My Scope of Practice: The Heart and Soul of Determination

  Nothing is an obstacle unless you say it is. – Wally Amos, founder of Famous Amos cookies

 Christy Kroboth, CRNP, WOCN, is not the type of person to let situations get the best of her. She began her medical career when she was 15 years old, working as a first aide assistant at the volunteer fire department where her stepmother was an EMT and her father an ambulance driver. Christy then attended EMT training. Upon graduating from high school and before becoming a certified EMT, Christy joined the Air Force and served as a medical technician stationed on Andrews Air Force Base (Prince George’s County, MD). This, she says, is where her nursing career began.   Christy attended Prince George’s Community College (Largo, MD) where, after 5 years, she earned her Associate of Science in Nursing. Two years into the program, she married her husband, whom she met in the Air Force, and gave birth to their son during her first semester of nursing classes.

  In her second year of nursing classes, Christy developed medical problems. “My son was 10 months old and I started passing out and having migraine headaches,” she says. “They ran tests and decided it was anxiety- and stress-related.” The symptoms disappeared, and in May 1998, Christy graduated; 3 months later, she passed the nursing boards.

  Because the military did not yet honor a 2-year nursing degree, Christy could not be released from her military contract. She continued to work as a medical technician and take classes toward her bachelor’s degree, although she did not enter a program until a few years later. Christy was honorably discharged from the military in 2000, at which time she began her registered nurse (RN) career in the medical ICU at Deborah Heart and Lung Center (Browns Mills, NJ), moving to the cardiac clinic and staff development department. In the cardiac clinic, she was responsible for providing postoperative care for patients with coronary artery bypass grafts and valve replacements, as well as persons who had myocardial infarctions and arrhythmia issues.

  Her working situation was serendipitous; after the birth of her daughter in 2002, symptoms similar to those after her son’s birth resurfaced. Physicians conducted an echo stress test, which showed an ejection factor (EF)—a measure of the percentage of blood leaving the heart each time it contracts—of 25% to 30%. A normal EF ranges from 50% to 70%, and anything lower than 35% increases the risk of life-threatening irregular heartbeats that can cause sudden cardiac arrest and death. “After multiple tests, they found I had a hole in the atrium of my heart (a patent foramen ovale [PFO]),” a hole in the heart that does not close the way it should after birth. A PFO is a relatively common condition, but additional news was devastating: she also was told she might need a heart transplant.

  Christy was determined not to let this information get to her. “Instead of thinking about everything going wrong in my life, I decided to focus on my future,” she says. “With my husband’s support, I started the bachelor nursing program through the University of Phoenix (AZ) and in about 3 years, I completed my BSN.” During this time, Christy recovered from her cardiomyopathy and was just being monitored for her PFO. She no longer needed a heart transplant.

  Her interest in wounds, and the encouragement of a colleague, led Christy to attend LaSalle University’s (Philadelphia, PA) Wound, Ostomy, and Continence Nurse (WOCN) program. But it wasn’t long before she hit another bump in the road. “About 5 days before the program started, I had my first TIA/mini-stroke and was diagnosed with lupus.” Once again, she did not let this news slow her down. “I started the WOCN program the day after I was discharged from the hospital,” she says. “I met Dr. Janice Beitz, who is now my mentor and friend. I thought I was going to give her a heart attack when I completed the introduction form. The form gives you the option of detailing any medical problems that may interfere with class. I listed what I had just been through and was still going through.”

  Christy had her PFO closed at Deborah Heart and Lung Center her first semester of class, but suffered another mini-stroke shortly after. “I came back to class the day after I was discharged,” she says. Her perseverance did not stop there. Christy completed her WOCN and moved on to the Nurse Practitioner (NP) program, also at LaSalle. Her mini-strokes did not make classes and exams easy; she had to teach herself how to study and adapt to different learning styles. After making multiple changes and with the support of loved ones, Christy graduated with her Masters of Science in Nursing as an Adult NP. She passed her boards this past November and in March began her job with Fellowship Community (Whitehall, PA), a senior care facility as their first NP.

  Aside from overseeing the clinical care of more than 100 residents, as well as revamping the facility’s incontinence program, Christy is involved with Girl Scouts, dance, and Family Promise of Carbon County (Lehighton, PA), a program that offers temporary shelter, meals, and fellowship to homeless children and their families.

  Christy maintains a positive outlook on life and believes others should, too. “If I can work full time, have a husband with two children, have multiple medical issues, and obtain three degrees, anyone can do it.” With that kind of attitude, Christy is the embodiment of determination, both in and out of her scope of practice.