Portraits by Bill Hughes
These unsung health care professionals work hard to heal the sick and comfort the suffering (and deliver the occasional squealing bundle of joy)
Susan Vanbeuge, Assistant Professor, UNLV School of Nursing
Nurse Practitioner, Brian Berelowitz Endocrinology
She’s helping to pave the way for the next wave of nursing professionals
The elder Susan would be proud. VanBeuge is not only a nurse, but also a nurse practitioner, holder of a doctorate in nursing practice and professor of nursing at UNLV. And she’s accumulated these and her other numerous titles and certifications while raising two children and breaking new ground for others in her field. VanBeuge is like a human Thor’s Hammer: The more challenges life throws at her, the more powerfully she smashes them into oblivion.
An example: She’d been working as an emergency room nurse (her specialty as an RN) when she and her husband split up in 2001. Looking for a better way to support her children on her own, she went back to school for her master’s degree while going through a divorce, learning to parent on her own and continuing to work 10-12 hour shifts in the ER – all in a new city, Las Vegas.
“If I put a lot on my plate, I’m much more productive,” VanBeuge says. “I don’t like drama, but I like to have a lot going on.”
This industrious spirit carried her through her greatest professional challenge, and one that helped pave the way for many other Southern Nevada NPs. After she received her board certification as a nurse practitioner, her first job was working with a surgeon at the medical school who wanted her to act as his first assistant in the operating room — a privilege previously unavailable to NPs. VanBeuge tackled the daunting administrative process of garnering the necessary permissions, one by one, at each hospital where the surgeon operated.
“It took me a year, from a blank piece of paper, to being able to be in a hospital, see patients, write in progress notes and be in the OR,” she says. “At the time, I was doing it for myself. I had a job, and I needed it to work. But I later realized that other people were able to follow the same process. Now, there are lots of nurse practitioners working in hospitals all over the valley.”
That’s not all that has changed for her and her peers over the last decade. There is now an American Association of Nurse Practitioners and Nevada Advanced Practice Nurses Association, which VanBeuge helped form. With the shifting health care landscape, clinics increasingly rely on NPs for many preventive and primary care services. The last big obstacle left to obliterate: the ambivalence of MDs when it comes to trusting their nursing counterparts to play a larger role in health care.
“In states where nurse practitioners have gained their full practice authority, physicians are doing better financially, because nurse practitioners can see the sore throats and rashes, freeing physicians to see people with complex problems,” VanBeuge says. “I think that’s a nice way to illustrate how we’re able to work together and solve the problem of the shortage in primary and preventive care.” — Heidi Kyser
Dr. Lisa Miller, Pediatrician
Good Night Pediatrics
Activism and volunteerism are integral to this tireless doctor’s practice
“I had just moved back to town, and I’m still unpacking — there are boxes everywhere and I’m in my pajamas — and there’s a banging on the door. It’s Lonnie Hammargren. He goes, ‘You need to come to El Salvador!’ I said, ‘What are you talking about?’”
The former lieutenant governor and retired neurosurgeon explained to Lisa Miller — a fellow parishioner at Community Lutheran Church — that the church’s annual medical mission to El Salvador needed a pediatrician. Dr. Miller didn’t think twice. Since that fateful door-knock in 2008, she’s joined the church’s mission to El Salvador every year, bringing basic medical care to poor villages in the jungles. The team does everything from dispense diabetes meds to perform ultrasounds to hand out eyeglasses.
“They give us a lot more than we give them,” Miller says. “When you give them a pair of glasses and they look upon their grandchildren and they can finally see them, or they get medicine and all of a sudden they don’t have horrid heartburn anymore, when they feel somebody cares about them, they give you a lifetime of karma, the feeling you’d made a difference.”
The word “compassion” gets thrown around a lot in the health care industry. Doctors, medical practices, hospitals, and even insurers love to tell us how compassionate they are. These days, it’s less a word with actual meaning than a branding buzzword intended to evoke deep human connectivity. So it’s kind of ironic that Dr. Lisa Miller doesn’t utter the word even once when we talk — not when she’s talking about her gratifying graveyard-shift work at Good Night Pediatrics, not when she’s talking about the annual medical mission to El Salvador, not when she’s talking about conscripting her two dogs, Teao and Taonga, to visit sick kids in local cancer wards.
Those disparate threads are bound by a spirit of service — compassion in action — inspired by her parents, both longtime educators in Southern Nevada. “It’s not that far of a stretch to come from a family in education and go into pediatrics,” says Miller. After all, in both cases, caring for kids requires patience, understanding and a willingness to see things from their point of view.
Again, the payoff is personal. “That’s the thing about kids,” Miller says. “Adults will start to get a little sick, and we’ll be grumpy and be sad and we’ll whine and complain. But kids will play and play, and they just want to be happy until they physically can’t anymore. They will keep taking what they have given to them and keep trying to be happy and live their lives.”
Miller learned a few lessons of her own when she was diagnosed with breast cancer earlier this year. She was suddenly thrust into the role of patient — an invaluable experience for her.
“I got a huge empathy wake-up call, because you get to sit there in the paper gown, and you get to be vulnerable and scared and worried about whether I’m gonna wake up, about what this is going to mean for my life and family — is this going to destroy everybody, will I be able to go on financially? It’s a really good lesson for a physician to pick up a lot empathy that way.” Leave it to Dr. Miller — now cancer-free — to turn a harrowing health odyssey into a vital spark for personal and professional growth. — Andrew Kiraly
James Kilber, Executive Director
Comprehensive Cancer Centers of Nevada
He’s quietly orchestrated a major evolution in local cancer care
“I had to weigh which route I would take — the clinical side of health care or the business,” he says today. “I believe I made the right decision.”
That’s an understatement: Kilber ended up running Desert Radiologists. After four years as CEO there, in 2007 he became executive director of Comprehensive Cancer Centers of Nevada. Since then, he’s upped their game considerably, recruiting 17 new physicians — including renowned researchers such as Nicholas Vogelzang and Fadi Braiteh — and investing $10 million in diagnostic and treatment technology. He’s proud to note that there’s been less than 1 percent turnover in administrative staff since he took the helm.
“I believe in praising my employees,” Kilber says. “I don’t think there’s enough of that done in any business, and I couldn’t do my job without their expertise.”
But his most significant contribution may be his commitment to multi-disciplinary care. Anyone who has had a brush with disease knows how stressful the logistics can be, making several trips to different facilities and having separate conversations with various specialists (who may or may not communicate well with each other) about the same problem. Kilber’s goal is to offer as many services as possible under the same umbrella — in other words, to fully realize the “Comprehensive” in the centers’ name. His addition of a breast surgery division, for instance, means that breast cancer patients can now get oncology, hematology, radiation and surgery services from the same provider.
Besides easing the patients’ stress, Kilber says, this approach is a commonsense way of reducing cost and increasing efficiency in health care. More importantly, it makes tracking outcomes and communication among physicians easier.
“My goal is to get more doctors working together,” he says. “When you do that, care is improved. There’s no doubt in my mind.” — Heidi Kyser
Nancy Hunterton, Marriage and family therapist
She helps keep together families of all shapes and sizes (on TV and off)
“The issues of having a sense of belonging, a sense of purpose in a home, of strength and self-identity, those kinds of things exist no matter where you are,” she says. “If it’s a single mom with one kid, you have those issues. If you have a multiplicity of people, it’s still there.” Plus, Hunterton has experience treating patients who grew up in polygamy. “It’s very reminiscent of life on a military base when the majority of husbands have been deployed,” she explains.
Even though she’s been practicing since the mid-'90s, Hunterton calls therapy a second career. Before that, the mother of two held several positions, including a few in HR in upstate New York, where she grew up. She’s also worked for the Democratic party, and she’s held various teaching support positions, both in Washington, D.C. and here — where she served a stint in the ’80s as the academic coordinator to Tark-era Runnin’ Rebels. “That pretty much integrated me into Las Vegas at a much deeper level than before,” she says.
She admits that when she first came to Las Vegas in 1978 with her then-husband, Hunterton had some trouble finding her role in the unique culture of the city. But, she says, “Probably at every job I ever had, I was assuming, somewhat, the role of therapist.”
It was in the midst of her divorce that Hunterton really began practicing, when a local psychologist hired her to pre-interview patients in order to place them with compatible therapists. Hunterton was so soothing and caring that the patients demanded her instead. “So, this is probably where I was meant to end up, I just didn’t know it,” she says. While she doesn’t subscribe to a strict therapeutic method, encouraging deep reflection and self-engagement is often the key to good outcomes. “I am a believer in personality typing systems,” she says, “not because I think that people need to be identified as an X, Y or Z, but because I believe that often gives a neutral way for people to reflect off: Am I this way? So I use some of that and I think therapeutically, I help people pretty quickly know things about themselves they might not have known before.”
But when she pulls a couple back from the brink, the rewards are mutual. “I have a sense of delight when I see them together and I know how utterly hostile they (once) were to one another.” On or off the TV.
— Chantal Corcoran
Elizabeth Brown, Labor and delivery nurse
St. Rose Dominican Hospital, Siena Campus
This delivery nurse’s secret? ‘Love is a big word for me’
“We deal with more alcohol, drug abuse and poor living-caused failures, kidney failures, liver failures, those kinds of things. It was more long-term illnesses and a lot of losing battles, and it was just hard,” says Brown. “So, it was time to make a switch and love in a different way.”
For the last seven years, Brown has been a floor up, in Labor and Delivery. She’s attended the births of thousands of babies, and she’s nurse-delivered 35 on her own. “You know babies get to a certain point and there’s no turning back,” she says. “It’s always a little bit anxiety-producing. The most important thing is to provide that experience for the patient and the families because it is ultimately about their experience.” (For the last year, St. Rose has also maintained a physician on the floor at all times.)
And that’s what sets Brown apart from the other nurses. “She is the one we all say we would choose to be there if we ever had another baby,” says Maria McLay, with the hospital’s Maternal Child Services. “She truly makes every delivery special for our patients.”
The love is in the details: Brown is well-known for her endless patience, as well as her unstinting kindness to laboring mothers (who might not always be in the mood to reciprocate); she makes sure to always include the fathers in the process, too. “I remind them how important this event is in their lives, because often times the birth of a baby is the mortar that holds families together or brings them back together,” says Brown. “And they remember their birthing story forever.”
They remember Brown, too. She tells the story of overhearing a mother tell her young daughter that Brown was the nurse who delivered her — a fact the mother commemorated by naming her daughter after Brown.
“We see the happy things, and that’s wonderful,” Brown reflects. “But we also have battered women and prostitutes and teenage children having babies. Being at St. Rose, we take the sickest mothers and the sickest babies, because we have the resources. We see a lot of things. Sometimes you don’t know what to say, but a lot can be said in what you do. Love, love is a big word for me.” — Chantal Corcoran