Richard Bernard chose his career as a nurse practitioner before it became apparent that the role is going to be a key in the future of health care.
“I’m a certified adult nurse practitioner,” he said. “I’m a midlevel practitioner. We can do a lot of the same things that physicians do: write prescriptions, see patients, render diagnosis and treatments for various conditions. I can treat patients ages 17 and up.”
Out of high school, Bernard’s original career path seemed to point to physical therapy, but that also led in a different direction: nursing.
“I had a lot of family relatives who were in nursing and I found out that, for me at least, physical therapy wasn’t something that I wanted to do lifelong. That aspect that drew me to nursing was the fact that you can go so many different ways with it. There are so many different fields and types of nursing and you could go on to get your nurse practitioner and could move up that way was enticing to me as well,” he said.
Bernard talked about his career and how nurse practitioners will be more needed in the future.
QUESTION: Are you pleased at the way your career has developed?
Bernard: The nice thing with nurse practitioners is I think our role is going to evolve even more. We’re going to become an even bigger part of the health care system and health care in general. Somebody has to see and take care of these patients who are going to flood us. I think nurse practitioners and even physician’s assistants are going to be there to do that. I think with my nursing background, prior to being a nurse practitioner, helps me be a lot more empathetic and helps me communicate to the patient in a language they understand. I feel like I can communicate with my patients on a level they can more understand.
Q: What have been the technological advances that have occurred during your career?
Bernard: The main thing is the ability to treat certain disease processes with smaller and smaller equipment without having to do open surgery. The equipment is getting smaller and smaller and the guys who are coming out of medical school with the training are getting better at doing these endovascular procedures. If we get the right patient, many times the patient is going home the next day. That’s how it’s supposed to be, and that’s the really neat thing to tell people: if we can find blockages early and treat them, these minimally invasive treatments really work wonders.
Q: Of those innovations, which has been most important as far as patient outcomes?
Bernard: I think that primary care is doing a better job of screening these people so that they’re fixing their diabetes and high blood pressure and high cholesterol, so we’re not seeing these train-wreck patients as much. If you look at how much open-heart surgery and even coronary stints that we used to do, it used to be the Wild West. When I worked in the cath lab, we spent all day doing coronary stents. Now, because of these screening things, they are not as ill. Statins are the penicillin of my generation for sure.
Q: What are the treatments for varicose veins?
Bernard: We used to do vein stripping or cutting the vein out of the leg. The way we do it now, we use a radio frequency to heat the vein to shut the vein that is not working down. For most of our stuff, we send out patients home that day. The funny thing about venous disease is a lot of time the symptoms are really mild. There is really an underlying problem and these can cause really bad problems. We see all aspects of vein disease here. The main thing is to let people know it’s not just a cosmetic thing. If they show tendencies toward a real underlying problem, we try to get them to the right place in our practice, on the vascular side rather than me injecting it and trying to make it look nice. It will look nice for a month, but if you have a real problem, it’s going to come back.
Q: What are the factors that cause varicose veins?
Bernard: It is genetic. Ninety percent of the time, if you have a relative with varicose veins, that trait is inherited, but standing professions like nursing or waitressing, that adds to it.
Q: How long has nurse practitioner been an emerging field?
Bernard: It’s evolved to say we needed a master’s level to be a nurse practitioner. Now, in 2014, they want entry level to be a doctorate of nursing. That’s going to be a whole new ball of wax, because you’ll actually be a doctor without being a doctor. It certainly is an evolving and important part. Right now, there is not enough physicians to see patients. In our practice, if they didn’t have a nurse practitioner, they would have to see 40-plus patients a day, but with a nurse practitioner, it keeps the patient loads manageable.
Q: What is your favorite part of your job?
Bernard: I like when you are trying to describe what’s going on to the patient and they have that “a-ha” moment where you can see that they finally get it. That’s a great feeling.
Q: What is most difficult?
Bernard: The worst part of my job is, there comes a point where we have to give the patients the keys to the car back. We can do a lot of thing nowadays to fix problems, whether in arteries and veins. The worst part of my job is when people continue to smoke, continue to go down the road to self-destruction and have not made the changes they need to make. That’s the tough part. They have to take ownership of their health problems.
Article By Florida Today