Tuesday 15 October 2019

How I became an NP: Reproductive Endocrinology and Infertility


I didn’t always know I wanted to be a women’s health nurse practitioner. Honestly, I didn’t even know I wanted to be a nurse. Here’s what I did know: I was skilled in science. I wanted to work directly with people, and I needed to have many options for growth in my career. So, when a recruiter from the University of Pennsylvania spoke to my AP biology class and introduced the numerous paths that you can pursue with a nursing degree, I was ready to sign on the dotted line and applied to Penn (and only one other school, by the way, which was idiotic and a topic for another day).
After graduation, I accepted a position as a staff nurse in the Neonatal ICU at a large, metropolitan teaching hospital. I observed with awe the autonomy that was afforded to the Neonatal Nurse Practitioners who worked there. They worked in parallel with the neonatal fellows, and each baby, once admitted, was assigned to either the Nurse Practitioner (NP) or Fellow team.
It took me, oh, about a day before I realized that I wanted all of ‘my’ babies assigned to the NP team. They were knowledgeable, confident, and approachable. Then it hit me: This is what I wanted to do.
I decided that I would explore women’s health, maybe become a certified nurse midwife. Accordingly, I transferred to Labor and Delivery and realized that I loved women’s health, but in an outpatient setting, probably as a Women’s Health NP working in an OB/GYN clinic. I returned to Penn for my MSN, then moved back to NYC fresh and ready for people to employ me. But there were few job opportunities for a Women’s Health NP new grad, and I had some student loans looming, so I took a leap of faith and what happened next was both inadvertent and serendipitous.
I saw an ad for a Reproductive Endocrinology and Infertility (REI) nurse at a large hospital in NYC and scheduled an interview. Although I usually pride myself on the depth of my preparation, this time I decided to wing it and go to the interview relatively unprepared. I didn’t really want this job anyway, I thought. I was just was going to see it as an intermediary step in my journey to work at an OB/GYN clinic. At the time I didn’t know much about REI nursing (we had a sum total of 2 lectures on it in school) and I didn’t realize that the clinic to which I was applying was the biggest one in the country.
I met with the medical director (whom I later realized was a world-renowned fertility doctor revered by most) who asked me why I wanted to work there and what subspecialty within REI I liked the most. Wait, I thought, there are subspecialties within the subspecialty? I tried to deep breathe through my panic and answer his questions somewhat intelligently. He was also concerned because it was a teaching hospital where residents and fellows were training and he wanted to know how an NP would assimilate in this environment. Luckily, I had an answer to this because I saw this staffing model work well in the Neonatal ICU.
Ultimately, I either convinced him, or he must have liked me in spite of fumbling and bumbling, because he offered me a job under one condition: I would work there for six months as a nurse (as opposed to an NP) to learn about REI and during that time period he would learn how an NP can function in his practice. If, after that time, we were both satisfied, then he would transition me to an NP role within the practice.
That was 20 years ago. I fell in love with REI nursing and have worked in the field ever since. And, guess what? The medical director who questioned an NP’s role in a teaching hospital? He has steadily employed NPs every year since I left to move to a different part of the country and remains a strong advocate for our profession which, of course, I consider my legacy and attribute to my contribution to his practice (let me have my moment here).
Happily, my career continues to grow and evolve. In addition to being an REI NP, I’ve been a nurse manager, nurse educator, a writer and now, an entrepreneur with my own education consulting business. When new nurses or nurse practitioners ask me to list the important qualities for career success, I would add curiosity and flexibility. Had I been firmly tethered to my initial desire to work in an OB/GYN clinic, I would have missed out on this opportunity for growth in a field in which I had little knowledge. My last piece of advice: just realize that sometimes the risk is part of the process. Allowing yourself to take a chance, regardless of the outcome, can be incredibly rewarding.
Monica Moore MSN RNC, started her NP career in infertility over 20 years ago. She has worked as a staff nurse practitioner, and nurse manager, but found that her true passion is educating nurses. As a result, she founded Fertile Health, LLC and The Fertility Nurse Newsletter to provide valuable resources and content for all levels of nurses in the infertility field.

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