Eileen Meyer, DNP, CRNP, ACNP-BC, is a two-time UAB School of Nursing graduate and Board of Visitors member. She completed her Master of Science in Nursing in Acute Care Nursing in 1997 and her Doctor of Nursing Practice in 2017. Meyer is Assistant Director of Advanced Practice Providers at UAB Hospital, where she has created the ACE (Augmented Clinical Experience) program to help advance clinical experiences for nurse practitioner students. She also works to advance nursing education and advocate for advanced practice nursing in Montgomery. Meyer is a Clinical Assistant Professor of Nursing and is an instructor in NUR 740, Health Policy and Politics.
2020 looks a lot different than we all expected. How has COVID-19 changed your experience this year, and what has the experience been like organizing the COVID test site?
It has actually been a great experience. What has made it great is the people that have pulled together and been tasked with making this test site work – it is unbelievable how well we all work together. You had so many different areas that came together to make this testing site work, and have a positive attitude – including nursing, advanced practice, lab, medicine, medical assistants, clinical informatics, quality, facilities, the UAB police. None of us at the testing site had ever worked together, so what makes it so special is that we all came together with a common goal, to make this COVID testing site safe and efficient, and we accomplished that goal.
In working in these interprofessional teams, how do you think the testing site has emphasized the importance of interdisciplinary collaboration?
This is where my DNP comes into play. The DNP emphasized teamwork and leadership, and we were able to bring our ideas to the table and respect each other’s ideas – what works, what doesn’t. I know what advanced practice brings to the table, the nurses, CMAs, lab – they bring their thoughts and ideas to the table and we developed a process that works– that’s really what made the experience good.
Do you think COVID-19 has changed how people view nurses and their role in health care?
Nursing is the most trusted profession. Everyone loves their nurse, and they are thought of as kind and caring – but that’s it. You don’t hear a lot about what they bring to the table outside of that part of nursing. I think the COVID pandemic has shown that nurses are the frontline workers. They are sacrificing their jobs, themselves and their families to come to work and provide care for these patients when no one else wants to. I hope COVID has changed the perception of nurses beyond just caring – that these are the people who are providing the care and doing the majority of the work for these sick, sick people.
You worked to create the ACE program to place students in a clinical setting. How does this program work, and why is it important?
When I became the Assistant Director of Advanced Practice, I was tasked with streamlining the students entering into our system and providing them with a good, solid clinical experience. UAB employs about 650 of the best advanced practice providers in almost every setting, which is a huge resource for students. So, I knew that we could take several specialty tracks (women’s health, acute care, psych, etc.) and tailor a year-long, structured clinical experience that incorporates professional development opportunities giving the students the ideal environment to learn and flourish in.
In creating each ACE specialty track, the Lead APPs and I looked at the needs of new hire graduates and developed the clinical experience based on those needs.
For example, in family practice, it is beneficial to stay with one provider for a longer period of time so that the student is able to care for patients, to see their medical management over a longer period of time. With FNPs, a lot of times they just have to go wherever they can find a placement. They may get 80 hours in one clinic, then 80 hours in another clinic, and they never get to develop relationships with the patients and provide their care for longer than 180 hours.
I talked to physicians in primary care, and they loved the idea of taking one nurse practitioner student and having them for the whole year. That way, you get to know the patients over the year, to care for them and to see what happens when you make adjustments in their medical management. The goal is to give students not only that year long experience, but to lessen the transition to practice and possibly recruit those graduates. We also include professional development, which helps those students see themselves as a provider and to fully transition into that role.
We took a similar approach for acute care track. We looked at what the students’ needs were as a new hire, and in this case, we found that many students had never provided care for patients several days in a row, so they were not able to see how their daily plan of care effected the patient. With the AGACNP ACE program, the student has six clinical block rotations throughout the year and must attend subsequent days. This ACE programs allows the AGACNP students to experience six different specialties and see how their patient progresses
We have placed 11 out of 12 students from our first AGACNP cohort and we have seen very few transition to practice problems with these students. The preceptors also benefit because they have students who are eager to go out of their way to learn.
How does this program reflect UAB’s support of advanced practice nurses?
UAB is invested in advanced practice which is clearly demonstrated through the creation of the Office of Advance Practice. I was the second graduating class from the acute care program in the 90s, and I think when I started there were very few advanced practice nurses, less than 20, now we have 650. When you think about how many advanced practice providers UAB employs, we are actually one of the largest employers in the United States. Many large systems employ 200-300 APPs but we are over 650.
We have a lot of buy-in from the UAB Medicine, including senior leadership, medicine, and advanced practice. The preceptors have embraced this new concept of training nurse practitioners in the coming years, this program will be the standard for which a student will be trained at our institution.
What has it been like to see advanced practice nursing grow at UAB, and to see the field change?
When I started at UAB, there were hardly any nurse practitioners, probably less than 20. I was incredibly lucky to start my career with surgeons who trusted me and took the time to teach and invest in me. I think over the years, a lot of physicians have seen that nurse practitioners are the constant in our service line – residents and fellows come and go, but advanced practice is there to stay.
How did individuals in your early career impact your trajectory and career?
Both of my collaborating physicians were really important and influential to my career.
Dr. Albert Pacifico was my first collaborating surgeon and one of the first surgeons to staff his service line with nurse practitioners. He trained us like the residents, had expectations of us, and if there was something he didn’t like, we were held accountable for it. He was definitely a role model, he was a mentor, and he knew that if he taught us the way he wanted us to be, he could stay in the OR and his patients would receive good care from us.
When Dr. Pacifico retired, Dr. Jim Kirklin became my second collaborating practice for the next 10 years of my career. He realized I wanted to continue to learn and was motivated so he took me to the next level. If I presented him with a complex congenital case, he would question me for details. And if I had a hard time answering (given the complexity of the congenital cardiac cases), he would draw pictures of the defect and refer to his father’s textbook.
These two surgeons took the time to shape me and they realized that if they invest their time in me, I can contribute to their team by allowing them to be in the operating room knowing that their patients are being cared for.
How do you think your degrees prepared you for your career?
My Master’s, way back in the 90s, prepared me well. When I was going through the acute care program we had a class of 6! There were no acute care nurse practitioners out in the workforce in this area so the physicians taught me similar to that of a resident. The learning opportunities were outstanding if you were willing to take advantage of them. Dean Harper actually encouraged me to pursue my DNP, and at first I resisted because I thought it wouldn’t help me clinically, or it would take me away from the bedside, which is where I loved working. My husband finally encouraged me as well, and about a year in the program, I could really see the benefit. The skills I developed through my DNP program were leadership, clinical instruction, problem solve, improve patient outcomes and improve nursing practice.
The faculty at the School of Nursing also eventually became my colleagues. I really value a lot of the faculty over there, and they have all been great mentors and friends to me.