Marie-Annette Brown, PhD, ARNP, FNP-BC, FAAN, FAANP
Educator
Becoming an NP was the best decision I ever made. Being an NP has enriched every part of my life; it is the fabric of who I am. Knowing that, it was easy to respond last week when a new NP, in practice for 3 months, asked for inspiration.
Most days when I leave clinic, I experience deep satisfaction along with the pangs of "Did I miss something or should I have done something differently?" I reflect on how my NP values about relationship and holistic care made a real difference beyond the traditional form of treatment. I learn something new, expand my worldview, and remember that to be a witness to someone's suffering is in itself healing. These experiences enrich my soul, so to speak. They enhance every relationship in my life. Many clinic days, I also consciously celebrate my ability to practice to the full scope of NP practice. I can easily prescribe a controlled substance, along with other kinds of coaching, for my primary care patient who is experiencing panic after her home was broken into. Our journey together included divorces, family caregiving and deaths, well-deserved promotions, and celebration that her troubled teen graduated from college as an engineer! I remembered that I worked hard for scope of practice changes that were the foundation for my joy!
As soon as I realized that each small victory for NPs planted a seed for the future, I saw the power of renewal through each collective success. Whether it was a Health Resources and Services Administration grant to expand our university's NP program, the 1985 WA State Advanced Practice survey (the first of its kind), or our new DNP post-BSN program, the possible value to my students and practice colleagues re-energized me. I know what it means to "take a village." Over the years I designed multiple NP surveys and the doctoral courses about questionnaire design finally seemed worth it! I loved my 1985 pink APRN survey that built academic-practice bridges, empowered clinicians, and supported legislative and practice changes!
What if we had a regular practice to share what keeps us going? Now I fully embrace the value of talking with family, friends, and coworkers about what went well today. Ironically expressions of gratitude about the day's opportunities nurture my mindfulness and motivation. Recently, I wondered, what if documentation of these small gratitudes were required to turn off our computers?
As my ability to celebrate successes increased, I was able to relish local, state, regional, and national NP meetings! I am now eager to attend our medical center's NP professional practice group meetings, even when we are updating bylaws (honestly!). My joy grew with good reason. Twenty years ago I realized that my treasured clinic NP practice colleagues felt invisible. I encouraged the 4 of us to meet in a basement room at the end of a long day. It was our dream then to someday have our voice heard. To maintain progress, I organized our meetings, took notes, and solicited a personal favor from 1 of our nursing PhD graduates to volunteer to be our liaison, even though it was not in her job description! Each new member was cause for celebration. Imagine our joy when, after 5 years, we became a formally recognized practice council! Our small dedicated group grew, and formal leaders were appointed. Now, 20 years later, we have medical staff appointments, bylaws that reflect our autonomy, and a chief NP who tirelessly advocates for NPs!
Birds that stay together are more likely to survive in the face of strong winds and predators. Whether you are an introvert or extrovert, run, not walk, to your closest NP group! When I began my academic NP position, I received a seminal piece of advice from a retiring colleague: become involved nationally. Quickly I realized the isolation of NPs in western states, even though Washington State was a pacesetter with full scope of practice. I felt rejuvenated and re-inspired to have found my flock of birds! In gratitude for my newfound sanity, I poured my heart and soul into the National Organization of NP Faculties. NONPF helped me feel less alone and enriched my analysis of curricular issues. My participation in NONPF and national NP organizations helped me survive. My experience as a practitioner and advocacy for our NP program did not seem valued by my academic tenure line colleagues. In my faculty practice setting, where clinical productivity is paramount, the relevance of my academic work, research, and teaching remained unexplored.
My experience taught me that engagement in the "now" is paramount. Paying attention to the present may ironically enable me to spot a promising idea, especially in today's world of accelerated change. A powerful influence on career decisions are vigilance, awareness, and a sense of salience.
I have been surprised, shocked actually, to discover how every chapter of my NP journey, both large and small, provided knowledge, skills, experience that became invaluable in subsequent chapters. Sometimes it's easy to feel impatient about one's current situation as temporary or merely a stepping stone. I might have dismissed my work as a per diem NP at an organization during my graduate studies as simply about supporting myself. Unexpectedly, that role led to teaching women's health to FNP students and the invitation to lead the university's FNP program. When I began the PhD program, I was simply an NP seeking to grow, open to who I would become. In the past 40 years this theme has repeated itself many times.
It is easy to remember the anxiety, churning stomach, and self-doubt as a novice NP clinician or the new president of a fledgling national organization. Sometimes I still feel anxious about being a "good enough" NP clinician, advocate, leader, teacher, or researcher. I will never forget walking across the university campus in tears as a new PhD student, thinking, "Why did I think I could do this? This is really hard." I had let go of a rewarding and comfortable NP position to become the only NP in my PhD cohort. I felt like a stranger in a strange land. As a practitioner, the academic language and jargon seemed very foreign.
The world seems very different now. My identity as an NP is even stronger. It is the core of who I am. I am enormously grateful for 50 years of NP collective work and wisdom and to my colleagues who created a world where NP practice flourishes.
Bio: Dr. Brown is professor of nursing at the University of Washington and a primary care provider/NP at UWMC Women's Health Care Clinic. Her BSN is from Vanderbilt University and her MN and PhD are from the University of Washington. First a women's health care NP and mental health CNS, she later became an FNP. Her career successfully combined research, teaching, and clinical practice. She served as president of NONPF, received their Achievement in Research Award and the Washington State Nurses Association Outstanding Researcher Award, and was highlighted by the 2014 Seattle Met magazine's "Among the Top Docs and Nurses" in 2014. The UW School of Nursing celebrated her work with the Excellence in Teaching Award. Further leadership is reflected as a fellow in the American Academy of Nursing and in the American Academy of NPs. Dr. Brown has authored over 80 research and clinically oriented publications, including 3 books, all of which originated from her research. Through her leadership, teaching, and practice, she is devoted to building the nursing profession and supporting NP students and colleagues.