“The task of the modern educator is not to cut down jungles but to irrigate deserts,” said mid-20th century scholar and writer C.S. Lewis. Although he was speaking to the importance of the holistic education of students, the same idea rings true for a 21st century nurse practitioner (NP) new to rheumatology. Indeed, the care of patients suffering from rheumatic diseases requires knowledge, but knowledge has little to offer if it does not come from a person who is compassionate, creative, patient and humble. Not found in textbooks, these qualities must be demonstrated in practice by teachers and mentors.
Through the Rheumatology Research Foundation’s Mentored Nurse Practitioner/Physician Assistant Award for Workforce Expansion, I was able to experience the ways in which my colleagues in the Washington University School of Medicine (WUSOM) Division of Rheumatology, St. Louis, embody these attributes in their practice.
Journey to Rheumatology
My first experiences in the medical field provided little interaction with rheumatology, although they did involve the care of patients with complex diagnoses and circumstances.
After earning my undergraduate degree at Belmont University School of Nursing, Nashville, Tenn., I was accepted into a nurse residency program and worked at Vanderbilt University Medical Center, Nashville, on a cardiac step-down unit. I later worked at Vanderbilt’s Comprehensive Care Clinic as part of PATHways, a grant-funded project created to engage high-risk HIV patients in care.
This multidisciplinary program was developed by Robertson Nash, PhD, a nurse practitioner with a focus on identifying every challenge facing patients, including stigma, socioeconomic status and untreated mental health illnesses. The work and mentorship of Dr. Nash inspired me to pursue my own graduate education.
I started a Master of Science in Nursing degree program in St. Louis with the goal of becoming a provider with a holistic perspective. In my last semester of graduate school, an opportunity arose through Washington University’s School of Medicine to obtain a Musculoskeletal and Rheumatic Disease certificate through the ENRICH program.
This program was created by the clinical director of rheumatology, Deborah Parks, MD, to train NPs in rheumatology. It highlighted to me the complex issues facing patients with rheumatic diagnoses and prompted my interest to work in this specialty.
ENRICH provided the foundation and experience to begin my career in rheumatology, but as I started practicing, I began to see my need for additional structured training. This prompted a Google search that landed me on the Rheumatology Research Foundation website, which contained the details of the Mentored Nurse Practitioner/Physician Assistant award.
This award would provide the resources for additional training, while allowing me to operate in a mentorship framework. I knew I needed didactic training, but what most appealed to me about the award was the emphasis on mentorship for growth and development.
My exposure to rheumatology thus far had demonstrated the vast complexities that affect patients with rheumatic illness. I knew that understanding the complexity of rheumatology diagnoses is an essential aspect to their care, but considering the ways in which a person’s culture, socioeconomic status, past traumas and mental health affect their physical symptoms is crucial. The ability to see people in this way comes from seeing them through the eyes of those who have this perspective.
I applied for, and received, the award for 2020. It has provided the opportunity for the mentoring that has irrigated my practice, providing me with the holistic perspective needed when I walk into the room of a patient with a rheumatic disease.
From a didactic perspective, this award provided excellent resources for further training. I have since completed the online ARP Advanced Rheumatology Course, attended two ACR conferences and am scheduled to attend a musculoskeletal ultrasound training course. Through the award, I have received opportunities for growth and networking in the field of rheumatology.