My name is Clare and I am a nurse practitioner in the Cardiothoracic ICU (CTICU) at University of Chicago Medical Center. I work with Dr. Ota in the CTICU, and he asked me to write about my experience working as a nurse practitioner while having children. A nurse practitioner is different than a registered nurse in that a nurse practitioner goes through additional schooling and credentialing process to have privileges that include diagnosing, prescribing medications and interpreting diagnostic testing.  Prior to becoming a nurse practitioner, I obtained a Bachelors of Science in Nursing degree and practiced as an ICU nurse for seven years. I completed my Masters of Science in Nursing degree at Loyola University with a specialization as an Adult Acute Care Nurse Practitioner, which means I received additional training to care for adult patients in an acute or critical care setting. I then sat for and passed a national board examination that allowed me to obtain a license and practice as a nurse practitioner. I do not practice at the same level as an attending physician, therefore I sign a contract with an anesthesia critical care attending called a collaborative agreement, which allows me to practice in collaboration with an attending physician.

 My role on in the Cardiothoracic ICU is to manage patients after cardiac or thoracic surgeries with other members of the ICU team. This team is comprised of surgeons, including Dr. Ota, an anesthesia attending, myself, another nurse practitioner, a pharmacist, at least three anesthesia residents, and a fellow or senior resident. The anesthesia residents and fellows rotate every month and have varying levels of experience with cardiac surgery patients and mechanical circulatory support. I work with the surgeons on regular basis and know what their preferences and expectations are for the management of their patients. Therefore, a large part of my role is to provide guidance to the residents in decision making and patient management. I hold the ICU service pager and phone, respond to emergencies on the unit and collaborate with consulting services. The other nurse practitioner and I provide consistency for the patients, their families and the nurses as we are a constant presence on the unit versus the anesthesia residents that rotate every month.

 In addition to being a nurse practitioner, I am also a mother. I have a daughter that is one and a half years old and am expecting another child later this summer. It is not uncommon for women in my field to work while having small children, and many women go back to work immediately after taking maternity leave. This is because there are systems set in place in the United States that make the transition back to the workforce after having a child easier. Employers are required to give all employees twelve weeks off annually for qualifying medical events, including childbirth, under the Family and Medical Leave Act. This law does not guarantee paid leave, however it does prevent an employer from firing a woman because they are pregnant and ensures that the woman will still have her job at the end of the twelve weeks. This may seem like a burden to the employer, however it is likely more cost effective to provide some form of maternity leave and retain an employee than to have a job vacancy, interview candidates and train a new employee.

   In addition to maternity leave, there are also different options for childcare, which include daycare or hiring a nanny, that make it easier to women to go back to work after having a child. While there are not federally funded public daycare centers in the United States, there are many privately owned daycare centers for parents to choose from. The alternative to using a daycare is to hire a nanny. A nanny will come to your home and care for your child and often do light housework. Because so many women with small children work in the United States, there is a large child care industry, including websites and private agencies that one can use to find the best solution for their family. Due to mine and my husband’s work schedule, the best option for us was to hire a nanny.

 The balance between having a career and being a mother can be difficult, however it is very fulfilling. For many women, it is important to them to pursue advanced degrees and have a career in addition to having a family. I work with many physicians and residents that also have small children or have recently returned from maternity leave. I could choose to stay home, however I enjoy my job as nurse practitioner and feel a responsibility to my patients and co-workers to continue to work while having a family.