HL20: Robert D. Donaldson, NPC—The Nurse Practitioner-Run ED

Donaldson laughs easy and says he loves his post, juggling the clinical and administrative worlds. He is thrilled with his working relationship with physicians, and is convinced that under his leadership, the ED, now with four full-time and two-part time nurse practitioners and physician assistants on staff, is doing a standout job.

The hospital staff also has worked hard to reduce the length of stay of patients in the ED with much success, he says. Length of stay was reduced from 2 hours and 12 minutes in 2004 to 92 minutes last year.

Not every patient who walks into the ED is happy that a nurse practitioner is in charge. A patient's family member complained that Donaldson tried to pass himself off as a doctor.  As Donaldson recounts the story, the CEO knew right away it wasn't true. The administrator told the person, "Donaldson is a nurse practitioner. He's proud of that. He would never pass himself off as a doctor."

Not every patient who walks into the ED is happy that a nurse practitioner is in charge. A patient's family member complained that Donaldson tried to pass himself off as a doctor.  As Donaldson recounts the story, the CEO knew right away it wasn't true. The administrator told the person, "Donaldson is a nurse practitioner. He's proud of that. He would never pass himself off as a doctor."

Donaldson laughs.

He recalls in detail the patients who come back to thank him, whether it's the man who was bleeding profusely after a dental procedure and scheduled for cardiac surgery, or the mother of the 3-pound premature baby who had been near death. Donaldson talks haltingly about those cases, and his voice cracks with emotion.