Nurse Practitioner

It is not uncommon for nurses to have many stops along their career, but even so, few nurses have traveled the same career path as Camilla Bicknell. A nursing school graduate for nearly 40 years, Bicknell was an active member of the Navy Nurse Corps, worked in an obstetrical unity in Germany, and served in the Gulf War for four months.

Now Bicknell is a Women’s Health Nurse Practitioner who has worked in the same clinic in Colorado for nearly two decades, helping women with their primary health care needs during their life cycle. The work can include GYN exams and procedures, high-risk OB care, and psychiatric care for women with depression or anxiety. According to Bicknell, the rewards come in different forms and she still remains highly motivated to do her work, something she considers essential to becoming an effective nurse practitioner.

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Can you tell us a little bit about the work you have done as a registered nurse?

I graduated from nursing school in 1975. There was no nursing shortage back then, and finding a job without “experience” presented an employment challenge. I visited my local military recruiters and decided to go into the Navy Nurse Corps as a pathway for gaining the necessary experience. At that time it was only a two-year commitment. I joined in 1976 and served on active duty for 10 years (was having too much fun to leave after two years) in various locations and nursing disciplines. The variety of nursing experiences included General Medicine, Medical/Cardiac ICU, Labor and Delivery, Pediatrics, and Post Partum. As both a staff and charge nurse my nursing skills and confidence expanded while living in San Diego, Okinawa Japan, and Oakland.

When I left active military service I moved to Germany where I worked on the Obstetrical Unit at the Army Hospital in Landstuhl. My husband was an Air Force family physician and we enjoyed all the benefits of living in Europe. When we returned to the U.S. I attended graduate school at St. Louis University and earned my MSN in Nursing Service Administration. We moved again to Colorado in 1991 shortly before the Gulf War started. I maintained my military career in the Active Reserve force and was called for service in that war and served for four months in Bahrain.

My administrative skills were constantly challenged as I continued in the Navy Nurse Corps (reserve) for a total of 34 years. During that time I enjoyed many annual training sessions as both an RN and as a Nurse Practitioner. I was also selected as the commanding officer of my reserve field hospital unit.

Upon my return from the war, I worked as a public health nurse and a home health nurse until I made the decision to go back to school (again). I figured out that the administrative degree was helpful, but I longed for the clinical side. That’s when I went back to school for my NP certificate.

The clinical work after this coursework is described below. Of particular pride during these past few years of my NP career, I co-authored a pregnancy guide for patients that is different from anything on the market today. The Pregnancy Power Workbook helps women better understand their pregnancies by offering them the most important pregnancy questions and answers. It is a workbook style that is readable, interactive, and practical. This simple system gives women what they need to know to best prepare for their unique pregnancy experience.

At what point did you decide that it was the right thing to go back to school to become a NP?

The variety of nursing skills I acquired for the first 20 years allowed me to hone in on what I really enjoyed, the care of women. I desired a shift in focus and decided to return to school to become a Women’s Health Nurse Practitioner (we used to be called OB/GYN NPs). Over the years I worked with several, and respected their dedication and mission.

How difficult was it to get into the program?

Since I already completed a master’s degree in nursing, I sought an NP program that would jump-start me towards the clinical side of health care (without having to write more papers). In Colorado at that time, Planned Parenthood offered a “certificate” program for becoming a Women’s Health Nurse Practitioner. The entire program was one full-time academic year. When I called to inquire, the program director, sensing my excitement, informed me that a student had canceled from the upcoming class. She said, “Could you start on Monday”? I was on my way.

Can you describe your educational experience?

The experience was exactly what I needed. The intensity offered by a full-time program required four months of 40-hour weeks dedicated to hands- on training. I completed my clinical rotation at an inner city urban health clinic that exposed me to many unique and challenging OB and GYN patients.

As a NP you specialize in women’s health and pregnancy, can you describe your work for us?  What is a 9-5 in your life?

I’ve continued to work in the same health clinic for 18 years. Although many co-workers have come and gone, we have maintained a fairly stable professional staff dedicated to the particular unique needs of the medically under-served (the working poor and undocumented patients). We offer full spectrum OB/GYN care that includes:

1) Routine well-woman GYN exams/STD testing/Contraception
2) Routine and high risk OB care (120 deliveries per month)
3) GYN procedures (colposcopy, biopsies, IUDs, etc)
4) Full range of workup and referral for GYN surgery
5) Psychiatric management for depression and anxiety

A workday is long and full. As NPs we see 21-25 patients per day. Their health conditions vary from routine to very complex. Whatever comes up on the schedule you is assessed/managed/treated/referred, based on each patient’s special needs or situation.

What about your job challenges you?

Similar to any practice, time with the patients continues to be the biggest challenge. To keep our doors open, we must have certain numbers of patients seen per day. Balancing that with patient’s needs is a constant test of perseverance. When you add the complexity of electronic health records, electronic prescriptions, and computer glitches, at times it can be quite overwhelming.

Can you describe something about what you do that is exceptionally rewarding?

Rewards come in many ways. Most of our patients face incredible barriers for accessing adequate health care, If I can work through one of those barriers (language, transportation, financial, lack of empowerment), I feel like I’ve succeeded in offering that person something special. Something they wouldn’t get anyplace else.

I find many women want to ask questions…but they don’t want to bother the provider, or they feel their question is “not worthy”. My personal rewards come when I take that extra minute to allow the formation of a pressing question. Maybe by finding the correct interpreter helps that person feel like an active participant in their care. That’s the beginning of empowerment.

Do you have any final words of wisdom for nurses looking to go down the NP career path?

I truly believe nurses who want an NP career path need to do a personal motivation check. First and foremost, we are nurses not “mini physicians”. Becoming an NP is not just a career path that gives you a “normal” work schedule (Usually no weekends or night shifts). It is a personal commitment to the expanded role, but not a departure from nursing’s core principles of critical thinking, compassion, and a desire to make a difference in our patient’s lives.