Cheryl-Lynne Kitts, DNP, APRN, FNP-BC and Amy DeVece, MSN, APRN, FNP-BC, CCRN, CEN are nurse practitioners (NPs) working in the specialty health care field of interventional radiology. Practitioners working in interventional radiology use innovative technologies to treat patients with cancer, stroke, venous disease, peripheral vascular disease and trauma.
Cheryl has been a nurse for 40 years working in critical-care, obstetrics and radiology. She is a testament to life-long learning as she started off as a licensed practical nurse, then became a diploma registered nurse and then received her Bachelor of Science in Nursing. Cheryl didn’t stop there, she then obtained her Master’s degree as a family nurse practitioner, then obtaining her doctorate in nursing, and is currently completing a family to acute-care NP bridge program. Cheryl said, “I love nursing because you have the ability to reinvent yourself and your career, all while serving others.”
Cheryl is completing the bridge program with her colleague and friend Amy DeVece. Amy’s background includes emergency and critical care nursing and work as a family nurse practitioner.
What keeps them coming back to radiology? They say it’s the excitement of new advancements in interventional technologies and procedures. Cheryl, Amy and their interventional nurse practitioner colleagues float among different areas under the umbrella of interventional radiology. Some of the most common practice areas include heart and vascular interventional procedures, MRI and CT scan patients, outpatient follow-up, the radiology care unit where outpatients are treated, inpatient hospital consults and inpatient rounding on patients pre/post interventional procedures.
Some common procedures that NPs are performing include removal of tunneled central venous catheters, tunneled dialysis catheters, chest tubes and percutaneous drains. Nurse practitioners are also trained to perform bedside diagnostic and therapeutic paracentesis.
Top of License Practice and the Consensus Model
The recommendation that all nurses work to the top of their education and licensure has been discussed for decades. It gained national attention in 2010 with the release of a landmark report from the Institute of Medicine (now known as the National Academy of Medicine), The Future of Nursing: Leading Change, Advancing Health. From extensive research and interprofessional discussions, the number one recommendation from this report was that nurses work to the full extent of their education and licensure.
Cheryl and Amy are exemplars of taking this recommendation and putting it into practice. Cheryl completed a performance improvement study related to delays in performing outpatient paracenteses. Under Cheryl’s leadership, the team developed process improvements including training NPs to relieve physicians, which reduced patient wait times, increased satisfaction and freed physicians to attend to other critical issues. This project resulted in permanent scheduling changes and more NPs trained to perform paracenteses.
How else are Cheryl and Amy performing to the top of their license? The nurse practitioner team performs comprehensive periprocedural care, history and physicals, discharge planning, medication management, rapid interventions in clinically unstable patients and collaboration with other health care providers. Amy states, “In one shift you can move from an uncomplicated outpatient to an unstable intensive care unit patient, all while making independent care decisions. That is why it’s so important to have the background in both family and acute-care practice.”
Continuing to Develop a ‘Jack-of-all-Trades’ NP Role
“Radiology/Interventional Radiology is a unique and complex specialty that is always changing and requires critical decision-making. Collaboration with other health care disciplines is vital in order to create optimal outcomes. We are not just a service that places tubes and lines, we do so much more than people understand,” stated Amy.
Interventional radiology is one of the most exciting specialties that is technology driven and can offer minimally-invasive, image-guided interventions to solve some of the toughest medical problems.
Now that the value of NPs in this specialty role has been demonstrated, there is an increased demand for them. Although the role has come so far, it must continue to be developed with the leadership of NPs and collaboration of other professions.
Cheryl reflects on a colleague, Barbara “Bonnie” Wilson, DNP, APRN, CNS, who was one of the first radiology NPs at ChristianaCare. “Bonnie proved to leaders what NPs could do and the value they created. You couldn’t find a Nurse Practitioner in radiology 20 years ago, now every major medical center has NPs serving in these areas.”
Amy said, “the interventional radiology nurse practitioner role will continue to evolve with NPs managing more complex patients and performing more procedures.” Cheryl added that nurse practitioner students should investigate this specialty because of the significant collaboration with health care providers and patients with varying diagnoses. Cheryl said, “this specialty is fulfilling in so many ways.”