Could you share a little bit about your background and what drew you into one of the most demanding professions?

My mom was a nurse, so I was inspired to go to nursing school, and she encouraged me to go into advanced practice. Because she worked in the operating room (OR) setting, she encouraged me to become a Certified Registered Nurse Anesthetist. But once I started nursing school, I realized that I didn't really like being in the OR, and I didn't just want to put people to sleep and monitor their vital signs. I really wanted to interact with them and make a difference in their patient care. So, I quickly pivoted to saying, "I'm going to become a nurse", and then, "I'm going to become a nurse practitioner."

Nurse practitioners are often looked to as a playing key role in increasing access to health care across the U.S., especially primary care. Could you talk a little about how you see the profession in that regard?

One of the most important things about the nurse practitioner (NP) profession is that it was born out of the necessity to increase access. When the Centers for Medicaid and Medicare Services were established in 1965, a lot of people gained access to healthcare who didn't traditionally have it....The focus for nurse practitioners was initially in pediatrics, because with Medicaid more children had access to primary care. States quickly recognized that this was a way to get access to areas like rural areas, where healthcare was always a challenge. 

You noted Simmons’ long history of promoting social justice and how this is important for understanding health inequities. How can a nurse at the bedside address structural inequities? How do you embed that in the curriculum? 

One of the major things that nurses learn at all levels–undergrad, pre-licensure, throughout graduate education–is about our role as an advocate. Advocacy, which is really tied to social justice, happens every day at the bedside. For example, you mentioned a patient with a wound. You have to advocate for them to get the best care, the resources they need, and to be transferred to a facility that has the resources to deal with the wound. Nurses often become the patient's voice because navigating the healthcare system is incredibly challenging. 

The Simmons MPH program has had several nurses start the program because they struggled with the limitations of not being able to affect broader, systemic change in their position as a nurse. And it’s possible they were simply not exposed to health care policy and advocacy during their studies.  

[P]ublic health gives people a different credential and a different toolkit, although there is a lot of overlap. I think that having that separate credential outside of nursing can open different doorways, in different spaces. Unfortunately, nursing isn’t always at the policy table, so getting an additional credential outside of nursing can offer some people a pipeline. But you can certainly do it within nursing. Getting an MPH does allow a different path, but within nursing you can also create opportunities for yourself. For example, I’m really involved legislatively at the state level.

Another thing we are facing, generally, is misinformation in health care.... How is misinformation showing up and impacting practice?

Combatting misinformation is an issue of trust. I think upwards of 85% of nurse practitioners practice in primary care, and primary care providers are in that beautiful position to have long-term trusting relationships with their patients. The best way to combat it is by building relationships, earning their trust, and being respectful of their opinion, even if it's based on something untrue. You have to hear them compassionately, and then gently steer the conversation in a way where you're sharing the true scientific evidence. In primary care, this is powerful because if we're repeatedly engaging, we can change their mind over time. 

What is the AI landscape looking like in health care and for nursing?

In a lot of healthcare settings, they're adopting algorithms for predictive models and alerts. Big hospitals and electronic medical record systems like Epic are doing a lot with AI. There's Ambient AI, which listens to your patient encounter and will do your note for you, which is great when you think about administrative burden and burnout for clinicians. What really worries me, since I’m a policy person, is the lack of regulation, guidelines, and standards from the federal and state governments. Big tech says they can regulate themselves, but I don't believe that.

We are living through some difficult times right now, and this might be especially for health care professionals. Where do you see hope for the future?

I think that there is a path forward, and it starts with each of us using our voices and sharing the information that we know based on evidence. Facts are very important, and opinions are also very important, but we have to ground them in science and evidence. Especially in our profession, we have a duty to ensure that we keep striving for health equity.