Pediatrics is a unique specialty for a few reasons. First, you almost always have a parent or family member to include in your care. [...] Second, longitudinal studies abound that support the connection between health in childhood with health in adulthood. In my opinion, many of the behaviorally-modified health problems that are seen in adults should be addressed in the pediatric population first. Third, pediatrics requires creativity. I may need to be able to discuss super-heroes with one patient, professional athletics with another, and sing-along cartoon songs with another. I laugh at some point during every clinical day and that’s a great thing!
About Ginny Angert: Ginny Angert is a Pediatric Nurse Practitioner at Associated Pediatricians, a group of physicians, nurse practitioners, and other medical staff serving pediatric patients and their families in the Valparaiso, Indiana area. In addition to her direct work with patients as a nurse practitioner at Associated Pediatricians, Ms. Angert is the Founder and Principal Consultant at EHR Optimize, a firm that specializes in IT solutions for healthcare institutions in order to optimize workflow, patient evaluation, and service delivery. Prior to her role at Associated Pediatricians, Ms. Angert worked as a nurse practitioner across several different settings, including IU Health La Porte Hospital, HealthLinc CHC, Orchard Park Pediatrics, EmCare, and Johns Hopkins Hospital. Ms. Angert earned her Bachelor of Science in Nursing from Towson University in 1994, her M.S. in Pediatric Nurse Practitioner from the University of Maryland Baltimore in 1998, and her M.S. in Medical Informatics from Northwestern University in 2014.
[OnlineFNPPrograms.com] May we have a brief description of your educational and professional background?
[Ginny Angert] I majored in Nursing as an undergraduate at Towson State University (now Towson University); what a great program! I knew pretty early on that I wanted to be a pediatric nurse practitioner (PNP) so I enrolled at the University of Maryland, Baltimore two years after I graduated from Towson. My clinical background has been fairly varied. My first RN experience was on the pediatric oncology and bone marrow transplant unit at Johns Hopkins Children’s Center. In order to accommodate my graduate school schedule I transitioned to the in-house pediatric RN float pool and picked up some extra hours as an agency RN at various hospitals in Baltimore. My first PNP job was at Hopkins in the newborn nursery. Since then, my PNP experience includes hospital coverage, pediatric emergency department, physician-owned pediatric practice and hospital-owned pediatric practice. A few years ago, I developed an interest in health informatics and completed the Masters of Medical Informatics (MMI) program at Northwestern University. This led to consulting work; I have worked for hospitals to help them utilize their electronic health records and other technology more effectively. I have also worked with technology companies to help them understand healthcare workflow and providers’ technology needs and I also founded a start-up company to work on patient engagement.
[OnlineFNPPrograms.com] Could you please describe your role and responsibilities as a Pediatric Nurse Practitioner at IU Health La Porte Hospital? What kinds of medical conditions and challenges did your patients face, and how did you help them manage their conditions?
[Ginny Angert] At IU Health La Porte, I worked clinically at the hospital-owned pediatric practice. The nurse practitioners and physicians work collaboratively to provide primary care to our patients from birth to about age 21. We do regular check-ups and diagnose and treat common (and sometimes not so common) childhood illnesses and injuries. The nurse practitioners have their own schedules and generally work independently but collaborate with the other providers when necessary. Since our focus is pediatrics, we include the parent or family member in decision-making when possible. For a little over two years, I also worked with the clinical informatics team. My role involved helping to evaluate potential technologies, working to optimize current solutions, and serving as a liaison between the clinical staff and the informatics department and hospital leadership. In order to meet the demands of the informatics position, my clinical time was reduced significantly. I really missed direct patient interaction and have since transitioned back to clinical work.
[OnlineFNPPrograms.com] You have worked extensively in both pediatric acute care and primary care settings. Could you please explain what the difference is between pediatric acute care nursing and pediatric primary care nursing? How are pediatric acute care and pediatric primary care work settings different, in terms of patient conditions, medical staff’s interactions with patients’ families, the overall team delivering care, and the role of the nurse practitioner?
[Ginny Angert] When I was in the PNP program, we had the option to follow the primary-care track, which focused on outpatient and office-based clinical experience, or the acute-care track, which focused on hospital-based healthcare. Most students followed the primary-care track and leveraged their RN experience to find employment in either the acute-care or primary-care settings after graduation. Now, many hospitals require the acute-care track and certification for hospital-based work, but this varies depending on the setting. I would definitely recommend that potential students consider their desired employment and make sure that they choose a program that will support that decision.
While the core knowledge set is the same between primary-care and acute-care settings, there are nuances that require consideration. The acute-care setting involves almost constant collaboration with other clinicians. Specifically in the emergency department, I collaborated with the emergency physicians, radiologists, surgeons, specialists, social workers, and of course the excellent RN staff! Things move at a quicker pace in the acute-care setting and the PNP needs to be comfortable interacting with the team in order to provide safe and competent care in a timely manner. Academic settings also include interaction with resident physicians, many of whom will look to the experienced PNP for guidance.
The primary-care setting is not really slower, but it is different. Where I might have seen 15 patients during a 12-hour shift in the emergency department, I may see 30 patients during a 8-hour shift in the office. With primary-care, you don’t have immediate access to the specialists and other providers that you would in the hospital so the PNP must learn to work more independently. Also, with the patient volume, time management becomes essential! One of the most rewarding aspects is that you really get to know your patients and their families over time. It is really special watching a child grow up.
[OnlineFNPPrograms.com] Why did you decide to become a pediatric nurse practitioner, and what academic and professional experiences helped you determine that this area of advanced practice nursing was the right one for you?
[Ginny Angert] During my undergraduate studies, I realized that I wanted to work in pediatrics. I volunteered at a camp for children with cancer and became interested in pediatric oncology. During my early RN experience, I had the opportunity to observe various PNPs in their clinical work and this led to my decision to enroll in the pediatric nurse practitioner program at the University of Maryland. Over the past 20-plus years I have never doubted this decision! Pediatrics is a unique specialty for a few reasons. First, you almost always have a parent or family member to include in your care. Their concerns and experiences definitely influence my decisions; I have learned an incredible amount from the parents I have worked with. Second, longitudinal studies abound that support the connection between health in childhood with health in adulthood. In my opinion, many of the behaviorally-modified health problems that are seen in adults should be addressed in the pediatric population first. Third, pediatrics requires creativity. I may need to be able to discuss super-heroes with one patient, professional athletics with another, and sing-along cartoon songs with another. I laugh at some point during every clinical day and that’s a great thing!
[OnlineFNPPrograms.com] What have been some of the most rewarding aspects of working in pediatric primary care nursing and pediatric acute care nursing? On the other hand, what specific challenges have you encountered in this field of work, and how have you managed these challenges?
[Ginny Angert] One of the most rewarding aspects of pediatrics is the ability to help a patient or parent understand their health in a way that actually changes their lives. For example, it is awesome to see a parent of a child with asthma learn about the disease and management and avoid a trip to the ER or a seasonal hospitalization. There are former pediatric oncology patients of mine who are now adults with children of their own and that never ceases to delight me! In the primary-care setting, the PNP is invited into the families’ lives and gets to watch their patients mature over time.
Pediatrics is not all fun and games though. Pediatric patients do get serious life-threatening illnesses and injuries. Family dynamics and parenting skills are not always healthy. While those instances can be challenging, they also require a PNP with strong clinical knowledge and the ability to advocate for the health of the child. Clinicians definitely need to develop strong coping skills and strategies to avoid burn-out in these difficult situations. My favorite way is to simply talk with my co-workers and debrief the situation.
[OnlineFNPPrograms.com] For current and prospective MSN students who are interested in becoming pediatric nurse practitioners, what advice can you give them about optimally preparing for this field while pursuing their degree?
[Ginny Angert] Current PNP students should really seek out as varied a clinical experience as possible. They should be honest about their knowledge and experience gaps and seek out experiences to help mitigate those gaps. They should be aware that most programs allow some “piecing-together” of clinical experiences. They might be able to spend time with a radiologist to learn how to read X-rays or a dermatologist to hone their rash skills. Most clinicians are very welcoming to students and love to explain their specialty. I recommend this to new-graduate PNPs as well. Spend some time with the specialists in your area. In the primary-care setting, you want to reach out to the specialists your office refers patients to frequently. Establish that relationship and learn what they want (and don’t want) from you in terms of a patient referral.
Potential PNP students should seek out PNPs in their community. Many welcome potential students to shadow them to learn more about the role. We have welcomed high-school students who are considering potential undergraduate majors, college students looking toward graduate school, and employed RNs who are interested in expanding their education. In general though, I recommend leaving a little bit of room for serendipity with your graduate program. While you want to find a program that suits your interests and meets your needs, it is impossible to fully predict what will ignite your passion once you start your program.
[OnlineFNPPrograms.com] In addition to your extensive clinical work, you are deeply involved in initiatives that improve healthcare system workflows and communication between and among healthcare professionals and their patients. Could you elaborate on Ananse Health and EHR Optimize, your role and responsibilities as Founder of both of these companies, and what the core mission of these organizations are?
[Ginny Angert] One of the reasons that I have such varied clinical experiences is that my family has moved frequently to accommodate my spouse’s employment. Additionally, national initiatives for the adoption of technology in healthcare were driving EHR adoption among hospitals and primary-care settings. It seemed that each place at which I worked was implementing an EHR go-live and subsequently tackling workflow optimization. IU Health La Porte Hospital was embarking on a large-scale informatics project shortly after I joined the clinical staff and I transitioned over to the informatics department to work on this and other projects. Ultimately, this led to my enrollment at Northwestern in the MMI program; I wanted to build on my “high-level” understanding of the concepts involved. Once my project contract ended and I returned to clinical work I decided to start a consulting firm that focuses on helping private (non-hospital-owned) practices utilize technology effectively. Hospitals have technology support departments but private offices generally have a sole employee who takes on this role. This led to a long-term contract with a technology company that wanted to develop a solution for paper and document management in medical and dental offices.
During this time I also started getting more involved in the local start-up community and attended a StartUp Weekend event. At this event, I was part of a team that pitched a solution to help people manage their own health information. We proposed a web and mobile application that would utilize health data from various sources and had the ability to present it to the person in an easy to understand interface. Our team won the StartUp Weekend competition and we eventually were accepted into a technology incubator program. We are still working on this project!
I would absolutely encourage potential and current students as well as practicing PNPs to seek out opportunities to work creatively to solve hurdles that affect health and healthcare. PNPs have a unique and valuable perspective that is welcomed outside of traditional clinical settings. Don’t hesitate to step outside of your comfort zone!
Thank you Ms. Angert for participating in our APRN career guide interview series!