More care for more patients

MVH nurse practitioners rise to meet the growing needs of our Island.


When I washed ashore on Martha’s Vineyard a couple of decades back, I considered myself lucky to find a doctor. But actually seeing that doctor? Not so easy. Appointments could take days, often weeks, to schedule. So the sudden onset of a sore throat, or that red bullseye rash, indicating a tick had had its way with me? Those were accepted grounds for a visit to the hospital emergency room.

Those days are over. Urgent care is now most often delivered in a clinical setting instead of the ER, by a team instead of a single physician. A certain number of ”sick visits” are now structured into the way the hospital does business, allowing for more immediate response to patients. Same-day — or at least same-week — appointments are routinely available, depending on need. A sick patient’s call for help is initially handled by a triage team of nurses who assess need, and schedule an appointment with a member of the care team.

Members of the team most often providing urgent care are nurse practitioners (NPs), a record number of whom currently practice at the hospital, according to Dr. Ellen McMahon, chief of medicine at Martha’s Vineyard Hospital. And that number is growing, due in part to the online education programs for nurses to become nurse practitioners, financially underwritten by the hospital.

This growth is not unique to Martha’s Vineyard. The U.S. Bureau of Labor Statistics projects that “nurse practitioners will be the No. 1 fastest-growing occupation in the U.S. over the next decade.”

The reasons for nurse practitioner growth are many, including an acute shortage of primary care physicians and the significant number of duties nurse practitioners can take off the hands of harried physicians, among them ordering tests and prescribing medications. A hospital switching from single-doctor care to a team-care approach benefits both patient and provider, according to the American Academy of Family Physicians: “Patients get seen faster, and the possibility of physician burnout is lowered.”

Not all patients are enthusiastic about the switch to team care, admits Dr. McMahon: “Sometimes if a patient is used to seeing just one person, it’s been really hard.” Full disclosure: I was among the unenthusiastic about team care, at least initially. My beloved primary care provider, Dr. Barbara Krause, died suddenly, about the time the team approach to care was being implemented at the hospital. Suddenly I found myself sitting across from a rotating cast of providers. In time, however, I changed my attitude: Instead of seeing my exposure to a number of different practitioners as an annoyance, I came to think of it as kind of an “audition” process — an opportunity to pick from the pack a single practitioner who best suited my healthcare needs. Now I schedule routine care, such as annual wellness visits, with Katie Friedman, NP. And for urgent care, more times than not, Katie is available — if I ask.

Nurse practitioners are among an increased number of what Dr. McMahon calls “advanced care providers” practicing at the hospital, including physician assistants (PAs) and nurse midwives: “They are also part of many teams we’ve built up throughout the hospital, not just in primary care.”

In dermatology, Nurse Practitioner Paula Karol, a former bedside nurse in acute care, now works alongside Dr. Michael Bigby. In the operating room, surgeons are supported by physician assistants (PAs) Anthony Piland and Mark Colucci.

In surgical services, Elizabeth Anderson Moriarty, NP, works alongside aspiring nurse practitioner Shannon Surpin, R.N., who is one of five M.V. Hospital nurses currently studying online to become a nurse practitioner. I’ve gotten to know this pair during months of wound care, after an unfortunate accident involving a vacuum cleaner and a stupidly stored storm window left a large gash in my left leg.

Discussing her online classwork as she bandaged and unbandaged my leg dozens of times, Surpin explained some key differences between medical school studies and the subject matter in her masters-level coursework at Regis College. “In med school, disease is studied at a cellular level; in my courses we approach it at a more practical level.” Practical, as in the subject of a 13-page paper she recently completed on patient compliance: how to get folks to wear anti-embolism pressure stockings. Her paper will be shared with other nurses in her course from as far away as California.