Helen Dandurand (Host): Welcome back to The Well Within Reach podcast. I'm your host, Helen Dandurand, and today I'm going to be joined by Liji Surrao, Primary Care provider at Riverside Healthcare's Internal Medicine Bourbonnais office to talk about nurse practitioners as primary care providers.

MyChart ad: Healthcare can be confusing, but thanks to your My Riverside MyChart, you can easily manage not only your care, but your family's as well. With a single click, your My Riverside MyChart lets you stay well connected to the same information your provider sees. You can view your health history, get test results, request prescription refills, pay your bill or make an appointment.

Manage your care from anywhere, your laptop, phone, or tablet. Learn more and enroll today at riversidemychart.org. 

Host: And we are back with Liji Surrao. Thank you for joining me today.

Liji Surrao, FNP-BC: Thank you for having me.

Host: Of course. So this is your first podcast with us, right? Let's get started by having you tell us a little bit about yourself.

Liji Surrao, FNP-BC: Okay. My name is Liji Surrao. I'm a Board Certified Nurse Practitioner. I'm fairly new to Riverside. I started in, in August of 2024. I'm a wife to my lovely husband. I'm a mom to my three children, ages seven, five, and three. A little bit about my medical. I have been in the healthcare field since 2010. I graduated from Loyola with a degree in psychology, and then I was like, what do I want to do with my life?

And then I was like, let me try nursing. My mother's been a nurse for a while, so, I started off as a LPN program, graduated that. I worked in a skilled facility and then shortly after I pursued my BSN and I went to Lakeview College of Nursing down South. And after the BSN, I started working in an ICU and I moved to then a bigger institute because I wanted to get more complex patients and see more opportunities.

So I went to John H. Stroger Hospital, which is also known as Cook County. And so I was there in the telemetry unit for a few years, and then I got married, I moved to Sunny California and I was in a few hospitals over there. And I rotated between like a step down unit, surgical unit, neurosurgery, and stroke unit as well.

And then in California, I was growing my family and I was like, oh, why not grow my skills? So I went ahead and enrolled in a master's program for FNP family practice. And I graduated in 2022 and when I graduated near the end of it, I kind of convinced my husband to come back here to Illinois and I've been here since. After I graduated I did a fellowship type of residency. It's at Cook County as well. It was a NP residency where you can do different specialties. Like I did anti-coag clinic, I'd done PAP smear, Women's Health Clinic, preoperative clearance over there. And then I interviewed for a Riverside and I got a job here. So, voila.

Host: That's awesome. That's quite the journey to California, but that's great. I mean, I know this episode is literally about kind of that becoming a nurse practitioner and things like that, and I've really heard great things. I mean, just like talking with friends who have went into becoming a nurse practitioner saying like, yeah, it's the way to go.

You get all this experience, You've had a lot to learn from before, you know, going into, say, doing primary care. So that's really awesome. So can you then explain exactly if people aren't sure what a nurse practitioner is and then how that role differs from a physician in a primary care setting? 

Liji Surrao, FNP-BC: An NP is an advanced practice registered nurse with extra additional educational training and skills that allow us to treat, diagnose, interpret things, um, illnesses. So we can order, we can interpret diagnostic tests, we can prescribe medications, we can manage acute and chronic conditions. And we pretty much educate on preventative care, you know, health screenings and so forth. Of course, physicians have broader scope of practice, and they have more different type of schooling, right? They go through medical school and then, pre-med, med school, fellowships, residencies. But the main difference is basically just the training. But we essentially can do the same functions.

Host: Cool. Cool. What kind of training and education does a nurse practitioner go through to get that degree and become a primary care provider?

Liji Surrao, FNP-BC: So you have to be an RN first, right? So whether you're an ADN or you get, you have your BSN, your Bachelor of Nursing. And then that's usually about four years. And then you graduate, you can start working and it's good to have some experience. And then you enter a graduate program, which is a master's program, and then with a certificate of nurse practitioner. And that's usually about three years. Some people go on and do like a doctorate a nurse practitioner and that's an additional extra year. But before you can sit for your boards in your training, you do about 500 to 800 hours of clinical practice, practicum to sit for your boards.

Host: So it's still a lot, it's still a lot of education and a lot of experience that you have going into it. What would you say are some of the biggest benefits of choosing an NP as a primary care provider for you?

Liji Surrao, FNP-BC: There are many benefits, such as like a more holistic approach where we focus on the person, not just the disease. Prioritizing prevention and overall health, like lifestyle counseling, screenings, help promote better outcomes.

With NPs, because we kind of fill in that gap, there's a lot more accessibility and availability, especially when you're trying to deal with primary shortages, with primary care providers. So we essentially, like we said, we perform the same tasks and the same services as most physicians.

But we work closely with collaborators and other healthcare professionals.

Host: You did kind of answer this before. But, just my next question was going to be how does an NP approach patient care differently, if at all, from other providers? Do you have anything to speak to on that?

Liji Surrao, FNP-BC: I think mainly it's just education and preventative care. We follow that model of more of a holistic approach, and so we try to build those relationships with our patients so that we know how they live, what their goals are, what their values are, and we try to stick to that with our care plan.

But I think mainly it's big on education, right? Because a lot of patients that we think that have, oh, that's a common knowledge. It's not so common. Everyone has diff has a different background. So, educating and just explain to what we're trying to do for them.

Helen Dandurand (Host): That's great. So, can nurse practitioners prescribe medications and order tests exactly like a doctor would?

Liji Surrao, FNP-BC: Yes. NPs can prescribe medications. We can order tests and do diagnostics as well. In some states they have like full practice authority NPs. So like here in Illinois, we don't have that yet, but we have a collaborating physician who oversees us, but in about like 28 states, they have full practice authority where NPs can work without having the oversight of a physician. 

But yeah, we can prescribed medications, we can treat illnesses, acute and chronic, and diagnostics.

Host: We're going to take a quick break to talk about primary care at Riverside. Consistency is being able to count on someone to be there when you need them. At Riverside Healthcare, your primary care provider is dedicated to being in your corner, helping you and your family stay healthy and thrive.

Find the right primary care provider for you and your family at myrhc.net/acceptingnew. And we are back. So what types of conditions and health concerns do NPs typically manage in a primary care setting?

Liji Surrao, FNP-BC: NPs can manage a wide array of acute and chronic illnesses from acute infections like UTIs, URIs, or upper respiratory infections, minor injuries, to more chronic issues such as hypertension, diabetes, respiratory complications like asthma, COPD, cholesterol. Even common skin conditions, and we do a lot of screenings. We can do PAP smears.

Host: Got it. So it's basically everything that you, if you were to say like, I need to go see a doctor. That's your, your, your, your doctor even it's not. Cool. And how does having a nurse practitioner as your primary care provider help to improve access to healthcare for patients? 

Liji Surrao, FNP-BC: With the primary care shortage, like I mentioned before, I think NPs fill in that gap because sometimes you may not get into a physician. Their panel might be filled really fast or booked up. So you have NPs that can kind of fill that in. We can take you in and take a look at you and if we need to, refer you to someone with a specialty, we can get you in sooner than you waiting.

I gotta wait three months to see my physician. And we work with our physicians closely. We collaborate with everyone. So I think, you know, that's the way we kind of fill in those gaps.

Host: Yeah, that's great. Can you talk about the importance of preventative care and how you encourage patients to kind of take control of their health?

Liji Surrao, FNP-BC: Preventative care is so crucial and it's important for keeping chronic diseases at bay. So if we were to keep up with the preventative screenings, like the immunizations, colonoscopy, mammograms and everything, and have a regular checkups, your overall health would be better. Your prognosis would be better.

We can detect diseases early on with blood work and other diagnostics. So if you think of like preventative care and screenings, we think of like, you know, you get your car tuned up and you do regular maintenance, right? You don't wait till your car just stops working and then you're like, oh, what happened? You know? So same way we go to your provider, let us do your blood work, let's do screenings on you. Ultimately prevention is the best medicine. And that's what we try to do. We try to educate our patients on.

Host: That's great. And then I'm sure then you have a relationship and you collaborate with other providers and physicians within specialties then to help get patients where they need to go after that. How does that all work?

Liji Surrao, FNP-BC: Well, of course if someone is more complex and needs more specialty care like a cardiology or neurology, we'll refer them and we'll talk with them. We make sure that the specialist has their background information, their history, what we've ordered, if we've ordered any baseline tests for them, and then they also can see all that and they can take it from there.

And usually those specialists, they usually, when they see the patients, they route those notes to us so we can see what's going on. So we keep up with each others. So it's kinda like you're having more eyes on a patient. 

Host: They're kind of the person in your corner. They're going to know what's going on with you. Yeah. And, see you throughout the years. What advice would you give to someone who is trying to choose maybe a primary care provider and they're considering maybe choosing a nurse practitioner?

Liji Surrao, FNP-BC: Just remember, NPs, we're highly trained. We go through schooling and we are licensed to provide most of the same services that a physician can do. We include personalized approach to your care. We do a holistic approach, we will hear you and hopefully build that great relationship with you. Ultimately when you're choosing a provider, you just want to find someone that's going to be listening to you and meet your needs and help you achieve your healthy goals, whoever that may be.

Host: Well, thank you so much for joining us Thank you for having me.

Of course. And thank you listeners for tuning into the Well Within Reach podcast brought to you by Riverside Healthcare.

For more information, visit riversidehealthcare.org.