Future nurse practitioner shadows in Littlefork, By TOM LAVENTURE, Staff Writer

Nancy Burmeister is completing her final two semesters at The College of St. Scholastica in Duluth to become a nurse practitioner. She spends more time at the Littlefork Medical Center than in Duluth, however, as she adjusts to what will be her new role with expanded responsibilities.
The Littlefork Medical Center is a rural health clinic with one family practice and internal medicine physician, in addition to Linda Nordlund as the family practice nurse practitioner. Burmeister is “shadowing” Nordlund, a term given to a student nurse who is preparing to work as a nurse practitioner in a clinic setting.
Nordlund said the term does not reflect the level experience and participation of the shadow nurse in daily patient encounters.
“I hope the student gets a valuable experience, because the end result is that they will be practicing independently themselves,” said Nordland.
“Nancy is a very bright student and is very on top of things,” she added. “She deducts as she goes along and has lots of questions.”
Burmeister has lived in Littlefork since 1988, where she raises three sons with her spouse, a Boise employee. Becoming a nurse practitioner is a natural progression in her professional development. She attended Bemidji State University to become a certified nursing assistant, and worked as she studied to become a licensed practical nurse. She continued working as she completed her bachelors degree to become a registered nurse.
The goal of earning a master’s degree and becoming a nurse practitioner was possible, she said, because of a love of learning and her good fit with her chosen vocation.
“I just continued to want to know more and to do more,” said Burmeister.
Burmeister is currently completing 140 semester hours of clinical work, and will need to complete 200 hours this fall, and another 270 hours next spring. She joins Nordland in her daily rounds in the rural clinic, along with adjoining long-term and assisted living facilities and a chemical dependency recovery center.
The NP experience, she added, is “combining the science of nursing with the primary management piece.” As an RN, Burmeister can assess a patient’s condition and their immediate needs. As an NP, the nursing role is still there, along with the enhanced role of developing patient health plans, conducting prevention education and awareness programs, writing prescriptions and monitoring health conditions.
“That is where the role changes and sometimes we are so entrenched in our old habits,” she said. “It is comfortable, and it’s hard to step out of that and get into a whole new role of managing the patient by yourself.”
The value of shadowing, Nordland added, is to take a student with years of practical nursing experience behind them and having learned to keep their cool under pressure, can help them adjust to a new role, using a new decision making process and communication skills.
“That is not learned in a graduate program, but from being a nurse, mother and spouse,” she said.
Nordland said the NP expands the role of nursing with another function in primary care health maintenance when it does not require a physician. She said the NP is prepared to deal with common health issues and disease processes of the life process from childhood to old age. From diabetes to arthritis, and blood pressure and obesity, they handle the conditions that require intervention and continuous monitoring.
The physicians and specialists come in when ailments “deviate from the norm,” said Nordland. “The NP will hopefully, keep people healthier throughout their life if their health is managed appropriately.”
The NP plays a critical role in rural health and Burmeister said this is partly because they are relatively autonomous, and without the benefit of specialists on staff, they must assess the patient’s condition and refer out when necessary.
“You get a little bit of everything,” she added. “You are going to be monitoring their condition after they have seen a specialist, and that is not usually the case in the city.”
Nordlund is also a lifelong caregiver who became a nursing assistant out of high school before completing an undergraduate RN program at Gustavus Alolphus. She worked at various clinics and hospitals until accepting the director of nursing position back home in Littlefork.
After four years Nordland said she came to a crossroads and had to choose between a path in administration or patient care. She chose to attend the St. Scholastica NP program and has enjoyed becoming a primary care giver and the first NP at Littlefork.
“It’s been pretty darn exciting to be able to work with people and do what nurses are educated to do,” said Nordland.