Hear from Amanda Chaney, DNP, APRN, FNP-BC, FAANP, recipient of the 2018 NP State Award for Excellence in Florida, on her experience as a nurse practitioner (NP) in hepatology.
After starting her career as a nurse on the surgical floor at Mayo Clinic in Florida, Dr. Chaney sought out new opportunities to learn and make a difference: “Initially, I thought there could be a path for me to become the nurse manager on the floor, but the eventual end of that path is in administration. I wanted to still take care of patients, and I knew there was so much more in the health care field to learn.”
After returning to school, working full time at night on the floor as a nurse and completing clinicals during the day, she transitioned to become a clinical nurse educator for a year with Mayo Clinic and provided content for the surgical, orthopedics, hematology and transplant departments.
After graduating in 2006, a friend suggested she apply to the transplant fellowship group at Mayo Clinic. “Learning about hepatology and transplants was an inspiring new world for me,” she says. “I was familiar with the field, but it is very specialized, and I had to learn the intricate details. Often, I found that the ‘boots on the ground’ transplant advanced practice providers [APPs] had no resources or tools to turn to.”
She took it upon herself to partner with a physician mentor early in her career to help share the NP perspective on transplants and hematology through research and literature. “He was very helpful guiding me through the institutional review board [IRB] process and the steps to publish my vitamin D deficiency study,” says Dr. Chaney.
The study notes that vitamin D deficiency can be found in up to 96% of patients with liver disease. Dr. Chaney found that vitamin D supplementation may be required in high doses in patients with a moderate to severe deficiency, and primary care NPs can assist patients with liver disease in learning about optimal nutrition and vitamin supplementation.
A Love for Education
Stemming from her time as a nurse educator, Dr. Chaney’s passion for learning and mentoring others had motivated her to remain involved with education, particularly for APPs like NPs and physician assistants (PAs). “I’ve always been inspired to learn more and spread knowledge. It’s very rewarding to hear that I’ve helped make a complicated topic easily understood,” she shares.
It was at AANP’s national conference that she connected with Springer Publishing Company on the need for more information on gastrointestinal (GI) conditions and liver disease — leading to the publication of her book, “Fast Facts About GI and Liver Diseases for Nurses: What APRNs Need to Know in a Nutshell,” in 2016.
“As more patients are getting transplants, it’s important for all NPs to be aware of complications and reasons to refer patients back to the transplant center. Therefore, education on cirrhosis and sepsis is hugely important,” Dr. Chaney says, emphasizing the need for early intervention on such problems. “There are 4.5 million people in the U.S. living with liver disease, and fatty liver disease is becoming more common — soon becoming the most common reason for transplants — but the liver doesn’t always get the recognition it needs.”
To help remedy this lack of information, Dr. Chaney has partnered with the International Transplant Nurses Society, Advanced Practice Education Associates (APEA) and the American Association for the Study of Liver Diseases (AASLD) on GI and liver disease education for APPs. In fact, at AASLD’s The Liver Meeting® in 2019, she was instrumental in bringing NP and PA speakers to the table to share their unique insight.
She’s also quick to note that NPs in particular can be an excellent resource because of their focus on patient education: “For fatty liver disease, as an example, it’s all about making small changes every day and helping patients understand that there isn’t a quick fix. There’s no pill to cure this; it’ll take hard work and, truly, a lifestyle change. As NPs, we’re well suited to explain this in a way that makes sense and make recommendations that are sustainable for each individual patient.”
Support in Practice
Wanting to grow in her role, Dr. Chaney was accepted into AANP’s 2014–2015 inaugural leadership program. She has since used the skills she developed to positively impact her daily practice and work site.
“I’ve had the opportunity to chair the APP subcommittee at Mayo Clinic in Florida, which was founded because we needed a centralized body where we could talk about best practices, onboarding, professional development and more,” she explains. “The first year, we spoke with an APP from each department to understand how they were being utilized and what their expectations were. The subcommittee plans to follow up in 2020 to gauge improvements and areas where additional support is needed, and we’re looking into specific quality metrics to track for each department.”
She was also key to creating a professional development group, partially influenced by her desire to publish and provide education on a number of pressing hepatology topics as she was beginning her NP career. The group grew to an impressive 400 individuals in just one year.
“Representation on a senior level is a huge honor,” she says, “and it’s wonderful to know my organization understands that we need a seat at the table.”
Hepatology Sessions at the 2020 AANP National Conference
AANP’s annual national conference is the biggest NP event of the year — and you’re invited! Join thousands of NPs from every specialty, including hepatology, in New Orleans for a week dedicated to learning, relationship building, practice insights, career advancement and enjoying all that the Big Easy has to offer.
If you are interested in learning more about hepatology and GI conditions, you may want to select these sessions, presented or co-presented by Dr. Chaney:
Fatty Liver Disease; Management of Abnormal Liver Function Tests: Gain a brief overview of fatty liver disease and its complications and review practical lifestyle modifications that can be implemented to better patient outcomes.
Irritable Bowel Syndrome (IBS): Review best practices for documentation and coding surrounding IBS as well as the latest treatment options available to provide patients with relief and positive long-term outcomes.
Gastroenterology Specialty Practice Group (SPG): The co-chairs of the Gastroenterology SPG will be available to guide the discussion and facilitate conversation on a number of topics. You do not need to be a member of the Gastroenterology SPG to attend, which makes this an excellent opportunity to learn more about this exciting group!