Honoring the Expanding Role of Nurse Practitioners and Physician Assistants
Janine Brown’s career has been a series of firsts. Her first job after completing her NP training in 1997 was at Sentara Norfolk General Hospital, where she was an outpatient heart transplant nurse practitioner – the first NP ever hired at Sentara in this role. It wasn’t her first choice, she says – she initially wanted to find a position with a family medicine practice, caring for folks in the community and helping them stay healthy. But in the late 90s, those jobs were few and far between locally. She could relocate to West Virginia or the Eastern Shore, but she wanted to live and work in Hampton Roads.
She had been a cardiac step-down nurse and also worked part-time during NP school in the heart transplant clinic, so when the opportunity arose to help craft a nurse practitioner role caring for heart transplant patients at Sentara, she took it. She remained with the program for three and-a-half years, and during that time, established professional relationships with many physicians and surgeons, whose patients often overlapped with her own.
One of those physicians was Dr. David A. Johnson, a gastroenterologist with Digestive and Liver Disease Specialists (a division of Gastrointestinal and Liver Specialists of Tidewater), to whom she had referred several patients. After Brown left Sentara to care for her newborn daughter, Dr. Johnson called her at home and asked if she’d come to his office to talk with him. “He said he wanted to start something new,” she remembers, “and he said he wanted me to start it with him.”
Dr. Johnson’s idea was to utilize nurse practitioners in the hospital to support his GI practice. “No other GI practices in Hampton Roads were doing that,” Brown recalls. “There were nurse practitioners in the office, but they didn’t round on hospital patients.” Aware of her responsibilities to her family, Dr. Johnson offered her the opportunity to work six hours a day, twice a week. “He asked if I could handle that,” she remembers. And indeed, she could.
In fact, she says, it was the perfect fit for her. The learning curve from cardiology to gastroenterology, while huge, was eased by her innate ability to appreciate what was urgent and what wasn’t. Dr. Johnson describes the transition as “seamless, thanks to Janine’s strength of immediate assessment of acuity of illness.” She credits Dr. Johnson’s training – he dedicated two full months of working exclusively at Sentara Norfolk General to teach her – with helping her make the change.
Today, in addition to working four days a week at Norfolk General, she helps mentor medical students, NP students and residents. As part of the practice’s ongoing commitment to the students and residents at EVMS, she can often be found giving advice on presentations or the best ways to approach the diagnosis and therapeutic plans to be presented.
Brown says she was inspired by two exceptional women who served as her role models. Her mother she describes as “the kind of nurse that every doctor wanted to work with,” adding with pride, “she gained a lot of well-deserved accolades throughout her career.” Her high school biology teacher was the spark that interested Brown in life science. She also credits Dr. John Herre and Dr. David Eich, both cardiologists, with mentoring her through her early days as a nurse practitioner.
“Janine has the foundation of family and faith to guide her,” Dr. Johnson says. Part of that foundation is reliance on the Golden Rule: “I try really hard to treat every patient the way I’d want to be treated,” she says.<
