The Team Behind the Team: Bringing Nurse Practitioner Care to the Paris Paralympics

Meet the nurse practitioner selected for the Team USA Paralympic Track and Field medical team.

On Sept. 8, the Paris 2024 Paralympic Games came to a close. The event hosted approximately 4,400 athletes from across the world as they competed in 22 sports at historic venues such as the Eiffel Tower, the Chateau de Versailles and the Grand Palais. At the end of the competition, the Team USA Paralympics Track and Field team came home with 38 total medals, including 10 gold. 22-time Paralympic medalist Tatyana McFadden from Baltimore, Maryland, won her 21st and 22nd Paralympic medals in Paris, becoming the most decorated U.S. Paralympic track and field athlete in history. But what about the team that supported them and kept them healthy — the team behind the team?

A dual-credentialed, board-certified family nurse practitioner (NP), Joel Dekanich, FNP-C, MSN, DC, MS, DACBSP was selected for the Team USA Paralympic Track and Field medical staff. Previously having worked on the medical team in the Rio and Tokyo Paralympics, his attendance at the Paris 2024 Paralympics marks his third Paralympic Games in just eight years. In honor of Team USA’s incredible wins in Paris, the American Association of Nurse Practitioners® (AANP) spoke to Dr. Dekanich about his time at the Paralympic Games with Team USA Track and Field, his decades of expertise working with athletes and his journey to becoming an NP.

Q: I understand that you are an athlete yourself. Could you tell us how you first became interested in health care, and how did you ended up becoming an NP?

Joel Dekanich: Before I was a NP, I grew up as a typical high school athlete. I've been a long-distance runner and an endurance runner, and I got into ultra marathons 20-some years ago. After receiving a back injury, I went into the career path of physical therapy and sports medicine. I ended up going to chiropractic college about 30 years ago, as a matter of fact, with a specialty in sports medicine.

I primarily worked at a musculoskeletal orthopedic outpatient clinic for the better part of three decades before deciding to go back to school to get my NP degree. I wanted to expand my knowledge base, patient-care wise, while increasing my ability to help patients. I'm so thankful that I became a NP, and I wish I'd done it sooner.

But I’m very proud to be an NP with an orthopedic background. I've proven over my 30 years that I like to keep learning, staying abreast on evidence-based practice in orthopedics, sports medicine and pain management.

Q: How did you become involved more specifically with Olympic athletes?

Dekanich: My previous background in sports medicine and chiropractic got me into the Olympic and Paralympic circles. I interned with the United States Olympic Committee (USOC) medical staff at the Olympic Training Center. While you're there, you're working with medical physicians, physical therapists, athletic trainers, chiropractors on the resident athletes there and the teams that kind of come and go for training camps.

After that internship, I didn't hear anything for a couple of years. That was until the national governing body (NGB) for Team USA Para Track and Field contacted me to work on my first games. I wasn’t just asked to work my first games, but my first international games — the 2011 Parapan American Games in Guadalajara, Mexico — as part of the medical staff with Para Track and Field.

Q: What is it like traveling with a team for an international sporting event?

Dekanich: This trip to Paris has been my fifth international travel with Team USA. You’re a little green at first, so the Parapan Am Games in North and South American countries are a great way to experience a multinational event that's not the Olympics, and I think they do that purposefully to help you get your feet on the ground.

In general, there are so many things to learn. You’re working with the delegation and alongside other health care providers, so you need to understand the lingo — medical, sports medicine, infectious diseases and things like that. But Team USA and the NGB do a very, very good job of supporting the team behind the team, so to speak. That’s essentially how we consider ourselves: we're the team behind the team.

Q: Most recently, you traveled to Paris for the Paralympics. Could you tell us about that experience, and what exactly your day-to-day schedule is like when you’re at an event like this one?

Dekanich: Every Paralympics I’ve worked in — Rio, Tokyo and now Paris — has been a little bit different, but Team USA does an amazing job in the months leading up to the event. As part of the Team USA Paralympic Track and Field medical staff, which is comprised of a medical physician, a couple of physical therapists, couple of athletic trainers, sports chiropractors, massage therapists and sports psychologists, we are responsible for the 55 athletes on the Team USA Paralympic Track and Field team.

Starting at 7:30 a.m., our athletes are already warming up the track — and we’re right there with them. As an NP, my role at the Paralympics was to assess, diagnose and treat common musculoskeletal disorders and conditions of any of our athletes, which includes treatments on the track as well as treatments at the Olympic Village. We have daily conference calls and provider calls briefing us on everything that's happening with Team USA and around the Village to try to prevent things like gastroenteritis, COVID-19 and other illnesses from affecting our athletes.

All this goes on right up until the start of the competition, where we then go to the Olympic Stadium. Our team works right outside the Olympic Stadium, providing any last-minute therapy or treatment to our athletes on the warmup track. All throughout the competition, I am providing supportive musculoskeletal care to help Team USA win their medals and perform the best they can.

Q: I imagine that in addition to the stress on their bodies, some competitors might feel emotional stress at the high stakes involved in a big tournament. What kind of perspective can you give those athletes to help them compete at their highest level?

Dekanich: The emotional stakes and the scope of the competition can be a lot to take in as our team gets ready to perform. Due to the COVID-19 pandemic, there were no fans in the Olympic Stadium in Tokyo. So, for many of our Paralympic athletes in Paris, this is their first time ever being in front of 70,000 people screaming and cheering.

Thankfully, Team USA has resources on hand to support our athletes’ mental health. We have a sports psychologist with us on the team, and our athletes check in with them in addition to performing their own mental health checks throughout the competition.

Q: You’re crossing into different time zones and working long days. How do you, as a provider, maintain a work-life balance and prevent burnout?

Dekanich: This is not for everybody. These are very, very long days. Everyone asks, “Oh, is your wife going to go with you?” and you chuckle because there is no time for that. On busy days, we start as early as 7 a.m. and work until our athletes leave the stadium at 11 p.m. If one of our athletes gets pulled for a doping check — which is very common and very routine — we've got to have medical personnel with them. So, we’re always on the clock.

In order to avoid burnout, it's important for even health care providers such as myself to maintain a good sleep routine, which can be difficult when you’re traveling internationally. It’s also important to maintain your exercise, eat well and practice self-care. If you’re tired and throttled, these long days can really grind on you. Our team supports each other — taking breaks, covering each other and keeping that balance as best we can.