Rachel Asquith, left, and Janna Evans are two of the seven graduates in the first class of the Adult Gerontology Acute Care Nurse Practitioners program in the School of Nursing
The man’s immune system had kicked into overdrive, pumping out massive amounts of chemicals to fight an infection.
In such large amounts, however, the chemicals charged past the infection, causing other parts of his body to swell. The condition, known as sepsis, can reduce blood flow, form blood clots and lead to leaky blood vessels. For this particular patient, it led to multi-organ failure.
Janna Evans was trying to keep him alive.
A nurse practitioner at Erlanger Hospital, she was well aware that sepsis can be deadly, especially in patients with weakened immune systems. But it also can be successfully treated with antibiotics and fluids.
Ms. Evans, physicians and other medical staff at Erlanger used drugs to battle the sepsis and a ventilator to keep the man breathing.
He lived.
During the intensive days of treatment, however, Ms. Evans says it occurred to her: ‘Wow, this is acute care.’”
It was something of an eye-opening moment for Ms. Evans, one of seven students in the Adult Gerontology Acute Care Nurse Practitioner program in UTC’s School of Nursing. The group finished in May, the first graduating class in the program.
The students already were certified as nurse practitioners, and all were working at Erlanger when they began the gerontology program. Now they have either a master’s of science in nursing or a post-master’s certificate to add to already-impressive resumes.
New skills
Although the students were familiar with the intricacies of medical care in a hospital, they have spent a year working with both physicians in different specialties and other medical professionals at Erlanger. In doing so, they’ve developed new skills or enhanced ones they already have.
“We collaborate with other specialties better than we did before just because of more exposure to them and getting familiar with them and familiar with what we’re capable of doing,” says nurse practitioner Kelley Hill.
“The clinical part was very beneficial,” Ms. Evans adds in something of an understatement considering the man with sepsis.
Ms. Hill says she and the other six students also deal with patients sent to Erlanger from other facilities.
“They may have shown up in outside facilities in critical care but they don’t have the means to deal with it,” she explains.
Beginnings
Dr. William Crowe, assistant professor and program coordinator for the Adult Gerontology Acute Care program who also works at Erlanger, says nurse practitioners are spread throughout the hospital.
“We have acute-care nurse practitioners on the stroke team, on the neurology ward teams, with pulmonary critical care medicine teams, with the hospitalist team, with cardiology teams,” he says.
“They are also in the emergency department, and could even be found in occupation medicine treating work-related injuries,” he adds.
Dr. Crowe says the program started about 2½ years ago after Erlanger officials noted that the Chattanooga region had a shortage of nurse practitioners who could bring acute-care training into a hospital.
“In response to the need for these specifically educated nurse practitioners from our local hospitals, UTC started the Adult Gerontology Acute Care Nurse Practitioner concentration,” says Chris Smith, director of the School of Nursing.
Each word in the program’s title adds to the entirety of its scope.
“Acute care” deals with situations that have gone beyond the state where they can be treated without hospitalization. For instance, high blood pressure can be treated by a nurse practitioner through medication, diet and exercise but a stroke caused by high blood pressure calls for an acute care nurse practitioner.
“Gerontology” focuses on helping people through the aging process, taking into account the social, psychological, cognitive, and biological aspects. But it also can include geriatrics, which deals with diseases in older adults.
And the word “adult” was a specific choice made by School of Nursing officials to expand the program beyond just gerontology.
“Previously, the term was just ‘acute care nurse practitioner’ but was changed to show that we cared for the adult population, including the gerontology subset,” says Dr. Crowe. “So we care for patients from age 18 until death.”