APP Spotlight: Meredith Arevalo, Nurse Practitioner, Internal Medicine; Union Corners Clinic

Tell us about yourself.

I started two years ago at UW Health as a float advanced practice provider (APP) and transitioned to UW Health Union Corners Clinic after about a year. What I love about internal medicine is I get to see patients of all ages and socioeconomic backgrounds.

I am a dog mom to two mini goldendoodles, Rosie and Violet. I love taking them on walks and to local dog parks. Prior to the pandemic, I also loved to travel often, and hope to be able to do so again soon.

Where did you grow up?

I grew up in Brookfield, Wisconsin, and attended St. Olaf College in Minnesota. I earned my master’s degree from Emory University in Atlanta, Georgia.

Tell us about your family.

I’m the youngest of four kids. My mom grew up in Monona so we visited my grandparents and extended family in the Madison area often. Eating at Ella’s Deli is one of my favorite memories of coming to Madison as a child.

How did you come to UW Health?

I started my career as a nurse practitioner working in a Federally Qualified Health Center (FQHC) in Maryland, where I also have family. After several years, I missed the Midwest and decided to move back to Wisconsin. While looking for a job, UW Health stood out for the quality of care it provides to patients and the generous benefits offered to employees.

What inspires you about your profession?

Internal medicine continually pushes me to learn and gain new skills to help our patients. Sometimes this means learning about unusual conditions in the process of evaluating a patient’s symptoms and concerns. It also involves identifying the best type of care for each patient, whether that be in a primary care setting or with a specialist.

Tell us about the Suboxone/Opioid clinic work you are doing and your hopes and goals for the program.

I’ve been working with my internal medicine and family medicine colleagues on a quality improvement project to start providing medication for opioid use disorder within our primary care clinic. My hope with this project is to improve our patients’ access to medication for this chronic condition, which has been shown to reduce hospitalization and death from overdose. I also hope this helps to streamline their care, as specialty referrals may involve long wait times or the need to find transportation.

We will start by working with patients currently seen outside specialty providers for buprenorphine-naloxone (Suboxone) medication as part of managing their opioid use disorder. We will discuss with the patient and their current providers whether they may be a good fit to have their medication managed within primary care instead. As our clinic and providers gain more experience working with this medication, we may later expand our services to help patients struggling with opioid use disorder start buprenorphine-naloxone as well.

Do you have a memorable experience in your career that has stayed with you?

Prior to working in internal medicine, I practiced family medicine for several years. One moment that was particularly meaningful to me was when I identified symptoms of preeclampsia in the mother of a newborn patient I was seeing in the clinic. I got the mother in for a visit and then helped coordinate her transport to the hospital for further evaluation, where she was admitted.

What have your patients taught you about yourself?

Working with my patients helps remind me of the importance of vulnerability. We ask this of our patients—to be vulnerable and share with us their lifestyle choices that can impact their health—to help us provide them with the best care possible.

In a few words, how would you describe your coworkers and team at UW Health?

I feel lucky to work with a team that is dedicated to our patients and always willing to help each other. In particular, our nurse triage team works tirelessly to help make sure our patients have access to care.

Outside of work, what did you accomplish this year that makes you proud?

I got engaged! My fiancé, Zeb, and I will be getting married next summer.

APP Spotlight: Emily Smith, Physician Assistant, Cardiovascular Medicine; East Madison Hospital

Tell us about yourself.

I’ve been a physician assistant for 15 years but just started with UW Health in February of this year. Prior to that, I was in emergency medicine. I loved the emergency room, but the schedule made it hard to maintain balance with my home life as my kids get older and more involved with school and sports. It’s been quite a leap to go from emergency medicine to a clinical subspecialty but I’m loving it so far. The normal sleep schedule isn’t too shabby either.  

Where did you grow up?

I grew up in Fort Atkinson, Wisconsin. I completed my undergraduate degree at the University of Wisconsin-Stevens Point, studied abroad in Australia, and then attended the University of Wisconsin School of Medicine and Public Health in the Physician Assistant Program. I now live in Sauk Prairie with my family.

Tell us about your family.

My husband and I have two kids, a 10-year-old daughter and a 9-year-old son. We tend to spend our free time in the woods or on the water, trying to squeeze as much summer out of Wisconsin as we can with wake surfing, kiteboarding and foiling.

How did you come to UW Health?

When I was looking to transition out of emergency medicine, I wanted something that would not only allow me to be more present for night/weekend activities with my family, but also something I genuinely had a passion to learn. I had a reputation as a bit of an “EKG nerd” in the emergency room, and have always been fascinated by cardiac physiology, so the electrophysiology position seemed like a great fit. I was also drawn to the fact that it’s an academic hospital. I love learning and teaching, and there is never a shortage of opportunities for either.

What inspires you about your profession?

I am grateful that the advanced practice provider (APP) profession allows me to carry my love for teaching to the bedside. Helping patients understand their condition aids them in taking ownership of their own health. It allows them to be a part of the decision-making process instead of just a bystander living with a diagnosis. We see many patients with atrial fibrillation (Afib) in clinic, and this dysrhythmia can be significantly impacted by lifestyle modifications, an area of medicine that has piqued my interest the last few years. Counseling patients on medication, procedural options and everyday lifestyle decisions puts some of the control back in their hands. It is gratifying to follow these patients as they implement modifications and then see the changes translate into better quality of life.

Do you have a memorable experience in your career that has stayed with you?

Since nearly all my career thus far has been spent in the emergency room, most of my memorable moments are there. Even though I can recall plenty of patients due to the severity of their trauma or illness, some of the connections that are most memorable are with family members. I worked at some smaller rural emergency rooms where we didn’t have a large team at our disposal, so oftentimes once a code was up and running, I would then be responsible for gathering more information from family and talking them through the code. It’s an incredibly raw and vulnerable time, usually the worst day of their life, and it’s important that they feel informed and connected to what’s happening to their loved one.

A patient’s wife wrote me the nicest letter after her husband had coded, saying I was the one person she and her kids remembered from the whole experience. They live out of town and one of her children asked if I could come back once their dad was an inpatient at a hospital closer to home.

Although I’m still quite new to the electrophysiology team, some of my most memorable clinic experiences are post-procedure follow up visits. They tend to be straightforward, but they are far from mundane. Whether it’s an ablation or placement of a device, patients come back to the clinic eager to share with me all that they’ve been able to return to gardening, cycling, playing with their kids/grandkids, all without the limitations of their dysrhythmia. Hearing patients’ gratitude and seeing their motivation never gets old.  

What have your patients taught you about yourself?

My patients have taught me to be a better listener. I can sometimes get a little overzealous about the science and pathophysiology of it all, but patients don’t always share that same intrigue. Oftentimes, and understandably so, they just want to know how a particular condition or procedure is going to impact them, their family, hobbies and daily life. Through my years of experience, I’ve come to recognize the importance of meeting patients where they are. I listen to their concerns and goals of care, and then providing education that is specific to their unique situation.

In a few words, how would you describe your coworkers and team at UW Health?

Brilliant. Welcoming. Driven. Electrophysiology is a complex field, and coming in as the newbie, I’ve asked a ridiculous number of questions. The APP team, doctors, electrophysiology nurses, device nurses and cardiology APPs at large have all been so gracious with their patience and willingness to teach. It’s both inspiring and humbling to be affiliated with this team.

Outside of work, what did you accomplish this year that makes you proud?

I learned how to drive a Zamboni! I have a hunch you were looking for something different from that question, but driving a Zamboni is pretty rad.

APP Spotlight: Darmis Toribio, Nurse Practitioner, Family Medicine, SwedishAmerican Rochelle and Davis Junction Clinic

Tell us about yourself.

I always knew I wanted to do something in healthcare. Anything that had to do with the human body amazed me. When I was young, I wanted to be a doctor. Given my interest in the medical field, I decided to join my high school’s tech prep program. This allowed me to get clinical hours and college credit in order to complete a certified nursing assistant (CNA) program while still in high school. Upon graduating, I worked at a local hospital as a CNA and decided that nursing was the right route for me. 

I earned my Bachelor of Science degree in Nursing from Saint Anthony College of Nursing in Rockford. After several years of working as a hospital nurse, I was ready to further advance my career. It was a challenging time in my life. My boys were 2 and 3 years old and I was not quite sure how I would be able to juggle working 12-hour nights and finish school. With the help of my family, especially my mother, Rosenda, I was able to complete the program and graduate in 2016. 

Where did you grow up?

I was born in my hometown of Rockford, Illinois. I have always been a bit of a homebody so have not ventured far.

Tell us about your family.

Family is very important to me. My husband, Jason, and I have been married for 15 years and we have three children—Jason, 13, Enrique, 12, and Valentina, 7 months. We feel complete with the addition of our daughter. My boys love having a little sister. I am blessed to have my parents and four of my five siblings close by.

How did you come to UW Health?

I was drawn to SwedishAmerican Health System (now UW Health) because for as long as I can remember, it has been a healthcare leader in my community. I went to an open house before I applied for a position and was pleasantly surprised by the diversity among the employees. I could not have asked for a better place to work.

What inspires you about your profession?

I feel inspired knowing that patients trust me to help them regain their health. I truly enjoy taking care of others. When I was a hospital nurse, I felt confident knowing that my patients were well cared for and comfortable on my watch. As a nurse practitioner in a clinic setting, it is a more hands-off approach, but I still can have a positive impact on the patients I see. My goal is always to teach and empower patients to learn the necessary tools to feel confident making decisions at home that will ultimately have a positive impact on their health.

Do you have a memorable experience in your career that has stayed with you?

Throughout my career I have had so many special patient encounters. I will always remember one geriatric patient who unfortunately was struggling with addiction. He was the only patient that I ever had to administer Narcan to. On that particular day, he had used before his visit and despite his lethargic state, his friend brought him to the clinic in a wheelchair. He always came to the clinic with an open mind, and after a while, I realized he was extremely lonely, and likely saw our visits as “therapy.” Sadly, he lost his battle with addiction. He taught me a lot about myself, not only as a provider but as a person. Sometimes it’s the smallest things that we do that can have such a positive impact on a patient.

What have your patients taught you about yourself?

I am constantly learning from my patients. One big lesson I had to learn early on was to be more humble. I have made the mistake of coming into a visit thinking I knew what was best for the patient before sitting and listening to them. Sometimes the most important part of our job is just being present and listening. My patients also help remind me how important it is to not take my health for granted and to take time to enjoy the little things in life.

In a few words, how would you describe your coworkers and team at UW Health?

I feel very fortunate to work with such a great team. There are a few provider teams within the clinics but despite these designated teams, we all work together to make sure patients are well cared for. My colleagues and I often discuss patient scenarios with one other and I love the fact that we all value each other’s input. I feel that the organization truly values the work that APPs provide and I feel blessed to work in such a supportive environment.

Outside of work, what did you accomplish this year that makes you proud? My most important accomplishment this year would have to be giving birth to my daughter, Valentina! 

APP Spotlight: Cory Sieburg, Nurse Practitioner, Pediatric Neurology; University Hospital; American Family Children’s Hospital

Tell us about yourself.

I was born and raised in Wisconsin just outside of Madison and lived there with my parents and older brother. My mother was a nurse who cared for geriatric patients, and I knew early on that I wanted to be a nurse, too. I always loved working with children and aspired to a future in pediatrics. I spent time working with children who have special needs and nannied in college. My husband, Jack—who was my high school sweetheart—and I have two kids, Everett, 5, and Adeline, 3, and a dog named Selke. We enjoy staying busy on the weekends and are a huge hockey family.

Where did you go to school?

I attended Edgewood College in Madison for my undergraduate degree in nursing, completing my clinicals at UW Health. After graduating, I moved to Phoenix, Arizona, with my best friend for my first job in a pediatric intensive care unit. We lived there for a few years, joined by my now husband, Jack. We later moved to Chicago for his job and I worked in the emergency department and post anesthesia care unit at Lurie Children’s Hospital (formerly Children’s Memorial). During my years in caring for patients, I saw a lot of my colleagues going back to school and soon had the same desire. I attended an accelerated Acute Care Pediatric Nurse Practitioner program at Vanderbilt University, with monthly travel for classes and completion of my clinical hours in Chicago. It was a crazy time in my life, but I was so thrilled to have the experience.

How did you come to UW Health?

After I completed my nurse practitioner program, I was open to any specialty but wanted to find a team and organization that supported the success and growth of nurse practitioners. When I met with the wonderful providers that make up the pediatric neurology team at UW Health, I knew I wanted to work with them. I joined the team early in 2016 and have been here ever since.

What inspires you about your profession?

My patients are always my inspiration. I find kids to be the most resilient and accepting of challenges, and they love the joy they find in all they do. I’m a big kid at heart, so to be playful and have fun with the kids is the best part of my job.

Tell us about your work with spinal muscular atrophy.

I found an opportunity to utilize my expertise in research to provide life-changing treatments. Though I have done many things within pediatric neurology, my job transitioned at UW Health to a focus of neuromuscular diseases. A large area of my focus has been to manage and coordinate the treatment programs for children with spinal muscular atrophy (SMA). In short, this is a genetic mutation that results in a deficiency of a protein that is critical to the function of nerves that control our muscles. Children with SMA do not produce enough protein, which impacts the nerve cells and results in muscle weakness. In the most severe form left untreated, SMA can be fatal. When I joined the neurology team, there was no treatment for this disease. A large team managed patients’ respiration, nutrition, rehabilitation needs and many other aspect of their care. Since then, there have been many advancements and clinical trials, some of which we have had the privilege of offering to our patients, and now these patients have better outcomes.

Do you have a memorable experience in your career that has stayed with you?

I have two. The first one still makes me tearful to this day. I was caring for a young woman who had recently gotten married, but had a very life-limiting diagnosis of severe pulmonary hypertension. The movie “Wall-E” had just come out, but due to being sick, she missed seeing it in the theater. She wanted a movie date with her husband. I bought the movie for them and brought it to her room, along with popcorn, candy and other movie snacks. It was a small gesture, but they were so happy. That moment carried them through the harder weeks to come. Unfortunately, she died shortly after. Later, her husband came to the unit and brought the movie back to me with a card thanking me for my kindness.

The other memorable experience was a family who had gotten a neuromuscular diagnosis for their first child while pregnant with their second. There was a possibility the new baby would have the same diagnosis. We performed testing early and waited for results. It was a Friday. I was picking up dinner for my family when I received the call that the result was positive. I stopped on my drive home to personally call the family and share the news, not wanting them to wait one minute more to know. It was one of the hardest calls I had to make, not just as a provider, but as a mom. I shared the result with the mother and we just cried. I reminded myself what I would need as that parent, and worked to provide it. We successfully treated this infant and she is doing very well. 

In a few words, how would you describe your coworkers and team at UW Health?

Everyone on our team is exceptional and irreplaceable. We celebrate big and small victories. We have fun, even when things are stressful. Dr. Jennifer Kwon always encourages me to push myself and further hone my skills. She is supportive and acknowledges my value in the success of our programs and our patients’ care. I am so grateful to her.

Outside of work, what did you accomplish this year that makes you proud?

I celebrate the happiness and growth of our family.  My husband is supportive of the work I do, often dropping his work when I have urgent issues to attend to. Our kids bring us so much joy and I am proud of the little people they are becoming. I am so happy to have both a family and a career.

APP Spotlight: Claire Johnson, Nurse Practitioner, Psychiatry, 2275 Deming Way Clinic

Tell us about yourself.

I earned my doctorate as a psychiatric nurse practitioner from the School of Nursing at the University of Wisconsin-Madison. I met my husband while pursuing my Bachelor of Science in the School of Nursing at the University of Wisconsin-Eau Claire. We have an adorable 3-year-old daughter who loves to play outside, rain or shine. When I am not chasing after her, you can find me in my garden with my dog. 

Where did you grow up?

I have been a Wisconsinite all my life. I love experiencing all the seasons here, particularly the fall. Growing up in the small town of Lake Mills, I learned the importance of supporting the school district and the community you live in.  

How did you come to UW Health?

When UW Health created a new role for a psychiatric nurse practitioner to be part of the child and adolescent consult and liaison service, I jumped at the opportunity. I was excited to help further develop this scope of care for advanced practice providers. It’s a small but amazing outpatient practice.

We work with children and adolescents—kids who are suicidal and/or have depressive episodes. We’ve also recently seen an increase in children who have eating disorders.

What inspires you about your profession?

Children are remarkably resilient. They face unbelievable challenges and traumas. They inspire me to do this work. I believe in uncovering who a person is and wants to be and supporting them in their development. 

What have your patients taught you about yourself?

I have learned to slow down and appreciate the simple things in life. I am grateful for my family and the ability to have a career as well as dedicated time for my daughter. 

In a few words, how would you describe your coworkers and team at UW Health?

My coworkers at 2275 Deming Way Clinic and American Family Children’s Hospital are dedicated and caring. They all have been welcoming and a fun team to be a part of. 

Outside of work, what did you accomplish this year that makes you proud?

I am biking to work! Wish me luck as I am hoping to continue this in rain, snow or on 100-degree days.

APP Spolight: Amanda Breuer, Physician Assistant, Cardiovascular Medicine; Arbor Gate Clinic

Tell us about yourself.

I am a physician assistant (PA) with the electrophysiology team and have been with UW Health since August 2016. I am a graduate of the Physician Assistant program at the University of Wisconsin School of Medicine and Public Health. My agrarian roots led me to pursue a career in medicine. At a young age, I developed an understanding for the circle of life and immersed myself in anything pertaining to medicine, when I had the opportunity. My rural upbringing instilled in me life lessons that continue to resonate with me each day. I learned selflessness, compassion, humility, responsibility, patience and the importance of a strong work ethic. 

Where did you grow up?

I was raised on a family dairy farm in Slinger, Wisconsin.

Tell us about your family.

My father is a farmer and my mother is retired from the United States Postal Service. I am the second oldest of four children. I have one older brother, Ryan, and two younger sisters, Brenda and Brooke. I also hold the title of “Auntie” to a 3-year-old niece and an 11-month-old nephew.

How did you come to UW Health?

Following graduation from the PA program, and prior to my UW Health employment, I remained in Madison and was a PA with the cardiology team at the William S. Middleton Memorial Veterans Hospital.

What inspires you about your profession?

The PA profession was created to improve and expand access to healthcare. There has been a rapid increase in new training programs due to the projected demand for PAs. It’s a profession that is constantly evolving to meet the ever-changing needs of patients of all ages. I am inspired by the power of humans and the importance of human interaction. I chose to become a PA because I value developing individualized treatment plans for patients and am passionate about a career that embraces the principles of patient education and communication, developing rapport and emphasizing health outcome improvements.

What have your patients taught you about yourself?

My patients have taught me that making a difference and the will to succeed is not about gender, education, socioeconomic status, ethnic background or how big or small something may be, rather it’s about measuring a person by the size of their heart. They’ve also taught me there is power in hope. One person can make a difference simply by giving another person hope.  

In a few words, how would you describe your coworkers and team at UW Health?

My colleagues and team are like family. They have integrity and are a loyal, empathetic, dependable and engaging group of individuals. Despite obstacles and adversity, they’ve been resilient, and persevered by remaining focused and ambitious. The Electrophysiology Advanced Practice Provider team is a dynamic and accomplished group. We lead quality improvement initiatives and seek ways to improve delivery of arrhythmia care, such as the implementation of a dedicated APP-driven Atrial Fibrillation Clinic and collaboratively developing a Hybrid AF Ablation Program. We are comprised of innovators, researchers, mentors, educators and patient advocates. We are wholeheartedly committed to our patients.

Outside of work, what did you accomplish this year that makes you proud?

I’ve been brave enough to choose the harder routes for better or worse. I’ve learned to appreciate any small life accomplishments and have come to appreciate that there is value in incremental success.

UW Health advanced practice providers who work in partnership with physicians provide high-quality, patient- and family-centered care. Meet a few of the APPs here at UW Health:

APP Champion:  Carol Carr, CNM, retired, UW Health West Clinic, UW Health 20 S. Park Clinic, UW Health Union Corners

Carol Carr, who retired from UW Health in September 2021, says she attributes her career success to truly listening to her patients and being present in their care. She retired after a 35-year career of nurse midwifery, 31 of those years at UW Health. She has been an RN for 42 years. The definition of the word midwife is, ‘with woman.’

“So, to me, whether it’s in the office simply listening to a woman talk at a prenatal visit or during the labor process, I’ve learned to just be attentive, listen and be present and patient. Sometimes that can be hard. But it’s always best to just step back, look at the entire situation. Listen. Truly listen,” she says.

Her love of nursing came at a very young age. Carol grew up in Wales, Wis., one of seven children. “My mom certainly embraced having children. She and my dad were both only children. My oldest brother is 21 years older than my youngest brother. I was in the middle of the seven, so I was around babies while growing up, often caring for my siblings. My mom was a nurse and so were some of my cousins and great aunts. The desire to become a nurse came very naturally to me. I knew I wanted to be a nurse since I was 5 years old!”

Carol attended Marquette University in Milwaukee and earned her Bachelor of Science degree in Nursing there, enjoying her liberal arts classes as much as her nursing classes. She initially thought she wanted to be a pediatric nurse. “I was lucky to have one of my early student nurse rotations at Family Hospital in Milwaukee, where they embraced family-centered care and were one of the first hospitals in Wisconsin to have certified nurse midwives attend births. After this experience, I knew I wanted to be a nurse midwife.”

A certified nurse midwife (CNM) is a registered nurse (RN) who has a master’s or doctorate degree in nursing. They have also received certification from the American Midwifery Certification Board.

While at Marquette University, she met a woman who went to England for midwifery training. At the time, she says, it was hard to get into the graduate nurse midwifery programs in the U.S., so she decided to go to England. “I was fortunate to live in England for 16 months, where I completed my initial midwifery training. This was in the early 80s. I made such lovely friends while living there. I lived in the northern part of England,” Carol says. “At that time, home visits to new moms and families were part of postpartum care. It was such an incredible experience and I still talk to families I met there.”

When she returned to the U.S., Carol earned her master’s degree from the  University of Illinois Chicago. Her early midwifery clinicals were at Cook County Hospital. She then returned to Milwaukee to do her final clinical at Family Hospital.

After finishing the master’s program and becoming a certified nurse midwife, Carol moved to Hyden, Ky., for her first job. Carol says going to Kentucky was a dream of hers since she was a girl and read a book about a woman who was teaching in the hills of Kentucky. “The hospital where I worked was named after Mary Breckinridge, a pioneer nurse midwife who brought modern nursing to the rural environment. In the 20s and 30s, she helped decrease maternal morbidity in the hills of Kentucky. She was an inspiration.”

When Carol got engaged and married, she made her way back to Wisconsin. At the time, there was only one nurse midwife at UW Health. “We established ourselves at UW Health and soon expanded, developing a solid patient base. Today, we have nine certified nurse midwives working in five clinics and assisting in 500–600 births per year.”

UW Health nurse midwives are members of the Department of Obstetrics and Gynecology and work in collaboration with OB-GYN doctors and residents. They also work with the Maternal-Fetal Medicine doctors at the Center of Prenatal Care. “Our OB-GYN department has grown to be large, dynamic and comprehensive in prenatal care. We co-manage and provide care for women with high-risk medical conditions.”

Carol says a woman may choose to come to a midwife for many reasons. Sometimes it’s a personal connection or word-of-mouth — women talk to other women, hear good things and want to see us. She says many women also like that all UW Health midwifery staff are female and they can meet many of the nurses at their clinic visits. “We spend a lot of time with them in prenatal visits and during the labor process. We meet them in triage. The biggest difference is we are there through their labor, not just the birth.”

“Many women choose nurse midwifery care as they hope to avoid interventions such as induction, epidural or C-section. Our group practice C-section rate is less than 10 percent.”

When asked what inspires her about midwifery, Carol says she has really enjoyed having many colleagues and friends come to UW Health for their nurse midwifery care. “I’ve also had the pleasure of attending the births of my nephew and niece. It’s inspiring to work with midwifery and medical students. It’s always so incredible to experience their first births with them.”

As a nurse midwife, Carol says she has the pleasure of being a part of a woman’s incredible journey of mothering and parenting. “It brings me to tears. I recall one young woman — I was at her first birth and unfortunately, her husband was not present as he was detained in immigration in Chicago. She had church friends who were with her as she labored. Her husband was with her for her next three births, and I was able to be her midwife at all four of her births. I still keep in touch with her.”

Sadly, it’s not uncommon for a woman to experience a miscarriage. Carol has been present at the births of rainbow babies. A rainbow baby is a name for a healthy baby born after losing a baby due to miscarriage, infant loss or stillbirth. “It is a privilege to attend these births as it’s a true gift and brings intense joy and healing for these families.”

When Carol reflects on her long career in midwifery, she recalls a memorable moment at one of the first births she was a part of when she was a nursing student. It was a young woman having her first baby. “The physical strength this woman had in the act of giving birth was incredible to watch. Then as that baby was put in her arms, she transformed into this loving, beautiful mom. It was amazing. I knew very early in my nursing education that I wanted to be a midwife. There is a Norwegian proverb that I hold close to my heart, “The greatest joy is to become a mother, the second is to be a midwife.”

Carol has three children with her husband, John. Their oldest, George, is 27, and they have twins, Jack and Katie, who are 21. Carol says she looks forward to becoming a grandparent and spending time with family in her retirement. “Once you hit 60, you start thinking of retirement. My son and his wife are expecting their first baby, a boy, at the end of October.”

Now that she will have more time, she says she may consider working with friends who are involved in maternal healthcare in other countries, including Belize, Africa and Guatemala.

“Retiring is a big change. It’s hard to leave but we’re looking forward to spending time with family and hoping to travel. As I reflect on my career, it’s funny — my initial school/work/places I lived were in two-to-four-year stints, and then we moved to Madison, had children and suddenly, it’s been 31 years! It’s been a wonderful place to practice, to see midwifery grow. I’m very happy to have spent most of my career here.”

APP Champion: Renee Churchill, NP, Cardiovascular/Transplant Medicine, University Hospital, East Madison Hospital, Research Park Clinic

Renee grew up on a farm in Wisconsin — the second oldest of five girls — and knew she wanted to be a nurse, even at a young age. 

For Renee, working at UW Health is a family affair. Her husband, Peter, works in the neurosurgery intensive care unit (ICU) at University Hospital and her younger sister, Janelle, is a nurse in outpatient oncology and shadowed her at UW Health.

Renee’s nursing career started at Aurora St. Luke’s Medical Center in Milwaukee in the surgical intensive care unit (SICU). “Working with nurse practitioners while I was a nurse was inspiring. I wanted to challenge myself and continue to learn and grow professionally so I decided to become a nurse practitioner.”

Renee had previous ICU and transplant experience. She first started taking care of patients with end-stage heart failure and managing their ventricular assist devices. These are used in patients who have weakened hearts and/or heart failure. She really loved the continuity of care and getting to know her patients and their families.

“When the new heart transplant advanced practice provider (APP) position opened in January, I jumped in. The program is growing and it’s incredibly exciting to see,” says Renee.

She says this position has given her the opportunity to help define and build the role because it is so new and still evolving. “I’ve been able to participate in quality improvement projects and medical management meetings, which help identify ways to improve the transplant process and make it easier for our patients. It’s all about doing better for our patients and helping them be successful at home.”

Renee’s role as a transplant medicine nurse practitioner gives her the opportunity to help patients throughout their transplant journey. “Many transplant patients have a difficult road to recovery. We are so invested in their recovery. Partnering with my patients to help them through their hospitalization and returning home has been incredibly rewarding. Seeing our patients in clinic, post-transplant and thriving, is the best part of the job. They share stories, talk about plans and discuss new things they are involved in — it’s amazing.”

Renee says the team she works with is very dedicated to patients and the transplant program. “We all work really hard to ensure our patients are successful post-transplant. My colleagues are key to this success, knowing we can count on one another and working together is so important.”

When asked to recall a memorable experience that stays with her over the years, she says watching any patient leave the hospital post-transplant is always an incredible moment. She adds that it’s hard to pick one single moment, but recalls a patient who was being discharged earlier this spring after a long and complicated post-transplant course. “The entire unit paused as they left the unit to go home. About 30 employees stopped what they were doing, lined up to watch the patient leave and applauded as they went by. It was truly remarkable and so heartwarming. This serves as a reminder of why we work so hard. We are able to make a difference and improve our patients’ quality of life.”

APP Champion: Elise Strycharske, NP, Cardiovascular/Transplant Medicine, University Hospital, East Madison Hospital, Research Park Clinic

As a transplant nurse practitioner, Elise Strycharske says the team effort that goes into caring for this complex population is simultaneously challenging and rewarding. When she reflects on how she got into transplant medicine at UW Health, she said it was partly out of necessity. “We hired new doctors and surgeons and then the patient base tripled,” she says. “I enjoy being a part of the process to get a patient on the transplant list. Working in this field of medicine, we really have the honor of seeing patients progress from being sick with advanced heart failure to thriving post-transplant, and working with them for the rest of their lives. I like that aspect of my job.”

Her love for medicine started at a young age. She recalls a moment when her grandfather was hospitalized for 10 weeks when she was in middle school. “Watching those intensive care unit (ICU) nurses work with and take care of him was a memorable moment for me. It was the moment I knew I wanted to pursue medicine,” Elise explains. “ICU nursing compelled me. Now today, I see my grandfather in my patients. Or sometimes he comes to me in a situation when I have to make a difficult decision. The memory of my grandfather keeps me grounded in my work.”

When Elise looks back on her education, she says nursing was second degree. Her undergraduate degree from UW-Madison is in zoology. “I thought I would go into pre-medicine but started working in the intensive care unit, loved ICU nursing and decided to shift my focus to nursing. Then, I got into the nursing program at Edgewood College in Madison.”

While at Edgewood, she studied in Guatemala. Shortly after returning, she worked in the cardiac intensive care unit at UW Health. Elise worked there for seven and a half years while completing her Doctor of Nursing degree at UW-Madison, and then took a job in advanced heart failure and transplant medicine. She has now worked in this specialty for four years.

“I was the first nurse practitioner (NP) in transplant cardiology at UW Health. I’m honored to have pioneered that role. We’ve since expanded the department quite a bit. Watching the clinic grow has been incredible to see,” Elise says.

The UW Health Transplant Center performs heart transplants to treat heart failure and heart disease, and is one of just five centers in the nation transplanting hearts from cardiac death donors using a device that preserves heart function between donation and transplant. Wait times are among the nation’s shortest. The staff use minimally invasive techniques to improve patients’ health and for some, provide support while they wait for a transplant. UW Health proudly serves veterans as a Veterans Administration-approved transplant program.

When asked about her team at UW Health, she describes them as flexible, supportive and trustworthy. “We all have a shared expectation for autonomy,” she says. “We hold each other to super high standards. We are very dependent on our team and fully reliant on our heart failure and transplant nurses to help meet the needs of our complex patients.”

Elise says she feels lucky to have such great colleagues. “They are truly the best of the best and try to share an even workload among staff members,” she continues. “We run through scenarios with each other to gain a better understanding of what is needed to do the best we can in all situations. My physician colleagues are nothing but supportive. We truly have autonomy and our leaders champion us to be leaders too. My medical director is always looking for growth and opportunities to expand our skill set and leadership roles. I appreciate that.”

Working amid a global pandemic has been hard for healthcare workers. Especially as the delta variant makes its way in. “It’s been hard for all of us but it’s especially hard for our patients. Many of them have had to be here at the hospital for weeks without family or friends at their bedside. It’s been a super challenging time. Many of us providers and staff have had to be not only the care provider but also the friend or family member too. It’s been hard but we wouldn’t do it any other way.”

Elise says her patients remind her to recognize and appreciate the joy in life. “Take each day at a time, focus on what’s important and be appreciative for good times. My patients help me realize that health and wellbeing is so important. They help me put things into perspective when I get lost from that way of thinking.”

Outside of work, Elise stays busy with her 2-year-old son, Will. She likes boating, being active and working on her fitness. She also enjoys gardening, cooking and listening to music.

APP Champion: Loyda Braithwaite, MSN, RN, AGPCNP-BC, AOCNP, Oncology, University of Wisconsin Carbone Cancer Center

For Loyda, providing the best cancer care for her patients, empowering her daughters and giving back to those in need all boil down to doing what’s right as a professional.

Like many nurse practitioners, Loyda had a desire to work in healthcare since childhood. But her story has a different beginning than those of her colleagues. Loyda was born and raised in a small town in Panama. After high school, she moved to Panama City, where she earned her Bachelor of Science degree in Nursing at the University of Panama and practiced there for a few years. She says her interest in cancer care began early in her undergraduate nursing studies when she had clinical practice at the Panamanian National Oncologic Institute.

“I was inspired by one of my professors who was the only oncology-specialized nurse in Panama at the time,” Loyda says. “Since that experience, I knew oncology was my calling. This passion inspired my intensive pursuit of knowledge and motivated my development in nursing.”

Several years after establishing her nursing practice in Panama City, she met her now husband, who was an American Peace Corps volunteer serving in Panama. They fell in love and after dating for a few years, moved to the United States in 2009. “I didn’t know any English at that time,” she says. “With dedication and persistence, I learned English, obtained my nursing license in the United States and began practicing as a registered nurse in 2010.”

Loyda’s drive to succeed didn’t stop there. She continued her education and earned a Master of Science degree in Nursing at Loyola University Chicago in 2015, specializing in oncology. She then began her new role as an oncology nurse practitioner at the UW Carbone Cancer Center, and since 2018, has sub-specialized in the treatment and management of patients with breast cancer.

“In addition to my clinical practices, I wanted to make a larger impact for my patients, colleagues and the profession. This led me to pursue a doctoral education. I am currently a PhD student in the UW-Madison School of Nursing. As a future nurse scientist, I want to focus my research on cancer health needs in minority populations.”

When asked to describe her co-workers at UW Health, she says the nurses and physicians are the most knowledgeable people she knows. “They go the extra mile for every patient. From bedside nursing to advanced care coordination, the professionals at our cancer center are committed to providing the best care possible for every patient and their families.”

Outside of work, Loyda says her most proud accomplishment is her family. “My husband, Brandon, and I have two daughters, Ayla (7) and Hahmi (4). My mom, Esther, also lives with us here in the States. We continue to survive the COVID-19 pandemic, and honestly, working together to raise our children in a bilingual and multicultural family makes me proud every day. I hope my experience can empower my daughters to follow their dreams, because succeeding as a woman, person of color and immigrant is never easy. My family has been and will always be my greatest source of support and inspiration to do what I do.”

In addition to clinical and academic work, Loyda is involved in a variety of volunteer activities ranging from direct patient care to formal education for healthcare professionals. She has returned to Panama three times over the years to assist in orthopedic surgeries. She also helped develop and conduct an educational program for oncology nurses in Honduras, in collaboration with Health Volunteer Overseas (HVO) and the American Society of Clinical Oncology (ASCO). She provided rural general practice care in the Dominican Republic and volunteered with the Oncology Nursing Society (ONS) and ASCO to provide oncology nursing education in Colombia and Ghana. Loyda is also a member of the Oncology Nursing Certification Corporation’s (ONCC) committee that evaluates the learning needs for the oncology nurse practitioners’ national certification test.

Locally, she volunteers as a co-facilitator for a Hispanic breast cancer support group at the Catholic Multicultural Center, a social services agency in Madison assisting people in need. “COVID-19 has delayed us from meeting, but this community gathering has been the only Spanish-speaking breast cancer support group in Dane County. I look forward to the day we can safely resume our monthly meetings.”

When asked to recall moments that inspired her, she says it’s hard to narrow down because there are so many. “I enjoy and celebrate the happy moments with our patients and families,” she says. “Other times it is more difficult, particularly when patients are nearing end of life. Conversations are tough and many times there are tears of both joy and sadness. Sometimes there are physical symptoms to be managed, sometimes there are emotional ones to be healed, but the purpose of my work is to make their journey more manageable. When I hear a patient thank me for the care they have received, it’s rewarding and reassuring. Also, providing care to my Spanish-speaking patients in their own language is priceless. All of these are daily reminders that I have chosen the right profession.”

Loyda says her patients teach her humility at its best. “I think I’ve learned it’s always best to meet patients where they are. It’s never where I think they should be. No matter what I think I know, I always need to listen to my patients first. That’s very important to me as a professional.”

APP Champion: Abby (Abigael) Murphy, PA, Family Medicine, UW Health Odana Atrium Clinic

Abby was drawn to UW Health not only because of its academic reputation but because UW Health strives to be an inclusive and equitable workplace. As a physician assistant in family medicine, Abby says she loves the variety it provides. She gets to see patients from birth to old age and no two days are ever the same. She often cares for the entire family and gets to watch them grow and thrive.

“Transgender health has become a new aspect of healthcare I am proud to call a new specialty,” Abby says. “The last few years have brought in a boom of transgender patients. I offer guidance for hormone replacement therapy, gender affirming care and mental health resources, all of which are available at UW Health.”

UW Health supports transgender, gender expansive and nonbinary adults and children, not just by providing high quality clinical services, but also by working with community partners to support each patient’s unique physical, emotional and social needs.

“Recently, I’ve seen an increase in transgender, gender nonbinary and gender fluid patients in our younger patient population,” Abby says. “I think a lot of this increase has to do with the fact that people becoming more acutely aware of UW Health’s commitment to the LGBTQ+ community.”

In fact, UW Health is designated as a “Leader in LGBTQ Healthcare Equality” in the Human Rights Campaign 2020 Healthcare Equality Index. A record 765 healthcare facilities actively participated in the 2020 survey, and 495 — including UW Health’s three hospitals — earned the coveted “Leader” designation with a top score of 100. Our Gender Services Program is a key part of our comprehensive commitment to exceptional and affirming care.

Abby’s roots run deep in the Midwest, having grown up in the Sauk Prairie area of Wisconsin. She went to undergraduate school in Pittsburgh, earning a Bachelor of Science degree from Chatham University. She then earned her Master of Science degree from Baldwin Wallace University. After spending three years in Denver working in women’s health and primary care, she moved to Madison about three years ago with her partner, Michelle.

“I have a special passion for underserved populations, including the LGBTQ+ community,” she continues. “As a member of the LGBTQ+ community myself, I understand the challenges. It’s a personal goal of mine to be a provider who is open and accepting of all patients.”

When asked to recall a memorable moment in her career that stays with her, she says it’s hard to pick just one. But whenever she is thanked for recognizing someone for who they truly are, being respectful of their pronouns, that is a win. “Being told that my patient is ‘so excited to have a queer provider’ — these moments remind me why I so enjoy doing what I have the privilege of doing every day, which is caring for and supporting others on their life journey.”

Abby said she recently saw a patient in his early 50s who told her it was his first time coming out to a clinician. Another patient told her she had never seen a provider who was also a member of the LGBTQ+ community before. “I always ask patients what their personal pronouns are. It’s motivating to see how happy and positive my patients are when they leave my office after first being uncertain how honest they could be in their visit.”

Abby often spends her free time seeking out and bringing more attention to LGBTQ+ resources available locally. She says she often advocates for providers to have more CME training and diversity training.

“Gender expansive children and adolescents often have many questions. I use my time to listen, accept and learn about needs and offer support and resources to help them on their healthcare path.”

Abby is appreciative and thankful for her team at the UW Health Odana Atrium Clinic in Madison. She says everyone is passionate about our patients, and about learning and growing—both emotionally and intellectually, on both an individual and team basis. “No one ever seems satisfied being stagnant, complacent or ‘good enough.’ We enjoy getting to learn from and with our patients every day.”

Being a healthcare worker is difficult, especially now working during a global pandemic. Days are long, patient volumes are high. She says her patients teach her so much about herself, including reinforcing the importance and power of basic respect and friendliness. “Verifying name and pronouns, some quick chatting about their interests, pets and/or family, and a friendly smile — with the eyes these days — does so much in such an easy, short period of time.”