Nurse Practitioners Making a Difference for Carol Woods
February 1, 2019 -
In the bigger world when you want to speak with a health care provider, you will probably get a recording telling you something like “Press 1 for English,” “Press 2 if you are a physician,” or “Press 3 if you wish to make an appointment." It is comforting to be able to call the Carol Woods clinic, speak to a real person, state your concern and, depending on the situation, get a prescription called in, talk to a nurse, be seen the same day in the clinic or have an appointment to be seen within the next few days. This is possible (and affordable) because most of our routine primary care is provided by a staff of experienced nurses and two nurse practitioners – registered nurses who have a Master’s degree and are licensed to provide primary care, including writing prescriptions and being reimbursed by Medicare and other insurers for their services. Such nurses are playing an increasingly important role in the delivery of quality health care all over the U.S., while helping to control costs in our hospitals, clinics, and private medical practices.
Although many residents are already familiar with one or both of our nurse practitioners (NPs), we thought readers might like to know the paths they took to end up providing such a valuable service to Carol Woods. Both Michelle Faber and Melissa Rothrock were “straight arrows” in the sense that as teenagers they knew that they wanted to be nurses and have remained on that track. Neither of them began with the idea of working with older adults, yet their career paths uniquely prepared them for such an outcome.
Michelle’s choice of career arose from her experience as a hospital Candy Striper when she was in high school. After graduation from a nursing school within a small college, she worked in a hospital to acquire the experience necessary to apply to an NP program, planning to specialize in oncology. She moved to the Triangle to enter the UNC NP program and began working in the hospital’s bone-transplant oncology program. Then she decided she would rather work with patients she could get to know better and follow for a longer time. She transferred to Duke to complete her education specializing in gastro-intestinal oncology. She stayed on to work at the Duke Hospital, but realized when her first child was born that being on call 24/7 did not mesh well with caring for her family.
She became a nurse practitioner at a CCRC in the Triangle where the health care program is NP driven. She liked their model of service and the opportunity to know the residents before they were as sick as those she had been seeing at the hospital. Twelve years later she learned of a position open at Carol Woods and applied. She found the dementia-inclusive nature of the community particularly attractive, both from a personal and professional point of view. She joined our staff in 2015.
Melissa’s route to nursing was her love of science. After completing nursing school, she worked for ten years as a hospital nurse, spending much of her time with cardiac patients. As those years passed, she noticed that patients were becoming both younger and sicker at the time of admission and more difficult to treat. She wanted to understand this trend and what might be done to reverse it. When she learned in a nurse leadership class that UNC would provide tuition help for those entering its NP program, she applied, was admitted and specialized in cardiology. Like Michelle, however, she had a baby and understood that a hospital NP position in cardiology would not work for her family. On the other hand, her experience in cardiology made her a good candidate for working with residents at Carol Woods. She joined the staff in 2017.
When describing the joys and challenges of working at Carol Woods, both Michelle and Melissa cite the value of seeing residents over several years, thus knowing what they are like before they are seriously ill and being able to recognize changes, perhaps even before a resident presents a complaint or concern. They appreciate the way the other nurses and our UNC geriatricians work together to meet the diverse health needs of the residents.
They also value the support of the administration for personal and professional development. Michelle divides her time between the clinic and the residents who are in the health center, supporting those residents and attending to some of the challenges posed by our dementia-inclusive framework of care. She looks forward to the days she takes Schneider, her dog partner, on her rounds to see all the residents. He cheers up the residents, knows which of them will want to play and behaves accordingly.
Melissa has joined the Gerontology Advanced Practice Nurses Association (GAPNA) as part of her professional development. She recently returned from a trip to Washington where she admits that she was forced to act outside her comfort zone, while accompanying the current GAPNA president to lobby Senators Thom Tillis and Richard Burr (they saw only their aides) and Representative David Price (in person) regarding issues of Medicare payments for services delivered by NPs.
Melissa and Michelle agree that working with an aging and dementia-inclusive population presents both social and medical challenges: how to be sensitive to the needs of all residents regardless of their cognitive status and how to create systems for residents to manage their medication regimes when still living independently, carefully evaluating medications and their effects, etc. We are fortunate to have two such committed and competent professionals on our health care staff.
--Carol Woods Resident Nancy M.