Written By: Women & Infants Fertility Center on May 15, 2020
Jacalyn (Jackie) Finerty, MS, APRN, WHNP-BC, brings to the Fertility Center 20 years of nursing experience, an enhanced skill set as a provider, a gift for patient education, and a love of caring for others. In this blog, she explains her role as a women’s health nurse practitioner and how personal involvement improves patient comfort and infertility treatment success.
I am a provider. Nurse practitioners (NPs) are trained and licensed as providers. We start with the same skill set and training as nurses, however we have furthered our education to expand on our skills to be able to diagnose and treat patients. I still work closely with our nurses, and cherish the care they give our patients. Our office has a team approach for all that we do, keeping our patients at the center of it all.
I chose to become further educated with the focus of women’s health. With 20 years of experience in a wide variety of settings where I have cared for women and their healthcare needs, I am very passionate about this path. As a women’s health nurse practitioner (WHNP), I provide care to patients throughout their treatment here at the Fertility Center.
I see patients during their initial consultation, order their initial workup (dependent on their individual needs), make treatment plans for ovulation induction and IUI (intrauterine insemination) cycles, and follow them through these processes. If my patients should require IVF (in vitro fertilization) or surgery, their care is transferred to one of my physician colleagues, where they will get care based on their needs.
As I progressed in my career as a nurse, as well as throughout my education, I saw that infertility care has elements of everything I love. This team, and working as a women’s health nurse practitioner in REI (reproductive endocrinology & infertility), has always been my goal. I am able to directly care for my patients and develop relationships with them.
I also have the added benefit of having the ability to perform or assist in many of the procedures that may be needed while going through the process of achieving their goal of having a baby. This allows me to give continuity of care, which is something I thoroughly believe in giving to my patients.
Nurse practitioners focus on patient education. Making things easy to understand is an important aspect of providing care. It is harder for patients to move through the process easily if a patient doesn’t understand the rationale behind what testing has been ordered, why it is done at specific times, why they are done in a certain order, and why a specific treatment plan was chosen. They get frustrated because an already stressful process has become overwhelming if the steps are not clearly laid out. Explaining what the plan is in a way so patients can understand is important.
There are multiple ways to explain information so that it is understood; therefore, I try to use visual props, talking out loud, drawing pictures and providing written material to take home and review later. For example, when explaining certain procedures, I pull a uterus model out of my drawer and use it to explain aspects of why the procedure is being done and what it will show, while going through the methods to eliminate any questions or fear.
I send them to our website for information. I draw pictures, and I am talking while I am writing or drawing. And I always ask, “What questions do you have?”
Recently a couple came to see me after a long period of infertility. After reviewing their test results, we discussed that they had an option to do IUI versus IVF treatments. They both had high potential for success, however, there were many other factors in their decision making, such as the patient’s age and whether she desired more than one child.
These treatment options are very different, require different medications, procedures, time commitments for office visits and can be very different for patients financially. For someone who has not been through this process before and has not discussed infertility with anyone prior to meeting me, these two very different treatment options may be completely foreign and not well understood.
We talked about in vitro meaning lab, versus in the uterus meaning intrauterine. We spent some time on this, including drawing pictures, giving additional resources on the information they could review at home on their own time, as well as suggesting determining the financial differences between the two options prior to making a decision. I hope in the end the time we spent together discussing the options was helpful in order to choose the right path for them.
I think the comfort from understanding what’s in store makes for a better emotionally prepared patient. I too have been through problems surrounding infertility. It’s scary. There are all sorts of questions that run through your mind: What is infertility? What does it mean? When should I say something or see someone about it? What if there is something wrong with me or my partner? Why is everyone I know or see pregnant and NOT ME?
Often times, the fear of the unknown can be overwhelming.
There are so many different factors that determine the best care for a particular patient or couple. Questions such as: How old are you? Have you or your partner had children before? What’s your ovarian age? Do you want to have more than one child? Have you had multiple pregnancy losses? Are you a same sex couple? The answers to these questions need to be identified, along with many more, to develop a treatment plan that is best for the couple.
Often times, the fear of the unknown can be overwhelming. As a nurse practitioner, it is important for me to address this with my patients at our first meeting. I explain that we are making decisions together to determine the best course of action, while taking into account their health, values, beliefs and personal desires.
I focus on the patient as a whole and how the problem that they are seeing me for fits into that picture. The patients we see should always know that they are not alone in this journey toward parenthood, and that we are going to be there to support them throughout the process. I believe that this is likely the most important step in starting our patient off emotionally prepared for what lies ahead.
There have been studies on infertility and pregnancy loss that compare it to the stress of having cancer. Infertility is stressful and emotionally difficult. It’s not the route most couples think that they will be taking in fulfilling their dreams of being parents. Although there is significant stress during the infertility workup and treatment processes, I think a lot of stress can be eliminated by building trusting relationships with the provider, understanding the steps to complete workups and what the results mean, and the steps in moving forward to achieve a pregnancy.
I’m an educator and a social person. I think that helps in providing care to those I see. I am able to recognize different personality types, learn to read people’s body language and what makes them comfortable or uncomfortable. That helps me get to know them better as individuals and guide them through their care in the most comfortable manner for them.
My personality allows me to relate well to people. For me, a vital part of caring for my patients is getting to know them and get down deep to the root of the problem. I feel like trust is a giant part of taking care of a patient. It goes back to taking care of the patient as a whole and not just one aspect of the problem.
One example of how the personal connection works is that it allows patients to feel more comfortable talking about their sexual practices. Things that patients talk to me about are very intimate (things even their best friend or family members don’t know), but are so important in so many aspects of their journey toward parenthood.
It is important to talk about sensitive subjects such as how your partner ejaculates, or are you having intercourse during the right time of the month? These questions are important, as sexual practices can sometimes be at the root of the couple’s infertility. Some people didn’t discuss sexual practices or “baby making” with their parents, or they simply didn’t have this education in the past.
Some things are cultural. For instance, there are certain cultures that don’t accept infertility as an option, which can be very devastating for anyone who is made to feel “less than.” If this is the case, you could imagine that these people would not be likely to talk about their infertility with those they would otherwise trust.
During these conversations with me, many patients start to feel relieved, once they know it is a safe place to talk about all the things they have heard, folklore and questions that they may have regarding their own sexual practices and bodies. This is especially true when they are trying to conceive a child.
Sometimes certain aspects of treatment are foreign to them, and they’re embarrassed to ask. When I achieve that personal relationship with my patients, that embarrassment is gone, and I can really talk to them about all the different aspects and options that lie ahead in an open and honest manner.
My goal, and that of our entire team here, is to give our patients the best care possible. I become emotionally vested in my patients’ care. I laugh with them, cry with sorrows and celebrate successes. We are partners. I am part of their team, with an open heart and team approach, while giving the evidence-based care that is best for them.
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