NAPNAP President Dr. Jessica Peck on the Year of the Nurse and the Future of NP Careers

It really was never my intent to have a career like this in nursing. I actually am the first woman in my family to go to a university and get a bachelor’s degree. At the time, the only two career paths that seemed even remotely viable to me as a woman were being a teacher or a nurse.

They didn’t have teaching degrees at community college, so I became a nurse. I had always loved caring for people and I felt like I could settle into that well.

I intended to go get my associate degree and that was going to be the end of the story. After college, I started working for my own pediatrician here in my hometown. He offered me a job when I went for my physical for nursing school and I ended up staying with him for 20 years. He encouraged me to continue my education, as did my husband. I was really too afraid to go to a university! So my husband decided to get a master’s degree while I got my bachelor’s degree, and we went to school together.

And then I fell in love with school and wanted to go on to get my master’s degree and be a pediatric nurse practitioner because the faculty encouraged and inspired me to pursue higher aims. Frankly, they saw more potential in me than I saw in myself at the time. So off we went, and my husband got a second master’s degree while I got my first. By the time I got to my doctoral degree, he said, “You’re on your own. I don’t need a PhD in engineering. You can do this.”

On the way to my doctor of nursing practice degree, I also completed my post-master’s in nursing education. I was teaching at that time because it was a good career option for my life stage and I enjoyed it. I had four children between my master’s and doctoral degrees, and teaching gave me a little more flexibility than clinical practice did at the time.

It was one of my DNP policy professors that really transformed my career trajectory by encouraging me to publish a paper that launched me into the policy arena. I started putting my foot in the door in organizational leadership and doors have blown open since then.

I like to tell my students, I really was not the best student in my associate degree program. I was working three jobs and trying to put myself through school. Sometimes that’s just where you are in the journey, and passing is okay. There are other times when you go back and then you can excel. I really started to excel in my post-master’s and doctoral program. I was equipped and ready at that point, with the right amount of support. Although it’s been difficult at times, it’s definitely been worth every part of the journey.

As the 2020 President of the National Association of Pediatric Nurse Practitioners (NAPNAP), what do you envision you and your team will accomplish?

I’m very honored to serve such a wonderful organization.

NAPNAP is actually the first nurse practitioner professional organization in the world. Many people don’t know that the nurse practitioner profession was born as a pediatric nurse practitioner from the vision of a nurse named Loretta Ford at the University of Colorado, who partnered with a pediatrician named Dr. Henry Silver.

The first nurse practitioner role was created to create literal caretakers of the future, our children. And of course, the nurse practitioner role has just flourished and taken off and now encompasses many populations with more than one billion patient encounters each year.

I’m very proud of NAPNAP as an organization. We have always been very innovative and forward-thinking. We are problem-solvers. Of course, when I was elected, I never anticipated we would be leading through a global pandemic in 2020, the Year of the Nurse. I never expected my presidency to be virtual or to face the challenges we have encountered.

We’ve had to transition our conference entirely online. One of the things about NAPNAP’s conference is that we have about 2,000 members who come every year to the conference, which is extraordinary for an organization the size of 9,000. It tells you how engaged our members are that nearly 25 percent of our membership comes every year. Obviously, not everybody can come because then who would be taking care of the kiddos!

Over the summer as we started experiencing a global pandemic and unrest over social issues and racial injustice, we really started thinking very forwardly about child health equity. As experts in pediatrics and advocates for children, NAPNAP is taking responsibility to raise our voices to be thought-leaders in conversations surrounding child health equity.

As an organization, NAPNAP members want every child to grow up with every advantage they need to be successful. We know as holistic practitioners, there are social, emotional, mental, spiritual, academic aspects to health—and all of those things impact physical health. We care about those things, so we’ve taken intentional actions to move forward.

We’ve started a podcast called TeamPeds Talks and in doing so, we’re leading the conversation on child health equity. Our work is structured around what the CDC calls Social Determinants of Health (SDOH). We’re spotlighting members across the country, which has been a real privilege because the news can be dark and depressing with stories of violence and hate. But these episodes tell feel-good stories about positive things happening for children. There are leaders and clinicians who are truly inspirational in serving children across the country.

As the leader in education for pediatric-focused advanced practice registered nurses, NAPNAP has continued to innovate. We developed a series of town halls, discussing Covid-19 health disparities, racism, and Covid-19 vaccines. We have transitioned all of our education to online platforms to reach a wider audience. TeamPeds Talks is free for anybody, not just members. It’s available on pretty much any platform where you can listen to a podcast, and we’re offering eight hours of free continuing education for our first series featuring our child health equity curriculum.

Going forward, I see NAPNAP having a growing influence on health policy. We have a particular passion for vulnerable and underserved youth. We started our visionary foundation, NAPNAP Partners for Vulnerable Youth, where we’ve been leaders in the nursing profession on engaging in anti-human trafficking advocacy work.

There’s a lot of exciting things going on, but in short: NAPNAP members are thought and advocacy leaders. We’re experts in pediatrics; we’re advocates for children; and that’s what we’re going to continue to do moving forward.

You have dedicated your career to train nurses to recognize and stop child human trafficking. What have you accomplished through your advocacy?

This is the power of nursing. Again, I never envisioned to be an anti-trafficking advocate, even as a nurse practitioner. But about four years ago, one of my friends who runs an anti-trafficking agency called me and asked me to help her educate nurses about trafficking.

I told her, “No, I don’t know anything about trafficking. You have the wrong nurse. That’s not me.” And she said, “No, you don’t understand. Nurses don’t know about trafficking. I can’t find any nurse who knows about trafficking. But we can’t educate nurses if we don’t have nurses involved. We need nurses to educate nurses.”

So at first, I thought, Okay, well, I don’t know about trafficking, but I know about educating nurses. So you give me the content, I’ll give you the process and I’ll help you and you’ll go on and I’ll go on.

But as I continued to learn more, I recognized I was asking her the wrong question because I said, “How can I help you?” But by the end, I thought, No, the question is, “How can I not help you, knowing that this is going on?”

This is how NAPNAP Partners for Vulnerable Youth was born. We took on as our first initiative the Alliance for Children in Trafficking. I’m amazed at what we’ve been able to accomplish. We have provided expert consultation to the United States Senate and the House of Representatives. We’ve successfully influenced legislation, including SOAR to Health and Wellness and the Fight Online Sex Trafficking Act or Stop Enabling Sex Trafficking Act, which is called FOSTA-SESTA and was signed into law by President Trump last year.

We provided the first asynchronous accredited national platform for human trafficking training for healthcare professionals that is both accredited for medical and nursing education. We have a program called Act Advocates, a train-the-trainer program that’s trained more than 40 professionals across the country. Act Advocates are a part of a speaker’s bureau that helps communities be engaged and equipped on how to enact protocols or policies in healthcare organizations. They also help educate parents and children about trafficking.

We have a White Paper on human trafficking published in the Journal of Pediatric Health Care. Right now we are also leading the nursing response with the Office of Trafficking in Persons to create a set of core competencies for healthcare professionals set to be released in January 2021.

The work that remains to be done is continuing to provide education until all healthcare professionals are equipped. NAPNAP was instrumental in helping to pass a law here in Texas, House Bill 2059, that requires all direct care providers in Texas to take continuing education on trafficking.

So, we’re continuing to advocate for that in every state. And we are just starting the work on prevention. That’s really what we need to do: empower an upstream public health approach to ensure no children endure the horrors of child trafficking.

Nursing is a challenging and rewarding career. What keeps you inspired and focused to come to work every day?

The number one thing that inspires me is my own children. Hands down. I have four children, so I obviously take my love for pediatrics seriously! I also have to give a shout-out to my husband, who inspired me to go to school in the first place and is still my greatest encourager and cheerleader by far.

I want to do everything I can to make the world a better place for children. Seeing what my kids go through and the challenges they face and the world that they’re living in gives me a very close-to-home reminder of the individuality, uniqueness, and specialness of each child. The children I see in my practice every day are so resilient. They are so much braver than adults are. They complain a lot less and they inspire me every day.

I also find encouragement in the work of my students. They see old things in new ways and approach healthcare with such optimism and enthusiasm. To see what they have been through in Covid-19, in particular, has me in tears almost every day. There are hard, unspeakable things, but they keep caring.

The other thing that inspires me and keeps me going is nursing as a profession. Honestly, I believe nursing is the most innovative, resilient, and tenacious profession. Nurse practitioners, in particular, are the greatest disruptive innovation of 21st-century healthcare. We will always rise up and find a way to meet the challenges of tomorrow. We have reinvented ourselves so many times to meet the needs of the public.

Nursing is dynamic: always changing, always growing, always reaching. It is extremely inspiring to look around the country and see the work that my colleagues are doing. I have tremendous encouragement from a strong network of nursing allies around the country. My support circle calls ourselves “Renegade Thought Leaders.” Their support is a source of encouragement.

What advice do you have for nurse practitioner applicants to stand out for admissions committees?

I would say grades are everything early on. The higher the GPA you have, the better your chances are going to be—and it makes your path much easier and straightforward.

But don’t be discouraged if your GPA is not good. Like I said, when I graduated with my associate degree, my GPA was not even close to what I wanted it to be, but I went back and I started taking more classes and I worked until it was where I needed it to be. It took me longer and it was harder, but I still did it.

Keep in touch with your previous professors and employers. Send them a note to tell them how you’re doing and update them on any accomplishments. This helps when you need a letter of reference. Build professional networks of credible leaders who can recommend you and speak personally to the journey you have had. Keeping in touch and building those relationships will help. It’s surprising how few students do it, but it’s always impressive. Hand-written notes still rule!

I recommend joining a professional organization for networking opportunities. Continuing education opportunities are going to get you to the place where you need to be, to acquire the professional skills that are going to make you a competitive applicant.

Volunteer for any sort of leadership position. If you’re on a committee, raise your hand and volunteer. Yes, you. NPs are leaders and you have to demonstrate those emerging leadership skills.

Anytime you can be involved in any other inter-professional scholarship, that’s going to really help teach you the skills that you need to be an NP. If there’s a research study that’s going on, raise your hand and volunteer. Take advantage of those opportunities. A lot of my undergraduate students take a look at these opportunities and think, Oh, not me. I’m not qualified for that.

You just really have to have the confidence to raise your hand and say, “I volunteer!” Getting a mentor as an NP to walk along with you is really helpful too because they can help encourage you to look at those opportunities and say, “Yes, do that” or “No, not yet.”

As a clinical professor, what’s your greatest hope for your nursing students?

At the risk of sounding redundant, the greatest professional help I can give is to join a professional organization because that is just where you find comradery; you find support; you find energy; and you find resources. You get out of it what you put into it. The more engagement you give, the more rewards.

Be brave! Reach out! Organizations also have scholarships to help fund your project or your education. They have experts who are available to help you in whatever scholarly project you’re trying to work on at the time, or just give encouragement, resources, and networking.

As a clinical professor, I teach across programs, so I find that the needs of students are varied depending on whether they’re undergraduate or graduate students or post-graduate students. They’re all going to have different needs at different points in their life.

Early on, nursing school can be intimidating and scary as your learning experiences involve life and death. This means your personal support system is critical to remind you why you signed up for this and to encourage you to go back after a hard day. Later in life, you may be juggling carpool and kid needs or aging parents.

Personal support systems help. Nursing school is difficult under the best of circumstances, but life happens! Make sure you have people around you to lift you up.

Cultivating resilience is important for nurses. Having a healthy balance of yourself as an individual and remember that you’re not just a student: maybe you’re also a mother or father, a brother or sister, as well as being a nurse. You have a lot of different roles that you play in your life. Making sure that you leave time for those and take care of your mental and emotional health is essential because nursing is very difficult mentally, physically, emotionally, and spiritually, especially in times like this.

I’m amazed at what my students are accomplishing across the country. I have students that helped set up the Javits [Convention] Center to care for Covid-19 patients—students who are the only people with patients who are dying alone by FaceTime with their family, students who are helping deliver babies for women who are by themselves.

Making sure that you have a support system around you that’s going to nurture all those aspects of yourself is going to be really critically important throughout a nursing career.

What advice do you have for aspiring nurse practitioners?

I have never regretted my decision to become a nurse practitioner. It has been an extremely rewarding career and a rewarding life aspiration. I’ve been able to have a greater impact as an NP than I was able to have as a nurse.

As a nurse, you’re looking at that one-on-one patient dyad, but becoming a nurse practitioner—and especially obtaining a doctor of nursing practice—elevates your vision to population health. Instead of asking, “What can I do for this one patient who is in my clinic right now with this health problem?”, the question can change to, “What can I do for all of these patients in my community?”

I think that we’re still in the pioneer days, the early days of our profession. The first nurse practitioner, Loretta Ford, is going to be 100 at the end of this year. She still lives in Florida. She still speaks. She still talks about just how difficult it was at first, how she was mocked and belittled and judged, but she found joy in the accomplishments of her students.

And now you look at what that has done. Just being able to be in a profession that’s in its early formative days and has taken off like wildfire is really exciting. I think you have to have your eyes wide open and know that it’s not easy. It’s not for the faint of heart. You really have to think about what sacrifices are you willing to make in your lifestyle to be successful as a nurse practitioner to go to school because it’s difficult and it’s stressful, but it is worth all of the blood, sweat, and tears that go into it.

Is there anything else you’d like to share?

I teach at Baylor University’s pediatric nurse practitioner program. When I went to get my doctor of nursing practice back in 2009, there were no DNP programs in Texas, so I went to Alabama to get my DNP.

It’s been a very big privilege for me to be among the early DNP graduates in the country and the first at DNP faculty at my institution. Previously, I helped start a DNP program at my own institution at the University of Texas Medical Branch, and then went on to Texas A&M University-Corpus Christi because there was no doctoral education for nurses from Houston to Brownsville, which is a very long way.

Now I’ve moved to Baylor University where we have a DNP program with one of the most robust specialty track offerings in the country. Students in the Baylor University DNP program can specialize as neonatal nurse practitioners, family nurse practitioners, and certified nurse-midwives.

We also have executive nurse leaders and now we have started the pediatric track, which we had expected to be a small program of about 10 students per cohort, but we’ve accepted 30+ students and we still have a waiting list.

It’s really exciting to see Baylor leading the way in the state of Texas for nursing impacts across the country and the world.