From Oklahoma, we get a nurse practitioner’s perspective on healthcare has Lauren Duroy joins Rob Oliver on the Perspectives on Healthcare Podcast. Lauren practices family medicine in Velma, Oklahoma. Previously, she was an ICU nurse. She is a member of Generation Y (the Millennial Generation.) She brings a unique perspective from a rural Midwest medical practitioner.
Here are 3 things that stood out as Lauren Duroy shared a nurse practitioner’s perspective on healthcare:
· The rural population once to take things a little bit slower and feel like the medical professional is more present in the exam room
· There are cultural differences between communities as far as an understanding of what is healthy and the concept of quality of life
· Some nurse practitioners are trained at a mid-level and some are trained to provide care at a high level with only a minimal amount of MD supervision
You can find out more about Lauren Duroy through her website and social media:
Here is my conversation with Lauren Duroy as she gave us a nurse practitioner’s perspective on healthcare.
Introduction to Lauren Duroy
Rob Oliver: Thank you. And I appreciate you being here to hear another perspective on health care today’s. Perspective comes from Lauren Duroy. She is a nurse practitioner. She is from Oklahoma, practices family medicine, and is a member of the millennial generation. Lauren, welcome to the podcast.
Lauren Duroy: Thank you for having me.
Tell me a little bit about yourself and your role in healthcare
Rob Oliver: Absolutely. It’s my pleasure. So let’s start right from the beginning. Tell me a little bit about yourself and your role in healthcare, please.
Lauren Duroy: Sure. So I am a family nurse practitioner. I’ve been in practice for a little bit over five years now. Before that, I was an ICU nurse for four years. I have a son who’s almost five, one on the way, and I’m married. We live in Oklahoma, like you said, and we’ve been here in rural Oklahoma for the entirety of my profession as a nurse practitioner.
Rob Oliver: Okay. So just for clarification purposes, there are Norman, Oklahoma people and Stillwater Oklahoma people. Which side of the line do you fall on?
Lauren Duroy: Boomer Sooner.
Rob Oliver: Just, for people in Oklahoma, that’s important.
Lauren Duroy: It is, yeah.
Rob Oliver: Okay. So just for my own understanding, your ICU experience is also in rural medicine.
Lauren Duroy: That was actually in Norman.
Rob Oliver: Okay.
Lauren Duroy: I did do some during our first wave of the Covid pandemic. I had to take a few shifts in the ICU in Duncan, which is a bigger town, but it’s still smaller. So I have some experience in both. But I see you most of my experience in ICU was up in Norman, the actual town.
Rob Oliver: Okay. Can you talk to me a little bit about the difference between practicing with a rural population or in a rural setting as opposed to practicing in that more urban setting?
Lauren Duroy: Sure. There’s a lot of differences. I didn’t practice family in the city, so comparing those two are a little bit different, other than I had rotations and stuff there. But I feel the biggest thing, the thing that most people notice right off the bat is that people tend to want to be slower. They want to be more connected. They want to feel like they are actually present and not just a fleeting moment in your office. And that’s probably the biggest thing that I see, especially if I have a student or someone who comes in. And that seems strange to them at first. And it’s almost like we’re too close, too close to the patients, and then they get to love it. But that’s probably the biggest difference. There’s a lot of cultural difference, too, though, between perceived of what is healthy versus what is normal when it comes to diet or routines. Those type of things change quite a bit, too.
What does quality healthcare mean to you?
Rob Oliver: So you’re experiencing really, that’s interesting to me, the cultural difference that the urban versus the rural and work food, the whole thing, it’s different in both environments. Wonderful. What does quality health care mean to you?
Lauren Duroy: Quality healthcare to me means that I am providing to the patient what it is that they feel is necessary in their life and that I am honoring that first and foremost. I always tell my patients, especially if I have a new patient, I always tell them that my job is to be kind of like an information broker for you. I’m going to give you the information I know. I’m going to give you what I know is best practice, what is best evidence, and I’m going to allow you to be able to decide what is best for you in your time and your life. Many people have different values than a lot of health care professionals do, and I think that is especially true honestly in the role community. And I find that that’s the biggest thing that people feel more comfortable with on me, and that I feel that they are given that quality information or that quality healthcare because it’s different from one person to another. One physician might say that quality is making sure that all their numbers are within a normal range and that the A1C is good and optimal and that they’re on the exact amount of dose that’s prescribed or that is recommended. And to the patients, that may not be the case. To them, the risks may outweigh the benefit. Even though we don’t understand that from a medical perspective or it might be that quality to them is I don’t necessarily want to dig in deeper. I don’t want to prevent more things. I don’t want to do a whole bunch of interventions. I want to live my life peacefully. And as long as I’m playing that part for them, then I think that that’s what quality is.
Rob Oliver: It’s so very interesting, your definition of quality. Just so I’m understanding this right. It depends completely on the patient, not necessarily on the practitioner. So many times a practitioner, just as you mentioned, my quality healthcare is to have patients who are doing this or are in this range or whatever it is. Have you always had that perspective, or is that something you learned? Is it something you learned during training, or where did that perspective come from?
Lauren Duroy: It’s a really good question. I haven’t reflected on that in a while. I think that I’ve always felt that way, though sometimes almost the default. I can see both sides of almost every perspective, and sometimes you can start arguing yourself back and forth whenever you can do that. But I’ve always been able to see the I think maybe it started in the ICU, to be honest with you, in that I would have a patient who would not want anything further down to them. They were ready to be with their maker, and they were ready to end their life here and ready for things to go more naturally. And maybe a family member wouldn’t or not usually a health care provider, but most often a family member wouldn’t want that. And just seeing that there’s quality and value in both and having seen somebody extend that out too far and do too much intervention, it causes more pain. That does help. Maybe some of it came from my background in school, in nursing and that we do have more of a holistic perspective and we do look into different cultures. And I remember learning, especially in some Asian cultures, and this is more traditional. If somebody has a prognosis, that is not good, meaning that they have a poor prognosis, they may pass a cancer or something like that. And in the next few months or years, they don’t even want the patient to know because they believe so much in the mind body connection that if they know that if the family member may know, but you won’t tell the patient, and if they know that, then it’s going to make their situation worse and or it’s going to expedite their death because they’re focusing on it so much. And that’s very contrast to our culture or typical culture. So just understanding those different perspectives and knowing that my way is not necessarily the right way.
Rob Oliver: Yeah, okay. Mind blown, because here’s what I’m thinking, and that is there are times when people have a terminal diagnosis, and it’s almost as if they resign themselves to the fact that they are going to pass and they live the rest of their lives as though they are already gone, which is a real difficult thing. And the flip side of that is to cherish what you have and to live the days that you have to the fullest that you can.
Can you give me an example of quality healthcare?
Rob Oliver: You’ve already done this a little bit, but can you give me an example of quality health care?
Lauren Duroy: An example of that? I would say that, I’m debating on a couple of differences. We’re kind of talking with ICU, we’re talking about family care, some family care. We all stay with that because I’m a family care. Now, I would say that, well, I have one patient in particular, and he came to me and he said I’m actually a very thorough individual, even though it seems that maybe my description originally a lot of other players say, oh, she does things halfway or something, and I’m not actually myself. I’m a very thorough person. That’s how I want my health care personally. But I know it’s not everybody. I always go in real deep with my patients and explain all the labs and what this means. And that means he said, just go ahead and go ahead and stop because I’ve lived a really great life. And I understand that my cholesterol is bad, and I understand that the medication might be better for me. And I understand that you’re going to prolong my life. But honestly, I want less visits here. And I’m really just kind of here for a just in case type of scenario. And I say that’s totally fine. I understand that. I’ll honor that. And I always especially tell myself to cover yourself. And I always document that patient is aware of his or her risks and that I did recommend, based upon evidence based practice, that they should be on this medication. But they politely declined. And I’ll document it, of course, because I have to do that. And I tell them in case they see the chart or something, that I’ll just document that. And there’s nothing wrong with that. And to me, I feel the patient feels honored, and as long as the patient feels honored and they are aware and I’ve educated them and I know that they’re clear on what it is I’m telling them, then that would be a form to me of quality health care.
Rob Oliver: Thank you for sharing that. What do you wish people understood about your role in healthcare? And you can take this either from a nurse practitioner perspective or from a rural practitioner perspective or from whatever perspective you so choose.
Lauren Duroy: There are several different things, I think from a nurse practitioner. I will go ahead and I’ll go out on a limb here and say that I do wish that more people understood that not all of us are trained and not all of us practice at a mid level.
Rob Oliver: What does that mean?
Lauren Duroy: So a mid level is you’re a physician extender and that you have an MD or a DO that you work with very often, and you may be given an HNP to them or sorry, history and physical, and you will let them know the information. You might make a few decisions on the treatment plan, but most of the treatment plan is being handed off to the physician, and or the physician is reviewing each one of those and making sure that it’s in line with their practice. Not all nurse practitioners are trained that way. In my program, we were trained to practice independently in that we were given the information that we needed to be able to do that confidently. And in my practice, I do have us in State, Oklahoma. I have to have a collaborating physician on paper, but they have not ever been in office while I’ve been practicing. And they are a great individual and there’s no hardship or anything there by any means. And I greatly respect physicians and MDS dos, but just that we can practice to a full scope of family practice, and many of us do.
Rob Oliver: Okay, so what I’m hearing you say is because when you started off with not all of us are trained, I thought there’s a lack of training in some area. But what you’re saying, it’s actually the other way around, that you are trained so well that you can practice independently and not need to be housed within either a DO or MD’s office that you’ve got the independent level that you’re able to provide your patients with that level of care. Wonderful.
What excites you about the future of healthcare?
Rob Oliver: What excites you about the future of health care?
Lauren Duroy: What excites me is that more of the power is being given back to the patients, that we are seeing more of a responsiveness between the patient taking the initiative in their health care and that they are viewed more as the individual in kind of charge of their healthcare. I find it funny, and I almost like the I tried to not use verbiage such as patient is compliant or against medical advice or those kind of things because it’s so much it puts a level of like the provider is higher than the patient and that they know more about their needs and their benefits than the patient does. And certainly I do have patients also who come to me and they say, I don’t have a clue. I just want you to tell me what to do. And in that case, I do.
Rob Oliver: Right, yeah.
Lauren Duroy: I take over. But I think that a lot of people are wanting to be more independent in their own health and make a decision. And I think that’s actually a really great thing, and it’s helpful to us as long as we embrace it, and we go with that because you have another person kind of backing you up and working with you in their care versus against you.
What can medical professionals to to improve the quality of healthcare their patients receive?
Rob Oliver: Yeah. Again, that makes a lot of sense. What is one thing medical professionals can start doing today to improve the quality of healthcare?
Lauren Duroy: I think that the number one thing they can do today is… I think the word today kind of struck me a little bit different than I expected it to, and then it kind of took my mind to a totally different place, if that’s okay.
Rob Oliver: Absolutely.
Lauren Duroy: Okay. I think just understanding and many people are very understanding of this, but especially in health care today, there are so many unknowns and knowing and respecting and understanding where people are at and that everything is so new. And I am kind of referencing the pandemic and everything that we’re in and knowing that even though we have the science to back things up and that we may believe a certain thing should be done a certain way and statistically we might be correct. Forcing that upon somebody or doing something that is more abrasive is actually going to push people away from us and what our mission is as opposed to pulling us together with patients.
Rob Oliver: You’re basically saying there needs to be a respect for patient choice in where things are. And I think this goes back to what you were talking about earlier. Sometimes patients may make decisions that are not exactly in line with what you would prescribe or what you would suggest, but your respect is this is your life and you’re making the choices. I don’t know if I let you be in charge, but I respect the fact that you’re in charge of your own life and are making informed decisions. Is that right?
Lauren Duroy: Yes.
Rob Oliver: Perfect. Lauren, thank you so much for being here. I appreciate you bringing a perspective that we have not heard yet and you truly have a unique viewpoint for all my listeners, I appreciate you coming and I hope that you have had your mind expanded today. Lauren Deroy, thank you very much for sharing your perspective on healthcare.
To connect with the show on social media use the links below:
We would love to hear from you. Visit the “Contact Us” form:
Look around the website for more Perspectives on Healthcare.
Disclaimer: All opinions expressed by guests on the Perspectives on Healthcare Podcast are solely the opinion of the guest. They are not to be misconstrued as medical diagnoses or medical advice. Please consult with a licensed medical professional before attempting any of the treatments suggested.