Healthcare 360: Nursing Within the Primary Care Setting

October 25, 2023

Podcast: A Discussion on Nursing in the Primary Care Setting

On this week’s episode of Healthcare 360, Dr. Rob Fields sits down with Kristen Silva, BSN, Director of Nursing, Beth Israel Lahey Health Primary Care, Northern Region, to discuss nursing and its role within the primary care setting.

The Journey to Director of Nursing

With almost 20 years of experience within the healthcare field, Silva has had the advantage of learning about hospital operations through a series of unique roles. She started out in patient registration where she operated a switchboard and placed transfers before going to work as a nurse in a small community hospital in rural New Hampshire. From there, she spent a few years as a travel nurse, eventually returning to Boston to work on her master’s degree.

In time, she started to witness the problems that she had heard about as a travel nurse and began to feel burnt out. She explains that, at that time, she felt she had gotten to a place where she no longer felt like she was good for her patients or colleagues until one of her college professors pointed her in the direction of the Institute for Healthcare Improvement (IHI) – and that was a pivotal point for her.

“I got involved with the IHI and it really gave me my career back,” she says. “The IHI not only taught me leadership and organizing and change, but they create a safe space for people to practice those skills.” Her work through the IHI led her to Lahey Hospital, and she’s remained a part of BILH ever since.

Primary Care and Nursing

Speaking about the evolution of the team model, Dr. Fields and Silva discuss the way that’s changed throughout the years and how many primary care physicians come out of training having not worked extensively with nurses. When asked why that might be, Silva explains that nursing has been a longstanding part of the inpatient care delivery model, but it’s a newer addition to the outpatient care delivery model.

“In the primary care setting, I think the role of the nurse is really to come in with that [holistic thinking] wraparound care to supplement the important work that our providers are doing around diagnosis and treatment,” she says.

“But then to help understand: what is the patient’s comprehension of this really complex chronic disease? Do they understand what it means to have diabetes in their body? Do they understand what that looks like? Nurses are well positioned to help a patient break that really complex concept down and then also meet the patient where they are.”

She adds that when it comes to chronic disease management, having regular visits with a nurse in addition to seeing a provider for diagnostics and lab tests allows for more patient-centered care and patient education.

Every other week, we’ll chat with a leading expert in healthcare to learn about the many challenges and opportunities facing the industry. Listen to the full conversation with Silva here, and check in regularly for new episodes of Healthcare 360.

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