The observance of National Nurse Practitioner Week (Nov. 12-18) provides us an opportunity to recognize our nurse practitioners (NP) and increase awareness of the exceptional care that these NPs provide. We sat down with Shelby Lee Freed, a nurse practitioner at OHSU, to learn more about her and her career.
What led you to practice primary care as a nurse practitioner?
In high school and college, I participated in the Appalachia Service Project where a group of us went to Appalachia each summer and repaired homes for low-income families. One evening, we were driving to get ice cream after a long day and our van saw a person laying on the side of one of the very rural country roads. Two of the women in our van were nurses. Without hesitation, they stopped the car, jumped out, assessed what was going on, offered compassion and understanding, and got the person where they needed to go for help.
I was astounded, in the best way, by their gut instinct and immediate reaction to what seemed to be a precarious scenario. I was hooked!
In the beginning phases of our nursing education, nurse practitioners spend a considerable amount of time in the hospital and at the bedside where patients are incredibly sick and vulnerable. What resonated more with me, however, was our ability to see patients in the clinic setting, where they are a different type of sick and vulnerable.
In my advanced practice training, I found it more empowering for both myself and my patients to focus on ways to keep them out of the hospital, evaluate and work with the family dynamic and social determinants that contribute to one’s overall health.
I enjoyed sitting down with patients and establishing an ongoing relationship—trying to help them articulate what their values and goals were, and what health meant to them. I enjoyed making the connection between social circumstances, lifestyle choices, health and wellness and where these intersected. I appreciated the ability to work with patients in pursuit of their personal goals. I learned the wide breadth and scope of what primary care nurse practitioners could do to treat medically and socially complex patients with limited resources.
I was and continue to be impressed by the caliber and commitment of those I am so fortunate to work with and be supported by on this adventure.
Throughout my career, I have reflected on that person sitting on the side of the road. Then I had no idea what could have possibly brought her to that place, but now see many of the factors that could have led to that particular moment. I recognize and appreciate when patients allow us to see into their lives and trust our decision-making process. I appreciate the wide range of services we can perform, provide, and have access to in our primary care setting that can reduce the burden on both the individual and our system within a small exam room. I am inspired daily by the people who coordinate to make all of this happen.
How does working in an academic medical setting affect the care you provide in the clinic?
Working in an academic medical center certainly keeps you on your toes. You are surrounded by the newest information, active research, dedicated colleagues, and bright young minds that push you to check and double-check that the care you are providing is the safest and most evidence-based. The energy, enthusiasm, optimism, inquisitive nature, and humor that my students and colleagues bring to the clinic each day is unparalleled to any other setting I have worked in. After almost a decade of patient care, as exhausting as it may be, I still get excited to come to work. I attribute this to an ongoing pursuit of knowledge and understanding, the high-level of care we can provide, and the dedicated team we work with.
If you could name one of the most important qualities nurse practitioners bring to healthcare, what would it be?
For me, the most important qualities nurse practitioners bring to health care are treating the whole patient, not just the disease, and the collaboration and collegiality we engage in to reach this goal. We use the term “patient-centered care” a lot in our world. For me, this looks like a revolving circle made up of many different parts. The patient is at the center with life going on around them. When they come to us any portion of their circle may need help or support. It is up to us to find out which part is affected, how that affects all of the other parts, how we as nurse practitioners can help directly, and when we need to rely on our colleagues for additional support and expertise. Healthcare is a team sport and to make any progress, we need to work together. It is this interprofessional, collaborative, team-based, coordinated care that leads to improved safety and better outcomes for all.
I said it before and will say it again. I am so fortunate to work with an exceptional team like the one we have at Richmond and OHSU.
