This practice is geared more toward educating patients,” said Jennifer Facteau-Rabideau, ANP-C. She is entering her third year as a nurse practitioner in independent practice at Small Town Health Care, 396 Tom Miller Road. “I try to involve my patients in their care. It is so rewarding when they follow my advice and feel better. We’re a holistic healthcare facility. I arrange my schedule so I can spend the time I need to really listen to patients, and take their opinion into consideration. It takes time to understand all the factors that contribute to a patient’s health needs.”
According to the International Council of Nurses, a nurse practitioner (NP), also called an advanced practice registered nurse (APRN), is “a registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which she or he is credentialed to practice.” The present-day concept of the APRN as a primary care provider was created in the mid-1960s to address a shortage of physicians, especially in primary care. The first official training for nurse practitioners was created by Henry Silver, MD (1918–1991), a pediatrician who influenced the early development of the physician assistant and nurse practitioner roles in the United States, and his co-founder, Loretta Ford, a nurse. Together, they had a vision to help balance rising healthcare costs, increase the number of healthcare providers, and correct the inefficient distribution of healthcare resources across rural areas.
A native of Saranac, Facteau-Rabideau knew since first grade she wanted to be a nurse. “I entered the nursing program at Clinton Community College right after high school. After completing my associate’s degree in 1998, I worked at CVPH while I finished my bachelor’s degree at SUNY Plattsburgh,” she explained. “I enjoyed my job at CVPH, but realized I wanted to interact with patients more on an educational and preventative level.” With this goal in mind, Facteau-Rabideau entered a nurse practitioner program at Stony Brook University, and finished in May 2012.
“I began working with Dr. Wolczynski at Adirondack Primary Care in December 2012, and then opened my own office on Cornelia Street in October 2013. In order to balance family with my ambition to develop a practice, I decided to work for myself,” said Facteau-Rabideau. After building the practice in a renovated space on Cornelia Street, Facteau-Rabideau moved to the free-standing location on Tom Miller Road in December 2015. “The property is owned by my friend Nancy and Steve Sucharski; they invited me to lease the building. There was better parking and road access, and the office space is smaller and more inviting.”
As the only nurse-practitioner-led practice in Plattsburgh, and one of the first in the state, Facteau-Rabideau fulfills a need for primary care in the chronically underserved North Country. In addition, the enactment of the Affordable Care Act in 2010 means more people have access to health care—making the need for primary care even greater.
Certified in Adult Primary Care, Facteau-Rabideau offers:
• Preventative care
• Diagnosis and treatment of acute and chronic illnesses
• Annual pre-operative exams
• Ordering and interpreting lab orders
• EKG interpretation
• Post-hospitalization care • Gynecological exams
• DOT physicals
• Suture/staple removal
• Health education
Also part of the team are Facteau-Rabideau’s first cousin and office manager, Carrie Coryer, and clinical assistant Suzanne Davis. Facteau-Rabideau’s husband, Otis Rabideau, helps run the business by taking care of payroll and taxes as well as co-parenting their two children.
Being a North Country native, and having worked at CVPH for many years, Facteau-Rabideau is more than familiar with the physical and emotional needs of her patients. “Overall, I try not to make any patient feel rushed. I block out 40-minute appointments for each new patient, and will only do a maxi- mum of two per day. I do home visits for elderly people who may have trouble getting into the office. We try to set up our schedule so that it is flexible enough to accommodate busy adults, and to give me time with my family,” she said. While Small Town Health Care is still accept- ing new patients, Facteau-Rabideau’s current caseload hovers at a thriving, and “nearly maxed out,” 1,200 patients. Currently booking out to two months into the future, and need- ing time for the required paperwork for each patient, Facteau-Rabideau may have to reluctantly put a hold on new patients.
Walking through the organized, homey facility, each examining room has an essential oil diffuser next to state-of-the-art medical equipment. “I embrace alternative therapies,” said Facteau-Rabideau. “If I had room for acupuncture and massage, I would add that too. Depending on the season, I use lavender or peppermint oils in the diffusers. Thieves is another oil that has cleaning properties and creates a comfortable, clean-smelling environment.”
With education being a primary focus, the Small Town Health Care facility is filled with charts, booklets, and other materials to help promote healthy lifestyles and manage chronic conditions such as diabetes or high cholesterol. In addition, Facteau-Rabideau welcomes nurse practitioner students who need to complete clinical studies. “The students have been awesome,” she said. “I get some help, and an opportunity to train nurses. The students teach me too.”
Jennifer Facteau-Rabideau’s old-fashioned approach, while offering state-of-the-art primary care, is a welcome addition to primary care in the North Country. Her success shows it is fulfilling a need, and that there is room for more such practices. With her example, let’s hope that some of those nurse practitioner students will stay and do just that.
INCREASING NEED FOR NURSE PRACTITIONERS
As a result of advances in technology leading to better health care and a greater variety of solutions for health problems, more people living longer and more active lives, the aging of the baby boomer generation, and the passage of the A ordable Care Act, many reports conclude that the need for nurse practitioners will increase significantly in the next 10 years.
According to the U.S. Department of Labor Statistics, jobs for nurse practitioners are expected to increase 19 percent by 2020. Growth is also expected to be much faster in outpatient centers, where patients do not stay overnight. Moreover, due to the expansion and easy access to new and better technology, an increasing number of procedures that were once only able to be performed in hospitals can now be performed in physicians’ onces. In addition, the need for nurse practitioners is expected to be greatest in places where people have long-term illnesses, such as dementia, or have suffered head trauma.
“Nurse practitioners are becoming a growing presence, particularly in primary care,” said David I. Auerbach, PhD, author and health economist at the Rand Corporation. In an analysis published July 2012 in Medical Care, the official journal of the medical care section of the American Public Health Association, Auerbach estimated that the number of nurse practitioners is expected to double by 2025. Auerbach also told American Medical News, “There’s a lot of experimentation going on looking at different ways of working together, and there’s a lot of interest in collaborative team-based models. The new care models, such as the patient-centered medical home and accountable care organizations, really depend on nurse practitioners and physician assistants.”