Professor with a Passion

Professor with a Passion

Qualifications for tomorrow’s senior nurses include working familiarity with the nuts and bolts and strategic implications of technology systems, entrepreneurial business vision and, of course, quick, sound decision-making skills in life-and-death situations. Troy Heidesch’s job is to make sure all Brenau graduate nursing students get that – no matter where they study.

At nine o’clock on a Saturday morning, Troy Heidesch, BU ’09, a doctor of nursing practice, runs a little late for his first class of the semester at Brenau’s campus in Norcross, Georgia. He finds students from several programs on the North Atlanta campus frantically trying to connect remotely – from a few counties away in Gainesville as well as half a world away in Turkey. Heidesch happens to be the only tech expert in the building today, so before he begins his own class, he has to make sure all systems are go for everyone.

Heidesch effortlessly flutters, hummingbird-like, from classroom to classroom, tapping keyboards and checking microphones. Part professor and part tech whiz, he helps the students connect to Brenau from their corners of the world. Although these chores briefly slow his pace, the extra effort is a necessity. One of Brenau’s key differentiators in the world of higher education is that it offers these kinds of remote learning opportunities for undergraduate and graduate students with the same quality and commitment as its on-campus experiences.

“It’s another way for us to open our doors for students, wherever they are,” he says.

With the tech problems solved, he gets on to his real job – instructing a group of about 20 second-year Family Nursing Practitioner master’s students. His first-day-of-class talk isn’t about the syllabus or where to find the PowerPoint presentations he’ll use for the semester. (Actually, he warns the students, he won’t be using them at all.) He dives straight into the daily realities of being a nurse practitioner.

“When you’re out there practicing, there will be times when you’re not going to know what to do. And that’s OK,” he tells the class. “My job is to teach you where to find the answers.”

Most of the course work, he says, will center around case studies and a robust debate on possible patient diagnoses, tests and treatments. The idea is to give students the confidence to take charge of patient care in the clinic.

“Our job at Brenau is to prepare you to be the executive, making the executive decision,” he says.

Heidesch has spent much of his career exploring new frontiers of the nursing world, as a nurse practitioner, a CEO of his own health care tech company and, since 2012, a member of Brenau’s nursing faculty.

When Heidesch became the Richards Chair of Graduate Nursing in 2014, overseeing the curriculum for master’s and doctoral students, he wanted to help an already strong program meet the growing demands of a rapidly changing era in health care. For Heidesch, that means more experience with technology, more chances for interactive learning and a continued commitment to making the program fit into the realities of life for the adult student.

“Troy is an outside-the-box thinker,” says Dina Hewett, Ph.D., director of the School of Nursing. “He’s constantly looking for new ways of doing the same old thing.”

Heidesch says it is all about making nursing education at Brenau a launchpad that enables students to step up as leaders and innovators in the field.

“Nursing is changing. It’s dynamic. And the biggest opportunity for nurses, especially master’s and doctoral students, is a change in how they are viewed in the clinic,” he says. “Instead of being someone who’s just taking orders, they’re really going to be the primary source of health care.”

Troy Heidesch, BU '09, the Richards Graduate Chair in the Brenau School of Nursing.
Troy Heidesch, BU ’09, the Richards Graduate Chair in the Brenau School of Nursing.

An Eye for Innovation

Heidesch has spent most of his career in nursing looking for ways to innovate. He graduated from Brenau with a Master of Science in Nursing degree in 2000, and started work in the Athens, Georgia, area as a nurse practitioner in a family medicine practice and in the emergency department of St. Mary’s Hospital. His initial goal was to start his own clinic, but that idea evolved into a bigger idea for addressing a critical issue of health care: that most health care providers cannot reach some patients who need them most because of some mix of time, distance and cost.

He decided to go back to school first, and graduated with a Doctor of Nursing Practice (DNP) degree from the Medical College of Georgia in 2009. At the same time, he started working on his business model: an on-site clinic to serve employees of local companies that would be run entirely by nurse practitioners.

The idea didn’t quite pan out the way he’d planned. But it did draw his attention to a bigger problem that needed solving: most health care providers can’t reach all the patients who need to see them because of some mix of time, distance, and money.

In many states, especially those with large rural areas like Georgia, a patient who needs specialized care might live hours away from the nearest doctor, nurse, or therapist who can help them. Hospitals in rural areas often don’t have clinicians who practice every specialty that their patients might need. Even doctors and nurses who are willing to travel to other towns to provide care could lose a day of business at their regular practice just to get there and back.

For Heidesch, one possible solution emerged: telemedicine, the use of telecommunications technology, like two-way video conferencing and real-time screening tools, to connect health care providers with patients. The trick is linking providers with the hospitals that have patients to treat. In 2010, he founded (and still serves as president of) Smart House Calls, a firm that sells telemedicine software, complete with tech support services, to clinicians and clinics to help them work together from different locations to deliver care. The company’s services are used by nurse practitioners, psychiatrists, psychologists, cardiologists and internal medicine physicians across the United States. In Georgia alone, there have been approximately 45,000 patient consults in mental health centers by psychiatrists and psychiatric nurse practitioners using SHC in 2015.

Heidesch said his idea boiled down to seeing a patient need that wasn’t being met.

How Things Should Be

“You see how things should be and you’re able to come up with something innovative,” he says. “There’s a great satisfaction in being able to see your ideas come to life.”

The entrepreneurial drive can be a challenge for nurse practitioners, mostly because of laws that limit the scope of their practice. According to the Kaiser Family Foundation, Georgia is one of 12 states that doesn’t allow nurse practitioners to care for patients without the supervision of a physician, even in clinics they own and run. But Heidesch said more and more nurses, especially those with advanced degrees, want to turn their innovative ideas into profitable businesses.

“A lot of DNP graduates see a problem and think, I know what it would take to solve this,” he says.

He said he’s proud that Brenau’s DNP graduates are known not only for their passion and deep knowledge, but for the ability to make real change in the field.

“What’s really wonderful is when our DNP students start getting calls from hospital CEOs asking them to come on board, apply their research, and devise a new program to improve the lives of hundreds of patients,” he says. “That’s when you’re really seeing our program changing patient care.”

Game-changers

Brenau’s graduate nursing programs, particularly the DNP, certainly focus on developing students’ nursing skills so they can step up in critical clinical settings and make better decisions on patient care. The programs also develop the entrepreneurial and enterprising natures many nurses have in efficient, effective health care management. The key to all of that will be an embracing of technology, not only in traditional skills and decision-making learning, but also in the application of technology for future problem solving and innovation.

That will be key as health care in the U.S. confronts a looming problem: how to provide care to millions of newly insured patients, many of them aging, in the coming years. Experts say nurse practitioners will be an important part of how the system handles the almost 17 million people newly insured under the Affordable Care Act. The law also requires that more hospitals use data and information systems to drive the quality of care. Nurses entering the field will need to be comfortable making use of that technology.

“My job is to teach you where to find the answers.”

Heidesch says nursing education must equip future nurses for these changes, and he and his colleagues are working on ways to do it for Brenau’s students. The school’s curriculum will continue to offer students the chance to train in business and health care management along with clinical care, giving them tools to help their big ideas take off.

To help students learn to handle health care information systems and technology, the school is looking to expand its simulator lab, a facility that lets undergraduate nursing students practice real-life care scenarios on “patients” — computerized mannequins programmed to show symptoms and respond to treatment that a student suggests. Soon, the lab will also use telemedicine technology to allow master’s-level students to connect remotely to the lab and advise on patient care.

Heidesch is also leading a greater push to get more classes into the online world, even those that meet in person, to let students participate wherever they are and whenever they can. This year, the DNP program has two students who will attend classes and conduct research remotely from Texas and Florida.

The ability to blend education, career, and the rest of real life together is especially important for many of Brenau’s graduate students, Dr. Hewett says.

Most of them have to work, and it’s easier for them to be in class at night, on the weekends, on their own time. So we have to be flexible,” she says. “Troy has been very good about working with our faculty to get them more comfortable in that format.”

The flexibility to continue to work during school was one of the main reasons Heidesch said he chose Brenau as the place to get his master’s degree. And it’s still a priority for the program.

“We feel that people have lives outside of school that are just as important to them,” he says. “Structuring the program so that someone can go to a kids’ soccer game or a family reunion is really important to me and to the university.”

 

Professor with Passion

In the first half hour of his Saturday morning class, Heidesch peppered his students with questions about what they wanted to get out of the course and how to structure it to make it work for their busy lives. All are practicing nurses, and their schedules just don’t allow them to meet anytime.

That’s OK by Heidesch.

“I like to experiment,” he tells them. “So let’s figure out how we can make this work for you guys.”

Do they like online discussion boards? What are the best nights of the week for everyone to join in a live video-conference discussion of a case study? Can they take quizzes online to save more in-class time for debate?

Next, the class dives into discussion on their first case study — a new, overwhelmed mom who’s exhausted by her baby boy’s breastfeeding schedule. Together, they walk through some of the potential diagnoses, called differentials in nurse-speak, that might be causing her trouble. What tests would you order? What interventions would you recommend? What else should you ask her about?

Patiently, he encourages everyone to voice their ideas and back them up with reasoning and evidence.

It’s not just an academic exercise, he reminds them. He recalls a time from his first years of practice when he prescribed the wrong kind of medication to a woman with a thyroid problem.

“I missed it because I didn’t go through my differentials. And you guys are going to miss stuff, too, sometimes,” he says. “But in this class, my job is to prepare you for these situations and scenarios.”

Heidesch says he not only aspires to prepare Brenau’s nursing students for the new realities of health care, he also wants to help them see potential in themselves and find ways to affect change in their own way.

“It’s fun to watch nurses move from those traditional roles of keeping patients safe and executing orders to that self-discovery they go through when their roles change and they become the decision makers,” he says. “When you see those lightbulbs click on, it is really a wonderful thing to watch.”

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