Nurse Practitoner uses advanced skills to optimize patient care

Payal Fichadiya, MN, NP, is a nurse practitioner who helps care for critically ill patients in the Coronary Care Unit at Rockyview General Hospital (RGH). We sat down with her to learn about how she spends her days and what she loves best about her job.

How does your work differ from that of an RN?
In my role as an inpatient nurse practitioner (NP), I often participate in assessing and medically managing patients as part of a multi-disciplinary team. My nursing training gave me invaluable knowledge of bedside clinical care and the health care interface, while NP training gave me additional skills in physical examination and medical management. As a result, my responsibility is quite broad and focused on advancing the patient’s management plan to get them better. I work closely with our physician colleagues to help deliver this care.

What’s a typical day look like for you?
My morning starts with a handover from the on-call team: I receive updates on new patients and any overnight inpatient concerns. I then familiarize myself with patients on the CCU and visit each patient, writing a progress note describing issues and plans. Formal interdisciplinary rounds start at 9 a.m. During rounds, the attending cardiologist, nurses, pharmacists, and I meet to discuss our patients, with each team member providing a unique area of expertise. Together, we determine how best to care for our patients. The rest of my day is spent completing inpatient and emergency department consultations and reviewing with the attending cardiologist to establish disposition. It is amazing to see the breadth of different clinical presentations a single day can bring!

What do you like best about your job?
I enjoy working as a cardiology/ CCU NP because I find cardiac physiology and the management of cardiovascular diseases rewarding. We encounter patients on their worst days and help them recover back to normal health. The environment I work in, with our great team of NPs, nursing staff, physician colleagues and patients, is the best part of the job. It is a privilege to come to work every day.

What are the biggest challenges you face?
As with many inpatient services, increasing patient volumes, personnel shortages, and resource constraints have made the delivery of safe and timely-care difficult. My colleagues and I address this by providing high quality care one patient at a time and by reminding ourselves that the patient is at the centre of it all!

What advice would you give to someone considering a career as a Nurse Practitioner?
Chase your passion. The work is exciting, patient care is rewarding, and you will never stop learning!

What do you want people to know about nurse practitioners?
NPs are integral members of the health care team and provide tremendous value in many areas of clinical care in both urban and rural environments. Within the health-care team, NPs enhance workflow by being resourceful and efficiently navigating the health care interface to improve the delivery of quality and timely patient care.