One of My Best Friends is 93

Abstract

When I started my career as an intensive care unit nurse, I thought I had a pretty good idea of what it takes to be a nurse practitioner (NP). But my experience in post-acute and long-term care over the past five years has certainly changed that. It has been a privilege to be a part of older adults’ care teams. The relationships I have developed over the last five years as an adult geriatric NP have afforded me a lifetime of smiles, tears, laughter, and personal growth in addition to my professional experience, and this is just the beginning of my journey in PALTC. I moved to Texas from Minnesota five years ago to begin my career as an NP, not knowing what to expect but anticipating an amazing journey nonetheless. Unbeknownst to me, I would learn more than I ever expected from the older adults I care for. For instance, a 113-year-old taught me about what matters: never leave your room without lipstick and colorful scarf so you will always look presentable. These older adults also have given me unanticipated care in return: the handwritten thank-you cards, the candid conversations of first loves, the shared stories of the last six democratic conventions from a couple who attended them together, and even a romantic crush on another resident that someone felt comfortable sharing with me, an NP from “way up north.” A 93-year-old has called me on my personal cell phone just to check and make sure I’m OK during the COVID-19 pandemic. Older adults have taught me to be comfortable in my NP role and remain true to my authentic self. Whether I’m talking about the latest haircut, wigs, or lip color with my “girlie girl” residents or listening to Hank Williams’ “Hey, Good Lookin’” while sifting through pictures of tractors from the 1950s with retired farmers living in nursing homes, I have learned to find great joy in these shared moments. I have to remind myself when rounding in a building or making home visits to make sure I actually address the medical concerns because it is easy to get lost in conversation with my newfound extended family. As a 2016 Futures scholarship recipient, I have learned so much since beginning the program and joining the family of AMDA – The Society for Post-Acute and Long-Term Care. The Society has furthered my love for establishing relationships with residents in my long-term care, assisted living, and clinic settings. I find myself checking in on residents “just because,” and I have felt comfortable crying, laughing, praying, or just sitting in a few moments of silence together. It’s the shared experiences that make this work special for me. The Society has strengthened my knowledge base within the management of acute and chronic illness and encouraged my advocacy on behalf of this population. I had the privilege to attend a policy conference hosted by the American Association of Nurse Practitioners in 2020 right before the pandemic and was amazed at the impact I can have as an NP advocating for change. The Society has helped strengthen this voice. In addition, I have been invited to join in subcommittees within the Society to include clinical issues, where I led the creation of the Society’s white paper on the use of marijuana in long-term care and helped update the white paper on staffing issues in long-term care. In addition, I participate in the Nurse Practitioner/Physician Assistant Practice Group and participated on a panel in 2020 regarding our role as NPs in practice. The 2021 Annual Conference will be my third year speaking on a panel, and I am honored to continue to represent my fellow NPs/PAs in long-term care. I thought I had the “patience of Job” before becoming an NP as I had spent many nights with complicated patients in the intensive care unit during my bedside nursing days. Now I accept there is an entirely new level of patience I have to learn as a PALTC practitioner, as I walk families through transitions of care, end of life, and new diagnoses. Learning how to discuss changes/recommendations with patients and families, using the terminology and culturally/spiritually inclusive language and practices, has helped strengthen my ability to truly help older adults age better. What a privilege and honor to be a part of my patients’ health journey as they age. To my special “golden girls,” see you at the next virtual tea party! Ms. Walker is an adult-geriatric nurse practitioner at Baylor Scott and White Health in Texas. She is also currently a doctoral student at the University of Texas, focusing on transitions of care among older adults.