During her time at the School of Nursing as a Doctor of Nursing Practice (DNP) student, Spring 2024 graduate Jennifer (Jennie) Joyner, DNP, MSN, CPNP-AC, experienced personal and professional growth.
Before completing her studies, Joyner began applying the skills she acquired by assuming leadership roles. She serves as the president for the Austin chapter of the National Association of Pediatric Nurse Practitioners. Additionally, along with her fellow DNP graduate, friend and colleague Vickie Goodwin, she co-founded an Advanced Practice Provider Council at St. David’s North Austin Medical Center, where they both practice.
Joyner’s dedication to advancing pediatric care extended to her involvement in research aimed at improving the care of late preterm infants. Her research, titled “Social Determinants of Health Affecting Health Care Cost in Near-Term Infants: Analysis from a National Cohort,” was selected for presentation at the Pediatric Academic Societies Meeting in Toronto in May 2024.
As an acute care pediatric nurse practitioner specializing in newborn nursery settings, Joyner has a profound connection with late preterm infants, born between 34 and 36 weeks. Despite often being comparable in size and weight to term babies, these infants face heightened risks due to their physiological and metabolic immaturity, making them a particularly vulnerable population that Joyner feels is often overlooked and understudied.
Early in her DNP journey, Joyner published a systematic review examining factors contributing to the frequent hospital readmissions of late preterm infants. Her analysis, utilizing data from the Health Care Cost and Utilization Project: Kid Database, shed light not only on clinical considerations but also on the significant impact of social determinants of health on health care costs. Through her research, she and her team developed a predictive model identifying factors associated with higher health care expenditures, sparking vital discussions on the integration of non-medical determinants into care delivery.
Joyner emphasizes that social determinants, such as birthplace, living conditions and socioeconomic status, have a substantial influence—approximately 50 to 80 percent on an individual’s overall health, shadowing the comparatively minor contribution of health care interventions. She emphasizes the importance of addressing these factors to optimize long-term health outcomes effectively across the lifespan.
“While it’s important to understand all of the things we’re doing in the health care setting, if we don’t care about other factors that influence health outcomes and think about how to optimize care through that lens, we can’t improve the whole health for that person in the long term,” she added.
For Joyner, pursuing her DNP was driven by a desire to cultivate leadership skills and effect systemic change, inspired by her experiences in advanced practice roles within the hospital setting. Her decision marked a departure from traditional career goals, focusing instead on personal growth and professional fulfillment.
“You get your DNP because you want to impact nursing or patient care on a deeper level, and you want to contribute to the care plan for patients to treat and diagnose differently—more responsibly,” Joyner said. “And I have to say, earning my DNP is the best decision I ever made. It reignited my love of the nursing profession. I think coming back into the academic setting and being able to connect with why good, effective leadership is so important and why navigating systems is so important. That’s why it’s important for nurses to lead and have a voice at the table.”
Joyner credits her professors, including the late Gayle Acton, PhD, RN, for igniting her passion for nursing and instilling in her a sense of purpose. Joyner said Acton’s emphasis on nurses’ responsibility to advocate for change and actively engage in the health care system resonated deeply with Joyner, motivating her to present her work and pursue initiatives to improve practice.
“Gayle Acton was amazing, so kind and always made me feel so welcome,” Joyner said. “She would tell you things that made you feel like you truly belong. It was the first time, in a large institution, where I felt something so personal, like me being here mattered.”
Central to Joyner’s educational journey was Acton’s course on nursing theory and philosophy, which emphasized the distinctive humanistic approach that sets nursing apart. As part of the course, students were asked to draw from their own experiences and develop their own personal practice models. Joyner developed the Caring CURE, an acronym for the concepts of compassion, understanding, reflection and empathy.
“I use the Caring CURE every day in my nursing practice and how I interact with people in my leadership roles,” she said. “To be able to take concepts inspired by work from nursing ancestors and how they were utilized and then apply it to how I take care of people and how I show up in my profession—it’s transformational.”
The inspiration Joyner gained from her professors is what led her and Goodwin to propose the Advanced Practice Council to their hospital administration. Fellow DNP graduate Jacob Paul, DNP ‘24, MSN, BSN ‘14 also played a role in getting the Council off the ground. Paul was brought on as the Council secretary and helped with the beginning formation and planning. This initiative has empowered advanced practice providers to actively participate in policy development and shared governance, driving educational and quality improvement initiatives across the hospital system.
The Council’s efforts have been recognized at the highest levels, with invitations to submit biannual reports to the Medical Executive Board and contribute to defining the scope of practice for advanced practice providers. Their interdisciplinary approach seeks to foster collaboration, recognizing the many perspectives essential for effective health care delivery.
“We all need to show up, too, because we’re all part of this intricate system that works together,” Joyner added. “With the development of the Advanced Practice Council, we’re hoping to give light to a different lens that’s not just ‘this or that,’ but incorporates more viewpoints to help the health care system function at its best.”
Reflecting on her journey, Joyner emphasizes the vital role of nurses’ voices in shaping health care delivery. She advocates for embracing diversity and fostering collaboration across disciplines, highlighting the interconnectedness of individual experiences within the broader health care system.
“Nurses’ voices are vital, and we need a variety of voices at the table and need a variety of teams taking care of people,” Joyner said. “For health care to truly take the best care of people, we have to think outside the box and connect with others different from ourselves. And that’s so true in nursing. We need to connect with different kinds of nurses. We need to connect with different levels of nursing, different generations of nursing and different backgrounds within nursing. And then, we need to connect with different disciplines outside of nursing.
“No one is alike, and the more we can understand ourselves and each other, the better we can connect to take care of the whole,” she continued. “All this work I do is a raindrop in the ocean of possibilities, as Rumi said, ‘We are not a raindrop in the ocean, we are the entire ocean in the raindrop.’ We need to reflect the values we want to bring to the care we give, and see those values reflected in the outcomes we measure.”