As a nurse for 21 years and a Nurse Practitioner for 17, I was drawn to the profession after having an amazing interaction with a healthcare provider when I was a teenager. The very person that piqued my interest and first spoke to me about becoming a Nurse Practitioner crossed my path, by chance, years later in the small world that is the St. Louis Metropolitan area. I was preparing to leave one job for another, and she had applied for the position I was vacating. When I saw her name in the resume stack I was floored. “How perfect!” I remember thinking, “so dynamic, thoughtful, and so personable. She’ll be a fantastic match for the office!” I was lucky enough to see her at the interview and excited to regale her with how her approach with me so many years earlier had made such an impact. And this is where we have a plot twist. I (re)introduced myself to her – and she smiled, nodded, and seemed less than impressed. Talk about a fizzle. Ultimately, she was hired for the position but did not last long—only about six months. She left the practice on her own terms. But the feedback from everyone was that she seemed “burned out.” One of the physicians in the practice later told me “she just didn’t make connections with our patients.”
I’ve been working on the front lines of public health for just over 10 years. And in recent months, since COVID-19 hit our country, I have given thought to that scenario often. In the blink of an eye, we had to shutter the doors, come up with a viable plan to continue to deliver essential services in some capacity, and get creative with testing and treating patients. We had to figure out how to protect ourselves and our patients from something that cannot be seen with the naked eye. Out of necessity, the telehealth service delivery model has become a part of our new reality. There is a process to get folks on a schedule and prepare them for what to expect. Appointment times can be tricky. Sometimes there are pressing matters in the clinic and I am late with calling. Sometimes they have a cranky toddler who is on a nap strike, clinging to their leg making it difficult to do anything, let alone discuss personal health concerns. It is not a perfect model for the delivery of care – but it is what these times have called for, so we oblige.
I have been missing the interactions with my patients at the bedside something fierce. Their body language, their shoes, the belongings in the chair next to them – I was not aware of how much I relied on direct observation until the past few months. I try to find light and levity in nearly every interaction – but that can be an interesting feat when you have little to no rapport with someone. Picking-up on ques from the patient and allowing those to help guide the discussion has always been integral to how I practice. So now, more than ever – I need to be striving to build rapport, listening for ques, and hearing what my patients are telling me.
My realization: the COVID19 pandemic has sparked new life into my practice because I know my patients deserve the kind of connectivity I had so many years ago. It may look a lot different and not always be easy to come by, but I know there is power when people are heard and seen. Even through the telephone or over a video conference line. And so with the advent of widespread telehealth services and a whole lot of fear and unknowns as we look to the future – one of my most important roles is connecting with my patients: making them feel heard, giving them the space and time to make their health the priority. I can let them know we all have a public/shared experience that is the year 2020, but also their private/personal experience deserves acknowledgement. I find myself affirming and re-affirming on most of my calls: “You matter. Your story matters – and only you can tell it. I am hear to listen.” In closing, take care of yourself. Take care of one another. And as a wise man once told me: continue to learn more, do better.
Kate Wagner, MSN, RN, FNP-BC
Jefferson County Health Department Nurse Practitioner
Alive & Well JeffCo Steering Committee Member & Ambassador