing passion for innovative creative nursing programs, I was involved in developing the dual specialty (AGACNP/ FNP) in the DNP.  This dual specialty is critical especially for NPs in rural areas as the scope of practice requires the skills of both specialties. I have established negotiations with the CEO of National Institute of First Assisting (NIFA) the leading educational program in training Advanced Practice Nurse Practitioners Surgical First Assists. This collaborative relationship would market the University of Arizona College of Nursing as the first DNP program to have an Advanced Practice Surgical First Assist Program in the country (see attached documents for innovative contributions).  I have also begun discussions with the Veterinary College about a joint DVM-DNP degree.  This type of degree would be highly innovative and the first in the nation.

Other evidence of my excellence in teaching includes a number of presentations to faculty and the community to enhance innovative and creative teaching strategies.  A few examples include 1) presented a workshop for faculty in the use of presentation platforms such as Prezi & Panopto; 2) presented a faculty forum on “Marketing your Legacy”; 3) provide continuing education on Compassionate Conversations: Dying and Living Well; 4) attended at the National Organization of Nurse Practitioner Faculties on Distance Education for the NP Learner;  5) attended at the Summer Inter-professional Geriatrics Conference on Train the Trainer End of Life Discussion; and 6) attended AANP National Conferences obtaining continuing education requirements to maintain national certification as an ACNP-BC, which is critical in my teaching role. 

In sum the evidence of my creative innovations in teaching is strong and shows the passion I feel about motiving students for progressive engagement in learning. 

 

Research/Scholarship

            My scholarship activities developed from areas I value in clinical practice. My scholarship supports my teaching/learning and service/practice contributions as all focus on my beliefs  related to preventive health and wellness and emergency medicine. During my first tenure 15 years with the University of Arizona as a master’s prepared nurse, I completed two experimental studies (McRee et al., 2007; McRee et al., 2003) about the effects of preoperative massage on intraoperative post-operative outcomes. Both studies were published in peer reviewed journals: Journal of Gynecologic Surgery, AORN. These studies were among the earliest nursing studies using a rigorous RCT design. 

            My expertise in massage and integrative modalities as evidenced by these studies is why I was invited to be on the advisory board of a national program, Integrative Fellowship for Nursing Faculty (INFF). The INFF is designed to teach faculty integrative therapeutics, which will be incorporated into curricula throughout the nation. The goal is to then teach nursing students who will incorporate integrative therapeutics into daily nursing practice.

           For my DNP capstone project in 2014, I evaluated electronic medical records for sepsis surveillance (McRee et al., 2014). Among my findings were that implementing EMR sepsis surveillance significantly improved home discharge (49.0% versus 25.3%, p