Patricia O’Brien, CPNP-AC, Outpatient Cardiology

O’Brien in clinic this past fall

What drew you to nursing?

I was the child of immigrants — both of my parents were from Ireland and very practical people, so they encouraged me to choose a practical profession. And since I always liked biology and science and knew I wanted to work with people, nursing seemed like a good fit.

How did you become interested in pediatric cardiology?

I ended up in pediatrics after a rotation in adult neurosurgery that nearly made me rethink a career in nursing. I’m a small person, and I had a hard time lifting the patients, many of whom were large adult men. Fortunately, my next rotation was in pediatrics, and that was a much better fit. I discovered I really liked the atmosphere of working with kids and the family-centered approach.

During that rotation, I spent a lot of time working in the infant and toddler wards, and I gravitated towards cardiac surgery.

When did you start at Boston Children’s?

I’ve been working for the Heart Center since 1987, after three years in cardiac surgery at UCLA and a short time teaching at Yale. I was the first inpatient nurse practitioner hired to work at Boston Children’s.

What was it like to be the first?

It was a welcoming place and luckily they had a clear vision of what they needed. Since the surgeons were in the operating room all day, they wanted me on the ward to talk with parents and assess patients if there were clinical changes. So that’s where I started, and then took on additional responsibilities from there.

After I was hired, a few more NPs were hired in close succession, and then it just blossomed. Now we have close to 400 NPs across the hospital and we keep adding more, so I think that’s a testament to how well we’re integrated into the system here and how much we’re contributing.

What are the biggest changes you’ve seen in the past 30 years?

Overall, the biggest change the Heart Center has undergone is its sheer size. It’s grown a lot in the past 30 years, with more sub-specialties and expanded clinical staff.

The biggest change for NPs came in the early 90s, when we got prescriptive privileges and our role changed because we could prescribe, put orders in and do more. It allowed us to be more independent and to start seeing patients in clinic.

Two-time heart transplant recipient Tim Gallagher, who recently turned 40, with O’Brien and other members of his care team in the early 90s.

What have been your roles here at the hospital?

I started in Inpatient Cardiac Surgery, and did that for nearly 20 years. During the first 15 years, I was also the coordinator for the Heart Transplant Program, so I had dual roles. Then in 2008 or so, I made the change to Outpatient Cardiology. It’s been a nice combination.

I currently work with two cardiologists, David Brown and Kevin Friedman. We coordinate New England referrals from Rhode Island, New Hampshire and Vermont for patients needing surgery or catheterizations or other procedures. I coordinate the care of these patients during their stay at Boston Children’s, communicating frequently with their referring cardiologists, and oftentimes collaborating with our providers to see some patients in clinic.

I’m also involved with our home monitoring program for babies with single ventricle heart defects. We send all of our single ventricle infants home with an oxygen saturation monitor and a baby scale, and a nurse practitioner calls the parents every week to check on them and answer questions until their second surgery. I’ve been involved in that program since it started about eight or nine years ago.

What’s your favorite part of the job?

Working with families. I really enjoy helping parents anticipate what’s going to happen next and supporting them with whatever they need. I work to make a big system a lot smaller and more personable, and help them understand how all the pieces fit together. It feels good to help families get through a difficult experience and come out well on the other end.