Below, I interview Lt. Meg Whelpley, a nurse practitioner (NP) with the National Heart, Lung, and Blood Institute (NHLBI) on the Cardiology Consult Service at the National Institutes of Health (NIH). She tells us about her career as a bedside nurse, a travel nurse, an NP, and now as an officer in the Commissioned Corps of the US Public Health Service.
Tell me about your background.
I got my bachelor of science in nursing in 2005 from Johns Hopkins University. My first degree, however, was in information technology, and I worked for the federal government before deciding that I needed to go into nursing. I have worked in both adult and pediatric emergency departments (ED), the intensive care unit (ICU), and I now work in cardiology.
What was your first nursing job?
My first job as a nurse was in the ED at Inova Fairfax Hospital, a level-one trauma center in Fairfax, Virginia. It was wild and fun, and the teamwork was outstanding. It was an amazing introduction to nursing and medicine, and I am grateful each day that I started my career there. The challenges of that environment were innumerable, and the lessons I learned continue to impact my daily life, both personally and professionally.
What did you do next?
As can frequently happen in an ED, there was a mass staff exodus when I had been at Inova Fairfax for almost two years. Travel nurses were hired to fill open nursing positions. The new travelers told me about the glory of the travel nurse life, and I was single and ready for a change.
Where was your first travel assignment?
My first stop was a tiny rural hospital on the Eastern Shore of Maryland. They had fewer beds in their entire hospital than we had in the ED at Fairfax! It was a huge eye opener. In only my second week there, I was made charge nurse of the ED four nights a week. The manager told me I had more experience than any of her night nurses despite having less time actually at the bedside.
Being a charge nurse must have been a great leadership experience for you. Where did you go for your next assignments?
My next adventure was to was Denver, in a pediatric ED. I was nervous about taking care of kids, but I had a great time and loved the work. I was there for nine months before heading to Chicago. There, I was in the ED of a level-one trauma center, and again was part of a great team, but the work was tough. Inner city Chicago was very different from suburban northern Virginia. I was there for the last six months of 2008 when the financial markets crashed. The effect was definitely felt in travel nursing. I was thrilled to be asked to come back to Denver and returned there for a three-month contract in January of 2009. I was then offered a position there as a staff nurse, and I took it while I worked on taking the next steps to pursue my master’s degree.
What led you back to school for your advanced practice degree?
I really liked the idea of participating in patient care at a higher level. As a bedside nurse in the ED, most of the physicians I worked with appreciated my assessments, and they challenged me to think further about possible differential diagnoses. They were wonderful teachers. I wanted to focus more on diagnosing and treating patients, and I really believe in both the art and science of nursing, so becoming an NP was the clear choice for me.
Where did you start working after you were a CRNP (certified registered nurse practitioner)?
My first job was in the ICU at Inova Fairfax. I loved the work, but the schedule was really challenging. We rotated days and nights, and I even worked a few 24-hour shifts as needed. It was harder than any schedule I had as a nurse in the previous seven years! I quickly found a new position with the cardiology service at MedStar Washington Hospital Center in the District of Columbia, and I stayed there for two years. It was a great place to learn, and we had a great team of NPs. It was a very autonomous NP service, which was professionally satisfying. I had the opportunity to return to federal service with a position at NIH in 2013, and I jumped at the chance!
Do you remember when you first heard about the United States Public Health Service (PHS)? What drew you to this organization?
My first encounter with the PHS Commissioned Corps was at a job fair at Hopkins during my nursing undergrad. I was reintroduced to the service when I took my position at NIH—many of the people that work here are Commissioned Corps officers. I had always been interested in serving. You could say it’s in my blood: My brother was in the Marine Corps, my father spent his entire career as a civil servant, and my mother worked as a priest and social worker. Of course, my husband’s service in the fire department was also a big influence on my decision to serve. We hope to instill the value of service in our son, as well.
The idea of being a part of a group dedicated to “protecting, promoting and advancing the health and safety of the nation” was very appealing to me. I had looked at other branches of service a few times through my years of education, but the fit with the PHS was definitely right for me.
What did it take for you to become a lieutenant in the PHS?
There is a multi-step application process (detailed at www.usphs.gov) that requires that you obtain employment in a federally qualified position prior to commissioning. My position with the NIH qualified, but many other positions are available throughout the federal government, and you can begin the PHS application process before securing a qualified position. We work in the Bureau of Prisons, the Indian Health Service, the Centers for Disease Control, and the Federal Drug Administration, to name a few agencies. Once you receive your call to active duty, there is a required two-week Officer Basic Course as a part of the commissioning process, and then it’s time to get to work.
Where do you work? What is your role? What is a “day in the life” like for you in your current position?
I am currently an NP with the National Heart, Lung, and Blood Institute on the Cardiology Consult Service at NIH. I work with a team to evaluate patients enrolled in any number of research protocols there. We see patients before, during, and after their participation in research, depending on their cardiac history and needs. I get to spend a lot of time educating and learning, with both my patients and the students that round with us. It is a very rewarding job. I wear my uniform every day with pride.
What responsibilities do you have with the PHS?
As an officer in the Commissioned Corps, I have added responsibilities with the PHS, which include working with the Capital Area Provider (CAP) team in support of the Office of the Attending. My CAP team duties also include local deployments to act as medical support for mass gatherings throughout the District of Columbia. Additionally, I volunteer with the MobileMed-NIH Heart Clinic, which is an organization that provides cardiac evaluations for underserved citizens of Montgomery County, Maryland.
What is most challenging about your job?
Understanding the complex diagnoses of my patients in addition to the proposed treatments and their cardiac implications is a challenge every day! We see some amazing things at NIH, and almost none of it is straightforward. I have been here three years and not a day has gone by that I haven’t learned something new.
What type of person would be good in this role?
I think that my success in this job has come from my strong foundation and training in the art and science of nursing. Caring is an art form, and it is essential in developing relationships with patients and the teams with which we consult. Science requires focusing on details and critical thinking about patients to ensure the best outcomes possible. The type of nurse that would be good in this role needs to be a caring, detail-oriented, critical thinker—oh, and I write patient reports constantly, so good written communication is a must!
What is most rewarding about your work?
Patients here are very appreciative of their care. Because they are participating in research, there is no charge for the care they receive, which makes people really grateful. Grateful patients are refreshing for me, as that was not always the case in the other places I have worked. I also get to take my time with patients. I can really help them better understand their own hearts and how to best care for themselves. Education is an amazing gift to give to patients, and empowering them in their own care is very rewarding.
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