APP Spotlight: Elizabeth Gesse, MSN

For as long as she can remember, Elizabeth (Liz) Gesse, MSN, enjoyed both science and helping people, so nursing was a natural career path. She came to Duke as an RN before becoming a nurse practitioner, and then joined the Stroke Unit of Duke University Hospital. In this week’s Spotlight interview, Geese talks to us about how she uses her master’s training in her daily work and shares some of the patient-provider interactions that she loves about her job. Gesse also shares her plans for earning a doctorate in nursing as well as her loves of time with family and at the beach when she’s not at work.

What are your current responsibilities in the Stroke Unit of Duke University Hospital? What does a typical day look like for you? 
I am currently a nurse practitioner on the Stroke Team. I recently graduated with my Master's in Nursing from Duke and I am currently pursuing my Doctorate in Nursing Practice from Duke as well. As a nurse practitioner, I am responsible for managing patients' care at the provider level. I get to work around 6:30 am and begin reviewing my patients and their overnight events. 

If this is my first day for the week, I would have typically reviewed some pertinent information the night before. After reviewing this information, I 'pre round' on my patients and complete a neurological exam while introducing myself and my responsibility. After this, the neurology team rounds as a group and gets input on patients from both the attending/fellow/residents. We then see the patient again as a team to develop a further plan of care. After rounds, the rest of my day is spent writing notes and following up on the plan of care. 

Where were you working before you came to our stroke unit, and how does that work compare to your current position?
Prior to starting my career as a NP, I was a bedside nurse on 9DCT (the stroke unit's "sister" unit) for 5 years. I loved being a RN and the skills and knowledge I learned as a nurse have definitely helped me transition to a NP role. As a bedside nurse, I provided direct patient care, medication administration, and assessment. As a NP, I get to be more central in patient care decisions and less involved in direct patient care. The bedside nurses I worked with and continue to work with are some of the smartest and kindest people I know. I could not do my job without them. 

How and when did you first become interested in nursing? How did you decide to focus on treating patients with stroke in particular?
Before my undergraduate studies, I always knew that I liked science and I liked helping people, so nursing was the perfect fit for me. I always knew I would pursue a graduate education to become a nurse practitioner as well. Neurology is one of the most complex specialties and that has always intrigued me. We can deduce so much information from a detailed neurological exam and I find that exciting. In regard to stroke patients, there is amazing medical treatment that we can provide that helps reverse or minimize the effects of a stroke. To see that in action is truly amazing. I also love seeing patients improve over the course of their hospital stay. As a nurse and a new NP, I get emotional when I see patients be able to do something they priorly haven't like giving me a thumbs up or being able to walk in the halls. 

What’s one experience from your master’s training that stands out as very helpful or memorable to you?
I feel like I had the best experience at Duke. The faculty there is incredibly knowledgeable in their respective fields. I learned the most during my clinical experience at the Burn ICU at UNC. I had the privilege of taking care of very critically ill patients. Burn trauma is something I knew very little about and it was a very rewarding experience to learn and gain skills in acute care that I use and apply today. 

What plans do you have for after you complete your doctorate? If you could have any job in the world, what would it be?
After completing my doctorate, I hope to continue working as a nurse practitioner on the stroke team. One day I could imagine working in academia but not anytime soon. I love being a nurse practitioner and truly couldn't imagine doing anything else but if I had to pick something outside of medicine, I would pursue a career in fashion merchandising. 

What do you enjoy most about your work?
I truly enjoy getting to know my patients and their families. This was my favorite part about being a nurse and has continued as a NP. Our patient population tends to be older, so they have numerous stories to tell. Even though my days are busy, I try to always take the time to get to know my patients on a more personal level.

I had a young patient as a bedside nurse who was essentially nonresponsive for over a month. The other nurses and I would do her skincare and her hair. When she eventually woke up and left, she told me she loved me while I was helping loading her into the ambulance. I sobbed like a baby. The impact we have on patients goes so far beyond the medical care we provide, and I always try to put on emphasis on this with my career. 

What’s the hardest part of your job?
The hardest part of my job is definitely multitasking. With a lot of patients, there are usually multiple consults, labs to follow up on, and procedures going on at the same time. It is difficult to focus on one thing at at a time. Getting a system down to organize this was paramount. This will definitely become easier as I settle into my new role. 

What other passions or hobbies do you have outside of the Department?
I love spending time with family and friends. My mom and identical twin sister are in Indiana (twin sister is actually an OBGYN resident) and my brother is in Boone at App State so seeing them when I can and talking to them is extremely important to me. I also love trying new restaurants or traveling with my friends. I consider myself a social butterfly so most days I am not working, I am enjoying time with my friends. My favorite place is the beach. Whether it be Mexico or Wrightsville, I love it. 

Gesse wedding
Gesse shared this photo of herself attending a friend's wedding in South Dakota.