Diabetes Forecast

Nurse Practitioners Help Medically Underserved Areas

Lisa Taylor, CRNP
Photography by Thao Trinh

Lisa Taylor had been working for over a year to help a middle-aged man with type 2 diabetes bring down his A1C. She’d tweaked his medications and recommended he replace soda with water, eat breakfast every day, and aim for 200 minutes of exercise per week. Taking meds is one thing, but adopting lifestyle changes is arguably much harder. So on the day the patient’s A1C dipped below 9 for the first time in 18 months—thanks in part to a 16-pound weight loss—he and Taylor exchanged fist bumps. Then she broke into what she calls her “happy dance,” a spontaneous expression of pure joy that invariably catches her patients by surprise.

Taylor is a certified registered nurse practitioner at First Choice Community Healthcare clinic in Belen, New Mexico, a medically underserved area 30 miles south of Albuquerque. “We have a large number of people who live with diabetes and prediabetes,” Taylor says. “They don’t have a lot of resources or a lot of support, so the challenge is balancing that with what I want for them.”

More Than a Nurse

Equal parts nurse and practitioner, a nurse practitioner is a registered nurse with advanced education and training in diagnosing and treating illness. New Mexico is one of 22 states that allows nurse practitioners to practice independently. So, like medical doctors, they’re licensed to give physical exams, diagnose, treat, and prescribe medication. But their approach to health care is holistic, with a focus on prevention, wellness, and education. “I’ve lost track of the number of patients who’ve told me, ‘No one would explain why I take this med, how it works, what it’s for,’ ” says Taylor. “When you see a nurse practitioner, you’re getting a different kind of care. We’re nurses first, so we always come from a patient-centered approach. We’re looking at a person’s economic status, their work, home, and lifestyle.”

Taylor had her light-bulb moment when she was a nursing student helping care for kidney transplant patients. “I kept thinking, ‘I need to be more upstream so I can work with people on prevention,’ ” says Taylor. Becoming a nurse practitioner who’s also board certified in advanced diabetes management would allow her to do precisely that.

“What’s important to me is the opportunity to educate,” she says. “We’re all constantly bombarded by claims about some new treatment or miracle drug. And in New Mexico, we have a large percentage of people who are on Medicaid and have no insurance. All those things drive what I do.”

So, too, does her personal connection to diabetes. Her mother died of kidney disease associated with type 2 diabetes not long before Taylor started nursing school in 2009. Although Taylor didn’t inherit the risk factors for diabetes from her mother (she was adopted), as an African American woman, she knows she’s more susceptible to developing type 2 diabetes than if she were a non-Hispanic white woman. So she takes the advice she doles out to her patients. “I’m conscientious about my portions, I exercise five to six times a week, and I get my cholesterol and my A1C checked once a year,” she says. “Diabetes is always at the back of my mind.”

The most rewarding part of her job is when she shares breakthroughs with a patient. “They’ll say, ‘I notice that when I eat such and such, my blood sugars go up.’ In my mind, I’m thinking, ‘By George, they get it!’ ” says Taylor. And that’s when she breaks into her happy dance.

At A Glance

Nurse Practitioners

What is a nurse practitioner?
A nurse practitioner (NP) is a registered nurse (RN) with advanced training in diagnosing and treating illness. Like registered nurses, they perform assessments, but in many states they’re also trained to diagnose patients, prescribe treatments and medications, and take charge of patients’ overall care.

How do I know if I need a nurse practitioner?
If you live in an area with inadequate access to medical care, a nurse practitioner can provide many of the services a medical doctor would.

How do I find a nurse practitioner?
To find one in your area, visit the American Association of Nurse Practitioners at npfinder.aanp.org.

What credentials does a nurse practitioner have?
Nurse practitioners—short for certified registered nurse practitioners (CRNP)—have advanced clinical training beyond their initial registered nurse preparation. They have either a master’s degree in nursing (MSN) or a doctor of nursing (DNP) degree. They must pass a national certification exam and be licensed in their state. Look for a nurse practitioner who is also board certified in advanced diabetes management (BC-ADM).



Take the Type 2
Diabetes Risk Test