Nina Collins, MSN, RN, ANCP-BC
Nurse Practitioner
Trach/PEG Consultation Service
Division of Trauma and Surgical Critical Care
My professional journey started while attending Law school; despite doing well academically, I felt unfulfilled and that I had missed my opportunity to serve others. Thus, I was drawn to nursing. I took a leave of absence from law school and found a position as a medical receptionist, working night shift while attending nursing school during the day. After I graduated with my BSN, I was hired as a bedside RN in the Trauma Intensive Care Unit at VUMC. The Trauma Nurse Practitioners were an inspiration and I knew that I wanted to follow in their footsteps.
Eventually, I finished my Masters in Nursing, passed my board certification exam and applied for the only job I really desired. The learning curve on the inpatient Trauma service was steep. It was a fascinating role, with the perfect balance of autonomy and support. The Trauma service is fast paced and their nurse practitioners are a huge part of its success. Over the years, I saw these extraordinary NPs step up to handle mass casualties, new roles and responsibilities, high censuses, tornadoes, and every other thing you can imagine.
As the service grew and the census continued to grow, we wanted to be more involved and help earlier in the patients’ hospitalization. We proposed adding more NPs and hypothesized that it would decrease length of stay. We collected data and found that expanding trauma NP roles dramatically decreased length of stay and improved staff satisfaction. We presented and published the data and I will forever be proud of that work and my time on the inpatient trauma service.
As the Trauma/EGS Service started to do more elective procedures in other ICUs, it was apparent that this was an opportunity to create something new to improve care. The Trach/PEG Consultation Service was born! The goals were to streamline the process and to minimize complications. By creating a Nurse Practitioner-driven service, we could improve outcomes. I was intrigued by the idea of creating something new and proving that a NP service could really shine; I was ready to take on this exciting opportunity.
I started to focus on these specific elective procedures in 2014. I perform a preoperative evaluation/consultation and I evaluate the patient critically to determine if they are an appropriate surgical candidate. I weigh the risks and the benefits of the procedure carefully and then coordinate the surgeries with my attending surgeon and the primary and critical care teams. I ensure the patient has been prepared appropriately and that the correct orders are entered. After the surgeries are completed, I monitor the patients closely for complications. Eventually, I follow the patients in the outpatient clinic.
The process of building a service from scratch has been amazing. It is not a regular occurrence in other hospitals for a nurse practitioner to be given such latitude to create something new. The flexibility and trust VUMC extended to me was inspiring. I have been able to adapt and change the service to meet the needs of the institution as it continues to grow.