The decision to pursue a career in nursing was a natural one for Rita Meadows, PhD, FNP-BC. “I come from a family of nurses,” she says, citing her mother and her aunts, all of whom are part of the profession. “I practically grew up in a hospital. I would go there on weekends while my aunt was working as a supervisor. I grew up with the sights and sounds and smells of health care, and I grew up learning how to network with other nurses, physicians, and ancillary staff.”
That formative experience served Dr. Meadows well as she navigated her way to the pinnacle of her profession, earning a bachelor’s degree from The University of Maryland School of Nursing, a master's degree from Troy University, and a PhD from the University of Arizona College of Nursing in 2020.
“My major focus is on the health and wellness of vulnerable populations. I want to work toward more value-based health care delivery for them," ~ Rita Meadows, PhD, FNP-BC
Inspired by the example of her aunt Betty Falter, RN, MS, NEA-BC, an experienced nurse leader who helped develop the Arizona Health Care Leadership Academy, Dr. Meadows actively sought out experiences that would lead her to influence health care policy development and reform. Her passion for public service recently earned her an appointment by the state governor to the Delaware Primary Care Reform Collaborative, where she is the only nurse who sits on the committee.
The two-year-old Collaborative was established by the Delaware legislature to require commercial health insurance companies to make meaningful investments in primary care, including price increases for hospitals and non-professional services and requirements that health insurance companies work to improve health care value and increase the primary care investment.
We caught up with Dr. Meadows recently to learn more about her nursing journey, her experience in the UArizona Nursing PhD program and what she hopes to achieve in her new role.
What inspired you to pursue your PhD?
My aunt Betty was hugely influential in that decision. I’ve always done clinical preceptorship, so the educational role has always been ancillary to my clinical role. But we realized that my main interest was in developing an understanding of the theoretical foundation of my nursing career and who I was as a nurse and expand it into policy and research development. That’s what compelled me to choose the rigorous PhD program.
What was your experience like in the UArizona Nursing PhD program?
I interviewed at other places but from the day I first set foot in the college, it was the most nurturing and comfortable environment. It helped build me as a human being, and my human presence in the nursing world, and how my personal philosophy of life has become part of my practice of nursing. I connected with other likeminded and intellectual beings as colleagues. I was mentored by probably the most brilliant and nurturing individuals for four years of my life. Every single aspect of me was filled with thoughtfulness, expansion and growth. I have lifelong friends as a result, and I have mentors that I can always access if I need them in the future.
What were your primary research interests during the program?
Self-management of adolescents with Type 1 Diabetes. For years I’ve volunteered as medical staff at a summer camp for children with Type I diabetes. In that environment, I identified a lot of needs for these kids, so when I went to pursue my PhD, it was my volunteer work rather than my work as a FNP that took precedent. My research was in the facilitators and inhibitors of independent self-management of adolescents with Type I diabetes. It’s a unique population. It was exciting to build on that – not only to build on our present body of knowledge but also to implement it in the camp setting into a leadership program for adolescents with Type I diabetes.
What led to your appointment to the Delaware Primary Care Reform Collaborative?
After earning my PhD, I decided to pursue health policy versus research because I’m so embedded in my community as an NP. So rather than move to a career in pure research, I chose to maintain my practice and look for opportunities in advocacy. It really started when I was put on the Government Advocacy Committee for the Delaware Nursing Association. I had a background of volunteer work. I mentor between three and 10 nurse practitioner or doctoral students per year as a clinical preceptor. I’ve also worked on Doctoral student projects for students at a multitude of nursing programs that I have mentored NP students in. It’s a matter of evolution and my role has just evolved because I really took the plunge into policy development versus research. I was also the JDRF Government Advocacy Team leader for the state of Delaware for a couple years, which helped prepare me for a role as a government advocacy leader, where I was very quickly able to network, to show what I can do and what I’ve done for the community. They put the recommendations in and referred me for this position.
What excites you most about the work you’ll be doing?
Policy is where you can really push nursing interests and therefore the community’s interests as far as primary health goes. Right now, this is a big issue for Medicare. Reimbursement for nurse practitioner services is 80% of what a physician receives even though we’re giving the same services. This is all part of the reform bill. Not just nursing but primary care is one of the lowest reimbursed services, yet we are still poorly reimbursed comparatively. One thing we’ll be working on is increasing the investment in primary care from the insurance perspective.
During your two-year term, what do you hope to achieve?
My major focus is on the health and wellness of vulnerable populations. I want to work toward more value-based health care delivery for them. My health care practice is part of an Accountable Care Organization (ACO), but we’re already working in my practice to coordinate high quality care and preventative management in the Medicare population to ensure that they have access to health care.
What is the most meaningful part of your work as an NP?
My patients think I’m part of their family. I’m embedded not just in the community but in the lives of the people in this community, and I can influence them and their health and their wellbeing without judgement. The trust and respect that they have in me Is probably reflective of my desire to help them.
Big picture, what are your hope for the future?
My whole career, every time I’m given an opportunity, I say ‘Yes.’ Some of those shifts were really bad shifts, but I learned, and I grew from them. I take every opportunity to advance my career, advance me as a human, advance me as a person, and I see this is as a steppingstone. It is a state appointed position and I just wonder if there’s more that I can do on a national level one day. I’m going to use this time in the next two years to listen, to find out where the needs are, to do an assessment of the primary care needs in Delaware and how they compare to the national needs. I think maybe I do have a role in policy formation in a bigger way, but I’m open to every opportunity that lands on my lap. Perhaps I’ll go in another direction but in general I think policy is where I can make the most impact on the most people’s lives.