SCOPE OF PRACTICE
promoted collaboration . However , it was during this time in my career that I noticed my own lack of continuity with pregnant and surgical patients . Continuity with patients was something that I treasured , and it became one of the driving forces for my eventual return to school .
I enjoyed my career as a nurse practitioner . Obstetrics and gynecology is a unique , rewarding and sometimes challenging specialty that allows for repeat patients year after year . Most recognize that physicians do not have an abundance of time in their work schedules . The reasons are multifactorial and vary by practice setting , but due to these constraints , physicians are often allotted less time with each patient compared to a nurse practitioner . During my career , I utilized the luxury of additional time to develop a rapport and get to know patients as people . Through this approach to patient care , continuity became even more important to me because I had invested myself in their care . Experiencing the lack of patient continuity combined with a longstanding love for the operating room and a growing desire to become a surgeon , I decided to start investigating what pursuing medical school required .
After months of contemplation and researching logistics , I decided to return to school . I needed to complete several undergraduate courses to sit for the Medical College Admission Test ( MCAT ). Nursing and pre-medical education have some similarities but many of the courses in nursing are geared toward direct entry into patient care upon completion of the program . Pre-medical education focuses on providing a broad foundation of scientific concepts to prepare a medical school applicant for the MCAT and medical school . I recognized the limitations of my nurse practitioner education and I wanted to expand my existing knowledge to become an expert in the field of medicine . Nurse practitioners are vital entities of the health care team but there are differences in the educational models , goals , length and depth of education . Despite these differences , the health care team has a common goal of providing optimal care for patients . During the height of the COVID-19 pandemic , I continued to work as a nurse practitioner while completing the two-year Post-Baccalaureate Pre-Medical Program at the University of Louisville . I completed the program in May 2022 , then took a gap year to allow for additional time to study for the MCAT and continue working . In July 2023 , I resigned from my career as a nurse practitioner and became a first-year medical student at the University of Louisville School of Medicine .
I am often asked by former colleagues and peers , “ Why are you doing this now ?” I believe that what kept me practicing as a nurse practitioner for as long as I did were the relationships that I developed with patients . Those patient relationships were some of the more challenging pieces to leave behind as I closed that chapter in my professional life . Additionally , it was incredibly difficult to leave behind the professional relationships that I developed with such remarkable physicians who served as mentors and invested so much of themselves in me .
As multidisciplinary teams become more common , I ’ d like to share some key takeaways from my time as a nurse practitioner – what I learned about encouraging the continued growth of professional relationships . First , when it comes to working as a team , each physician had a specific level of comfort in trusting my ability to perform certain tasks . This most often occurs when the nurse practitioner ( NP ) is a new graduate or new to a practice , but may also occur when a new physician joins a practice . During this generally brief period , the NP will likely need to demonstrate their abilities . Both parties ought to grant the other patience while this relationship develops .
Second , the physician-NP rapport changes over time and that evolution supports a dynamic working relationship . Facilitating a rapport can be achieved in many ways , and doing so early in the professional relationship will alleviate misunderstandings .
Third , promptly addressing underlying issues within the physician-NP team is essential to preserve rapport and to promote continued growth . The military uses After Action Reports ( AAR ) where the team gathers after an exercise and discusses what went wrong or what could have been done differently . AARs can be applied to the physician-NP relationship as well . For instance , if conflict or an adverse outcome occurs , gather the team in a timely fashion to address the issue and identify the best strategy to move forward .
Fourth , I found that harnessing the ability to be teachable and learning to receive constructive criticism further enhanced the relationship . Furthermore , how constructive criticism is delivered is of equal importance . Finally , physicians can improve the physician-NP relationship by creating clear , explicit expectations of the nurse practitioner from the beginning . Of course , it should be emphasized that expectations can and likely will change over time . However , regardless of role , it is difficult to meet or exceed expectations if they are unknown to all parties involved .
As health care continues to evolve at a rapid pace , multidisciplinary teams are becoming increasingly integrated into various aspects of the health care system . Ultimately , each person on the team has a role and offers multiple backgrounds to contribute to the well-being of the patient . Finally , multidisciplinary teams are unlikely to dissolve . As we move forward , placing the emphasis on collaboration is the key to success .
Chelsae Nugent is a second-year medical student at the University of Louisville School of Medicine .
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