University of Delaware Office of Public Relations The Messenger Vol. 5, No. 1/1995 Prognosis: Excellent for nurse practitioners I'm working longer hours. I know I am. But, the job is so rewarding that it doesn't seem like I'm working harder," says Jane Govatos of Lewes, Milford Memorial Hospital's first nurse practitioner. "Even though I'm at the office from 8 a.m. to 7 p.m., can't eat supper until 7:45 p.m. and fall into bed by 9:30 p.m., it's very satisfying." Govatos is one of the first l3 graduates of the University's new Family Nurse Practitioner Program. She and her 12 classmates are all gainfully employed in positions that pay from $45,000 to $70,000 a year. Govatos works with Dr. Claudia McCarty in the Milford Memorial Clinic in Georgetown. Her patients in the rural practice range in age from 2 to 101. The 101-year-old lives across the street, and it's not unusual for Govatos to make a house call to him. Recently, when two disabled patients came in to have their tuberculin tests checked, she did a "car call," running out to the parking lot to meet them so they didn't have to go through the struggle of getting out of the car and into the office. That sort of time-taking, caring manner is pretty much standard operating procedure for any nurse practitioner. "Nurse practitioners tend to spend more time with their patients," says Barbara Sheer, director of the UD program. "I think they are good at developing interpersonal relationships with patients since they were nurses first. A nurse practitioner is more likely to talk with a patient to get what's behind the symptoms, to ask what's going on in a person's life that got them to the point of illness." Nurse practitioners have been around since the first pilot training program was started at the University of Colorado 30 years ago, Sheer says. The American Academy of Nurse Practitioners Scope of Practice describes nurse practitioners as advanced practice nurses who provide primary health care and specialized health services to individuals, families, groups and communities. Nurse practitioners, among other things, can obtain medical histories and perform physical exams; they can diagnose and treat common health problems such as infections and minor injuries; they can diagnose, treat and monitor chronic diseases such as diabetes and high blood pressure; and they can order and interpret diagnostic studies such as lab work and X-rays. To practice in Delaware, a nurse practitioner needs to be nationally certified. The University's two-year program has both a master's and a post-master's option and requires a minimum of one year's experience as a nurse, although most people who enroll have worked in the field for l0 years. Students take four clinical courses taught by practicing nurse practitioners and put in 90 hours of clinical practice with each course. At the end of the program, there is a concentrated block of clinical hours where each student is responsible for finding his or her own preceptor or instructor. Nurse practitioners enjoy great acceptance by patients, and an American Medical Association survey of physicians who employ nurse practitioners found them all supportive. Sheer says students who enroll in the program want more autonomy, want to be able to make decisions and want to work with a population that is healthier than, say, those patients in an intensive care unit. Michelle Galloway, Delaware '81, another graduate of the program, says variety is important to her. As such, she holds two nurse practitioner jobs, working for Planned Parenthood and for Brandywine Pediatrics. "While the diagnosing and problem solving is very rewarding, it's also very special to see the impact you can have on each child and family. If a baby is overeating or not sleeping, it's important to discuss that with a parent. If a child is crawling, it's appropriate to suggest safety locks, and, if a child is at the age when he or she is going to start riding a bike, it's important to talk about preventable injuries and bike helmets. "It feels good to be able to reassure a parent that his or her child is normal, that whatever behavior they might be concerned about is age-appropriate. With adolescents, it's a chance to avert problems before they occur." Working in clinics in Newark, Wilmington and Claymont gives her access to diverse populations, ranging from a coed out on her own for the first time to the indigent woman who can't afford the cost of a gynecological exam by a physician. Both Galloway and Govatos are finding that they are building a patient base as time goes on. Galloway, who worked in a newborn intensive care unit for 14 years and as a doctor's nurse, says patients who know her are happy to see her as a nurse practitioner. Govatos says she is pleased that all three of the staff members in the clinic have brought their sick children to her. -Beth Thomas