Spotsylvania Nurse Practitioners aim to alleviate the lack of medical care

After treating patients in the ER for the crisis that got her there, Jenn Thompson urges them to call their GP in a week or two.

But more and more, up to three out of four people the nurse sees tell her they don’t have a GP.

Thompson ponders what to do next. Should she prescribe drugs to treat high cholesterol or blood pressure, knowing that patients are unlikely to have blood tests later to check the drug’s effects on their organs? Can she send newly diagnosed diabetics out of the hospital when she realizes they may not see anyone to monitor their condition and provide follow-up care?

“It tugs at my heart every day when I see people who are in such dire need of help,” Thompson said. “There are so many people who come into the emergency room so sick that it is imperative that they be seen within at least a week of our visit, and there is no one who can see them. I mean nobody.”

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Thompson was a registered nurse in the Fredericksburg area for 28 years, earned her master’s degree and became a registered nurse 19 years ago. Nurse practitioners are registered nurses who can treat patients, order tests, diagnose illnesses, and prescribe medications.

Thompson has worked in primary care and emergency medicine, and she pulls many shifts in the ER at Spotsylvania Regional Medical Center.

Like others in healthcare, she has seen staffing issues that were problematic before COVID-19 become absolutely critical in the aftermath. Thompson said primary care practices in the Fredericksburg area are so understaffed and in high demand that it can take months to get an appointment if the practices are even accepting new patients.

As a result of the crisis, Thompson Advanced Primary Care has opened in the Breezewood area of ​​Spotsylvania County. Nurse Practitioner Laura Sullivan-Simenson will also treat patients there. Both will accept Medicaid, and Sullivan-Simenson will also focus on treating addiction, another problem of epidemic proportions.

At a recent appointment, Thompson reviewed patient Trish Williamson, a Spotsylvania woman who is in the process of becoming a nurse. As part of her clinical rotations, Williamson has worked in four Fredericksburg practices over the past year, including with specialists, and has seen the same issues Thompson described.

“There are countless patients that come in and they don’t have a family doctor,” Williamson said. “They call, they can’t get an appointment. It really is a huge problem and it’s not just a problem in Fredericksburg, it’s a national problem.”

The nationwide scene reflects what Thompson and Sullivan-Simenson found – that the workforce situation among nurses and other providers continues to deteriorate.

Problems abound: Healthcare workers have broadly left the medical field or taken jobs that don’t require bedside care to avoid bringing a virus home to their families. Others are burned out by longer schedules and more demands as fewer staff are left with more and more patients. Older providers nearing retirement have hung up their stethoscopes earlier than planned.

“I think the crisis is definitely the worst I’ve seen in 20 years,” Sullivan-Simenson said.

“I agree 100%,” Thompson added. “I haven’t seen the situation that bad in my whole career.”

Various reports estimate that the United States will need 1.2 million new registered nurses by 2030 to fill the existing shortage. In addition, the nation could be short of as much as 48,000 family doctors by 2034.

Something else interesting is set to happen in 12 years, according to the Census Bureau. Older adults are projected to outnumber children for the first time in 2034, and the elderly tend to need the most medical care.

The problem is that the therapists are also getting older.

“Probably about a third of active physicians will be over 65 (by 2034), so our physicians will — we’re aging,” said Dr. Sterling Ransone, who practices family medicine in Deltaville in the Middle Peninsula.

He is president of the American Academy of Family Physicians and was quoted in an American Medical Association story about physician shortages.

Last week, the Virginia Hospital & Healthcare Association launched a website listing medical job openings across the state in a bid to attract more healthcare workers to the Commonwealth.

More than 11,400 job offers were advertised nationwide, 371 of them in the Fredericksburg area. The positions on site ranged from pharmacists and paramedics to almost every imaginable type of nurse and therapist to general practitioners and neurologists.

This year, Mary Washington Healthcare launched a new Graduate Medical Education, or GME, program that allows medical school graduates to pursue their next level of training as residents at MWHC facilities.

The goal is to provide a pipeline of future physicians, particularly in the areas of family medicine and internal medicine, the “areas of greatest need,” said Dr. Stephanie Goldberg, general surgeon who leads the program.

The program was recently accredited and hopes to welcome 21 residents by July, 15 of them in internal medicine and the rest in family practice, according to a press release.

Goldberg said 1,800 people have applied to reside in internal medicine in Mary Washington and that the program will soon open applications to family medicine residents. The goal is to have more than 150 residents within five years and to expand the program to other specialties.

Thompson and Sullivan-Simenson have worked together as nurses for more than 20 years and have always said they would start a practice together and do it the way they wanted. Instead of seeing 25 or more patients a day — as is the case at some practices they’ve worked at — they would keep their “panels,” or patient counts, lower.

They have lower overheads than large practices and don’t have to pay off college loans like someone straight out of medical school.

“We’re both at that point in our lives where our children are growing up, and we have an opportunity to sit back and make that happen now,” Sullivan-Simenson said. “In my opinion, the crisis will not change at all in the next two to three years. I think it’s going to get worse.”

Because of this, Thompson wants to “leave a footprint so others can do the same because nurse practitioners can stand up and do this,” she said.

It’s also a “heartfelt thing,” Thompson said, adding that she needed to do more than “put band-aids to someone in the ER” and then send them knowing “there’s nothing really going on in their life changes. I want to change the lives of people who are unable to get care.”

Thompson is 53 and Sullivan-Simenson is 47. Both can practice independently, so they no longer need the supervision of a doctor. Virginia requires nurses to be supervised for five years and 9,000 hours.

Before starting her own practice, Thompson consulted with Nancy Lynn Sadler, who has a family practice in Manassas and is one of the first 100 registered nurses to have an autonomous practice in Virginia.

Medicaid patients, “the poorest of the poor and the sickest of the sick,” make up 90% of their practice, Sadler said. Even though she needs more care and Medicaid reimburses her less than commercial insurance, she can still pay her bills.

“I’m not going to get rich, but I’m very happy with my life,” Sadler said, adding that like Thompson, she believes nurses can help alleviate the lack of medical care.

“I think we’re going to be the saviors of the day,” Sadler said.

Cathy Dyson: 540/374-5425

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