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Transforming Primary Care: One Nurse’s Story

Nurse comforting patient sitting on couch

(The APNs Transforming Care series is brought to you by The Johnson & Johnson Campaign for Nursing's Future) The Johnson & Johnson Campaign for Nursing's Future and have partnered to develop a new content series, "APNs Transforming Care." The series looks at ways advanced practice nurses are changing the face of healthcare delivery and will include inspirational stories and interesting Q&As about APNs in different areas of the country who are meeting and exceeding the 2010 Institute of Medicine recommendations for the future of the nursing profession. The series also offers practical advice on pursuing a career as an advanced practice nurse. It culminates in a downloadable e-book that includes many topics from advice on broadening various nursing roles into APN roles; the benefits of a career as an APN; programs and academic prerequisites, finances, certifications and more. We invite you to join in a two-way conversation with your colleagues about nursing's expanding role in healthcare's future, via social media. -- Andrea Higham, senior director, corporate equity & partnerships, Johnson & Johnson

APNs Transforming Care profile: Marcy Bergeron, MS, RN, ANP

In the mid-1990s, Marcy Bergeron, MS, RN, ANP, felt the profession she knew and loved was in crisis and patient care was at risk. "Patient assignments had more than doubled in many facilities and mandatory overtime had become the standard, resulting in a demoralized nurse workforce and the inability to provide quality care," she said. [caption id="attachment_46621" align="alignright" width="216"]Marcy Bergeron, RN Marcy Bergeron, RN[/caption] Going through appropriate organizational channels, she worked to effect change. When unsuccessful, Bergeron decided to do something more. "Seeking higher education seemed to be the best solution. I hoped it would give me more control over my practice and allow me to advocate for safe care and influence care delivery by developing new care models," said Bergeron, who enrolled at Northeastern University and earned a BSN and MSN, majoring in the adult primary care nurse practitioner tract. Simultaneously, she shifted her practice from inpatient nursing to ambulatory care and learned about the many clinical opportunities there. "It was more exciting, challenging and rewarding than I had expected, and with this new perspective it was easy to make the decision to pursue my advanced nursing degree," she said. Bergeron has worked in a wide variety of settings and specialties, including NICU, ICU, ED, cardiac step down, med/surg, urban health centers, family planning, diabetes education, urgent care, relief work in developing nations, outpatient pediatric allergy, an HIV program and a group home for disabled children. As an NP, Bergeron has been a primary care provider for mostly non-English speaking patients and immigrants with challenging conditions and cultural barriers to self-care. She always had an interest in chronic disease management, and now, as director of clinical operations and nursing for primary care at Massachusetts General Hospital, Boston, she created a primary care, nurse-led initiative addressing care transitions. Along with a physician and administrative director, she oversees the operations of 21 MGH-affiliated primary care practices and health centers with more than 160,000 patients. Bergeron promotes professional nursing practice, leads Magnet efforts, mentors nurse leaders and oversees primary care quality and safety with a physician colleague. "Practicing at an academic medical center with so many educated and talented people, I feel it has been critical to have an advanced degree. I have gained the respect of my colleagues and have the necessary knowledge base when tackling complex problems and diagnostic dilemmas," she said. Modest about her achievements, Bergeron credits her colleagues for the success of the various initiatives she has led. Among her many accomplishments, Bergeron designed an evidence-based diabetes care model, now the model for all MGH primary care practices; created and implemented a post-discharge call effort resulting in higher reimbursements and decreased readmissions; developed a patient education center that expanded to a web presence for 25,000 patients; optimized patient registries as part of a widespread population management effort; and spearheaded the establishment of a primary care nurse leader council. "In primary care we now have a much greater emphasis on population health, caring for a group of patients outside of the traditional office visit," Bergeron said. "This shift requires a different nursing skill set and a new set of proficiencies, especially given the fact that patients are currently being discharged earlier and are much sicker. The telephone is our stethoscope, and keeping patients healthy and safe at home is our ultimate goal." Bergeron shares words of wisdom with those who wish to obtain an advanced practice degree. "Timing is important," she said. "Try to be at a place in your personal life where you feel you can do it and succeed. You will be challenged and it may be difficult at times, especially if you work full time. Spend time with other nurses who value and encourage your educational pursuits. Find a mentor who will provide you with the support and inspiration you need. Go for it!"