Nurse Practitioner Mary Maguire (right) spends many of her working hours in the operating room with Neurosurgeon Keith Kuhlengel.
Those thinking of pursuing a health care career working with surgeons would benefit from talking to the Physician Assistants (PA) and Certified Nurse Practitioners (CRNP) of Lancaster NeuroScience & Spine Associates.
Their training and work schedules are rigorous. Their role is critical to the quality and continuity of care that nurtures and educates a patient before and after brain or spine surgery. They say their close relationship, both with the surgeons and their patients, is the most satisfying aspect of their jobs. Spend a few minutes in their presence and it becomes clear that there are common threads in why they chose to go beyond their initial degrees and training.
Mary Maguire had experience as an oncology staff nurse, a perioperative nurse and a wellness educator before earning her Nurse Practitioner credentials at Villanova University. "I wanted more autonomy in clinical decision making," she explained.
"I constantly challenge myself to learn new technologies, pharmaceuticals, and ways to better the quality of care that we can give," she said. "When a patient returns and is genuinely grateful for the role I've played in their recovery, it's a privilege," she says.
"Our physicians are respectful and earnest," she continued. "They value our input. Our relationship is collegial. I am never afraid to voice my concern about our patients."
Physician Assistant Dennis Delozier (right) works closely with Neurosurgeon Chris Kager caring for patients who've had spine surgery.
Dennis Delozier's interest in becoming a Physician Assistant stemmed from his work as a volunteer EMT/firefighter. Like Maguire, he wanted to be involved with patient care beyond the initial crisis. After serving in the Air Force in air traffic control and as a weather radar technician, he received his Certified Assistant Physician (PA-C) degree at Saint Francis University, Loretto, PA, where he had previously earned his Bachelor's Degree.
He appreciates the close working relationship he has with Dr. Chris Kager, his supervising physician. "He encourages open dialogue about our patients' care," he says.
"Spending time with patients discussing their problems, and seeing them become less apprehensive as they get a better understanding of their illness or injury is the most rewarding aspect of the job," he said.
What's the hardest thing about their jobs? For Maguire, it's witnessing a catastrophic neurological injury or a needless death. "It's hard to stay positive, but you have to do the best you can each day," she said. Delozier answers it similarly. "Telling someone that it's unlikely we'll be able to help them with their problem is the most difficult part of the job," he said.
Both Mary Maguire and Dennis Delozier agree that, while their professions are better known to the public now, "ten years ago, that was not the case," according to Maguire. "I was constantly explaining to patients the role of a nurse practitioner. Now most of the general population is familiar with advanced practice providers," she continued. "They understand that I am credentialed and educated to take care of them."
According to Delozier, "People sometimes think that we only gather information for physicians," he says. "Many are unaware of the extensive training involved in preparing us to be comprehensive healthcare providers." But it's getting better, he agrees.
While there is overlap in terms of the responsibilities of a physician assistant and a nurse practitioner, the distinction between the two careers can be seen in the training required and the leaning a person has toward specialization.
A Nurse Practitioner has intensive training in a chosen field, in Maguire's case, neurosurgery. She began her career as a registered nurse, then went on to earn Bachelor's and Master's degrees. Her comprehensive nursing experience is now focused on patients with brain and spine injury or illness.
Physician Assistants like Delozier typically pursue a health science degree, an intense 5-year, 12-semester program that includes a masters program. It resembles more the model for medical school, covering all specialties from pediatrics to geriatrics, psychiatry to surgery. He worked in internal medicine before choosing neurosurgery.
"The roles of Physician Assistants and Nurse Practitioners started out with more of a focus on primary
care," Delozier said. "Both professions have made significant inroads into specialties like ours in neurosurgery," he said. "I do feel that as people see the specific role we play in health care, and the variety of areas in which we work, more people will be drawn to our careers," he concluded.
"I see nurse practitioners as vital to health care," Maguire said. "Because we start as nurses, patient education is a huge component of what we do. As a nurse practitioner, I'll often see a patient for one issue, and it gives me a chance to gently remind them of lifestyle changes that could improve their health," she said. I really enjoy being involved in neurosurgery," Delozier concluded, "The potential benefits of current technology to our patients are amazing." Upcoming advances will be even more life-changing, he believes. And he considers himself fortunate to have a front row seat.
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ABOUT THESE PROFESSIONS:
Certified Physician Assistant (PA-C)
PA-C’s are formally trained to provide diagnostic, therapeutic, and preventive health care services as delegated by a physician. They do pre-operative evaluations and teaching. They also assist with surgery, in-hospital patient rounds and post operative follow-up. They serve as a vital liaison between hospital nursing units and surgeons’ offices and they coordinate home health services.
PA-C’s must complete an accredited, formal education program and pass a National exam every six years to maintain their license. Training is intensive and multi-disciplined. Previous work experience in the health care field is typical for those seeking PA certification.
Certified Registered Nurse Practitioner (CRNP)
A nurse practitioner (NP) is a registered nurse (RN) who has completed advanced education (a minimum of a master's degree) and training in the diagnosis and management of common medical conditions, including chronic illnesses. Nurse practitioners provide a broad range of health care services. They provide some of the same care provided by physicians and maintain close working relationships with them, including assisting in the operating room. An NP can serve as a patient's regular health care provider, collaborating with physicians and other health professionals as needed, including providing referrals, educating patients on health behaviors, self-care skills, and treatment options.
