The board meeting is underway. Around the table sit bankers, attorneys and finance executives. Agendas have been distributed. Numbers are being discussed. And then, on a question that matters—staffing, safety, the direction of patient care—the conversation pauses. Heads turn.
They look to the nurse.
For Barbara Petersen, DNP’23, APRN-BC, CPHQ, CPPS, that moment is not hypothetical. It is a regular feature of her professional life. As chief quality officer at Great Plains Health in North Platte, Nebraska, an independent rural hospital, Petersen sits on her hospital’s board of directors, a surgery center board and the Nebraska Nurses Association board of directors. She has earned those seats, and she knows exactly what happens when the room turns her way.
That question, “What do you think?” embodies the promise of nursing leadership education. Nurses have always known what they think. They know it at the bedside, during an overnight shift, in the emergency department at 3 a.m. and in the long hallways of rural hospitals where resources are limited, and decisions are critical. What they have not always had is the credential, the language and the seat that allow that knowledge to extend beyond the unit and into the rooms where healthcare decisions are truly made.
Creighton University’s Doctor of Nursing Practice is designed to bridge that gap. For those who earn it, the impact has been a shift in how they see their own influence.
The most common hesitation nurses express when considering a move into leadership is a version of the same fear: that they are leaving patients behind. They worry that trading the bedside for a boardroom means sacrificing direct care.
Shelly Luger, RN, DNP, NE-A BC, associate professor and Soto Global Nursing Scholars director at Creighton, explains that with straightforward numbers. A bedside nurse working full-time will care directly for roughly 150 to 300 unique patients in a given year. That is real, meaningful impact. It is also a ceiling.
Bedside nurse: 150–300 unique patients per year
Unit nurse leader: 1,000–3,000 patients per year — 10× the reach of bedside practice
Division director: 10,000–50,000+ unique patients per year, with hundreds of thousands of encounters over a multi-year tenure
Source: Creighton University
A nurse who moves into unit leadership is no longer making care decisions only for the patients on her shift. She is making decisions about staffing, practice standards and team performance that shape the experience of every patient who comes through that unit. A division director shapes the systems that determine how care is delivered across multiple units and service lines, often for years.
The shift is not about stepping back from patient care. It is about multiplying the capacity to serve it.
Dieja Martin, BSN, RN, DNP’26, nurse lead at Overland Park Regional Medical Center/HCA, spent ten years at the bedside before she enrolled in Creighton’s program. She had always gravitated toward leadership—charge nurse roles, stepping up in a crisis, being the person others came to—but was uncertain what shape that leadership should take. So she did something that felt unconventional at the time: she enrolled in the DNP program while still working at the bedside.
The program, she says, changed not just her skills but her entire lens—the way she sees problems, the way she understands her organization’s mission and the way she shows up in conversations that used to happen without her.
Molly Hendricks-King, BA’03, MSN’21, DNP’23, RN, NE-BC, NPD-BC, earned both her master’s and doctorate at Creighton before going on to serve as regional director for Nursing Professional Development and Practice Excellence at Intermountain Health, Peaks Region, covering eight hospitals across Colorado and Montana. She describes the shift in perspective that leadership education produces in terms of altitude. A bedside nurse sees four or five patients. A charge nurse lifts to see the whole unit. A manager sees a department. A director sees a system. At each level, the scope of the question expands, not contracts.
“It’s just more building blocks. Now I have to look at eight different hospitals in just my region, and we’re part of 34 hospitals. So we do have to think: if we’re going to make a change in one area, how might that impact every other area?” Hendricks-King said.
Luger names the core gap the program addresses: great clinicians are regularly placed in leadership positions without ever receiving training in systems thinking, complexity science or the human dynamics of leading organizations through change. The program opens with exactly that foundation—a framework for leading within complexity rather than above it. And students consistently say it surprises them.
For Petersen, the clearest transformation was in strategic thinking. Before the DNP, her perspective was shaped largely by her department. The program pushed her toward the organization as a whole and then beyond it—toward finance, policy and the full landscape of what healthcare leadership requires. When she walks into a committee or board meeting now, she arrives already anticipating the financial objections and return-on-investment questions the room will raise. She can meet those questions because the program trained her to think in the same terms.
Mandy Putnam, BSN’20, RN, MSN’26 candidate, a NICU nurse at CHI Health Good Samaritan in Kearney, Nebraska, working overnight, describes her thinking as a gradual, cumulative process. She no longer sees only the problem on her shift but also considers its causes, potential solutions and whether it is a patient safety issue or is, in her words, simply an irritant. Now, these two categories are stored in different parts of her mind and drive different responses.
She is not a formal leader yet. But she is already leading differently.
At the heart of every story these nurses share—even when they’re discussing boardrooms and budget cycles—is the patient. That thread never breaks. It stretches.
Petersen describes her role as chief quality officer as still patient-facing, even if the contact looks different than it once did. She oversees patient advocacy, risk management and infection control. Several times a week, she’s upstairs in a patient’s room, listening. When a patient is upset, she sits at their level, makes eye contact and says, “Tell me what’s going on.” Then she is quiet. She says the gap between what the patient perceives and what the clinical team thinks happened is almost always where the real issue lives.
For Putnam, patient advocacy is especially urgent. NICU patients cannot speak. Their parents, often overwhelmed and frightened, may not fully understand what is happening around them. The nurse at the bedside acts as a protector between that vulnerability and the system surrounding it.
Martin makes a similar argument from a different perspective. Her hospital is an adult facility that includes NICU and pediatric services, which creates a persistent advocacy gap: the administrators and executives around her often lack direct experience with pediatric care. They don’t know what they are missing. Martin does. Her degree gave her the confidence and vocabulary to ensure that perspective is included in the conversation before decisions are made.
This is the argument that nurses themselves make most clearly: nurse leaders don’t leave patient care. They extend it. A nurse in a leadership role, shaping staffing models, safety culture and quality outcomes, touches the experience of everyone who comes through the building.
The real test of any leadership training is how it performs during a crisis. For the nurses who have been through Creighton’s DNP program, COVID-19 served as a direct test.
Petersen graduated in 2021, into the turbulence COVID had already created across healthcare. In North Platte, the challenge was immediate and concrete. Her CEO walked in one day to say they had their first COVID patients: ten or eleven nursing home residents who had been loaded onto a school bus and brought to the hospital. They needed a COVID unit. By tomorrow.
Petersen compares it to a clinical trauma response: just as training makes certain actions automatic under pressure so you don’t freeze looking for step one, the DNP, she says, does the same thing for leadership. When the crisis arrives, you understand the sequence because the preparation is already ingrained.
The career paths available to DNP graduates are broader than many nurses realize, and the credential carries increasing weight in ways that are now structural.
Petersen has observed a concrete shift since completing her degree. In committee meetings with physicians and executive leaders, she is recognized for her doctoral-level preparation and regularly asked to weigh in. More significantly, she has noticed a growing baseline expectation across the field: many executive-level nursing roles now specify a doctoral degree.
Roles available to graduates span a wide range: Director of Nursing, Chief Nursing Officer, chief quality officer and regional director positions across health systems, as well as roles in policy, advocacy and organizational safety. Petersen’s own position as chief quality officer has historically been occupied by physicians. She brings the ability to walk into a clinical setting and speak from direct experience on both sides.
Hendricks-King points to policy engagement as one of the program’s less visible but lasting impacts. She never would have pursued policy work without Creighton’s encouragement, she says, and now actively brings bedside nurses with her, encouraging them to attend state capitol days and speak directly with their senators and representatives. The instinct to influence the conditions surrounding patient care, not just the care itself, is something the program deliberately builds.
The credential gave her not just knowledge but confidence in her own capacity to learn. That, she says, is the thing that compounds over a career.
Luger sees the program as serving two distinct groups equally well: nurses who aspire to leadership and want to build a foundation before they get there, and nurses already in leadership roles who want to deepen and formalize what they know. The common thread is intention, not résumé.
She is candid about one point of productive disagreement within the field. Some believe nurses should have formal management experience before pursuing advanced leadership education. Luger sees it differently. If a nurse on the floor has been told she has leadership potential, that is the right moment to come back to school, before a particular role has calcified her habits and while her thinking is still open to the full range of what nursing leadership can mean.
Martin is a living example of that argument. She enrolled while still at the bedside and uncertain about the direction her leadership would take. The program did not hand her a path. It exposed her to quality, policy, operations and relational leadership until she found her own gravity. Along the way, she realized she had been wrong about something she had long believed.
“I hated the business side of healthcare,” she says. “I thought it was absolutely ridiculous that we treated healthcare as a business. And now that I’ve gone through this program, I understand how my role can better advocate for that business aspect of healthcare—and why that matters for patients.”
Petersen puts it plainly from the other end of the career arc. When she enrolled, she had very little management experience. She performed well throughout, went on to a senior executive role and now co-teaches in the program. “Any nurse who wants nursing leadership, now or eventually, should explore this. The experience helps in the program, but is not required.”
The program’s flexibility extends beyond career stage. Creighton’s online DNP can be tailored to a nurse’s clinical background and goals, with specializations in Adult-Gerontology Acute Care, Family Practice, Neonatal Care, Pediatric Acute and Primary Care and Psychiatric Mental Health. The leadership foundation the degree builds is the same across all of them—what changes is the clinical context each nurse brings to it.
What stays with Creighton’s graduates goes deeper than curriculum—the Jesuit values, the relationships and the culture the coursework sits inside.
Luger highlights the program’s global focus as a key factor that she believes makes Creighton unique. It features intercultural journal clubs with nursing leaders in Africa and practicum opportunities in the Dominican Republic. “We are beginning to realize how much we can learn from our global partners,” she says, “how they help people access healthcare and what our similarities and differences reveal about what nursing leadership can be.” She also mentions intentionally small cohort sizes that foster genuine faculty-to-student relationships.
Petersen describes a moment that captures what Creighton feels like at a more personal level. She was once late on an assignment—completely out of character for her. She did not receive a form email or a zero. Instead, Luger called her.
“She reached out and said, ‘This isn’t like you—is something going on?’ I was so honored to be more than just another student. I still felt that personal touch even though it was all virtual.”
Petersen has since carried that approach into her own teaching. When a student’s work doesn’t reflect their usual quality, she reaches out the same way Luger reached out to her. The model moves forward.
When Putnam walks into the NICU at 3 a.m. and stands beside a family who is frightened and doesn’t know what to ask, she is not thinking about systems theory or board governance. She is thinking about what this family needs and how she can leave them less afraid than when she arrived. But the education she’s received has changed how she sees that moment—who else in the system she needs to involve, what pattern this family’s experience might be part of and what she owes them not just tonight but in the long arc of how their hospital is run.
That is the core lesson the program teaches: you can love individual patients completely and still recognize that loving them fully means caring about everything that surrounds them—the staffing decisions, the safety culture, the board meetings and the policies that haven’t been written yet.
It means being the voice in the room. Because the patient often can’t speak for themselves.
