273594The healthcare industry is full of leaders influencing changes to better the industry. Robert D. Donaldson is currently changing ideas for the role of advanced practice nurses across the country.

Donaldson is the clinical director of emergency medicine and president of Ellenville Regional Hospital’s medical staff. The emergency department, located in the Catskill Mountains about 40 miles from Kingston, NY, is a 25-bed critical access department and home to a staff of 25 advanced practice nurses – no doctors.

Donaldson’s background in emergency nursing was crucial when he first came to Ellenville in 2004. At that time, the hospital was ailing financially. In 2009, the hospital was having trouble filling the medical staff president position. Donaldson received several notices about the vacancy. Armed with knowledge and experience, Donaldson added his name to the ballot, eventually garnering 70 percent of the votes. Only physicians could cast a ballot.

Donaldson immediately reshuffled staff, weeding out some providers who weren’t meeting hospital standards and replaced them with nurse practitioners or physician assistants. During this time, the patient load in the emergency department increased from 8,000 to 13,000 patients a year.

Donaldson does acknowledge that a non-physician provider arrangement is somewhat unusual; however, New York state allows NPs the ability to admit, manage and discharge patients the same as doctors as it is a collaborative-practice state, which is not the case across the nation.

As an advanced practice nurse successfully leading an emergency department, Donaldson has paved a new road of leadership for future nurses.