Highlights | Nursing Focus on MS Care
- March is Multiple Sclerosis (MS) Awareness Month.
- At the UW Medicine Multiple Sclerosis Center, multidisciplinary teams help expand patient care and increase healthcare access.
- As part of that team, nurse practitioners support neurologists in patient care and research.
Nearly 1 million people across the United States live with multiple sclerosis (MS), an autoimmune disease that attacks the brain and spinal cord. Across the globe, 300 people are diagnosed every day — that’s one person every five minutes. As part of Multiple Sclerosis Awareness Month, it’s important to understand that even though MS doesn’t have a cure, it is treatable, and it is possible for people with MS to live a full life.
For Bevan Davis, ARNP, and Caroline Walker, ARNP, both nurse practitioners at UW Medicine Multiple Sclerosis Center — every day is MS awareness day. As valued members of the care team, they’re dedicated to helping patients living with this disease live their fullest lives.
“MS is a lifelong illness, so we see patients frequently throughout their care journey. We get to know them and help with their symptoms year after year,” Davis says. “I grew up watching my mom receive comprehensive MS care. It made me passionate about building relationships and helping people with this condition.”
Contributions to clinical care and research
As nurse practitioners, Davis and Walker provide timely and essential care within the multidisciplinary care team at the UW Medicine MS Center.
Davis and Walker augment the quality of care the Center provides. They check in with patients to monitor for new symptoms, order necessary labs and make sure MS medicines are well tolerated. They also see patients with acute symptoms that could indicate an MS relapse and help to triage, treat and refer patients for various concerns like pain, neurogenic bowel and bladder, neurological fatigue, mental health concerns, home safety and more.
Communicating with patients and staff is another important part of their job — they answer patient messages about lab and imaging results, make sure patient concerns are addressed and assist with questions from the other nurses in the clinic.
Walker explains that in addition to meeting patient needs, a lot of what they do supports the neurologists to help provide the most responsive and comprehensive care possible.
Research for new treatments
In addition to their clinical work, Davis and Walker contribute to research efforts. They’re trained to conduct the Expanded Disability Status Scale (EDSS) exam to help track MS symptoms during new treatment investigations.
“Research is important because the MS field has changed so much. So many new medications have been developed over the past 10 years,” Davis says. “Through these studies we are contributing to future new treatments that will hopefully be ever more efficacious at preventing relapses and disease progression. I’m excited to help change the future.”
The challenges facing MS care
MS is a complicated disease to treat, Davis says, largely because there’s no standard presentation — each person living with MS experiences different symptoms. People with MS can experience fatigue, vertigo, depression, muscle spasms, nerve pain, bladder problems or other symptoms; and the disease progresses differently for everyone.
“We really don’t know what each person’s MS will look like in 20 or 30 years,” she says. “A lot of thought is going into finding an individualized, patient-specific treatment plan for each person.”
Walker notes medication cost as another concern. Most MS medications are expensive, and insurance coverage is variable at best.
“Even when we recommend a medication for a patient, the insurance company may not immediately pay for it,” she says. The MS Center team is therefore constantly working to navigate tricky insurance situations.
“In some cases, a patient will be on a medication for 10 years, and their insurance suddenly won’t cover it anymore, and we must justify why the patient needs it. It’s frustrating,” says Walker.
But alongside the challenges are the wins: finding a medication that keeps a patient’s MS under control and that helps them be able to enjoy their passions and more.
A multidisciplinary approach
Part of what makes Davis and Walker’s work so successful is that they’re part of a multispecialty team committed to providing the best care possible.
“Our multidisciplinary center is known to provide superior MS care,” Walker says. “We specialize in multiple sclerosis and related auto-immune conditions of the brain and spinal cord, which allows us to offer the most up-to-date and evidence-based comprehensive care.”
Alongside neurologists, the MS specialty team includes physical medicine and rehabilitation doctors, psychologists, a neuro-ophthalmologist, a rehabilitation counselor, a social worker and an MS-trained pharmacist. The rehabilitation doctors help to manage MS symptoms — like performing botox for controlling spasticity or helping patients to stay active and manage neurofatigue. Psychologists help patients adjust to changes associated with an MS diagnosis and living with chronic disease; provide strategies for making physical, behavioral and social changes; and use therapies to help manage MS symptoms such as fatigue and chronic pain.
Additionally, specialties like neuro-ophthalmology are also conveniently on site and help diagnose and track MS-related eye concerns. Rehabilitation counselors help patients address employment concerns and social workers help to resolve issues with transportation, food security, caregiving concerns and more.
In addition to ARNPs, there’s the work that the nursing staff does — infusion nurses start IVs for patients who need contrast MRIs, and clinic nurses answer questions via phone or MyChart. Patients may also receive their annual flu shots and other immunizations. Overall, Walker says, the UW Medicine MS Center seeks to provide a seamless clinical experience.
“We try to be a one-stop shop for our patients,” she says.
Ultimately, Davis says, consistent interaction with patients makes the work fulfilling.
“I really enjoy being able to get to know my patients over time. You don’t get that much in many other specialties,” she says. “By working with them and monitoring their progress, I know we’re better able to meet their individual needs.”
