Issue link: https://digital.copcomm.com/i/1143172
16 Working Nurse l WorkingNurse.com July 15–August 12, 2019 MY SPECIALTY by Keith Carlson, RN, BSN, CPC, NC-BC Please tell us about your nursing career journey. I've been a nurse for 34 years. I graduated with my BSN from Penn State University in 1985. My first nursing job was in an adult med/surg ICU at Hershey Medical Center, taking care of mostly postopera- tive cardiac surgery patients. Not long after I started, my manager asked if I wanted to learn how to take care of pediatric cardiac surgery patients. That was my first experience taking care of children and I loved it. I wanted to earn my MSN, but there were only a few cardiopulmonary MSN programs in the U.S. and UCLA had one of them. So, I moved to California, graduat- ing in 1993. My next clinical position was at Stanford at the Lucile Packard Children's Hospital. It became apparent that I need- ed to medically manage patients, so I did a post-master's nurse practitioner certifica- tion at UCSF. In 2003, I returned to Southern California to pursue a Ph.D. at UCLA. I continued to work part-time as an NP in pediatric car- diac surgery at Children's Hospital Los Angeles. I completed my Ph.D. in 2007. Around 2009, I transitioned to acade- mia and took a faculty position at UCLA School of Nursing. Are you practicing clinically at this time? I still practice per diem as a pediatric nurse practitioner (PNP) at Children's Hospital Los Angeles. I enjoy that I can still engage in clinical work while being an educator. It enhances my teaching and keeps me in touch with the concerns of patients living with congenital heart disease. Tell us about your position at UCLA. Primarily, I teach in the PNP program and have an NIH-funded research program focusing on adolescents with congenital heart disease, in particular single ventricle heart disease. I'm looking at structural changes in the brain, cerebral blood flow and neurocogni- tive outcomes in teenagers who have had multiple open-heart surgeries at a young age. My goal is to develop and test inter- ventions that can improve cognitive deficits and the patient's future self-care ability. What changes are you seeing in the education of advanced practice nurses? Over the past decade, I've seen the grow- ing need for PNPs in the inpatient and acute settings. In 2003, the Accreditation Council for Graduate Medical Education (ACGME) imposed medical resident hour restrictions, which were updated again in 2010. Coupled with a shortage of primary care physicians in many communities, this has led to a need for highly skilled nurse practitioners — not just PNPs — in both acute and primary care. At UCLA, we have a well-established pediatric primary care program, but did not offer acute care training. With so few acute care PNP programs in California, I wanted to develop a program to train more pediatric acute and primary care providers to provide care across the con- tinuum of health/illness and increase employment flexibility for PNPs. The concept of a dual-educational mas- ter's degree program for acute/primary care PNPs is not new. Through the Association of Faculties of Pediatric Nurse Practitioners (AFPNP), which is an impor- tant national organization for our special- ty, I developed standards and guidelines for this type of program back in 2008. We conducted a UCLA pre-program sur- vey of 144 practicing PNPs and students Nancy Pike, RN, Ph.D., CPNP-AC/PC, FAAN Pediatric Nurse Practitioner UCLA School of Nursing Nursing Program Innovator Training APRNs to fill the primary care gap RESEARCH INTO ACTION Nancy Pike created a two-year master's program that allows pediatric nurses to be dually trained in both acute and primary care. Above, she presents her research at a nursing conference.