UT NURSE’S QUESTION COULD IMPROVE CARE FOR KIDS
By Laura Tenpenny (’11)
September 11, 2026
“Who’s going to fix these problems?”
Stephanie Fancher found herself asking that question many times during her years working in emergency departments across multiple hospitals.
As a pediatric nurse, Fancher cared for children in some of their most vulnerable moments. She also regularly saw children in crisis and their parents struggle with barriers like insurance, policy red tape, and lack of accessible information.
“Once, I was sitting in the behavioral health pod of the ER with a teenager who had a bad home environment and had experienced a couple of really traumatic incidents,” Fancher recalls. “She needed help, but she couldn’t get the care she needed at the critical moment when she needed it most, and I remember thinking, ‘Why should a child have to wait days for help simply because of the insurance they have?’”
Increasingly, Fancher wanted to understand what was happening before children arrived in the emergency room. What if the right care had been available earlier?
Following a move to East Tennessee for her husband’s job, Fancher found a way to pursue her questions as a nursing PhD candidate at the University of Tennessee, Knoxville.
Improvement would look like finding practical opportunities to strengthen Tennessee’s school-health system and more access to preventive care like dental hygiene, eye care, vaccinations, and primary doctor visits. It would look like helping more children receive care before they reach a crisis.”
Stephanie Fancher, Nursing PhD Candidate
Nursing PhD candidate Stephanie Fancher balances doctoral research with her role as a pediatric nurse at Dolly Parton Children’s Hospital.
Tami Wyatt, associate dean of research and Torchbearer Professor at UT’s College of Nursing, was conducting research in the ER at Dolly Parton Children’s Hospital, where Fancher worked. As they got to know each other through the study, Wyatt saw something in the pediatric nurse and encouraged her to consider UT.
“You could do this. You have something to offer,” Wyatt said, seeing a determined curiosity in Fancher.
“Her seeing that in me before I saw it in me was invaluable,” Fancher says. “She’s been my biggest champion on this journey.”
A Statewide System, Seen from the Ground Up
Fancher’s dissertation focuses on Tennessee’s coordinated school-health system, an initiative that began in 2000 through the Coordinated School Health Improvement Act. Through school-based health measures—from school nurses to hearing tests to chronic condition management—children and families have access to care through a place they already know and trust. Because healthy kids make better learners.
Fancher has been interviewing school leaders and administrators across Tennessee to understand the realities of implementing these school-based measures.
“What does this system look like in practice? What resources do school administrators and health professionals have? What are they missing?” says Fancher. “Those doing the work lacked a dedicated avenue for honest feedback.”
For each administrator she’s interviewed, Fancher asked a version of the same question: if someone followed you around for a day, what would they take away? Most tell the same story, noting how hard it can be to make ends meet to help as many kids as possible.
Part of this coordinated school-health system involves catching health concerns early and connecting kids and families with providers in their communities. In some cases, schools encounter children who need eyeglasses or hearing aids, for instance, but whose families cannot afford them. Sometimes, community organizations such as Lions clubs or Rotary clubs help fund those needs.
“But what happens in communities that don’t have those organizations or other resources to turn to? Or communities where primary care providers, eye doctors, or other types of needed care are limited?” Fancher asks.
“Improvement would look like finding practical opportunities to strengthen Tennessee’s school-health system and more access to preventive care like dental hygiene, eye care, vaccinations, and primary doctor visits. It would look like helping more children receive care before they reach a crisis,” says Fancher.
I wish more opportunities like this were available to PhD students. Donor support for graduate research that provides tuition and even a small stipend can really move the needle and propel UT nurse researchers into the field sooner.”
Stephanie Fancher, Nursing PhD Candidate
A Problem Too Big for One Discipline
For Victoria Niederhauser, dean emeritus of the UT College of Nursing, the implications of Fancher’s research are significant.
“Children spend a good majority of their early years in schools, and so that’s a place that’s familiar to families. It’s a trusted place,” Niederhauser says. “So school-based health programs are very effective. They make it easier for families to access care and receive ongoing support to manage chronic conditions.”
By identifying and examining barriers to implementing school-based programs, Niederhauser says, Fancher’s research could help inform how Tennessee improves care through schools and what can be achieved through stronger partnerships between policy, schools, and healthcare providers.
For questions that cross so many fields, Fancher has utilized UT’s extensive network of world-renowned scholars to advantage.
“I chose my dissertation committee purposefully,” she says. “They represent nursing, policy and law, analysis, and communication experts. I wanted people who would be able to add perspectives.”
This kind of collaboration is one of UT’s strengths, Niederhauser explains.
“As a comprehensive flagship university, UT brings together scholars and resources across disciplines, giving researchers opportunities to share expertise,” says Niederhauser. “There are a lot of wicked problems in the world that hopefully will be solved by research, but they’re not going to be solved by one researcher alone. They’re going to be solved by many people and perspectives that come together.”
Niederhauser saw an opportunity to help Fancher make those connections. Having completed similar research on preventive care for children, she connected Fancher with local and state-level public health leaders who helped inform and facilitate her work.
The combination of Fancher’s clinical experience and the perspectives she has gained through her UT network gives her research the potential to move beyond the university and into communities, where it can inform policy and improve access to care.
When the Nurse Became the Patient
About a year into her PhD program, Fancher became pregnant. Six months later, she was diagnosed with brain cancer.
“As a nurse, I’d spent my career advocating for patients,” says Fancher. “But then I was on the other side of the curtain and having difficulty navigating the system.”
Her experiences gave her new perspectives on the barriers patients can encounter in clinical care and in the systems surrounding it.
When she returned to UT about a year after her diagnosis, she was balancing final chemotherapy treatments, caring for her expanded family, and continuing her doctoral program.
Her advisor, Wyatt, understood that she needed to meet Fancher where she was.
“The way I needed to support Stephanie was to be a mentor for her professional development—and to help her prioritize her health and family—not just be an advisor to talk about her coursework and science,” Wyatt says. “My role has never been to encourage her to do more, better and faster; it has always been to be patient and accept her process.”
Fancher also received support from her classmates, across the college, and through UT’s offices for Title IX and Student Disability Services, which she credits with advocating for the access she needed.
After treatment affected her ability to process information and read for long periods, university accommodations helped her continue her studies, offering guidance on technology aids and pushing for deadline extensions on her behalf when necessary.
“I didn’t expect the standard to change; I just had to realize I needed some room to meet it,” Fancher says.
The insights Fancher gained echoed what’s at the heart of her research: access remains critically important to health and well-being. Without it, the conditions for success don’t exist. At UT, Fancher found the support she needed to persist and continue her work.
As a comprehensive flagship university, UT brings together scholars and resources across disciplines, giving researchers opportunities to share expertise. There are a lot of wicked problems in the world that hopefully will be solved by research, but they’re not going to be solved by one researcher alone. They’re going to be solved by many people and perspectives that come together.”
Victoria Niederhauser, dean emeritus of the UT College of Nursing
The Support to Keep Going
When Fancher took time off for her pregnancy and cancer treatment, she had to vacate a graduate assistantship that covered tuition. Upon returning to UT, she also returned to nursing at Dolly Parton Children’s Hospital. Her husband also worked, but between medical bills, a new member of the family, and school expenses, any extra support helped.
When she needed it most, a one-time scholarship through the Vol Nurse Endowment covered her school fees for one semester.
“I wish more opportunities like this were available to PhD students,” says Fancher. “Donor support for graduate research that provides tuition and even a small stipend can really move the needle and propel UT nurse researchers into the field sooner.”
Nationally, there is need for more nurses in the field and for nurses who pursue research careers. According to its latest 2024 workforce survey, the National Council of State Boards of Nursing reported only 2 percent of registered nurses hold a PhD.
For Niederhauser, that shortage represents an immense opportunity.
“When you think about hospitals and health care in general, nurses are by far the largest part of the workforce. They’re on the front lines doing the work, so they have firsthand knowledge of what’s working, what isn’t, and where there may be better ways to achieve outcomes for patients,” Niederhauser says. “Investing in nurses going on to advanced degrees can make a huge impact on the overall health of our nation through the investigations and research that they do.”
At UT, Niederhauser reports that nurses pursuing PhDs represent a very small part of College of Nursing students, especially compared with other institutions. Often, students at this level support families, so taking time out from work to study isn’t an option unless financial aid is available.
Fancher believes that path deserves more visibility.
“As a bedside nurse and graduate student, I see so many nurses who feel their only options for career progression are becoming a nurse practitioner or leaving the field. A PhD offers another path, but it’s often unspoken and overlooked,” she says.
A timely scholarship helped Fancher persist in her studies when she returned from cancer treatment. Now nearing completion of her dissertation, she is helping identify ways to improve preventive care for kids through her research.
From Researcher to Changemaker
Soon, Fancher will add to the number of PhD-prepared nurses. She is finishing interviews with school administrators and preparing to analyze what she learns before defending her dissertation, likely later this fall.
“My hope is that findings from my work highlight policy opportunities to strengthen Tennessee’s school-health system and present a representative voice of what’s happening at the implementation level,” says Fancher. “Ultimately, I hope it impacts access to preventive care for children and their families, with implications for removing barriers to care for other vulnerable populations. Tennessee’s Coordinated School Health program and this study can be a model for other states.”
She also wants to remain connected to the bedside because, she says, “you can’t know how to advocate or what’s going on in society without being at the bedside.”
At UT, Fancher has had the support and resources to turn a question born at the bedside into research that could inform pediatric preventive care across Tennessee. She once looked around an emergency department and asked, “Who’s going to fix these problems?”
Now, through research at UT, she is working toward an answer—so more children remain healthy from the start.
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