Advanced training key to nursing growth

HEALTH MATTERS: Dr. Al Kurose, CEO of Coastal Medical in Providence, on right, talks recently with the new wellness clinical team about the value of their Medicare Annual Wellness Visit center, which opened in March. The team includes, from left, nurse practitioner Christina Botelho and pharmacist Elyse Leandro. / COURTESY BILL GALLERY
HEALTH MATTERS: Dr. Al Kurose, CEO of Coastal Medical in Providence, on right, talks recently with the new wellness clinical team about the value of their Medicare Annual Wellness Visit center, which opened in March. The team includes, from left, nurse practitioner Christina Botelho and pharmacist Elyse Leandro. / COURTESY BILL GALLERY

Christina Botelho spent 7½ years as a nurse at The Miriam Hospital caring for some of the sickest patients, but today she is a family nurse practitioner at an independent group practice.
At the end of 2012, Botelho graduated from the University of Rhode Island with a master’s degree in nursing and was board certified two months later. She began work as a nurse practitioner in November 2014 at Coastal Medical Inc. of Providence, where she is now, after working for about 1½ years as an occupational health nurse practitioner at General Dynamics Electric Boat, she said.
The change in moving from a hospital to an outpatient setting reflects a general industry trend and means Botelho, 31, of Cumberland, can diagnose conditions, formulate treatment plans and prescribe medications – responsibilities previously reserved for doctors.
“I still feel I’m a nurse,” Botelho said. “I still look at myself as a nurse. I just had an opportunity to go back and get further education so I can service patients better.”
Demand for RNs overall, including nurse practitioners, is forecast to be strong, with 4,125 openings between 2012 and 2022, the fifth highest class of jobs in demand in Rhode Island, according to the DLT’s “Occupational Outlook.” (Retail sales is the highest, with 6,834 projected openings.) Nursing assistants are right behind RNs, with 3,883 job openings projected in that same period.
Many of those openings in both nursing categories, however, are projected replacements for existing jobs. Only the typically lower-paid nursing assistant is on the state’s list of the 50 fastest-growing occupations during the same time period, ranking second.
Mary Sullivan, interim dean at the College of Nursing at the University of Rhode Island, singled out nurse practitioners as the category for growth within nursing, noting RNs are seeking out more training to be able to do this work because they are aware of the “growing need for nurse practitioners in advanced [health care] practice.”
With overtime, Botelho says she could make as much as a nurse as she does now as a nurse practitioner. The switch, she says, had more to do with the autonomy she has as a nurse practitioner as well as the holistic care delivered to patients.
“Work in a hospital is very episodic,” she said. “You see a patient but you don’t get to follow them. I really like having that therapeutic relationship and the continuity [as a nurse practitioner].”
She also likes being able to collaborate with nurse care managers, pharmacists and specialists at Coastal Medical.
She plans to stay in Rhode Island, where she sees health care as a field with a bright future.
“I feel like it’s going to keep growing,” she said. “We have a lot of patients that still need primary care, and there’s a focus on working patients with diabetes and disease-specific populations.”

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