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Advanced degrees help nurses expand role

ALBUQUERQUE, N.M. — Q: Can you help me understand the role of pediatric nurse practitioners in caring for my child, both in clinic and in the hospital?

A: Here in New Mexico, nurse practitioners are vital in offsetting our chronic physician shortage. According to the state board of nursing, 972 certified NP licenses were issued or renewed in fiscal year 2016. In many states, including New Mexico, nurse practitioners must also pass a national certification exam. Then, they can practice autonomously in the outpatient setting, managing their own panel of patients, but work closely with physicians in a hospital setting. They are responsible for diagnosis and management of illness, as well as preventive care and anticipatory guidance.

In order to practice independently, they must complete graduate level study, including hundreds of hours of supervised clinical work. Often, they will start out with a bachelor’s degree in nursing, and spend many years honing their nursing skills. Later, they will go back to school and earn either a master’s or doctorate degree in nursing. This additional qualification makes them a nurse practitioner and expands their scope of practice.

Their course of study includes physiology, pharmacology, child development, clinical diagnosis, ethics and principles of research. These are similar to the subjects studied by doctors in medical schools. This curriculum prepares nurse practitioners to seamlessly integrate into either an academic teaching hospital or into a private practice model.

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This particular type of health care provider is often described as blending the best of doctors with the best of nurses. Patients often compliment them on their calm and reassuring manner, their willingness to listen and to personalize their medical advice for each patient’s circumstances. You will find pediatric nurse practitioners in a variety of settings including pediatric urgent care, outpatient pediatric clinic, pediatric intensive care units, pediatric hospitalist teams, pediatric surgical/neurosurgical/cardiothoracic surgical teams and pediatric oncology/gastrointestinal/organ transplant teams. In short, pediatric nurse practitioners have proven themselves integral team members across the spectrum of pediatric care, bringing a level of dedication and consistency to their work which is highly valued.

I work with some nurse practitioners, and asked them, “What is your favorite part of your job?” They all answered, “Making a positive difference in the lives of our patients and families.” They also expressed great admiration for the amazing resilience of children, who seem able to recover from severe illness and major surgery in a stunning manner, especially when compared to adults.

Sherry Kenna NP works on the UNMH cardiothoracic surgery team, and sees both adult and pediatric patients. Her work allows her the opportunity to see patients in many different environments — clinic, operating room, intensive care unit and then clinic again. She loves educating patients (and parents) about the surgery and about how to take care of themselves after surgery. She says working with children can be both heart-wrenching and uplifting at the same time, a dichotomy between extreme vulnerability and incredible resilience.

Barbara Bell NP is part of the UNMH neurosurgery team. She says her favorite part of her job is developing long-lasting relationships with patients and their families. She often meets patients in the Newborn ICU and then continues to work with them up to the age of 21. Another part of her job that she really enjoys is helping families navigate the very complicated medical care system — long hospital stays, insurance challenges, doctor’s office visits, referrals to other specialists, lab work… It can be overwhelming to a family. Her years of experience have made her an expert in how the medical system works, and it is incredibly satisfying to be able to simplify a system that can often be very confusing.

Amy Davis NP works in the Pediatric Intensive Care Unit and has taken care of sick children, as a nurse or nurse practitioner for the past 35 years. Her favorite part of the job is caring for the entire family. She feels privileged to witness the strength that both children and their families exhibit when faced with adversity, and derives great satisfaction from helping them navigate the diagnosis, the hospital stay and ultimately their discharge home.

The Pediatric Nurse Practitioners in New Mexico are a valuable part of our workforce, increasing the number of children who can receive timely care and providing a valuable resource to families in terms of education, support and collaboration. Here’s a big “Thank You” from all of us — parents and doctors alike!

Anjali Subbaswamy is a Pediatric Intensive Care Physician at UNM. Please send your questions to her at asubbaswamy@salud.unm.edu

 


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