Oregon NP works hard to empower patients
Oregon’s Lauren Carlson is a family nurse practitioner, not a doctor. But try convincing her patients.
“In my first few years of practice I would work tirelessly to correct people,” she said. “But for the patients, they were like, ‘I don’t care. You are doing everything that a doctor does, so you’re my doctor.’
“I will correct them, but if a person continues calling me doctor, maybe as an easy way to explain to their 4-year-old child who they’re seeing in the office, then I accept that.”
A nurse practitioner, in general, has more training than a registered nurse but less than a doctor. In Oregon and 26 other states, nurse practitioners have full practice authority. They can prescribe, diagnose and treat patients without physician oversight.
She provided that care for nearly nine years at the Aumsville Medical Clinic, part of Santiam Hospital, in Aumsville, Ore.
Studies show patient health outcomes for nurse practitioners are similar to those of doctors, although nurse practitioners tend to have better satisfaction. They are inclined to spend more time with their patients, which can lead to better relationships and more trust.
Carlson was reminded just how deep the connections can be when she left her position at Aumsville Clinic in December for a job as the director of health services at Willamette University in Salem.
“I was not prepared for the emotional response,” she said.
The clinic and hospital were home, and the staff like family.
As hard as it was to leave, she was excited about a new opportunity. Bishop Wellness Center on the Willamette campus serves students enrolled half-time or more when school is in session. She is both the administrator and the lead nurse practitioner at the center.
The administrative part of the job is not expected to change the way she practices health care.
“It’s really important for me to get to know more than someone’s chief complaint of why they’re there,” Carlson said. “I am legitimately interested in knowing, ‘How’s your family doing? What’s going on in your life right now?’
“As I’m expecting my patients to open up with me, I feel like part of that is I need to be transparent and allow them to get to know me a little bit as well.”
Carlson’s approach is more than just getting to know her patients. She wants to empower them, reminding them they are in charge of their health care, not her.
“I look at myself as the navigator, but they’re in the driver’s seat,” she said.
Carlson is the USA TODAY Woman of the Year for Oregon.
This conversation has been edited for length and clarity.
Question: Who paved the way for you?
Answer: When I look back and think about my family and the people who I came from – and I identify as a Black American woman – I’m very proud of my ancestors because they had to be so resilient and persevere through some really difficult and trying times.
And my family. Growing up, I just remember being told, “Get your education because that’s something no one can ever take away from you,” and I really took that to heart. My paternal greatgrandmother, in the very early 1900s, graduated from Fisk University and worked as a teacher all of her life. She ended up having four daughters and all were college-educated women who had careers. Those are the shoulders that I stand on.
Professionally, there are huge shoulders that I stand on. I’m really proud of the trailblazers in the field of nursing that have proactively fought just to be able to be a nurse practitioner, and continue to advance the field and protect and promote full practice authority for nurse practitioners.
What is your proudest moment?
I think what makes me proud is when I’m able to partner with my patients. I really try to work hard to empower them so that they know that they are singly the most important factor in the trajectory of their health. When people feel that empowerment, they’re able to make significant changes. Seeing the look on their face when they’re proud of themselves – we’ve been able to discontinue all of their diabetic medications, as an example – that makes me proud.
Personally, and this is going to sound very silly, but I get excited when my kids eat a vegetable. I’m super proud about that, or if they do well in their sports. When they achieve something that they’re proud of, that makes me proud. My husband’s a runner, I call him crazy runner because he does ultra, very long trail races, and when he completed his first 100-mile race, I was super proud. What is your definition of courage? Courage, to me, is definitely not a lack of fear, because I think fear is a very normal human response. I think courage is the ability to take action and stand strong, despite the fear that is present.
Is there a guiding principle or mantra you tell yourself?
The first one is from my paternal grandmother. I cannot tell you probably how many hundreds of times she said this, “If at first you don’t succeed, try, try again,” which I’m sure everyone has heard. But she said it so much it is so ingrained in me. The spirit of that, for me, means just keep trying. Don’t give up easily. And if it’s something you want to accomplish, just because it didn’t succeed the first time doesn’t mean it’s always going to be a failure, because you learn from those experiences.
I also remember when I interned at Benton County Health Department. I had a supervisor, her name was Jessica, and she told me at the conclusion of the internship, “Whatever you do, wherever you end up, you have to ask for what you want.” The background for that, as women, we don’t negotiate enough. I think she was basically saying with employment contracts and those types of things, and I’ve certainly taken that with me. But also, what I’ve turned that into is, “It never hurts to ask.” The worst somebody can say is no, but you’re bound to get a yes sometimes.
How do you overcome adversity?
I think that adversity is a part of life. It’s going to happen. I don’t necessarily mean to normalize adversity, but the reality is we go through it. There are hard times or seasons in life. I think the most important things that allow myself and maybe other people to overcome adversity, one is mindset. I think believing that you can overcome whatever it is, the challenge that you’re facing, is huge.
Secondly, I am incredibly fortunate in a sense that I have a lot of protective factors in my life. My mom lives with us, so we have a live-in grandma. That’s super fun but also a big support, as a mom of three. I have stable housing. I know where my food is coming from. I have health insurance. I have a stable job. I have reliable transportation. I have a supportive and safe relationship with my spouse. But I also recognize many of the people I see don’t have those protective factors, and it’s so much more difficult to be able to be in a mindset that allows you to get out of whatever challenge you’re facing.
What advice would you give your younger self?
Looking back at myself, especially in college and maybe even the first few jobs I had, I feel like I probably played it very safe. I think I would tell my younger self, “Hey, take risks. It’s OK, this is a good time to take those risks and try new things.” And recognizing that, again, I had a safety net. If something didn’t work out, it was OK. I would also recommend to my younger self to travel more, but my younger self didn’t have a travel budget.
“I really try to work hard to empower them so that they know that they are singly the most important factor in the trajectory of their health. When people feel that empowerment, they’re able to make significant changes.”