NP World News: Carla Mills – NP on the Edge
Reported by Laurie Lewis
for Nurse Practitioner World News
January/February 2009
Copied with the permission of NP Communications
Change has recently become a mantra on the political scene. Carla Mills, ARNP, is no stranger to change. She has changed her career in ways large and small. She is an advocate of transformational change that will result in NPs having the authority and recognition they have earned. And she is a strong advocate of lifestyle changes to reduce the risk of chronic disease.
Before She Became an NP
As a child in Nashville, Tennessee, Carla knew exactly what she wanted to be when she grew up: an actress. Unlike most little girls with stars in their eyes, Carla had every reason to believe this dream could become reality. She was active in Nashville Children’s Theatre and had achieved success in local community theaters by the time she graduated from high school. When she was accepted at the American Academy of Dramatic Arts, she headed to the big time: New York City.
After graduating from the Academy, Carla joined the legions of young actors hoping to make a name for themselves on the Broadway stage. She went on auditions and, in the tradition of starving actors, pieced together a living with any number of odd jobs.
After 7 years, she knew she wasn’t going to make a decent living as an actor. She decided it was time to get a college degree and a new career. Tired of workingso hard to make ends meet, she wanted job security. Given the perpetual nursing shortage, nursing seemed like a good choice.
To see if nursing would appeal to her, Carla did volunteer work in the emergency room of New York’s famous Bellevue Hospital. Seeing the Bellevue ER nurses at work, she decided that this was the only kind of nurse she wanted to be. So after receiving a BSN from the Hunter–Bellevue School of Nursing, Carla went to work in Bellevue’s emergency department.
“Wherever my career takes me, the thing I will always be proudest of is being a ‘Bellevue ER nurse.’ The nurses at Bellevue taught me by their example what great nursing is and how it heals,” Carla says.
Carla earned certification in emergency nursing at Bellevue and got critical care experience working in the ER intensive care unit and trauma slot. She also worked per diem in the coronary care unit, medical intensive care unit, and recovery room at Beekman Downtown Hospital. But after living in New York for 16 years, she was ready for a complete change of scenery. She decided to move to the southwest coast of Florida.
In Fort Myers, Carla once again worked as an emergency department nurse. She also worked in home health care and on a stroke rehab unit. “I learned so much working with people in their homes and in rehab recovering from catastrophic events like strokes,” she says. “These experiences opened my eyes to what I truly wanted to do: put a stop to the chronic illnesses that are destroying people’s lives.” She knew that to really make a difference, she had to become a nurse practitioner.
Work as an NP
In 1995, Carla Mills added “ARNP” after her name. She moved from Fort Myers to Naples, Florida.
At Naples Community Hospital (NCH), she worked with Robert Boyd Tober, MD. As medical director of both Collier County EMS and the NCH emergency department, Dr. Tober was developing one of the first direct angioplasty programs for patients with acute myocardial infarction. Carla created a simple computer database to help track door-totreatment times for Dr. Tober’s Save-a- Heart program. This experience was the foundation that led her to develop another database that enables professionals to complete a comprehensive risk assessment and generate a 20-page personal health profile—all in under an hour.
Her professional life took a different turn when Carla went to work at The Willough at Naples Psychiatric Hospital. For 3 years, she cared for patients with substance abuse and eating disorders. “I learned a lot about addiction, food issues, and the process of personal change and transformation working there,” she says.
In 2004, Carla joined the internal medicine practice of Diane Brzezinski, DO. This is where she currently practices. She and Dr. Brzezinski share office space and patients, but Carla is neither an employee nor a partner in the practice. She provides ARNP services to Dr. Brzezinski as an independent contractor, and they share in the care of all the patients. They work together the way 2 doctors would, except that patients go back and forth between them on different visits. This model gives patients the benefit of receiving both providers’ experience, perspective, and expertise. It’s a flexible arrangement—nothing is carved in stone— and patient preference is always paramount. Most patients are equally comfortable with both providers and appreciate the expanded spectrum of care they receive.
NPs as Agents of Change
“I really enjoy clinical practice, and my patients are a constant inspiration,” Carla says. “But Maverick Health is my dream for the future.”
Carla elaborates about the organization she began. “I see Maverick Health as the beginning of a social movement, founded and led by nurse practitioners. Its purpose is
to change the way we think about our health, our health care, and our health care providers. I’m working on several fronts to get this movement started, and I want to reach many more patients than I could possibly see in clinical practice.”
One approach is the database she developed to assess a patient’s health risks. Carla plans to turn this into an online tool. Research for the database was the basis for her book A Nurse Practitioner’s Guide to Smart Health Choices (for a review, see page 3). Carla chose the book’s title carefully. “I wanted ‘nurse practitioner’ in the title,” she says. “This isn’t my book; it belongs to all nurse practitioners—and to all patients, too. It demonstrates that we NPs are primary health care providers perfectly suited to manage the epidemic of chronic disease. And it directs attention to the critical role that nurse practitioners play in preventive care.”
Carla hopes that all NPs will read this book and then recommend it to their patients. “Chronic disease is lifestyle disease, and this is the perfect realm for NPs,” she says.
Carla supplements the information in the book with a blog she writes on the Maverick Health website, http://www.maverickhealth.com/blog. She loves to get feedback and comments from readers and other health practitioners.
Sharing Her Views with NPWN
“Baby steps for NPs do not interest me. I want to see a dramatic and transformational change that gives us what we have earned: recognition with full practice and prescriptive authority,” Carla says. “I am willing to do whatever I can to make it happen, but I cannot do it alone. I hope NPs and the physicians we work with will help see that this important job gets done quickly. There is no time to waste. Our patients need this now.”
How, exactly, will that transformational change come about? Carla Mills will be sharing her thoughts right in these very pages. Starting with the next issue, Nurse Practitioner World News will feature a regular column by Carla, called “NPs on the Edge.” Carla invites readers to post comments.
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