As practicing nurses, both Dara Geiser and Sharon Myers knew how to provide for the clinical needs of patients in their care. But that, they decided, wasn't enough.

Geiser, a clinical care manager at the Kennedy Krieger Institute, and Myers, a nurse in the geriatric center of Bayview Medical Center, felt they needed a business background in order to adapt to the changing face of health care. And as the first two graduates of the MS in Nursing/MS in Business program offered jointly by the schools of Nursing and Continuing Studies, they feel the degrees they received on May 21 will help them better understand the financial aspects of their chosen profession.

According to Jacqueline Dienemann, coordinator of the nursing and management programs at the School of Nursing, the program was started in January 1996 in response to an evolving health care environment.

Nurses today carry with them a greater responsibility to provide not only quality care, Dienemann says, but also quality understanding of the financial situation of both the patients and the health care facility.

"Health care was much less sophisticated 10 or 20 years ago in reference to clinical and managerial responsibilities," says Dienemann, who acts as adviser to the program's students. "Physicians and nurses took care of the clinical side, and the business people were responsible for balancing the books."

But Dienemann says that with cost of health care skyrocketing clinical heads of health care units must now understand the financial aspects of the decisions they have to make. For example, she says, deciding on the medical regimen of a patient and his length of stay at a hospital or other care facility carries with it "great financial ramifications."

"You can bankrupt a patient," Dienemann says. "Prudent use of health care resources is very important. People want value for their money, and they don't want to keep on paying higher insurance premiums."

Dara Geiser says she, too, was concerned with the rising cost of health care.

Geiser has been a nurse and now clinical care manager at the Kennedy Krieger Institute since receiving her bachelor's degree from the School of Nursing in 1991 and felt it was to her benefit to take the management and business courses. She says that empathy--the ability to put yourself in the patient's shoes--is a key concept of nursing, and the dual degree program allowed her the opportunity to understand the financial concerns of the patients.

"We need to be cognizant of the fact that health care is not free and find out what are the best ways to contain and manage the cost of it," Geiser says. "Sometimes in the health care field there is tunnel vision focused on just the care of the patient. But there is also the business side of things, and we need to know the barriers to health care."

The MS in Nursing/MS in Business program was created to prepare nurses to manage successfully nursing and integrated health services. The program's 50-credit curriculum--as compared to the 84 credits required to obtain the degrees separately-- builds on an undergraduate nursing education by adding graduate nursing and business foundation courses; in addition, students receive hands-on management experience in the setting of their choice.

Sharon Myers says it "feels good to be finished," but that she is glad she took the time to learn about the business side of the health care industry.

"Health care is changing rapidly. I knew I needed the business credentials, and now I can use them in a positive way for nursing," says Myers, who has been a nurse for 25 years.

Myers says she is not certain how she will apply her newly earned degree, but Geiser already has plans for her degree.

"I want to go into politics," says Geiser, "perhaps working in some kind of legislative position on the state or federal level."

Geiser envisions a world where everybody has health care coverage, especially the underprivileged. She says she believes that the key to improved health care is having people in legislative and management roles who are knowledgeable about the clinical side of the industry.

"I feel that legislators want to do a good job," she says, "but not being exposed to [clinical] aspects of health care hinders them."