Nurse Practitioner Combines Diabetes And Wound Care Specialties

By Jan Howard

Nursing as a profession is not viewed as an option by most men, but to one local man, nursing is a job he loves.

John Leopold, RN, MSPH, is on the staff of the Visiting Nurse Association (VNA) in Danbury in the newly created position of diabetes and wound care clinical specialist and program manager. VNA services the greater Danbury area.

“I think I have the best job in the world,” Mr Leopold said recently. “I struggle with multi tasks, but I couldn’t ask for a more perfect job.” A resident of Brookfield, Mr Leopold grew up in Danbury.

Mr Leopold is a family nurse practitioner with a concentration in diabetes management. He recently completed a wound care specialty that he noted, “goes hand in hand with diabetes. It’s a natural pairing.”

Mr Leopold has been a registered nurse for three years and a family nurse practitioner since last fall. He did not start out with a career in nursing, however. He earned a bachelor of science in mechanical engineering from the University of Connecticut.

“Engineering didn’t work for me,” he said. “My family was service oriented, and my parents were active in the community.”

So Mr Leopold returned to school, earning a master’s degree in public health from the University of North Carolina at Chapel Hill. After two years in the Peace Corps as a community health educator in Paraguay, he came back to the United States to work in several community health settings. In 2000, he joined the Alamo Migrant Health Center in Goshen, N.Y., as an outreach volunteer, where he screened and educated migrant and seasonal farm workers for diabetes and hypertension and connected farm workers to services provided by the health center.

It was during that time he realized he liked working with clients. “My personal goal was nursing,” he said. He received his nursing certificate in January 2001 and graduated from Yale University in May 2002 with a master of science in nursing. He said he was lucky as part of his training to take part in a rotation in the Clinical Diabetes Center of the Albert Einstein College of Medicine in Bronx, N.Y.

 As a family nurse practitioner, Mr Leopold can treat everyone from newborns to adults, but his specialty is diabetes. “Diabetes is a good fit for me,” he said. “It was a natural program for me. In the Peace Corps and in the hospital, it showed me I wanted to work with Latinos, who have a high prevalence for diabetes.”

Working for the VNA, Mr Leopold provides education, counseling, and home care. “I am very interested in patient education and health counseling,” he said. “It is a huge part of diabetes control. I discuss with patients how to assess their lifestyle and how they can make changes to a more healthful lifestyle.

“Homecare is my choice. I spend time in a patient’s home. I see how they live,” he said. “The patient is more relaxed and more comfortable with you. You see what they eat, and have a clearer picture of what is going on in their life. You can help them help themselves.

“It’s a rare patient that says ‘I can dramatically change my diet.’ I help them make compromises,” he said. “Understanding how a client lives can be crucial to facilitating behavior change and improving health outcomes.

“We talk about a schedule where exercise will fit in, or changes in diet,” he said. “As we get older, we’re more fixed in what we do. After working with the patient, do we think the patient has changed enough or should we go back to medication for control.”

Mr Leopold said he interacts with the patient’s physician to understand a realistic picture of the person’s everyday control.

In his position with VNA, however, he is unable to prescribe medications. “It’s a tradeoff,” he said. “I can’t prescribe, but I have more time with patients.”

As a nurse practitioner, Mr Leopold said his training was different from that of a physician. “There are different levels of comfort with clients you see. We require more time with the patient for counseling, education, and history.”

“It amazes me that nursing is not a more attractive occupation,” Mr Leopold said. He noted the many options nurses have today, in traditional nursing, as nurse practitioners, and working for state agencies or pharmaceutical firms, among others.

He said that while hospital nursing is only one of the many options available to nurses, experience in a hospital setting is critical as a foundation for other nursing careers.

In his position, Mr Leopold said he spends about 50 percent of his time seeing patients and the other 50 percent consulting with nurses and working on systems and staff education.

Mr Leopold said he was the only man in his specialty at Yale, and one of only three men in his class. Men need to be open to nursing as a profession, he said. “For whatever reason, men don’t view it as an option.”

Regarding a projected shortage of nurses and nursing teachers, Mr Leopold said he believes the problem will be resolved because of the attention the issue is receiving. “The pendulum will swing,” he noted. “I think people will become teachers. Some people have a calling to teach. I think hopefully it will work itself out.”

Nurses should be compensated better than they are currently, he said. Better salaries will solve some of the issue, he noted, but nursing “is not the low paying occupation it’s perceived to be. They aren’t walking into an occupation where they’re living hand to mouth.”

With the shortage of nurses, if the market helps correct it, compensation will become fairer, he added.

“I couldn’t ask for a more perfect job,” he said. “The sacrifice of prescribing is well worth it. It’s amazing to be in a job you love.”