Nurse Practitioner / Wound Care / Legal Consultant
Inattentive parenting and some immature young adult decisions were life challenges that would either crush her forever or create a will to persist while continuously learning how to do a job better, thus earning respect and stability.
FAMILY BACKGROUND
“SW” (anonymous initials standing for “Strong Woman” to preserve her privacy), born in the Western U.S., is a middle child among twelve with 7 brothers and 4 sisters. Her father was a traveling salesman whose career always involved sales while he shifted employers. Her mother was a nurse who never spoke favorably about her career or about much of anything else.
CHILDHOOD
With a father often away on sales trips and a mother preoccupied with her Catholic church affiliation over having to deal with more individuals under the household roof than play on a football team (11), each of the 12 siblings had to figure life out for themselves along the way.
The first discussion with either parent about SW’s adult future occurred after she graduated from high school, when her mother asked: “So, how are you going to pay for college?” SW was both confused and annoyed by the question, responding, “Why are you asking me now, as this is the first time I ever heard you talk about my adult future or say the word ‘college.’”
If not already clear to SW, she now firmly realized that she would have to figure out her own plan(s) going forward.
CHALLENGE – STATUTORY RAPE VICTIM and A DIVORCE
With no adult path forward yet in sight, SW – not yet of legal age (18) to lawfully consent to a sexual relationship and not yet emotionally mature to assess her self-worth and the intentions of others, was easily influenced by an older man with whom she had casual sex without a future commitment or understanding how she would care for both herself and a baby if her future did not involve that man. They married and had no children. When SW finally realized that it was a “bad” relationship, she divorced him.
POST HIGH SCHOOL EDUCATION – PART ONE
SW paid for her college education through a combination of scholarships and part-time jobs. While later proceeding with graduate-level education, SW followed a strategy – to be revealed later within this story – to have others pay for her continuing education.
CHALLENGE – A SECOND DIVORCE
Hoping she was wiser about long term relationships after her divorce, SW married a different man, with who she had a daughter.
It was not an easy pregnancy, culminating in a “C section” delivery, involving an observation by SW which would later prove to be a positive influence on her adult path forward: all the ‘baby’ (pediatric) nurses were nice to her, seemed to know what they were doing and were appreciated by the rest of the medical staff.
SW’s second husband was able to support the family financially by himself, so SW stayed home to raise their daughter and manage the household. When their daughter was 8, with more time in school and less need for full daily attention, SW found herself sitting at home, thinking “there must be more to life than what I’m doing now.” She decided that this second marriage was not the adult relationship she envisioned for the long term. With regret over having made a second bad relationship choice but glad to have a healthy, loving child and an emerging career plan, SW decided to get a divorce and obtain additional education to qualify for an interesting career with financial stability to support herself and her daughter.
CREATING HER OWN CAREER PATH
The memory of the caring, knowledgeable pediatric nurses now bubbled to the surface of SW’s consciousness as motivation toward her career path as a nurse.
While studying the requirements to be a nurse and talking with some experienced nurses about their daily responsibilities, SW was excited to learn about different nursing sub-specialties, each interesting, ranging from home care to hospital bedsides and operating rooms.
SW always loved learning about new things, especially if the subject would be useful. Certainly, this described the field of nursing.
WILL TO SUCCEED IS KEY TO OVERCOMING CHALLENGES
Decades later, SW realized that from the outset of considering nursing as a career, she must have had a survivor’s will to succeed, as she recalls her early thinking while observing some nurses: ‘I like what they do, and I’ll bet I can do it even better when I know more about it.’
As SW came to realize, ‘knowledge is power!’ – a phrase which eventually became her quiet (said frequently to herself) mantra and superpower.
MORE EDUCATION LEADS TO MORE INTERESTING RESPONSIBILITIES
Starting her career as a ‘home care’ nurse, SW decided – not for the first or last time – that taking additional professional courses within her career path would accomplish two goals: (1) expand her range of helpful patient care to make her daily tasks more interesting and (2) be better paid for her increased, professionally recognized expertise.
So, SW decided to become a ‘Nurse Practitioner’, which would require earning an N.P. degree and passing a state licensing exam for that specialty. Not surprising to herself or anyone who knew her, WW accomplished both goals, which she managed while working full-time by taking courses after hours.
(Editor’s note – A Nurse Practitioner (N.P.) is a nurse with advanced clinical training who provides direct patient care while working closely with physicians and other healthcare providers. N.P.s offer a range of services, such as ordering and interpreting diagnostic tests, treating acute and chronic conditions and prescribing medications.)
Within the range of responsibilities of general nursing is ‘wound care.’ SW observed wounds being treated by nurses using the long-standing protocol of ‘wipe, wipe, rinse’ – too often without full and timely successful healing. SW thought “there must be a better way – if I knew more about how to do it.” So, after learning that her employer and some drug companies would pay for advanced courses in wound care, SW enrolled in additional schooling to earn certification as a wound care specialist.
Always looking for ways to continue learning to better help patients, add interesting responsibilities and earn money beyond basic nursing pay, SW had now learned an important lesson to advance her career: Do not immediately proceed from one advanced degree to the next one without first working for awhile within the field you have just studied, for two reasons: (1) while you have earned the new academic degree, you now need practical experience, which will either reinforce your choice of specialization or lead you to another, even more interesting specialization focus; and (2) after a few years of working experience, many employers and businesses (providing ‘grants’ to increase knowledge about their systems or products) will gladly pay the cost of your next level of education – based on their hope that you will return to their employment to use your increased knowledge for the benefit of their patients or customers.
“Free education!” thought SW, “what’s not to like about that?”
Now as a nurse practitioner with wound care certification, SW was not limited to the hard work of bedside nursing but instead, was frequently called into Operating Rooms (“OR”) to utilize her advanced training when the surgeon was unable to adequately resolve a wound issue.
SW’s additional training – achieving both Master’s and Doctorate degrees related to nursing – led to more than earning professional respect within ORs; she was tasked with leading in-hospital training sessions in wound care, plus college-level teaching assignments as an Adjunct Professor.
Eventually, all of SW’s academic degrees were presented within her professional resume:
Associate’s degree (two-year community college)
BSN – Bachelor of Science in Nursing (four-year university)
CWOCN – Certified specialist for Wound care, Ostomy and Continence nursing
MSN – Master’s in science in Nursing
ANCC – Certificate in Gerontology Care
DNP – Doctor of Nursing Practice
ACAGNP – Acute Care, Adult Gerontology Nurse Practitioner
RNFA – Registered Nurse, First Assistant (operating room)
LNC – Licensed Nurse Consultant
(Editor’s note – Gerontology deals with medical issues for individuals aged 65 and up. An ostomy is a surgically created opening in the abdomen to allow waste or urine to leave the body. Continence is the ability to control movements of the bowels and bladder.)
CHALLENGE – PANDEMIC
The worldwide covid pandemic (2020 – 2023, now reduced but not eliminated) stressed everyone, especially nurses who were constantly needed at the front lines of patient care. Many nurses quit their profession while most remained on duty to provide the care for which they had been trained. SW’s loyalty to patients in general never wavered because by now, she had well learned how to cope with all types of personal stress.
CAREER RETIREMENT CONSIDERATIONS
At some point, every adult who is not forced to retire for reasons such as physical disability or other conflicting priority (e.g. having to devote full time care to a family member), must decide among two options (a) keep working until they die or are forced to quit or (b) retire – do they have sufficient finances (savings and income flow from such sources as Social Security, pension and investments) to be able to stop working in time to enjoy some less stressful years?
Through her hard work over several decades, SW had qualified for a retirement pension from a health system employer and controlled her living expenses enough (no fancy cars or yachts) to slowly add to her savings account. A financial advisor confirmed her analysis that she could afford to retire if she continued to live modestly.
LEGAL CONSULTANT / EXPERT WITNESS
Soon after retiring from her nursing career, SW was contacted by a law firm which had noticed her professional resume of both multiple academic degrees and long-time nursing experience. Would SW be interested in reviewing some medical records to provide her opinion whether the patient care of the law firm’s client met applicable professional standards – in other words, was there medical malpractice?
SW agreed to review all the relevant medical records, provide her written opinion and testify in court if the claim proceeded that far. (Editor’s note – Most legal claims are resolved before proceeding to trial.) SW and the law firm agreed upon her hourly rate charge – to be paid regardless of the outcome of the legal claim.
The law firm and SW also agreed on the time frame for her to provide her expert opinion after the lawyers provided all the medical records and other investigation documents.
Like any type of employment – except for being drafted into military service – the person asked to provide an expert opinion is free to decline the work. There are many reasons to decline, including (a) the facts do not relate to my area of expertise; (b) I don’t have the time to meet your schedule; (c) I don’t agree with what you are trying to claim; (d) I have a ‘conflict of interest’ between something in my background and your client’s involvement in this matter.
SW was glad to have the opportunity to review the records and provide an expert opinion that she sincerely believed was accurate. And she was happy to be promptly paid in full. Apparently, the law firm was pleased with her work since they retained her for additional reviews and opinions.
SW looks forward to defending her opinions in a courtroom.
Editor’s note – Qualifying as an Expert Witness – Individuals who have earned certain education degrees followed by either hands-on experience within a career field or relevant field research or a combination of both experience and professional investigation, may be hired by lawyers to provide their expert opinion to assist the lawyers seeking to prove or defend against claims in court.
Whether the individual hired as an expert consultant or court witness, could be considered an ‘expert’ would – in all cases – be subject to the decision of the trial judge if the matter proceeded to contested litigation.
Note that expert consultants / witnesses should be paid only for the time required to provide their opinions. It is unethical for the consultant / expert to be paid based upon the successful court outcome based on their opinion.
If a legal claim proceeds to court, three kinds of witnesses may testify to assist the judge or the jury to decide, in essence, which side wins. FACT witnesses may testify to what they saw or heard (subject to ‘hearsay’ evidence rules too complicated to discuss here); INDEPENDENT witnesses are appointed by the judge to review the facts, perhaps conduct interviews, and advise the court of their findings and recommendations. Only EXPERT WITNESSES may offer an opinion about who was right and who was wrong.
One example of courtroom testimony by an attorney hoping to persuade the judge to permit the witness to testify as an expert and provide an opinion about the evidence will always be remembered from a day when the editor was listening to a court battle over a Will:
Handwriting expert – An older gentleman took the witness stand in a lawsuit to determine whether a Will had been signed by the decedent or was forged by someone else. Before offering his analysis supporting his opinion, the witness must first be questioned about his qualifications within the field where he is presented as an expert who can offer an opinion beyond the ‘facts’ to which any witness can testify. Thus, the lawyer’s (L) questions and the witness’s (W) responses proceeded along the following lines:
L – What schools have you attended, courses studied, degrees achieved?
W – (names schools, courses, academic degrees)
L – Have you ever been involved with the F.B.I. for handwriting analysis?
W – I was the first FBI employee to devote full-time to handwriting analysis. I set up the FBI laboratory for handwriting analysis, where I devoted myself for over 50 years.
L – Have you offered, publicly, expert testimony in any court cases which those here in the courtroom today may have heard about?
W – I analyzed the handwriting of Bruno Hauptman in the Charles Lindbergh baby kidnapping case. I also analyzed the handwriting of Howard Hughes in his Will case. In each instance, the court qualified me as an expert witness to present my conclusions.
L – In how many jurisdictions have you been accepted as an expert for handwriting analysis by other courts?
W – In all 50 states plus The World Court in the Hague, Amsterdam.
L to opposing counsel – You may cross examine my expert witness about his qualifications.
Opposing counsel – No questions.
CAREER SATISFACTION
After college, SW had figured out how to have others pay for her continuing education which earned increasing professional respect.
While continuously learning to provide nursing care with more specialized skills, SW’s daily responsibilities were always interesting – no dull moments! She always aimed to provide the highest standard of patient care while sharing her specialty knowledge with other medical professionals and healthcare students.
A NURSE’S RECOMMENDATIONS TO ENHANCE YOUR NURSING CAREER
“If you decide that you have led a ‘sheltered life’ – without the time or finances to explore the world beyond your home area – consider joining the military as a nurse. This would provide the opportunity to explore a wide range of nursing and see more of the world at the military’s expense.
Bedside nursing can be physically hard work and repetitive. It will always be necessary, but a trained, dedicated nurse need not stay with the same routine forever.
After completing each degree, stay in that field for awhile before pursuing another specialty degree. It takes about 5 years of hands-on experience to become an expert in any nursing specialty.
Ask nurses with different specialties what they like and don’t like about the range of their daily responsibilities – you may find a new way to stay interested in your nursing career and provide even better care once you know how to do it better!
Consider becoming a P.A. – Physician’s Assistant. All your nursing background would be useful plus you would add a broader range of interesting responsibilities with more independence.”
