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Chapter 14 |
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"Every symptom we hear about or find in a patient has a basis in physiology."
Robin Andersen, a nurse practitioner (NP), always knew that she would pursue a career in health care." I became interested in nursing while I was in junior high school," she says. "Later I became aware of the role of nurse practitioner, which seemed interesting and challenging. I wanted to choose a career that would make a difference in a tangible way. So I decided during high school to become an NP." Robin works in acute care on a general surgery service in a major academic hospital. Her day begins at 7 A.M., checking in with the residents on her team for "sign-out" on each of the patients in their care. These are patients either being evaluated for an operation or in the post-operative recovery phase.
A Pivotal Role As a nurse practitioner, Robin forms a diagnosis then initiates whatever treatment the patients may need. "I address cases of hemodynamic instability, fevers, nausea, pus, and pain-anything that may indicate that a patient is having greater problems that may need a further work-up." Robin is first call for the surgical wards. "That means that when nurses have questions or concerns about the patients, they page me. I handle that throughout the day." On top of that, Robin also takes phone calls from outpatients- usually postoperative patients who call in about problems such as fevers. She works with those patients over the phone and sees the ones that she feels should come to the clinic for examination. At the end of Robin's nine- to eleven-hour day, she updates the team of residents on all of the patients so that they can continue with the care of the patients. A nurse practitioner must have completed a bachelor's program in nursing and preferably have worked as a registered nurse for a year or more before applying to a master's level program. Robin recommends that NP candidates make sure that they've completed all of the prerequisites they will need for the program, including biology, chemistry, and statistics. A good background in anatomy and physiology is also essential, both for obtaining the MSN (master of science in nursing) and to succeed as a nurse practitioner. According to Robin, "Every symptom we hear about or find in a patient has a basis in physiology. Physiology helps us understand why we are seeing certain lab results, hearing reports of pain, or finding changes in heart rate or blood pressure. Of course, anatomy goes hand in hand with that. If a patient complains of pain in a certain area, I have to know what is in that area, what might be the source of the pain."
Unique Rewards The job of nurse practitioner is uniquely rewarding. "One of the great things that being an NP offers over some of the other health provider roles is the two-piece combination of actual nursing experience with education in science and internal medicine. As a result, I'm able to interact with many different people in various states of health and effect a positive change on their lives. I help keep them safe, get them on an appropriate treatment plan, educate them about their illness, and help them take care of themselves." Nurse practitioners work in primary care offices, including pediatrics, internal medicine, and obstetrics and gynecology. Some, like Robin, work in an inpatient setting. An entry-level nurse practitioner who has passed the national accreditation exam is qualified to work in any of these settings. Regardless of where you work, says Robin, three qualities are essential: "You must have an interest in science, be intuitive, and be compassionate. You're handling a variety of patients and many with evolving presentations. But you're also handling the psychosocial issues that patients bring during a time of crisis."
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