Happy Nurse Practitioner Week to all of my fellow nurse practitioners. November is always an interesting month for me to reflect on my career as a Nurse Practitioner. I became certified as a pediatric nurse practitioner in November of 2008. A fun fact is that I have practiced as a nurse practitioner longer than I have practiced as a nurse.
Although I am not actively practicing as a Nurse Practitioner and took a sabbatical due to burnout, I do not take my career path for granted. I have no regrets about becoming a nurse practitioner and my contributions to patient care, hospitals, nurses, and to my fellow colleagues.
Why did I become a Nurse Practitioner?
Truly why I wanted to become an NP, to be part of the decision-making process in the care of patients. I wanted to influence patient care as a provider with advanced knowledge. There were 3 moments that made me realize that I wanted to be a nurse practitioner.
High School
Once I decided that I wanted to be a nurse, I immersed myself in the healthcare field and took any summer job that would allow me to be in a hospital setting. Senior year of high school, I found myself working in a file room at the Brigham and Women’s Hospital In Boston. It was the most boring job EVER! However, the file room was next to an office with cardiac nurse practitioners. One day, I asked if I could shadow one of the NPS and she said sure. I came in on my off day, elated to see what a nurse practitioner did in an office. I observed her carefully as she called back patients with Cardiac disease, answered all of their questions, and managed their care. I thought it was so cool.
College
Next, my alma mater, the University of Pennsylvania School of Nursing created a space for us to dream and think big. In the 1st 2 years of nursing school, we were exposed to so many nurses who were doing amazing things. As nursing students, we couldn’t help but think about how we wanted to make a difference in the healthcare field as a nurse. Like many schools now, there was an opportunity to submatriculate into the master’s programs. While that was not my chosen path, the seed had been planted for me to consider advanced practice nursing
My 1st role as a Nurse
Random fact about me, I am a May baby which means I am a Taurus. While some people may describe Taurus as stubborn, I would like to say that I am determined. 😊. In finishing nursing school, the recommendation at that time was to do medical-surgical nursing. That was not my cup of tea. I wanted to work in a Pediatric Intensive Care Unit. When I look back at my first job as a nurse, working in a large ICU, 22 years old, and caring for the sickest of children, with a few dying on you. Whew! I was definitely brave! In the ICU there were Nurse practitioners, who were smart intelligent, caring, teachers. I marveled at their confidence in leveraging their expertise to care for patients and working with teams that may have been the only ones!
What exactly does a nurse practitioner do?
Everything! Honestly, we do, and no 2 roles are the same, which is truly the beauty of the nursing profession in general. All of my roles as a nurse practitioner gave me a new skill set and what is possible for nurse practitioners.
1st Nurse Practitioner Role
My first job as a nurse practitioner was in outpatient Pediatric Gastroenterology. If you are saying .. Ewww.. You are right! I had no idea what I was getting into. When people heard I was moving from the sexy PICU to the world of guts, chronic abdominal pain, and poop, they said good luck but gave me the “crazy look.”
But here’s the deal. I was emotionally exhausted as a nurse after caring for critically ill patients. I received a grant during my master’s program that required me to work in New York City for a year. There were no other jobs available. And the physician really took a chance on me as I admitted to only knowing about “ Zantac and Miralax”. So I packed my bags and headed to the unknown. I could do anything for a year.
My 1 year became 6 years. I really loved that job. Working in a community-academic center, where 90% of your patients are immigrants and non-English speaking was so fulfilling. My department had 3 doctors, a secretary, and myself. That was it. I was the Nurse Practitioner, Nurse, Social Worker, Patient Advocate, and clinical manager in one. The role truly allowed me to use my nursing background and my advanced knowledge to its full potential. I felt like all of the Nurse Practitioners that I had shadowed and followed, I was making a difference.
Research
In the undergrad and grad school, I despised the word research. Again, boring! Some of the professors were studying really cool topics, but I was not excited to learn about theories and concepts.
Yet, I realized that my 1st hand knowledge of patients and managing illness placed me in a space where research was helpful. In my 1st role as a GI NP, the physicians trusted me to work on research. I collected data for registries on the chronic illness of our GI patients. I was the coordinator for a clinic on children with fatty liver disease due to obesity where we counseled them. I was the coordinator of a research clinical trial for a drug to help children with acid reflux. You may be thinking, Amy you did too much. No wonder you are burned out! Lol. Not really because that institution gave me the time, space, and compensation to do these projects for my career growth. I only left that job because I had outgrown the role and wanted a more general pediatric experience.
Teaching
Something that is often not discussed enough is how Nurse Practitioners impact the future of the field. In my examples above I mention how my surroundings, school, and mentors influenced my decision to become a nurse practitioner. I have had the privilege of paying it forward. Formally, by teaching nursing students at Kaplan or giving a lecture at my Alma Mater. Secondly, by precepting Nurse Practitioner Students and providing them with the support and understanding of the value of the role and what it means to be a nurse practitioner. And most recently as a Nurse Leader, where I pushed the nurse practitioners to develop their culture, be supportive of each other, and work together to advocate for their patients and their role.
The Challenges of the nurse practitioner role
As you can tell, I believe the role of Nurse Practitioners is a great profession. However, I must admit it’s not all glamorous and easy. With 355,000 licensed nurse practitioners in the country according to AANP, our role is still new and young compared to our nurses and physician colleagues. With every role functioning differently, It can be hard to compare yourself to another nurse practitioner to make sure you are aligned or not aligned.
Our education as Nurse Practitioners, allows us to provide medical care to patients with a nursing focus. Yet because of our adaptability and patient-centric focus, we can be given tasks that do not use our skill set to their potential or can be delegated to someone else. I have been asked to do tasks such as talking to insurance companies about prior authorizations. I HATED IT! Calling insurance companies 3-4 times a day, faxing forms, just to explain why a patient with a medical diagnosis really needed medication. It was exhausting! However, my WHY would always give me the strength to continue. I wanted my patients to have the best care possible.
In other scenarios, we have to demonstrate our knowledge and our skill set. Once we are accepted as part of a team, we are then given more work because “ we do it so well”. I have heard phrases such as “Resident replacement” or “ Doctor Helper” used to describe nurse practitioners. These phrases are hard to hear, especially if you are new to the practice. However, we truly are an added piece to any care team and our role should be acknowledged as such. No role is perfect. However, Nurse Practitioners are amazing and should be celebrated.
Still love being a nurse PracTitioner
I know you may be thinking,
”if you do, why are you writing a blog about sabbaticals, and not working as a Nurse Practitioner.”
All are valid questions. The thing is that after 14 years of working mostly clinically, I became tired, exhausted, and burned out. Through my sabbatical, I have been able to process what led to my burnout and how I can make changes. I believe our hospital systems do not support the clinicians and leaders as much as they should for better patient outcomes, and to have people stay in the nursing field. If I saw institutions that were supportive of breaks during the day, not always working to your maximum if there are no patients, then I would apply immediately to a role. But it’s not like that. My personal mission now is to support nurse practitioners, help them create healthy boundaries so they can thrive in their roles, or help them discover how their skill set can be used in other fields.
With that being said, I hope all of my nurse practitioners do something special for themselves this week to celebrate the work they have done, the lives they affected, and how they want to continue to contribute to health care.
Til Next time…
