Department of Medicine

‘Seeing What’s Possible’: A Nurse Practitioner Shows the Sky’s the Limit for APPs

Written by Mark Harden | September 26, 2024

When Whitney Vuchetich, DNP, was working on her bachelor’s degree in microbiology at Colorado State University in the late 2000s, “I was thinking I was going to do research and go down a bench science route. But as I studied about all these diseases and conditions and treatments, I found myself becoming much more curious about the impacts that these treatments and these diseases had on people than the physiology of the disease itself.”

That put her on the path to becoming a family nurse practitioner – and eventually into leadership roles. Vuchetich is now an assistant professor of internal medicine at the CU Department of Medicine. She’s the CU School of Medicine’s director of clinical quality for internal medicine clinics.

Also, for the last year and a half, she has served as medical director at the UCHealth Internal Medicine / Lowry clinic in Denver, where she helps supervise 22 physicians and 30 residents – an administrative role that’s rarely filled by an advanced practice provider (APP).

‘That opened my eyes’

After earning her second bachelor’s degree, this time in nursing, in 2013, Vuchetich – a native of Westminster, Colorado – went to work as an inpatient nurse in cardiac critical care at UCHealth University of Colorado Hospital (UCH).

“That opened my eyes,” she says. “It was a much different level of nursing than I had ever understood existed. UCH takes in the sickest of the sick, and a lot of the nurses are asked to do a higher level of critical thinking. I got a lot more curious about how medical decisions are made and wanted a deeper understanding of the conditions I was helping to treat.”

So Vuchetich began pursuing her Doctor of Nursing Practice degree, and also moved over to Children’s Hospital Colorado to work in its pediatric cardiac critical care unit. “I had decided to be a family nurse practitioner, so I figured I needed experience working with kids,” she says.

She earned her DNP in 2019, followed by a fellowship in primary care at the CU Department of Medicine and the Lowry clinic, “and I’ve been here ever since.”

A holistic view

Vuchetich says she chose the nurse practitioner path to a medical career because it better aligns with the way she thinks about care.

“The NP training programs are based on a nursing model, built on a holistic view of the person and how medicine and disease states affect that person, whereas the medical model is built more on hard science,” she says. “There’s a lot of crossover, of course, but for me the foundational theory of nursing versus medicine made more sense at the time.”

Vuchetich says that APPs – NPs and physician assistants – are “really lucky” to be working in Colorado, a state that allows them to offer a broader scope of practice, including diagnosing and prescribing, than in some other states.

“That’s really beneficial to the patients and to the health system as a whole,” she says. “There are fewer barriers here for providers to operate as they’ve been trained. I have colleagues who have moved to other states that have a much more restrictive scope of practice for APPs.”

Looking past traditional hierarchies          

As medical director at the Lowry clinic, “my function is largely keeping the wheels on the bus and organizing the day-to-day lives of the providers,” Vuchetich says. “If workflows aren’t working or if providers need more resources, I advocate for them.”

“It’s very unique to have an APP in this role,” she says. “But I did the bulk of my fellowship at Lowry, so I have known and been mentored by a lot of the physicians in this clinic, and I’ve had tremendous support from them. The providers here look past the traditional hierarchies and look more to abilities. They saw I was the right person for this job and advocated for me to do this role, which is incredible.”

In her parallel role as clinical director of quality control at five internal medicine clinics staffed by the CU School of Medicine, Vuchetich draws on her focus on quality improvement (QI) program management while earning her doctorate. She calls QI “my favorite thing.”

“I help coach the medical directors and their staffs on keeping their QI programs running,” she says. “Similarly, I’m a go-between for the clinics and the School of Medicine on quality initiatives and outcomes, which the school cares a whole lot about.”

Asked what she sees herself doing in the years ahead, Vuchetich says: “As I’ve gotten more exposure to how a clinic runs and how a health care system operates, the more interesting I find it. That’s why every year I put on a new hat. Who knows where that will lead, but I’d really like to keep exploring operations and quality at a higher level.”

Her advice to APPs who might aspire to a leadership role: Don’t sell yourself short.

“The biggest thing I've learned is to get your name and face out there. Not all these jobs are advertised as being open to APPs. But if I had gone by that and not thrown my name in the hat, I would not have been placed in these roles. Seeing yourself as on a par with physicians takes an identity shift. Try sticking your neck out and seeing what’s possible.”