Although Lefler waited 17 years to return to school for a graduate degree, she does not encourage others to delay when it comes

to advancing their education. “Pursuing more education is advantageous because nurses are trained to lead and the quality of care improves when nurses are better educated,” she said. “I believe nurses are the ones who can be the leaders in this movement to make health a shared value of all Americans.”

Erica Joseph: Bringing health to the severely mentally ill

Erica Joseph, DNP, APRN, PMHNP-BC, spends the vast majority of her working hours visiting severely mentally ill patients, and she couldn’t be happier with her choice of special- ties. “Before I started going into the community, these families didn’t have much support and there were many cases of noncompliance that ended in hospitalization,” said Joseph, an adult psychiatric mental health NP in the Southeast Louisiana Veterans Health Care System. “By going to their homes, I can see exactly what is going on.”

In many cases, she said, there are factors preventing compliance, such as lack of financial

resources, transportation or understanding about the disease. After Joseph completed her NP training, she applied to work at the VA. She expected to start in a primary care role, but there was an opening in mental health to serve severely mentally ill patients.

Eager to learn more about how to help this population — which included patients suffering from chronic paranoid schizophrenia,

bipolar disorder and post-traumatic stress disorder — Joseph enrolled in a post-master’s adult psychiatric mental health program at Southeastern Louisiana University. “Once I started caring for this population, I just wanted to learn more and more in order to help them function as well as possible,” she said.

After completing the program, Joseph earned a doctorate of nursing

practice from Southern University in Louisiana, and now she is enrolled in a PhD program at the same school.

By listening to patients and family members discuss their goals and

challenges, she discerns how to facilitate better outcomes. This may include educating them about topics such as medication dosage and side effects and suicide warning signs.

After working with several patients who had expressed suicidal intent, “

Before I started going into the community,

these families didn’t have much support …

Joseph launched a project to evaluate a computer-based suicide prevention training course in VA primary care outpatient clinic settings. She also applied for a minority fellowship program through the American Nurses Association. The program was supported by the Substance Abuse and Mental Health Services Administration. Joseph was selected to be a minority fellowship scholar, which will give her the opportunity to receive guidance from mental health experts during her PhD program.

” In the future she hopes to find ways to offer psychiatric services such as crisis intervention and substance abuse programs in rural

communities where access to care is scant. Although Joseph is highly motivated to make an impact, she acknowledges her mentor has been instrumental in helping her realize her potential as a nurse. “I met my mentor in my DNP program, and she advised me to apply for the Minority Fellowship Program,” she said. “She was thinking of ways to help me move forward in the profession and be a nurse expert, and I’m eager to see where this opportunity takes me.”

Lucia Alfano: A personal story of overcoming odds

to impact community health Lucia Alfano’s chances of earning a college degree seemed slim when she dropped out of school after seventh grade. She grew up in poverty and had limited skills in reading, writing and math.

Seven years later a friend suggested the idea of nursing school, and Alfano agreed to

enroll in community college after earning her high school equivalency diploma. After she labored through several remedial courses to learn basic skills, she was ready to take her first nursing course. Immediately, Alfano fell in love with learning. She knew she’d found her calling when she had an opportunity to use her coursework knowledge to help patients during clinical rotations. “After I had a community health rotation with a public health nurse, I knew that was what I wanted to do,” said Alfano, MA, RN. “I really enjoyed the

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