Teaming up: nurse practitioner and patient work together to manage heart failure

At 28, Ivette Sanchez has already been battling heart failure for six years. Through it all, John Meister, RN, NP, a nurse practitioner with LIJ Medical Center’s Heart Failure Program, has been there to help. “He’s my go-to guy,” Ms. Sanchez said.

Heart failure is a condition in which the heart can’t pump enough blood to meet the body’s needs. Ms. Sanchez’s heart failure is advanced, so it leaves her tired and short of breath, even when resting.
But by working with Mr. Meister, she’s able to feel better and do more.Ms. Sanchez’s heart failure was caused by previously undiagnosed lupus, an immune system disorder. By the time Ms. Sanchez was transferred to LIJ Medical Center from another hospital, her heart was already seriously weakened.

“Eventually, she will probably need a transplant,” Mr. Meister said. “But her quality of life is much better today than when I first met her six years ago.”

Heart Failure Success Story

“I see John every six to eight weeks, depending on how I’m feeling,” Ms. Sanchez said. Mr. Meister partners with Sandeep Jauhar, MD, Ms. Sanchez’s cardiologist at LIJ Medical Center. Together, they monitor Ms. Sanchez’s condition and fine-tune her treatment plan.

“John asks questions about how I’m doing. Then he makes sure I get everything I need,” Ms. Sanchez said. “If I need a prescription, John will call it in to the pharmacy. If I need some blood work done, he puts the order in.

“John also pays attention to how I’m feeling emotionally,” Ms. Sanchez said. Recently, Ms. Sanchez has been concerned about her grand-mother, who has cancer. “He always asks how my grandmother is doing,” she said. “He notices when I’m sad and is very supportive.”

“We’ve developed a really good relationship over time,” Mr. Meister said. “At this point, I can tell just by seeing Ivette and talking with her when something is wrong — physically or emotionally. With all my patients, I take a holistic approach to caring for the whole person, not just the disease. I think my nursing background helps me provide not only medical care but also emotional support.”

Key Player on Health Team

Mr. Meister is one of 600-plus nurse practitioners in the North Shore-LIJ Health System. Over the past half-century, these extensively trained professionals have become key players on the healthcare team.

“Nurse practitioners are registered nurses who are educated at the graduate level,” said Priscilla Samuel, RN, NP, corporate director of advanced practice nursing for North Shore-LIJ. “In addition to having a master’s degree or being doctorally prepared, our health system requires every nurse practitioner to be nationally board-certified.”

Nurse practitioners can examine a patient, order tests, make a diagnosis, provide treatment and prescribe medication. “But our focus isn’t just on treating a patient,” Ms. Samuel said. “We believe that patients should be viewed within the context of their families and communities while placing great emphasis on health promotion and disease prevention.

“Having NPs on the healthcare team ensures continuity and coordination of care while minimizing duplication of clinical efforts,” Ms. Samuel said. For hospitalized patients, working with a nurse practitioner after going home reduces the risk for readmission.

Full Circle of Support

Ms. Sanchez, who lives with her parents, said she’s grateful for the support she receives at home. “When I’m feeling like it’s too hard to go out and do things, my mom gives me a little push,” Ms. Sanchez said. “I’m always glad afterward.”

“Ms. Sanchez comes from a tight-knit family,” Mr. Meister said. “She’s a very strong-willed woman, and her relationship with her family makes her even stronger as an individual. That adds to her ability to cope with lupus, which is a lifelong disease.”

“My friends are great, too,” Ms. Sanchez said. “I have one friend who will come in from New Jersey and pick me up so I can get out of the house.” Yet Mr. Meister still has a special place in her support network because he addresses a wide range of concerns. “When I have questions about my medication or diet, he answers them,” Ms. Sanchez said. “When I need paperwork for government benefits, he sends it over the same day. And when I’m feeling down, he talks with me to help me feel better.

“John does a little of everything,” Ms. Sanchez said. “I just call him a godsend.”

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