How to Design a Nursing Program that Emphasizes Justice and Community Health

Regina Prusinski [00:00 – 00:12] – It’s going to be a bad day. You’ll have worked six twelves in a row. You hate everybody, but you know what you’re going to remember? And I tell them, I’m like, you’re going to look me in the face. This is not your bad day. Your patient had a bad day. They’re in the hospital. 

Jasper Nighthawk [00:18 – 02:16] – This is the Seed Field Podcast, the show where Antiochians share their knowledge, tell their stories, and come together to win victories for humanity. I’m your host, Jasper Nighthawk, and today we’re joined by Regina Prusinski for a conversation about nursing education and the strong need today specifically for nurse practitioners who take a lens of community health and social determinants of health into their work. Today, I’m excited to zoom out and ask, if we were to design a nurse practitioner program from the ground up, what would the considerations be and what decisions would we make? The reason this is our topic is that this act of designing a whole nurse practitioner program is exactly what our guest today has done. Regina is part of the founding team of Antioch University’s new Graduate School of Nursing and Health Professions, and she is specifically the director of the nursing programs and chair of the family nurse practitioner program. This is a big initiative. It’s been years in the making, and I’m so excited to learn more about the new nursing programs that we’re launching and how this model promises to push nursing education forward. So before we start talking, let me quickly introduce our guest. Regina Prusinski has a lot of degrees. She has a BS in nursing, an MS in nursing, in acute care pediatric nurse practitioner, a postmaster’s certificate in family nurse practitioner that gets written to FNP, and a doctorate of nursing practice, a DNP. She’s been a nurse for over 20 years with clinical practice in pediatrics and adult congenital healthcare. And she has been a nursing professor since obtaining her DNP. She was the longtime graduate nursing director and FNP director for Otterbein University. And now, through the magic of the Coalition for the Common Good, as those programs have moved over to Antioch University, she is the founding chair of the nursing programs at the Graduate School of Nursing and Health Professions at Antioch University. Regina, welcome to the Seed Field Podcast. 

Regina [02:17 – 02:17] – So glad to be here. 

Jasper [02:18 – 02:57] – So before we jump into questions about designing a nursing program from the start, I always like to ask our guests to disclose their positionality. And we’re going to be talking about health care and health outcomes in the U.S., which is unevenly distributed across different identity markers. So, yeah, I’ll go first quickly. I’m white. I’m a cisgendered man. I’m queer. I’m not living with a physical disability, but I do experience anxiety and depression. and I have since I was a kid. I have a college degree and a master’s. I have steady housing and a steady income, which I don’t at all take for granted because I’ve lived for long periods of my life without either. And I’m also a parent. I have a three-year-old kid. So Regina. 

Regina [02:58 – 03:22] – So I had to go look up positionality. This was kind of exciting and then to get to put it into action. So I’m a white cisgender woman. I do not live with a disability. I am heterosexual and I do have a college degree and you heard all the letters. I have a home and a regular income. I am a parent and I am lucky enough to also have a partner who wants to parent with me for three young children. 

Jasper [03:23 – 03:45] – That’s great. Thank you, Regina, for sharing that about yourself. And I want to go a little bit more into your story because I feel like, you know, the work that we do, especially when we’re having the chance to design something often comes out of our own experiences. So when we were preparing for this episode, you told me that you were, you called yourself an accidental nurse. Tell me, how does that happen? 

Regina [03:46 – 04:03] – I do describe myself as an accidental nurse. I did not come from a long line of healthcare workers. This was not a family profession. I’m the first in my family to go to college. And when they say that at graduation, I stand up every time. 

Jasper [04:04 – 04:04] – I love that. 

Regina [04:05 – 04:29] – Yeah, this was a field that I had never thought of joining. And just in passing, someone mentioned that nurses work three 12’s a week. And I said, that sounds like the most amazing job schedule ever. And that is what started my feet in the direction of doing nursing, along with a really big nursing shortage that happened in the early 2000s. So that is that is my accident. 

Jasper [04:29 – 04:33] – So how has that worked out? Do you just have four day weekends every day, every every month? 

Regina [04:34 – 05:11] – And I don’t think I’ve ever worked one job in my whole life. So this has been an ever fulfilled world for me that I think I try to fill up every minute. I don’t think I’ve ever worked just 312s ever, but it was a great idea. It did something for me that it really fulfills what you want in your life, which is something meaningful and to having purpose. And if you ever want to know, like, why do I do this job? If you ever get that feeling like I have gone to work and I do not know why they have me here today. I always get an answer with my job. I’m here to actually to help somebody. So it has really fulfilled as a profession for me. 

Jasper [05:11 – 05:16] – Yeah. There’s an idea that sometimes floats around of bullshit jobs. 

Regina [05:16 – 05:32] – Yes. Yes. And we’ve done many of that. Right. We’ve all done many of those. We’ve filled out the forms and played with our twiddles on our desk and, you know, wasted our moments knowing I’m just getting paid per hour here. But I really feel that you don’t normally get that moment in nursing as much. 

Jasper [05:32 – 05:48] – I love that so much. And I’m curious if there is anything in your own experience as a nursing student and going into your nursing career that really stood out to you where you were like, I am going to do that differently as you’ve been thinking about designing your own program. 

Regina [05:48 – 07:17] – Let’s see. I really enjoyed nursing school, which sounds funny if you’re not somebody who enjoys school, right? I have always done well academically, but I didn’t necessarily enjoy the act of school that sometimes some folks enjoy, like the groups of kids, the interaction, the social land. But I did get a diploma as my first nursing extent where you get an RN license at the end, and it really isn’t a degree. And I got that at the diploma school that is connected to Duke University. And it was a group of women, a really diverse group of women in Durham, North Carolina. And the 20 of us went through an 18-month nursing program, which is really intensive for time-wise. And I realized that I really liked these women, that I liked being a part of a group of women that worked really hard and that did really good things for people, for each other, and for the people they were helping. And so, I feel like that was what I got out of nursing school, that I could be a part of a group that I really looked up to. And then I wanted to give that back when I was teaching and having worked in the field as a nurse for a while and bringing that from my own past. I wanted them to get that same feeling that they’re a team, that they get a chance to work together and that you can take that with you even after school. This is now the group of people you’re a part of that, you know, that the nurse next to you has your back and you have theirs. 

Jasper [07:17 – 07:23] – Okay. That’s so interesting. So it wasn’t so much the curriculum, although I’m sure that was interesting. 

Regina [07:23 – 07:25] – You’re somebody who likes school. 

Jasper [07:25 – 07:29] – But it was the community that you found and became a part of. 

Regina [07:29 – 07:29] – Yes. 

Jasper [07:30 – 07:33] – Although you were a first-generation college student, you were in a PhD in genetics. 

Regina [07:34 – 07:34] – Yes. 

Jasper [07:35 – 07:39] – Do I have it right that you dropped out of it because you didn’t like the animal testing? Yes, I couldn’t. 

Regina [07:39 – 08:12] – We were doing reproductive options for men. So they were looking for the male pill. And they were using the hamster as the animal model for this. And I just could not do long-term research with animals. It wasn’t working for me. And yeah, so I really had to figure out what my values were and like, what could that be? And luckily I did end up into nursing where I could see that you actually help people on a minute to minute basis, rather than it being six years later, you see the abstract work that you’ve done and the help you provided. 

Jasper [08:12 – 08:35] – I was, I was thinking about that. Cause I feel like in some ways that they’re both of those works are like trying to help people be healthy and lead healthy lives. But in some ways, they’re so opposite. You’re physically helping other people. It sounds like you landed in the right career for you. Absolutely. I’m curious how you think about community in designing a new nursing program. 

Regina [08:36 – 09:40] – So we’re actually in the process of working with our future advisory board. So that is a part of us making community. And this is the first time I think any of us in this situation have been looking at it at a national level. So we’re trying to take the community we already have, which is very strong at Otterbein. We have a really great alumni group. We have wonderful student nurses that run an SNA group that’s very active. We have all the faculty that have worked to keep this program alive and have built it up over years, but it’s really central Ohio, right? It has its own little home. And now we’re trying to broaden that slowly out to cover more and more ground. And I can tell that our web is like stretching because I’ll get contacts from the West Coast that are now touching base. And I have some East Coast faculty and friends that are starting to be like, do you need some sites? Would you like to come out and see this? So I can see how we’re steadily making our web reach further out. And I can see that in the future, we could really make this our community that’s across the nation. Though at first I had a hard time imagining it. 

Jasper [09:41 – 10:04] – So I was thinking about your own path to becoming a nurse and how it was, it kind of took twists and turns. It wasn’t the classic like four-year BSN straight into a family nurse practitioner program. And I was curious with your students, do you see a mix? Are most people taking the straight path or are there a lot of students who’ve taken that winding path into the profession? 

Regina [10:04 – 10:49] – Nursing is a winding path at some point for everyone. You may think that you’ve gotten on the straight path and you know exactly where you’re headed, but almost invariably something will put a kink in your digit, right? You won’t get exactly the straight path you wanted. Many folks I’ve talked to are either coming back to education years after entering the nursing field, or maybe they started a nursing degree and they got sidetracked with life on the way and now they want to finish that and utilize it. I would say that even best intentions, folks end up with a slightly serpentine route when it comes to nursing. And I wouldn’t want it any other way, right? You get to touch every little bit of it as you go. And every field of nursing has a different aspect, a different positive piece of it, and they all work together. 

Jasper [10:50 – 11:23] – I think nursing is such a hands-on profession that whoever is a nurse in a specific situation, working with a specific patient, they’re bringing so much of their own experiences to that work, including their formal education, but also their informal education from life in the world. And I was just, while you were saying that, I was thinking of some of the nurses who’ve really helped me in the delivery of my child. When my grandmother was ill and in the hospital, these people who I got to know fairly well, they brought their whole background and personality to bear as well as their expertise. 

Regina [11:23 – 11:39] – Right. I think nursing can be one of the most authentic ways to be a part of who you are, right? You’re working, but you’re you. That is you authentically nursing those around you. You’re a part of them. That’s so beautiful. 

Jasper [11:39 – 11:58] – I want to switch in and think a little bit about it, about nursing as a career and why Antioch University and the Coalition for the Common Good are investing in building out this school. And I know that there is projected to be a great need for nurses in the coming decade. It gets talked about as the nursing shortage. 

Regina [11:59 – 12:13] – Yeah. I had to look it up too, because you had mentioned statistics. I was like, oh, he’s going to bring statistics. I have to go get my own statistics. Let me see. So I was like 40 to 46% growth rate over the next decade. I don’t know. 

Jasper [12:13 – 12:15] – This is for nurses in general. 

Regina [12:15 – 12:17] – For FNP, just for family nurse practitioner. 

Jasper [12:17 – 12:17] – Okay. 

Regina [12:17 – 12:42] – Because I just wanted to like narrow it down and just like pick what if you did this job. And I don’t know if you think about, think about groceries. If you pay a dollar for a candy bar and it has a 46% growth rate, that’s like $1.50 for the candy bar. Like we’re almost doubling our field. That’s such a huge percentage growth in 10 years. And along with that, it’s the number one fastest growing job on the U.S. News and World Report. 

Jasper [12:43 – 12:43] – That’s amazing. 

Regina [12:44 – 12:55] – I did not know that. So I was like, when did this get published? That’s amazing. So it’s a truly growing field with growth projected over the next 10 years. It’s not just now. 

Jasper [12:55 – 13:11] – Where I was looking at with the U.S. Bureau of Labor Statistics, it was saying that there will be about 32,000 open positions every year for family nurse practitioner. And that includes OBGYN FNPs. Sorry, I don’t know. 

Regina [13:11 – 13:12] – Women’s health. It’s OK. 

Jasper [13:12 – 13:22] – Exactly. So in my field of communications, there are not 32,000 open positions every year. That seems like a good field to be in in many ways. 

Regina [13:23 – 13:35] – And can you imagine a class? I mean, even having a class of 20 or 30 is a pretty good graduating class of masters prepared, maybe even doctorally prepared nurses. That is a huge amount they would need each year. 

Jasper [13:36 – 14:17] – I want to talk about the specifics of the new Antioch Graduate School of Nursing and Health Professions. the nursing program that you’re founding, and also our roots in the Otterbein nursing programs. So yeah, specifically, I wanted to ask about Otterbein. So Otterbein is Antioch’s partner in the Coalition for the Common Good, which was founded two years ago. We’re talking here in the middle of 2025. And I know that part of the reason we set up the coalition was to expand the impact of some of these Otterbein graduate programs across the nation. Tell me something about the excellence of the Otterbein nursing programs and why they wanted to expand them across the globe. 

Regina [14:17 – 15:26] – Luckily, I’ve not only been their FNP director and the graduate director for their nursing programs at Otterbein, I was also a graduate of their post-master’s certificate FNP. So I had the experience of going through their courses, doing the clinicals with them, working with the faculty as both a student and a faculty member. So I can legitimately know what the curriculum looked like on both aspects, but they have a strong foundation, multiple decades of graduates who were getting high percentages passing rates on their boards, which is lovely to hear. Nobody wants to have a non-passing rate. Everybody wants to pass the boards, but they didn’t just pass the boards. They also had like 100% jobs when they would get out of these roles. And you knew the programs were good because the students, after they become alumni, would then come back and be the people who were the clinical instructors would be the preceptors for our students. They wanted to continue to be a part of these programs and give back to what they got in the past. So those are all good signs that you have a great program, right? You have people that pass, but they also want to come back and actually teach with you. 

Jasper [15:27 – 15:49] – And I love the way that you talk about these graduates coming back, working in the program. That really gets to the community piece that we were talking about earlier and how it’s not just about getting the credential and getting out into the world. It’s also about finding people who you want to be in community with, study alongside, have as your friends, mentors, supporters, cheerleaders, and be able to give back to the future generations. 

Regina [15:49 – 16:12] – Yes. I want my students to get back with me to say, hey, I’m getting a poster out next month at this conference. Do you know anybody that’s going to be there? Could you have a look at it? I enjoy the interaction that we have, and I look forward to getting that across the board, right? So that we can take that from just our little Otterbein-Westerville campus to the nation. 

Jasper [16:12 – 16:34] – To zoom back in time to two years ago, when you’re the director of these graduate nursing programs, you’ve got your residential college campus there, and then you hear the Coalition for the Common Good is getting started. These programs are going to be moving over to Antioch University. What did you think at the start? 

Regina [16:34 – 17:08] – I know that I was really positive for our adult students. Otterbein does a great job with mainstream out of high school four-year degrees, but then the coffee shop closes at four, the library closes on the weekends, they don’t have great hours. I would love for these adult students who are working so hard to get the kind of acknowledgement, you’re a working adult, here’s your spot to park, here’s the coffee at your table, We are here for you, even though it’s Saturday in July, right? So I really looked forward to getting them the adult experience they all deserved because that’s what they were doing. 

Jasper [17:09 – 17:13] – How do you feel like it is changing to be more oriented around adult learners? 

Regina [17:13 – 17:59] – I think Antioch does that really well because they have across the board 24-7. Now we have people open up and responding from West Coast to East Coast, right? There’s very little time that there’s not human beings doing their job. We have writing resources that are meant for adult students. We have online access to a variety of things that they, as an adult, can choose what they’re picking, doing, seeing. And at the same time, we’ve taken this really strong curriculum that was tried and true from Otterbein, and we’ve decided to add in this, not only just the components of social justice and health equity, we’ve allowed for these elective courses outside of their mainstream nursing. 

Jasper [18:00 – 18:01] – Oh, that’s so interesting. 

Regina [18:01 – 18:15] – So we’re talking with our business partners. We’re talking with education. We’re talking with public health. We have a lot of other things that they can try pieces and parts and decide how that fits into their future leadership as an advanced nurse. 

Jasper [18:15 – 18:22] – Talk a little bit more about the ways that you’ve been redesigning these programs. Have the programs been on pause over the last year? 

Regina [18:22 – 19:03] – We’ve been able to integrate a lot of online virtual material that we’ve done like spot meal. We’ve tried it out. We’ve had a course that it was positive in. But now we’re effectively deciding that, yes, we’re going to own this. We’re going to have virtual assessment. We’re going to learn these skills in a virtual mode and in a physicality. So we’re getting to implement pieces that we didn’t necessarily have the ability to do across an entire curriculum. So there’s going to be real continuity that you’re going to see it from the start all the way to the end. And we want to see that same piece with our curriculum, having health equity and justice through each of the courses that also arcs along the entire program. 

Jasper [19:04 – 19:12] – That’s beautiful. Tell me more about health equity, like for people who aren’t familiar with this term, what it is and how specifically it comes into nursing education. 

Regina [19:12 – 19:50] – We are inherently not equitable when it comes to health. I can think of a few examples that are both logistically appropriate. A good one that’s published is about the pulse oximeter. It’s a mechanism that wraps on your finger, which tells you what your saturations are by using a little arc of light that measures the oxygen capacity that you have. When you have one tone of skin, It can work to a degree of specificity. And if you have a different color skin, it may not. And so one person may have one saturation, a number on a screen, that is in no way reflective of how much oxygen is in their body. So that inherently… 

Jasper [19:51 – 19:56] – So you’re saying it’s like it’s designed kind of to work for white people. 

Regina [19:56 – 20:01] – Right. It’s designed to work for the skin that they tried it out on, which was likely white men. 

Jasper [20:01 – 20:02] – Light or light skin. 

Regina [20:03 – 21:11] – Right. Light skin. Able to be seen. I do the same talk about taking care of someone who can speak and someone who cannot. If you come in and are ill and you have a fever and you feel bad, if you can tell me I threw up, I have a stomach ache, my head hurts, you have given me a very good description of how I can take care of you, right? We can now get a differential diagnosis. I know where to start. But if you’re three and you don’t talk very much. And what you do say isn’t, it isn’t understandable by me. I cannot get that subjective information. So we are inherently making it difficult for folks who don’t speak our language, who don’t speak at all, whether it’s developmental or life’s disabilities, right? So we just inherently have a lot of different patients in the world. We are all different. And our medical care, our health care really only is focused toward a certain small percentage of the population. So finding ways to meet our patients where they’re at and getting them to their best health ability is what we want to do. Yeah. That’s the goal. 

Jasper [21:11 – 21:27] – And just, I feel like there’s a power in saying it out loud. And then, then you can start thinking about how can we address this? How can we mitigate this? Knowing that we’re individually probably not able to change the bigger power structures. Right. Not today, at least. 

Regina [21:27 – 21:38] – Right. Today, I cannot take on the whole world, but I can take it on for one patient in this one moment that if you can’t speak to me about your problem, I can find other ways to make sure that we find out what it is. 

Jasper [21:38 – 21:44] – So this is, you’re discussing these questions with your students across the whole, like, curriculum in the program? 

Regina [21:44 – 21:45] – Yes. 

Jasper [21:46 – 21:46] – Okay. 

Regina [21:46 – 22:23] – So when we talk about pathophysiology, maybe we do talk about what are the differences about oxygen carrying capacity of those who have hemoglobin that have a different genetic base, right? So someone with sickle cell versus someone who does not have sickle cell, whether you have that trait, how you carry oxygen matters and your carrying capacity ultimately affects how you handle disease in the future. All of us have a health ability and some of us can respond to it in better ways than others, just like someone who’s vaccinated is going to respond differently to what they’ve been vaccinated against than someone who hasn’t been vaccinated. 

Jasper [22:23 – 22:43] – Yeah. And of course, vaccine access is also a question of health equity across the world. A big question of health equity. Yes. Yeah. I wanted to ask you about the doctor of nurse practitioner degree. Does that lead into education? 

Regina [22:43 – 24:00] – If you wanted to, yes. You can take the doctorate of nursing practice and take it anywhere you want to take a terminal degree. So it is equivalent to a PhD in nursing. It is a terminal degree in its own right. It was created for nurses who had practiced and wanted that terminal degree, but weren’t necessarily someone who had experience in research or abstract care. They had really been out in the field practicing. So it’s the right terminal degree for someone who has put in years of service to nursing using their nursing skills. And we have two tracks. One is for advanced practice, which is exactly what it sounds like. Someone who has been an advanced practice nurse, taking care of their patients, working in the field, and now want to hone that, take it to the terminal degree of their license, and really go back and look into things that they have questions about. The other track is our executive track. And that’s for nurses who have spent their careers in leadership roles, our CNOs, our managers, ones that have created their own business models. They’ve also been pioneers in nursing, creating their own leadership roles. And that’s a way for them to reach their terminal degrees, taking an aspect of their business leadership where they’re at and creating a way to make it better. 

Jasper [24:00 – 24:15] – Both of those sound like interesting ways to kind of like deepen your practice through a return to a formal educational environment. I wanted to ask as a last question, what are you most excited about when you welcome your first cohort of students this January? 

Regina [24:15 – 24:59] – I’m very excited to bring them to Antioch, to remind them of our ties to Otterbein, give them the foundation that we’ve had, and then roll out this well thought out, wonderfully aligned to the new essentials curriculum. But at the same time, to give them the feeling that they’re doing what they should do as a nurse, that they’re gaining in their practice, that we’re setting them up for success, that they’re going to learn new skills and know exactly how to use them and exit this program as a full member of their society and community, as someone who can provide the care they want to, the people they care about. 

Jasper [24:59 – 25:03] – That’s beautiful. Thank you so much, Regina, for coming on the show today. 

Regina [25:03 – 25:04] – You’re welcome. Thank you for having me. 

Jasper [25:10 – 26:10] – You can learn more about the nursing programs that Regina chairs on Antioch’s website. We’ll include a link to that page in our show notes. We’ll also include a link to the website for our larger university system, the Coalition for the Common Good, if you want to learn more about that. We post these show notes on our website, theseedfield.org, where you’ll also find full episode transcripts, prior episodes, and more. The Seed Field Podcast is produced by Antioch University. I’m your host, Jasper Nighthawk. Our editor is Nastasia Green. Our producer is Karen Hamilton. Dani LaPointe and Liza Wisner are our work-study assistants. We received additional production help from Amelia Bryan, Jonathan Hawkins, Melinda Garland, and Laurien Alexandre. Thank you for spending your time with us today. That’s it for this episode. We hope to see you next time. And don’t forget to plant a seed, sow a cause, and win a victory for humanity. From Antioch University, this has been the Seed Field Podcast.