MEDICAL STAFF SPOTLIGHT
Ask the providers: APP? NP? PA? CNS? What are their roles at Bryan?
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atients are benefiting from the efforts of advanced practice providers (APPs). In the following interview, these providers describe their roles in modern health care: Cindy Hammond, DNP, advanced practice registered nurse (APRN) with Gastroenterology Specialties and Lincoln Endoscopy Center; Mike Koebernick, certified physician’s assistant (PA-C) at Lincoln Orthopaedic Center; and Sarah Schroeder, mechanical circulatory support nurse practitioner (NP) and program coordinator at Bryan Heart. Q: Who fits into the category of APP? Sarah: APP generally means a nurse practitioner (NP), physician’s assistant (PA), or a clinical nurse specialist (CNS). Until the recent name change to advanced practice providers, we were sometimes referred to by the nickname, “mid-level.” Mike: I’m comfortable with various titles and categories. I think what is most important is that patients know we are well-educated and trained, and we work hard to help patients reach their best outcomes. Q: How independently do you work? Is a medical doctor involved in overseeing your work, or do you have broader responsibilities? Sarah: My role is unique from most NP jobs. As the mechanical circulatory support (MCS)
22 Fall 2016
nurse practitioner and program coordinator for Bryan Heart, I work very closely with two surgeons and two cardiologists who have additional experience in implanting ventricular assist devices (VAD). I have a degree of oversight; however, I look at it being more of a collaboration as I am able to make decisions on my patients, fully knowing that I couldn’t do my job effectively without the great teamwork from the physicians, the other MCS coordinator, and the staff at Bryan. I oversee and manage everything within this program from initial consultation of the patient and educating
patients and their families, as well as hospital staff and the community, implantation of the device, post-operative management and outpatient care of any patient with a VAD. Additionally, I am responsible for the programmatic side of overseeing the management of all equipment, scheduling multidisciplinary meetings and monitoring the financial aspect of an ever-growing program. Cindy: When I first started with Gastroenterology Specialties 13 years ago, we always were paired with a doctor — now, when we’re in the office, we have full practice authority as advanced practice providers, so we work more independently. We have gone from two NPs to seven NPs and two PAs.
Mike Koebernick, PA-C
Sarah Schroeder, NP