Every day NRS Nurse Practitioners educate their patients on how to apply self-management skills that increase self-awareness, which improves their overall health. The look on a patient’s face when they see the improvement in their labs, or they are not short of breath because of something that I taught them, is priceless.
About Derrick Love-Jones, MSN, AGPCNP-BC: Derrick Love-Jones is an Adult-Geriatric Nurse Practitioner and the CEO and Founder of Nephrology Rounding Solutions (NRS). NRS is a registered Service Disabled Veteran Owned Small Business (SDVOSB) company that provides Nephrology Nurse Practitioners to perform dialysis rounds and chronic kidney disease (CKD) office visits to nephrology practices nationwide, while also operating several primary care clinics. As a clinician, Mr. Love-Jones specializes in caring for dialysis patients and provides them with primary care and disease management services including health assessments, ordering of diagnostic tests, blood pressure and diabetes management, and patient education. Prior to his work at NRS, Mr. Love-Jones was a Charge Nurse for Fresenius Medical Care, and a Clinical Coordinator for DaVita Kidney Care, where he supervised the daily care of patients, developed dialysis plans in collaboration with the physician, and educated patients and their families on renal disease.
Mr. Love-Jones earned his BSN from The University of Texas at Arlington in 2010, and his MSN with a concentration in Adult-Gerontological Primary Care from the University of South Alabama in 2013.
[OnlineFNPrograms.com] Could we please have an overview of your professional and academic path in adult-geriatric nursing?
[Derrick Love-Jones, MSN, AGPCNP-BC] I first became interested in working in the medical field after battling cancer while in the US Air Force. I was diagnosed with a rare malignant peripheral nerve sheath tumor (MPNST) (also known as “malignant schwannoma”). The medical staff that cared for me was so kind that it left an everlasting impression. After beating cancer I worked for several years as a Paramedic/Firefighter, and one day decided that riding the “box” was not something I wanted to do the rest of my life. As a service-disabled veteran, I started working at VAMC-Dallas and balanced working full-time as a nursing assistant, while going to school full-time and raising a family.
I received my BSN from the University of Texas at Arlington where I was a University Scholar and a member of the Ronald E McNair Scholars Program. After graduating I joined Fresenius Medical Care (FMC), the largest dialysis provider in the world. While working at FMC, I created the idea of Nephrology Rounding Solutions (NRS). It was then that I decided I wanted to continue my career as a Nephrology Nurse Practitioner, secondary to primary care. I continued working at FMC for two years before leaving to work for the seconded largest dialysis provider, DaVita. As a Clinical Manager at DaVita I honed my leadership and management skills while attending nurse practitioner school.
I received my MSN as an Adult/Geriatric Primary Care Nurse Practitioner (AGPCNP) from the University of South Alabama. Upon graduation, I passed the American Nurses Credentialing Center (ANCC) certification exam to become a board certified AGPCNP. I currently have four classes remaining before receiving my DNP at the University of South Alabama, and expect to graduate August, 2017.
I formed NRS shortly after passing the ANCC, and today NRS has expanded beyond rounding on dialysis patients, to include CKD office visits, primary care house calls, nephrology consults in skilled nursing and rehabilitation facilities, and operation of primary care clinics and community based outpatient clinics for the Veterans Administration.
[OnlineFNPPrograms.com] Could you please describe your clinical role and responsibilities as an Adult Primary Care Nurse Practitioner for Nephrology Rounding Solutions? What kinds of medical conditions and challenges do your patients face, and how do you help them manage their conditions?
[Derrick Love-Jones, MSN, AGPCNP-BC] My clinical role and responsibilities as a Nurse Practitioner (NP) at NRS is a dual role. The first role is as an NP and the second role is as a CEO. As an NP for NRS, I manage a daily patient load of dialysis patient rounds, primary care home visits and/or office visits. The second role is managing the day-to-day operations of NRS.
As a Nephrology Nurse Practitioner at NRS, my daily and long term clinical responsibilities are to round on my dialysis patients and review any recent labs, discuss any dietary challenges, fluid management issues, and access issues. Patient compliance is essential in the treatment of end stage renal disease (ESRD); patients are often asked to adhere to rigid dietary and fluid restrictions, as well as treatment schedules. I play a central role in increasing patient compliance and managing comorbidities. Because of my frequent contact with dialysis patients, I am able to understand and recognize patient needs and influence their behavior, which can positively affect dialysis outcomes.
As an AGPCNP at NRS I perform primary care home visits and/or office visits, diagnose and manage acute and chronic conditions, as well as emphasize the importance of health promotion and disease prevention. These services can include ordering, conducting and interpreting diagnostic and laboratory tests, prescribing pharmacologic agents and non-pharmacologic therapies, and teaching and counseling. NRS NPs practice autonomously and in collaboration with other health care professionals to manage our patients’ health needs.
In my second role as CEO of NRS, I oversee the day-to-day operations of the company, as well as the primary care outpatient clinics we operate. I would like to take credit for managing the day-to-day operations but I have to admit, I have a great staff that assists me and keeps me informed on patient care issues or other important business related issues that need my attention, such as hiring, expansion, or any problems at any of the clinics we operate.
[OnlineFNPPrograms.com] How do you balance your clinical work with managing a business and the large network of nurse practitioners who are experienced with dialysis patients, end-stage-renal-disease (ESRD) and chronic kidney disease (CKD)? What motivated you to establish NRS, and how has your business evolved since its founding?
[Derrick Love-Jones, MSN, AGPCNP-BC] Time management plays a very important role in my life. Balancing my duties as a CEO and as an NP is sometimes a very delicate task, but manageable. I learned time management skills in the US Air Force long before I became a RN, while I was in the US Air Force. The military is very structured and learning those skills early in life really prepared me for life as a business owner and then later as an NP. Time management is one of the most important skills that an NP can have, especially a busy one.
Most NPs do not have experience with patients suffering from chronic kidney disease (CKD) or end-stage renal disease (ESRD). Overseeing the training can be overwhelming at times because there are so many issues that can arise in this patient population. Patients with renal disease have blood pressure issues, diabetes related issues, fluid retention issues, and many have mental health issues such as depression or anxiety. The skills needed to work with patients that have a multitude of health and social related problems go beyond just being a provider. NPs must have social work and mental health skills in addition to their medical expertise. Already having these skills and a background in working with this patient population on a daily basis is a great start.
My motivation to start NRS came while working as a Charge Nurse for Fresenius Medical Care. Many of the doctors in the unit in which I worked found it difficult to round on their current patient loads, round at the hospital, perform office visits for CKD patients, and complete all the other needs that come with caring for patients with kidney disease. After doing some research I found that there was a shortage of Nephrologists to care for a growing population of dialysis patients. Zuber & Davis, 2009 found that nephrologists grew at a rate of 2% annually but the annual rate of growth for dialysis patients was 5%-7%. As I did more research into the shortage it was not long before I realized that I had found a niche and that I could fill it.
[OnlineFNPPrograms.com] What motivated you to work in advanced adult primary care nursing, with a specialization in nephrology, and what professional and academic experiences helped you determine that this area of advanced practice nursing was the right one for you?
[Derrick Love-Jones, MSN, AGPCNP-BC] I first became interested in nephrology nursing during a clinical rotation at the county hospital. Being a paramedic for so many years I had seen and done so many things that many of my undergraduate classmates wanted to do after graduation. I wanted to do something in nursing that I had not already done as a paramedic and would challenge me mentally. During my rotation I noticed that the nurse caring for a dialysis patient was being challenged by the many issues going on with the patient. When I left that rotation I knew that working with dialysis patients was what I wanted to do in nursing.
After graduating from undergraduate school I accepted a job with FMC. I soon found out that working in dialysis was very challenging, because of the many issues this patient population can have. ESRD patients begin dialysis treatments with abnormally high blood pressure, which can then drop abnormally low which causes a different set of problems. After learning and being taught so much in nephrology and putting so much time into learning this specialty, it never occurred to me to learn a whole new specialty after becoming a Nurse Practitioner. I have always believed that working as a Charge Nurse prepared me to become a Clinical Manager, and that role prepared me to become an NP in nephrology.
[OnlineFNPPrograms.com] What have been some of the most rewarding aspects of working as an adult nurse practitioner in primary care and nephrology? On the other hand, what specific challenges have you encountered in this field of work, and how have you managed these difficulties?
[Derrick Love-Jones, MSN, AGPCNP-BC] By far, the most rewarding part of my career is affecting my patients’ lives every day in a positive manner, which in turn affects their health outcomes. Every day NRS Nurse Practitioners educate their patients on how to apply self-management skills that increase self-awareness, which improves their overall health. The look on a patient’s face when they see the improvement in their labs, or when they are not short of breath because of something that they have learned through NRS’ services, is priceless.
The most challenging part of being a Nephrology NP is the windshield time. As a Nephrology NP you spend at least half of your day driving from dialysis unit to dialysis unit, making rounds on your patients. It is imperative that you know the traffic patterns of your city, so that you do not waste too much time behind your windshield.
[OnlineFNPPrograms.com] For current and prospective MSN students who are interested in becoming adult primary care nurse practitioners, what advice can you give them about optimally preparing for this field while pursuing their degree?
[Derrick Love-Jones, MSN, AGPCNP-BC] The best advice I was given, was always go back at the end of your clinical day and review anything you did not understand. Understanding the patient issues during your clinical rotation will help you when you begin practice. Becoming an NP is not like getting your undergraduate degree. You will be expected to self-learn, meaning do not expect your instructors to teach you everything. You will have to learn and understand what it takes to become a Nurse Practitioner.
Nurse Practitioner preceptors are becoming increasingly harder to find, so start early when looking and have your resume ready to send. Once you graduate find a good mentor and ask good questions, they can be a wealth of knowledge.
The best place to get your pre-program questions answered is to speak to current Nurse Practitioners that are working in the field of study that interest you. Being a Nurse Practitioner is an awesome job to have, but it is hard work, because there is so much to learn. Gain as much knowledge about your new chosen career or specialty as you can, and never stop searching for new information. Always stay up to date with new processes and never stop learning.
Thank you Mr. Love-Jones for participating in our APRN career guide interview series!