After working with pregnant women for more than 20 years, Cheryl wanted to combine her passions for women’s health and nursing, and take her career to the next level. As a nurse practitioner, Cheryl now educates women about women’s gynecological health issues and works with women of all ages in a clinical setting. In this Salary Story, she talks about the wide variety in her daily work and how her diagnoses have changed patients’ lives. She describes her nurse practitioner job description and shares tips on getting started in the field, including a five-year plan strategy that could make or break a job interview.
PayScale: What is the job description of a women’s health nurse practitioner?
Cheryl: I assess and manage post-menopausal women for possible hormone replacement therapy. I also assess antepartum patients and postpartum patients, provide contraceptive counseling and management in addition to insertion of Implanon and IUDs. I do endometrial biopsies for abnormal uterine bleeding, STD assessment and management. I diagnose and treat polycystic ovary syndrome (PCOS). I review labs and follow through with treatment as needed or refer to the provider I work with or providers outside of the practice. I teach about everything dealing with women’s health, including decreased libido to postpartum depression. The only things I have not done, but have taken courses for, are Colposcopy and Ultrasounds.
PayScale: How did you begin your career as a women’s health nurse practitioner?
Cheryl: I loved women’s health, and after being a labor and delivery nurse for years and teaching vocational nursing, I felt there was much more that I was called to do. I wanted to educate women about their reproductive health. I also wanted to enjoy the clinical aspects of obstetrics and gynecology in a different setting, and at some point to publish articles related to women’s health issues. Becoming a women’s health nurse practitioner seemed the only logical road for me to pursue.
PayScale: What do you love about your job as a nurse practitioner?
Cheryl: I love working with adolescents and teaching them how to be healthy young ladies and how to protect themselves from becoming an STD statistic. I love working with the pre-menopausal, recently divorced women and teaching them how not to become an STD statistic as they reenter the dating scene. I love assessing and managing women with post-menopausal symptoms and helping them to continue to feel good physically, mentally, and emotionally. I love writing articles to inform my colleagues about the things I find in practice that may help them assess women more efficiently. I love the technical end of being a women’s health practitioner; I like putting in the IUDs and diagnosing chronic interstitial cystitis (IC) in women who have had the symptoms for years. Then, I diagnose IC and watch them become new women because they are able to drive ninety miles and not stop four times during the trip. And I also love speaking to the public, whether it is a church group, a youth group or a women’s group of some type, on issues that affect women. So, I love every aspect of my job. I have never been so happy to wake up and get to a job before. Each day is different and offers enough diversity to keep me happy.
One short story that really encourages me is about a young woman who was in her 40s and had been having an abnormal vaginal discharge since she was a teenager. She had been to many providers over the years. Some told her the discharge was normal for her, some told her she had chronic bacterial vaginosis (BV) but none could make the problem go away. Well, when I did her exam I knew the discharge was bacterial but I took a closer look at her cervix and I could see old scarring from what I thought was genital herpes so I suggested testing. She said, “I have been tested every year, and everyone says there is nothing there.” I convinced her to allow me to do an antigen specific herpes type II test and it came back positive. She was devastated with the news and the thought that she may have exposed other partners during the years she was dating, but so grateful to have someone confirm that something was really there like she initially had thought years ago. Now she is on suppressive therapy, educated on genital herpes and knows life goes on. Her bouts with BV are few and far between and she knows now that when she has an abnormal vaginal discharge, it most likely is a flare-up on her cervix of the genital herpes. And it makes me proud to know I look beyond what the norm is when assessing problems with my patients.
PayScale: What are the biggest challenges you face as a women’s health nurse practitioner?
Cheryl: The biggest challenge is to find a wonderful physician and staff to work with. I have been truly blessed to have fallen into an office setting where the staff works well with me, my boss loves working with me, and my boss allowed me the autonomy I needed to get comfortable in my new role as a nurse practitioner. Many of my colleagues have had troubles with the staff not working well with them or the office manager not working well with them. Also, having a physician that either over-worked them for almost the same pay they made as an RN or they paid well but the patient load was such that they could not do the preventive teaching we were trained to give and are accustomed to giving, or the personalities clashed.
I am so glad that one of my professors encouraged us to share our five-year plan with a potential employer during the job interview. This way, you know if your goals and theirs are on the same page. I was very fortunate that my employer was in agreement with everything from salary to personal and professional goals. And all the goals matched what she wanted her clients to enjoy in her office. That’s how we went from having 4,000 patients when I started to 8,000 patients more than five years later. We have only had two employees leave and they left because they retired or they moved out of the area.
PayScale: What advice can you offer to someone in your field?
Cheryl: I would suggest doing a preceptorship in an office you would love to work in. In doing so, once your internship is over, you may have found your dream job. The provider now knows how you work and you have also learned the dynamics of the office and know if you would fit in that setting.
PayScale: What are some interesting moments that you’ve experienced as a nurse practitioner?
Cheryl: I have built rapport with women of every possible ethnicity and social background. I have become a very well-liked and respected nurse practitioner in my community. I have not had to settle for doing only one facet of being an NP and I have written two women’s health articles in the Journal for Nurse Practitioners since being here.
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