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Nurse practitioner says she gets the best of two worlds: hand-holding and healing

By Cindy Atoji Keene
Globe Correspondent / January 3, 2010

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On the job with
Judy Walsh, nurse practitioner

During the course of a typical day at the busy Kaplan Joint Center at Newton Wellesley Hospital, nurse practitioner Judy Walsh does everything from injecting medicine in someone’s knee to ease pain to negotiating with insurance companies to get tests and medications covered.

As the sole “constant care’’ provider - overseeing the patient’s progress from the initial call through the rehabilitation process - Walsh brings a caring style and medical expertise to a practice that also includes nine orthopedic surgeons. Walsh says as a nurse practitioner, she enjoys being able to do the hand-holding, “coddling’’ nursing piece as well as the more practical treatment and prescribing of pain medications.

As a nurse practitioner working with surgeons, Walsh provides patients with an intermediary or devil’s advocate. Often she’ll answer questions that patients are uncomfortable asking their physicians.

“There has to be deliverer of hard cold news - the MD - and someone who has to help creatively integrate hard changes in folks’ lifestyles, which is often me,’’ says Walsh, who, as a nurse practitioner, can take health histories and provide physical exams; diagnose and treat chronic and acute problems; interpret X-rays and lab results; and manage medications and other therapies.

The nurse practitioner role evolved in the mid-1960s in response to a nationwide shortage of physicians. Nurse practitioners are registered nurses with a graduate degree in advanced practice nursing and are licensed through the state and national organizations.

“I spent 10 years as an emergency room nurse, and then it was a natural move for me to take advantage of a tuition reimbursement policy to get my master’s degree as an adult nurse practitioner,’’ says Walsh, whose first nurse practitioner job was doing geriatric assessments in a small community hospital, followed by working in a sports medicine clinic.

How did you move into orthopedics as a specialty area?

It’s funny, because while I was in the program at UMass Worcester, I vividly remember an orthopedic nurse practitioner giving a lecture, and thinking, “Yuck, I wouldn’t want her job, putting casts on all day and dealing with broken bones.’’ So you never know where you will end up. But I decided to work with the sports medicine doctor because I figured I could deal with the orthopedic issues, as long as they were sports medicine based, rather than strictly trauma. Over time, I’ve come to appreciate the caring/nurturing piece of orthopedics quite thoroughly.

How do you feel about the move, by 2015, for all new advanced practicing nurses to have a doctorate degree?

Theoretically, the shift to the doctoral level makes great sense. Practically, though, it’s nearly impossible. The capital outlay to get a doctorate today alone is enough to scare most nurse practitioners off. Then there is the problem of getting qualified teachers. Until these inequities are addressed, it’s going to be difficult to require the nurse practitioner doctorate.

Do you get asked medical questions at cocktail parties?

My nonmedical husband is very helpful in this kind of situation. He immediately informs people that my advice for any and all medical problems is, “Take a shower, you’ll feel better.’’ It’s worked for me for years.

Have you had to use your nurse training in an emergency situation outside the job?

These days my favorite emergency intervention is to call 911. I am very good if anyone faints, but I dread the day that I’m at the Natick Collection and I have to use an AED [automated external defibrillator] on someone.