A new faculty member and researcher at the University of Colorado College of Nursing will mean good news for geriatric rural health in the state. That’s because he brings with him research experience, honed by studying rural health in New York state.
Now Daniel Cline, PhD, RN, will turn his attention from the northeast to Colorado. He was attracted to CU by the interdisciplinary nature of the burgeoning Anschutz Medical Campus. “One of my colleagues works with a physician in the School of Medicine, and she recommended it,” he says. He was also impressed with the college’s commitment to develop a more robust geriatric curriculum to serve an increasingly aging population.
Dr. Cline’s research is of vital interest to Colorado’s Area Health Education Centers (AHEC). This outreach program by the university works to improve care for older adults in rural and underserved counties. The program director is Jack Westfall, MD, who also runs the high plains research network in 14 eastern counties. The AHEC connection offers Dr. Cline entré into rural communities to form partnerships with local organizations and conduct research related to improving the quality of care for older adults.
Dr. Cline was a 2010-2012 John A. Hartford Foundation Building Academic Geriatric Nursing Capacity (BAGNC) Scholar at New York University. In his work as BAGNC Scholar, he met another BAGNC student working on her PhD at CU’s College of Nursing, Marleen Thornton.
Dr. Cline uses a combination of qualitative and quantitative research methods to study ways to improve the quality of geriatric care. “In my dissertation, I wanted to learn about rural hospital work environments and the quality of care for older adults,” Dr. Cline says. He interviewed registered nurses to better understand how work environment factors in rural hospitals influence the quality of care for older adults. The results were that strong, collegial RN-to-RN relationships strengthened the quality of geriatric care, whereas cumbersome and inefficient technology, lack of geriatric specific education, poor RN-MD relations, and poor use and a shortage of nurse aides diminished the quality of geriatric care.
In addition to teaching on campus, Dr. Cline is active in offering faculty development workshops around the country to help nursing faculty teach care of older adults more effectively. He is on a campaign to generate student enthusiasm for specializing in adult-gerontological care. His concern is well founded, because new certification requirements focused on care of older adults in the nurse practitioner exam administered by the American Nurse Credentialing Center take effect in 2013.
Dr. Cline’s career started when he took a nurse’s aide job, looking for work after he got out of the Army. One thing led to another—more education and finally research. He found the more he learned, the more he understood. “My advanced practice degree and my PhD really opened my eyes to how much more there is to know,” he says. “I gained a better understanding about patients’ nursing, medical, and social problems, as well as policy issues. I understood more and more about the system, and that was transformative.”
People over age 65 are growing at an astronomical rate in the U.S. and have complex care needs. “Care of older adults must include a unique set of skills. It’s more than just acute care,” Dr. Cline observes. “Whether you’re caring for older adults in a hospital, their home, their community, or during a period of transition, you must understand the system, community resources, family dynamics, and patients’ abilities for disease self-management, as well as their ability to afford, obtain, and take their medications.”
Dr. Cline earned his BSN from the University of Vermont, an MSN adult health nurse practitioner degree from the University of Pennsylvania, and a PhD from New York University. He has clinical experience in critical care and emergency nursing, and his research interests include quality of care for hospitalized older adults in rural communities, nursing workforce development, and health system redesigns aimed at improving staff and patient outcomes.