‘YOU ARE A NURSE’
CAREGIVERS SHARE TALES OF REWARDING PROFESSION
It wasn’t until Darlene Sawicki was in her mid-30s and working in research at a Massachusetts General Hospital neurology clinic that she found her true calling.
During a particularly intense clinical trial that required her to put in long hours, Sawicki said she bonded with the nurses there.
At one point they looked at her, and said: “You are a nurse.”
But Sawicki, who was at the time the site director for the neurology clinical trials unit at MGH, felt too old to start a second career. Still, she eventually took her colleagues’ advice and got a nursing degree in 2008 and became an advanced practice registered nurse four years later. Today, at age 44, Sawicki is a nurse practitioner at the ALS clinic at MGH.
“I actually feel like now I have found my footing,” she said.
Sawicki is one of a rapidly growing number of adults who are choosing to become nurse practitioners, a type of high-level nurse that in certain states can provide much of the same care as a physician, with certain limits.
Hiring of advanced practice nurse practitioners — which also include nurse anesthetists, nurse midwives, and clinical nurse specialists — is expected to grow by more than 30 percent by 2024, according to the U.S. Bureau of Labor Statistics. A combination of changes to health care laws, a growing emphasis on preventive care, and the aging baby boomer population is fueling much of the demand, according to the bureau.
“Nurse practitioners are the fastest growing primary provider in the country,” said Taynin Kopanos, the vice president of state government affairs at the American Association
of Nurse Practitioners.
Over the past seven years or so, Kopanos said the number of nurse practitioners has surged nationally from 140,000 to 220,000. In Massachusetts, the number of nurse practitioners has also jumped, from about 5,500 in 2006 to more than 8,560 in 2016, according to statistics kept by the state.
“There is definitely a huge trend,” said Lorena Silva, the executive director of the Massachusetts Board of Registration in Nursing.
For the nurses, the position can be rewarding both personally and financially. The median pay is more than $100,000 per year, according to the U.S. Bureau of Labor Statistics, and several nurses interviewed for this story said they love their jobs.
“I have never dreaded going to work,” said Anne Krekis, who has been a nurse for 33 years and currently is a nurse practitioner specializing in internal medicine at Atrius Health’s Harvard Vanguard Medical Associates office in Copley Square. “The relationships you are going to have with patients are rich and therapeutic ... It really has been fun.”
But the educational and clinical requirements are rigorous — some of the toughest to complete
in the nursing profession. Typically, it takes about six years of schooling and training — and a master’s degree — to become a nurse practitioner, which is considered a type of advanced practice registered nurse.
Sawicki described nursing school as being “like boot camp” and said she is “very grateful I did that as an adult.”
And though it can be grueling, all the hard work ultimately translates into a good job.
“All of my students end up getting employed within six months of graduating,” said Patricia Halon, an advanced practice nurse and the graduate program director in the department of nursing at the University of Massachusetts Boston.
And though the Bay State is one of about 28 states in the country that still restricts the independence of nurse practitioners, nurses in Massachusetts generally enjoy great responsibility when it comes to providing care for patients. They can perform physical exams, provide medical advice and treatment plans, order diagnostic tests, run some medical equipment, and diagnose a range of health problems.
“We work as a team,” said Dr. Moira Cunningham, the chief of internal medicine at Atrius Health’s Copley office, who works with Krekis. She said having nurse practitioners on staff allows more patients to be seen at her office, and improves care.
The nursing profession is still largely regulated by states, but an effort has been underway for the past several years to make the roles and educational require-
ments of nurse practitioners more uniform across the country. Last week South Dakota became the 22nd state — along with Washington, D.C. — to allow what’s often called “full-practice authority” for nurses. Similar legislation is also being pushed in Massachusetts, which currently requires nurse practitioners to work under the supervision of physicians when it comes to writing prescriptions for medications, which limits their ability to open private practices.
At UMass Boston, Halon said the limits placed on nurse practitioners in Massachusetts probably haven’t driven many of her students to seek jobs out of state, but she does feel they should be lifted. And she said nurses play an important complementary role in caring for patients here.
“It’s patient-centered, quality care,” Halon said. “We really focus on disease prevention and we provide health education.”
A nurse for nearly four decades, Halon said she still loves her job and remembers why she decided to enter the field as a teenager.
“I was in the ninth grade, and my father asked me what I wanted to do,” she recalled. “I said, ‘I’m going to nursing school at UMass Amherst.’”