Why did you decide to become a nurse practitioner?
I love nursing, and working in emergency — especially here in Nova Scotia — I could see the potential for expanded nursing roles. After practising as a nurse in emergency for a number of years, I wanted to see that become a reality. I see the NP role not only as an advancement of my career but also as an enhancement of the nursing profession.
My work did not support me when I decided to go back to school and it is challenging when you’re a staff nurse working shift work to fit in time for school and classes. I left my job in the emergency department to pursue a Monday-Friday job, as it gave me greater flexibility and eliminated night shifts to ensure I could find the time to attend class and commit to school work. I did my NP part-time over four years after seven years of practice.
How do you feel you help patients the most?
I really partner with my patients to provide the care they need. In emergency, I tend to look after frail, elderly patients that come into the hospital. But I also do a lot of case management with patients who are frequent attenders or patients with alcohol or drug dependency issues: people that really need a care plan. I always work with my patients and start where they are. I try to think outside the box of a fast-paced emergency department — I don’t think in terms of time frames, as they typically do in emergency. If it takes me two hours to see a patient, then I take the two hours — I won’t cut someone off after 15 minutes because I feel I don’t have the time.
What is the most rewarding aspect of your job and what is the most challenging?
The fact that my job has developed as rapidly as it did is very rewarding. We created this role from the ground up, as there are no NPs in emergency in Nova Scotia other than myself. The fact that we were able to do that and eventually have buy-in and major support was fantastic. It is hard to now imagine what we would do without my role. There’s rarely a time when I leave a shift thinking I didn’t make a difference — every day I make a difference in people’s lives. We work very much as a team here, and everyone supports one another. My team’s acceptance of the role has made this job very rewarding.
Although creating this role and getting buy-in was very rewarding, in a lot of ways it was very challenging as well. It didn’t develop into the role I thought it would be — it developed into something very different. It took a lot longer to get off the ground and it was hard to get that initial acceptance from the emergency team.
More about Nikki:
Because my role is so unique, I tend to get a lot of students to mentor. I enjoy it. I find it interesting and very rewarding.
In order to get buy-in from physicians, there were some non-clinical things that I had to pick up over the years. Those pieces are very important to delivering complete patient care (e.g., engaging in care planning and dealing with frail, older patients).
One thing I want to emphasize is how much I love nursing and being a nurse. I want to provide nurses with as much capacity to be advocates for themselves in their profession, because it’s so easy to be diverted by the day-to-day pressures of working in a busy department — the challenges associated with doing more with less money and resources. I think nursing is the backbone of everything that happens within our health-care system. We are such good team members and I love being part of that team. My unique role helps show other nurses that they don’t have to follow the norm. You can create your own path.