Melanie Cole (Host): Members of the MIT Traditional Health Plan are required to select an MIT Health primary care provider, and students are strongly urged to select a PCP at MIT Health as well. Welcome to Conversations with MIT Health. I'm Melanie Cole. My guest today is Colleen MacDonald. She’s a nurse practitioner and PCP at MIT Health. Welcome to the show, Colleen. Tell us a little bit about your career path from a nurse to a nurse practitioner.

Colleen MacDonald (Guest): Okay. I started out as a nurse about 25 years ago, and I actually moved to Boston to be a nurse at Beth Israel Deaconess Hospital because Joyce Clifford at the time was the guru in nursing and she spearheaded a program called Primary Care Nursing, where, when any patient came into the hospital, they were assigned a specific nurse who was their primary care nurse. And every day, that nurse would be there. They would take care of that patient. And every time that patient came back into the hospital, that patient would be taken care of by the same nurse. It was a wonderful model in which the patient and the nurses got to know each other and could influence positive outcomes in healthcare just through their relationship and having worked together for so long, enhanced patient care when you knew each other so well. I moved from Beth Israel over to Cambridge Health Alliance to be a clinical leader, which was somebody who would train new staff with a mentor or lead change projects on medical surgical care unit at Cambridge Health Alliance. Cambridge Health Alliance was an extraordinary experience because there were days when I was working where English would do me no good because the patients were Portuguese, they were Spanish, they were Haitian Creole. It was a wonderfully diverse patient population and also with a diverse spectrum of illnesses. My years of being in nursing were really critical and remained critical in my ability to be an effective nurse practitioner today. After about 10 years of nursing, I went in to become a nurse practitioner and studied at UMass, Boston and started my career as nurse practitioner at Cambridge Health Alliance. At the time, it was what was considered the Haitian Clinic of Cambridge Health Alliance, and we dealt with many patients who were Haitian, many who just arrived at the United States and were getting their first healthcare experience ever. It was an opportunity for me to understand the challenges and the wonderful aspects of caring for somebody with different cultural beliefs and different health care experiences, or, in many cases, no healthcare experiences. That was a great way to start my nurse practitioner career. I eventually made my way over here to MIT Health, and one of the reasons I chose to come to MIT Health as a nurse practitioner was to continue to be able to treat the diverse patient population.

Melanie: Colleen, describe for us one of your most memorable patient interactions.

MacDonald: I think there are several that I can think of. When I go back to Cambridge Health Alliance, I had a young woman who was from Haiti and was diagnosed with HIV, and she had tried to kill herself. Then, while her case was dramatic, the thing that stuck with me is how we both learned from each other. It was kind of a language exchange when I took care of her. She was teaching me a few words in Haitian Creole and I was teaching her a few words in English. But it was also -- she helped me understand how it was to be a woman in Haitian society, at least from her perspective, how it was to be someone who moved to a country and was unable to speak the language—and not only unable to speak the language but in such vulnerable position as being in the hospital with a severe illness. That’s one of my memorable cases. My MIT memorable cases range from a student who needs help understanding what a pap smear is to the 80- to 90-year-olds who come in share their not only MIT history but their life history with me. Many of these people have lived in Europe through World Wars and moving and fleeing, and it has been phenomenal to work with them to improve their health and to understand their life perspective.

Melanie: How rewarding for you. So what do you like most about working at MIT Health?

MacDonald: I like several things. Like I mentioned before, the diversity of the international patients is phenomenal. I have a map in my office, and I ask my patients to mark where they are from. And literally, there are pins in the map from all over the world, and that’s a wonderful experience. The other thing you get to do at MIT Health is see all kinds of health issues that range -- you might be teaching someone preventative health strategies, and for other patients, you may be managing multisystem diseases, which is very challenging. The other thing I really like about MIT Health is that we have many colleagues who are experts in different fields of medicine and a very robust system of teaching and learning. So if you were the expert at one area of medicine, you share and teach and collaborate with patients to provide excellent care. And if you are not expert in one area, you get to learn from those people. So it’s a wonderful atmosphere. The other thing is if we have nurse practitioners, myself being one, and we have MDs and nurses, and secretaries who really function as part of a team to try to make the healthcare experience and the flow of your experience in MIT Health go smoothly.

Melanie: Colleen, just give us a little bit of a wrap up on your approach to medicine as you feel it differs from maybe some others.

MacDonald: I just really feel privileged to meet with patients, and I really need to know what aspect of their health care, what aspect of their life is important to them and how their health is either making that better or a barrier to them meeting their daily requirement or their daily functions or meeting their goals appropriately. I try to help them figure that out first and how their health relates to their success at MIT and in their life goals.

Melanie:Thank you so much. Listeners can visit Health.mit.edu for more information and to get connected to one of our providers. That concludes this episode of Conversations with MIT Health. Please remember to subscribe, rate and review this podcast and all the other MIT Health podcasts. . I'm Melanie Cole. Thanks so much for joining us today.