(Working Women) - Stacy, Nurse Practitioner on a Stroke Team

Full disclosure - Stacy is my very best BFF in the whole wide world. If I weren't already married to Alex, and her to Nick, I might propose an arrangement where we "marry" each other and raise our kids together just so we can hang out all the time. And have boyfriends on the side, of course. I jest. Kind of. Point being, she is one of my top three favorite people in the whole world (Alex and The Bean have made the cut, too). We met in college, moved to Telluride, CO together, travelled to Central America together, lived in Tahoe together, met our husbands around the same time, got engaged to these great guys, she was my MOH and just 2 months later I was hers, and started our journey to motherhood around the same time. She lives in Denver now, but we try to see each other at least a couple times each year, in addition to our annual college girlfriend Women's Retreats (WR). And while we are terrible about talking on the phone (weeks to months without chatting, then hours to catch up), she is my "person" (a la Meridith and Christina on Grey's).

A few randos about Stacy ...

1) When she and Nick were engaged (in this elaborately romantic grand gesture while catskiing with her whole family - yay Nick!), Stacy entered some sort of Today Show pay-for-my-wedding contest, where she and Nick made a music video with a play on Abba's "Take a Chance on Me" with "Take a Chance on Nick & Stacy." I wish I had the link for their video ...

(Ask and you shall receive! Here they are. Too funny.)

2) When we were living in Tahoe, we both became ill with what we referred to as "The Devil Baby." Endless heaving, barfing, diarrheaing, and general expulsion of our innards. At one point, although she was sick too, she drove me to the local hospital so I could get some anti-emetics and replace lost fluids. Somewhere in there I must have also been administered some anti-anxieties (who me?) and passed out hard that night ... only to wake up covered in my own diarrhea (gross?!?). Although Stac was still sick, she cleaned up my shit. Literally. Now THAT'S true friendship. And maybe a pretty clear sign she was destined for nursing. And I'm a gross individual who's most nasty secret is exposed to the whole Interweb.

3) Although Stac and I both consider ourselves to be at least decently intelligent people, when we are together, something strangely scientific happens where our IQ's, and specifically our senses of direction, are reduced to that of a hamburger bun. One time, when driving to Vegas, I fell asleep in the passenger seat, as I'm prone to do as Untrusty Co-pilot, and awoke a few hours later, having ridden in entirely the wrong direction. New Mexico = Vegas.

So although I could go on and on and on and on about how fabulous and funny and smart and sweet and everybody's-favorite-person she is, this interview has less to do with "let me tell you funny stories of me and my BFF," and more to do with her professional path and her awesome career as a nurse practitioner on a stroke team.

It was fun to read her written interview, because if we were to try and talk this out, we'd interrupt ourselves at least three dozen times and get lost on various tangents before we found our way back to the original story at hand.

And let it be known, readers. She's my best friend, so even though I want to you to think she's as amazing as I think she is ... without further adieu.

*****

Bio info - who are you, how old are you, where are you from, where do you live, what's your living/family situation, what are your hobbies, etc. Essentially, what's your story?

Hi! My name is Stacy. I’m 32 years old, grew up in Littleton, Colorado, and currently reside in Denver, with my husband, Nick, and my daughter, Vivian. I am pregnant right now with a baby boy who is due to arrive in November. Oh, and we have a huge hairy dog (Bernese mountain dog) named Samson. 

Nick, Vivian and Stacy in 2013

 

Vivian nowadays, ~15 months

 

Samson

We live in a charming neighborhood in a house that was built in 1943. My grandparents bought the house in 1953, when my mom and her brother were young, and my mom spent her entire life up until college living in this house. My grandparents then lived in this house until my grandfather passed away, and then my grandma held down the fort until 2010 when she transitioned to an assisted living facility (she was unable to safely live alone, due to dementia). All in all, it’s the perfect house for us right now and we feel fortunate to live here.

 

Home

My family all live in Colorado as well - my parents,  both grandmothers, two older brothers and their wives, and five nephews. My mom is a superstar who takes care of her six grandkids (all under the age of four years old) – but not all at the same time! - three days a week. Yep, she’s pretty badass and we are uber lucky to have her. Nick’s family is amazing as well, but we only get to see them a few times a year because they live in Michigan.  

Hobbies … I love the outdoors, specifically the mountains. I enjoy skiing, amusement parks (beware of the R-rated photo below), and the sound of laughter. I wouldn’t trade my yearly rendezvous with girlfriends for the world, and I’m a sucker for those darn Damn You Auto Corrects (here’s a link to a few that I find funny).

Stacy and Jo in Telluride, CO after a day of skiing

 

Rollercoaster ride at Cedar Point (Sandusky, OH)

My story … I went to college in Tacoma, Washington at the University of Puget Sound (UPS) where I met some truly amazing women (including Jo!).

 

2004 – University of Puget Sound

2009 - Anna, Stacy, Jo, Kathleen, Gretchen, Amy
 

2014 – revisiting University of Puget Sound:
Jo (not preggo), Amy (20ish weeks), Gretch (30ish weeks), Stac (18ish weeks), and Anna (not preggo)

After college I moved to Telluride, CO with Jo. I worked mainly as a front desk receptionist at the Telluride MedicalCenter and as a ski instructor at the Telluride Ski School.  Somewhere in there I also worked in there as a trip leader for Backroads. A few years later when Jo moved to Lake Tahoe, California, I knew I had to go check it out. So, in 2006 I showed up on Jo’s doorstep in Tahoe. Yikes, sounds kinda creepy and stalker-style now that I’m retelling the tale J

I met my husband-to-be, Nick, in Tahoe that winter (2006). And then in the spring of 2007 I moved to Milwaukee, WI to obtain my Master of Science in Nursing degree at Marquette University (more on that below). Nick and I got engaged in Steamboat Springs, CO in 2008 and married in Milwaukee, WI in 2009. In May of 2010, once I completed nursing school, we moved to Denver, CO.
 

2008, Steamboat Springs - Nick & Stacy get engaged

2009, Milwaukee - Nick & Stacy get hitched

Colorado or bust

What is your current job/profession? What path did you take to get there?

My official title is Stroke Nurse Practitioner. I’m a Nurse Practitioner who treats patients who have had, or are actively having, a stroke. A Nurse Practitioner (I’ll call it NP from here on out) is also known in the medical profession as an Advanced Practice Nurse. You may also hear an NP referred to as a mid-level provider. An NP is someone who has obtained a license as a registered nurse (RN) and then completed graduate school in order to obtain a Master of Science in Nursing (MSN).  
 

Since I wasn’t a nurse (I studied Biology and Psychology in college), I needed to attend a school that would help me achieve both my RN license as well as my NP license. Marquette University in Milwaukee, WI was the place! Long story short, I became a nurse in 1.5 years and then worked as a nurse at a nearby hospital while I took graduate courses for another 1.5 years and ultimately graduated in 2010 with my MSN.
 

While you’re in school to become an NP, you make a decision regarding the type of patients you want to treat. For instance, a Pediatric NP provides care to children; an Adult NP provides care to adults; a Family NP provides care to patients of all ages; a Geriatric NP provides care to older adults. I decided to become an Adult Nurse Practitioner. NPs often work closely with a physician, or group of physicians; although, in some states NPs have the ability to see patients on their own without a physician liaison. In addition, NPs are able to prescribe medications for their patients. Similar to the amount of autonomy an NP has in a particular state, the way in which prescriptive authority is obtained varies from one state to another. 
 

A few months after Nick and I moved to Colorado I took (and passed!) a board certification test. At that point, I was officially able to call myself an NP (hooray!) and that’s when the job search began. I started looking for NP jobs that revolved around internal medicine or family practice with the thought that I’d spend a few years working in a clinic learning a little about a plethora of different diagnoses and then transition to a specialty that I enjoyed. In an effort to better understand which clinics around town needed an NP I met with a physician recruiter who knew my father (my dad is a physician) and had graciously agreed to meet with me. She wasn’t able to tell me who needed an NP, but she was able to give me a list of over two dozen physicians who might consider having an NP join their team. That was a start. At the end of our meeting she said, “If you’re free tonight, there’s a get together for NPs and PAs (physician assistants) who have worked for less than three years and it’d be a good place for you to do some networking.” Networking. Ugh. Let’s just say that networking is not my strong suit. Anyway, I decided to buck up and go to this networking thing-a-ma-jig because I knew for certain that an NP job wasn’t gonna come find me.

The event was held at a Mexican restaurant – the drinks were free and the music was so loud it was hard to hear yourself think. I walked in and thought, “I’ll grab a drink, say hello to the woman who invited me, and leave.”

But it didn’t quite work out that way.

I arrived at the event, grabbed a drink, and said hello to the physician recruiter whom I had met earlier in the day. She immediately took me by the arm and whisked me around the room, introducing me to any and every NP and PA in sight. One of the women I met (who is now my co-worker) was extremely friendly and asked me where I worked as an NP. I explained that I had just finished school, moved to Colorado, and was looking for a job.

She then proceeded to ask, “What do you think about vascular neurology?”

I remember thinking to myself, “What the F*%# is Vascular Neurology?!?! Shit, I must have slept through that entire lecture in school!”

I’m sure I actually said something lame in an overly excited tone like, “I don’t know much about it, but I’d love to learn!!!!”

Well, apparently that’s all she needed to hear because she told me they had an opening as a Stroke NP and that I should spend the day with her and her colleague to figure out if I would be interested or not. I spent the day with the two of them and found myself inspired by their enthusiasm and passion for stroke.

Somehow all the stars aligned and I joined the Stroke Team in January of 2011. 
 

Walk us through a typical day, week, or month...

I am one of four Stroke NPs at my hospital and we all work four 10-hour days. Our schedules are a bit bizarre in the sense that we don’t work set days of the week, so it’s not as if I work four days in a row and then have three days off. Each week I work different days and each Stroke NP works at least one weekend a month. We are employed by the hospital; therefore, the success of the hospital’s stroke program is our responsibility. The hospital has obtained both Primary and Comprehensive stroke certification (more on that later), so it’s the job of the Stroke NPs to ensure that the certification is upheld year after year.
 

My job includes both patient care and administrative tasks. I see every patient in the hospital who has had a TIA (Transient Ischemic Attack) or a Stroke (Hemorrhagic Stroke or Ischemic Stroke). I only work in the hospital setting, but I go to several different units of the hospital. For instance, I may see a patient in the Emergency Department if he/she is brought in with stroke symptoms. I may see a patient in the Intensive Care Unit who has had a stroke and is in critical condition. Or, I may see a patient on the Neurology Unit who has had a TIA or who has improved since his/her admission and is awaiting discharge to rehab or home. We see an average of 20 stroke patients each day.
 

I am fortunate to work with a good team. There are a number of providers who are involved in the care of a stroke patient: Interventional Neuroradiologists, Neurologists, Stroke NPs, Interventional Radiology PAs, Neurosurgeons, Intensive Care Unit Nurses, Neurology Unit Nurses, Physical Therapists, Occupational Therapists, Speech Therapists, and Social Workers, to name a few.

Our Stroke Team

So, back to what I do. I take care of stroke patients, and only stroke patients. I work closely with a group of Neurologists but I do not see any of their other patients with neurological problems (i.e. migraines, transient global amnesia, multiple sclerosis, etc.). My job is 100% stroke.
 

I provide education to patients and families. I educate them about the type of stroke and provide a general idea of what to expect during the hospital stay.
 

There are two types of stroke. One is called a hemorrhagic stroke and the other is called an Ischemic Stroke. Approximately 15% of people who have a stroke have a hemorrhagic stroke whereas 85% of people who have a stroke have an Ischemic Stroke.
 

A hemorrhagic stroke occurs when a blood vessel bursts. Someone who has had a Hemorrhagic Stroke can have an Intracerebral Hemorrhage (bleeding into the brain tissue) or a Subarachnoid Hemorrhage (bleeding between the layers of the brain). The number one reason why people have an Intracerebral Hemorrhage is because of high blood pressure. More often than not, a Subarachnoid Hemorrhage is caused by an aneurysm that has ruptured. People can have other types of bleeding in their brain, but it is not classified as Stroke.

An Ischemic Stroke is when blood flow to the brain is blocked for one reason or another. When blockage of blood flow occurs, the brain tissue does not get enough oxygen or nutrients, and the brain tissue dies. This only takes minutes.  Blockage of blood flow can happen for many reasons: plaque buildup prevents an adequate amount of blood flow to get to the brain, a clot travels up to the brain and gets stuck in one of the vessels of the brain, a vessel in the neck or head is damaged or torn and blood flow is compromised.
 

And then there is what is called a TIA, or Transient Ischemic Attack. A TIA is when someone experiences blockage of blood flow for a short period of time but no brain tissue is damaged. An MRI scan of the brain is able to show if brain tissue has died or if all the brain tissue is healthy. Because of the many reasons why someone can have a TIA or a stroke, the workup (or number of tests) a patient goes through when they get to the hospital is extensive. All in all, some patients do well, some do ok, and some pass away.
 

Unfortunately, people do not know much about the signs and symptoms of stroke. Most anyone can tell you the symptoms of a heart attack and the importance of calling 911, but we’ve found that the general population is much less knowledgeable about stroke. The reason why we care so much about early recognition and treatment of stroke is because the earlier we figure out what’s going on, the more options we have to help save someone’s brain tissue (and ultimately, quality of life). If someone is experiencing stroke symptoms (I’ll review these in a minute), the most important thing to do is to call 911.
 

For someone who is having a hemorrhagic stroke (remember, that’s bleeding in the brain), that person needs his or her blood pressure controlled. If someone is having an ischemic stroke (blockage of blood flow), that person could be a candidate for a clot-busting medication called tPA or even a procedure (called intra-arterial treatment) where Interventional Neuroradiologists go into the brain to help restore blood flow. But, all of these interventions are time sensitive. Research published in 2006 in the journal of Stroke has shown that for each minute a person experiences blockage of blood flow (an ischemic stroke), “…1.9 million neurons, 14 billion synapses, and 7.5 miles of myelinated fibers are destroyed.” That’s scary shit.

So, what are the signs and symptoms of stroke?
 

We use the acronym FAST.

F stands for Face.

Ask the person to smile. Is one side of the person’s smile droopy?

A stands for Arms (or Asymmetry).

Ask the person to hold up his/her arms or legs. Does an arm or leg drift downward?

Does the person have weakness or numbness on one side of the body?

S stands for Speech (or Sight)

                  Ask the person to talk. Is his/her speech garbled? slurred? nonsensical?

Ask the person about his/her sight. Has he/she experienced sudden loss of vision, blurry vision, or double vision in one or both eyes?

 T stands for Time.

When someone is exhibiting stroke symptoms, he or she is experiencing a stroke at that exact moment. There are no warning signs for a stroke. The most important thing to do is to act fast and call 911.

The above listed are the most common signs of stroke, but there are a few others signs and symptoms to be aware of: sudden onset of nausea and/or vomiting, problems with balance and coordination, dizziness, worst headache of your life, numbness or tingling in your face, arm, and/or leg.

All of the symptoms of a stroke are sudden. The person will experience a sudden onset of symptoms and will more than likely need help calling 911.

Below are a few different videos related to stroke awareness. The first video is geared toward teaching kids the signs and symptoms of stroke. The second and third are commercials that were created by the American Stroke Association.

Education is a large part of my job as a Stroke NP. As I mentioned before, Stroke NPs educate patients and families in the hospital setting. In addition, the stroke team educates: hospital staff about how to provide efficient and effective stroke care; members of the community regarding the signs and symptoms of stroke; and we also travel to hospitals in rural areas to update staff about the latest and greatest stroke information. 

Aside from patient care, a Stroke NP is involved in: data collection and analyzing, process improvement, Joint Commission core measure compliance, meeting preparation and attendance, e-mails, phone calls, as well as anything and everything else that pops up throughout the day.   

What are the pros and cons of your current position?

Pros:

-Every day is different.  

-I work with a group of people who are intelligent, passionate, and generally enjoyable to be around

-I enjoy educating patients and families about stroke and taking the time to answer their questions

Cons:

-Every day is different (some days I wish I knew what I was in for).

-Oftentimes, there’s more to be done than my 10-hour day allows. Unfortunately, I do take work home.   

-It’s an emotionally draining job with lots of highs and lows.

 

What is something about your job that other people might not know or expect?

Strokes don’t discriminate. Strokes affect young people and old people, men and women, healthy individuals and unhealthy individuals, all ethnicities … you get the point. A stroke can happen to anyone at any time, so keep that FAST acronym tucked away in the back of your mind because you could save someone’s life by identifying a stroke and getting him/her to the hospital.

And speaking of hospitals, I don’t think it’s common knowledge that not all hospitals are equally equipped to treat stroke patients. There are Primary Stroke Certified hospitals and Comprehensive Stroke Certified hospitals. A national healthcare evaluation body (known as The Joint Commission) visits hospitals throughout the country to evaluate stoke programs and to designate a facility as either Primary Stroke certified or Comprehensive Stroke certified, based on the level of stroke care the hospital provides.
 

The hospital I work at is certified as a Comprehensive Stroke Center (CSC). As a CSC your hospital is recognized as a place that has the ability to treat the most complex stroke cases. Recently, Oregon Health and Science University in Portland, OR obtained their Comprehensive Stroke Center certification. Congrats OHSU!

What other jobs could you work with your education/training/experience?

As an Adult Nurse Practitioner you are able to provide care to adults (not children), but with regard to where you can work … you really have no limitations. You could work in a clinic setting, a hospital, a rehab, hospice, in an urban or a rural community, on a college campus, doing research, etc.  Also, you can work in any specialty that you’d like, as long as you are dedicated to learning the ins and outs of that particular area of expertise.

How much do you make? (Too forward?!? Probably. But let's be real, a large part of the reason we work is to make money - give us some deets about your income, as much as you feel comfortable sharing, whether specific to your personal salary, or generally speaking, as in, What Would Google Say).

Have you checked out glassdoor.com? It’s a site where you enter your profession and state and then it provides you with a salary range. It doesn’t let you get too specific with the job title (for instance, when I entered “stroke nurse practitioner” nothing came up), but it tends to work well if you use general terms. When I entered Nurse Practitioner in Colorado it reported a range in salary from $68,000 to $110,000 with a median Nurse Practitioner salary of $87,000. Try it out for your profession!  

Do you anticipate making any career changes in the next 5 to 10 years?

I just did! I transitioned to part-time (20 hours/week) and so far have been happy with the change. With regard to where I’ll be in 5 years … I have no idea! I know that in 5 months I’ll have two kids under the age of two and will just be trying to survive. Any and all words of wisdom are welcome!

If you could have any other job in the world, what would it be?

Any other job? Do I have to be qualified for it? Can I take my family with me?
 

If the answers are: Yes, No, Yes, then I would like to be a professional landscape photographer (think Ansel Adams or John Fielder).

If someone else was interested in your job, what piece of advice would you give them?

If you’re interested in becoming a Stroke Nurse Practitioner, I’d say, “Call or e-mail me first so I can talk you out of it.” No, I’m kidding (kind of).

If you’re interested in becoming a Nurse Practitioner, I’d say, “Good for you!” “Go for it!” and “You can do it!”

How do you balance work life and home life?

Ha! I am the antithesis of "balanced". Honestly, it’s a work in progress. Having an amazing support system (for me, that’s my husband, family, and friends) helps tremendously.

 

*****

Thanks for sharing, Stac. And readers, if you like reading these women's reports of their current professions and their career paths, check out this link for more interviews with Working Women.