August 11, 2021

APP Residency: All About Purpose

Central, Clinical Partners, Rural Health

What makes for a great Advanced Practice Provider (APP)? If you ask Bobbie Bertram, RN, CNP-Trauma Services, APP Practice Director, the answer is simple. “First and foremost, it’s purpose,” says Bertram. “We want people who have a calling to do the work we do. We can teach a lot of things and you’re going to get a lot of experiences, but we can’t teach that deeper connection to really wanting to serve another human being.”

Fortunately, there’s a long line of purpose-driven people who continue to fill CentraCare’s Advanced Practice Provider Residency Program.

Reason why

When the program launched in 2019, it was done largely to strengthen rural health primary care. “Our primary care providers in rural health often have to provide more specialty care when compared to providers in a more urban area, where it’s often easier to refer to a specialist down the hall or across town,” said Bertram. “We wanted to train APPs in rural primary care through a program that focused on the uniqueness of rural care, but also provide them with more specialty training they could take back to their primary care sites throughout the region,” she said.

“WE CAN TEACH A LOT OF THINGS AND YOU’RE GOING TO GET A LOT OF EXPERIENCES, BUT WE CAN’T TEACH THAT DEEPER CONNECTION TO REALLY WANTING TO SERVE ANOTHER HUMAN BEING.”

Bobbie Bertram, RN, APP, Advanced Practice Director

The program is beneficial, in part because it combines hands-on learning with opportunities to ask questions of providers. “Our program gives residents a chance to hear from their peers about how to handle conditions or challenges they will encounter in their clinic,” said Amy Hilleren Listerud, DNP, APRN, APP Residency Program Manager. “It’s not a typical lecture – it’s an opportunity to ask questions and also get practical tips on things that are relevant to their practice.” Residents also receive hands-on training through rotations, preceptors, and using simulators.

Starting small

The first APP Residency cohort consisted of three people: Megan Schneider, nurse practitioner, Carrie Herzog, certified nurse practitioner, and Josh Larson, nurse practitioner. This trio completed the residency program and now work in Long Prairie, Sauk Centre and Melrose – the same communities where they did their residency training. Larson, who works in the Emergency Department at Melrose, discovered his purpose after spending years working in an entirely different industry.

Finding his purpose

“I graduated from the University of Minnesota with a degree in graphic design and Spanish,” said Larson. “After five years of owning my own branding company and working with clients in healthcare, I realized I wasn’t super passionate about branding, so I decided to follow my purpose and pursue a new career in nursing.”

He packed his bags and moved to Ohio, completing his nursing degree at the University of Cincinnati. After working at Cincinnati Children’s Hospital, he realized he wanted to be closer to family back home in Minnesota. So he joined CentraCare and then learned about the APP residency program. “When I was hired, the recruiting team asked if I would be interested in this new residency program, and I was ecstatic,” exclaimed Larson. “It was such a great opportunity to bridge my position as an RN and nurse practitioner, and also be able to learn directly from the people who are already doing it. It was fantastic.”

As an added bonus, Larson’s experience working in Melrose has allowed him to use his Spanish-speaking skills too. “We were very intentional about Josh’s placement in Melrose given we have a large Hispanic and Spanish-speaking population in that community,” said Bertram. And from Larson’s perspective, it’s been a great fit. “I absolutely love it and all the people I work with are fabulous,” he said. “I don’t see myself working anywhere else.”

More the merrier

Realizing the positive impact the residency program has had on providers, Bertram and Hilleren-Listerud saw an opportunity to expand it to more people. What started as an inaugural cohort of three has now become a standard part of training. Bertram explained, “We thought, why don’t we provide this program for any APP new hire?” So they made a change and now any new graduate that’s hired into Family Medicine at CentraCare is automatically enrolled in the residency program.

That’s putting purpose into practice.