Full Circle: Nurse Practitioner Aids Patient In Two Roles, Seven Years Apart

Seven years ago, Becky Weaver, a nurse navigator at Winchester Medical Center, met with a patient named Joanne.

Joanne had chronic obstructive pulmonary disease (COPD), which was limiting airflow into and out of her lungs. She also had bronchitis and the flu, which had thrown her into atrial fibrillation. This was Joanne’s second time in the hospital in three weeks.

As a nurse navigator, Becky’s job was to educate patients and connect them with resources to keep them out of the hospital. She shared tools for Joanne to manage her COPD, tips on breathing, and potential triggers (like cold air and irritants) that could exacerbate her condition. She also connected her with Valley Health pulmonologist Jeffery Lessar, MD, and attended her first visit with her.

“It was very successful,” Becky says of Joanne’s treatment. “Once she got the education, she knew when to call and see a pulmonologist and how to manage her disease.”

With the help of Becky, Joanne eventually graduated out of the Nurse Navigation program. She credits Becky for saving her life all those years ago. “She was really a godsend,” Joanne, 81, says.

However, this February, Joanne was readmitted to WMC with end-stage COPD and congestive heart failure. The Palliative Care team was consulted to discuss symptom management and goals of care.

The palliative provider sent to see JoAnne was Becky, whose role had changed over the years.

“I was very, very surprised to see Becky again,” Joanne says. “It was a relief. I was really glad to see her and to have somebody I had a connection with.”

After a big hug, Becky discussed palliative and end-of-life care with Joanne. Palliative care addresses symptoms, communication and next steps for anyone living with a serious illness, no matter how long they have to live. It differs from hospice care, in which patients are expected to live six months or less and are no longer pursuing aggressive treatment.

“It was rewarding for me to be involved as a nurse navigator and then to change roles and hear Joanne’s story of how the Nurse Navigation program kept her out of the hospital all those years,” Becky says. “And then to see her as a nurse practitioner … it came full circle.”

Joanne received the information she needed and is now out of the hospital, living independently. “End of life is personal for everyone,” she says. “You really need someone to hold your hand through it. And Becky was that person. I consider her a lifesaver.”