Improving Hospital Visits with PD: Visiting Nurse Notes with Dr. Gerry Altmiller

altmiller_geralynHow can we improve hospital care for people with Parkinson’s disease (PD)? When people with Parkinson’s visit the hospital (usually for a non PD-related health condition), they can experience longer stays and more often need rehabilitation than those without the disease.

One challenge facing the health professionals responsible for care is the need for updated information on Parkinson’s disease. Luckily, Gerry Altmiller, Ed.D., A.P.R.N., AC.N.S.-B.C., an alumni of The Edmond J. Safra Visiting Nurse Faculty Program (EJS-VNF) at the Parkinson’s Disease Foundation (PDF), is helping to make that happen.

Dr. Altmiller completed the EJS-VNF program to find tools for preparing her nursing students to provide care for people with Parkinson’s. Soon after completing the program, she developed a teaching tool — a case study — to help students learn about hospital care in PD. We sat down with her to learn more.

Q. Can you provide an overview of your career in nursing?

A. I have been a nurse for 30 years. I worked as a staff nurse in the intensive care unit at Our Lady of Lourdes Medical Center in Camden, NJ, for many years. I have been a nurse educator for 18 years, educating future nurses about acute and chronic care for adult patients. Right now, I teach undergraduate nursing students at The College of New Jersey and serve as a clinical nurse specialist at the Einstein Healthcare Network in Philadelphia, PA.

Q. Why did you choose to complete the EJS-VNF program?

A. For many years, I taught about Parkinson’s disease as part of a nursing course about chronic illness. At the time, I thought I understood the disease. Now I realize there was so much more to learn. The EJS-VNF program seemed like a great opportunity to improve my understanding of Parkinson’s and find ways to prepare my nursing students who will encounter patients with the disease in the future.

Q. Can you share key lessons you learned about Parkinson’s through the EJS-VNF program?

A. Overall, my understanding of PD as a complex and varied disease is now much deeper. One of the biggest “aha” moments for me was understanding just how important it is for medications to be taken on time in PD. As nurses, we always want medications to be on time for every patient, but for PD patients, it is even more vital. Making people with PD wait for medications is not just inconvenient for them — it is dangerous. I also learned a lot about the benefits of speech and physical therapy, including LSVT Big and Loud. They can make such a huge difference to people with PD.

Q. Since completing the EJS-VNF program, you have become passionate about improving care in Parkinson’s disease by sharing your knowledge. Can you tell us more?

A. Going into the EJS-VNF program, I expected to learn a lot about Parkinson’s, but I never expected to find a passion for helping others understand it. Parkinson’s is a very misunderstood disease. The program helped me to realize that we as health care professionals can do a lot to improve the quality of life for people living with it.

To improve my students’ knowledge of PD, I brought in ideas from my work with QSEN (Quality & Safety Education for Nurses), which is focused on supporting nurses to provide high quality, safe, patient-centered care. I developed a teaching tool, in the form of a case study about patient safety in PD. In the case study, we walk through a scenario in which a person with Parkinson’s has been admitted to the hospital for a hernia. I ask my students to review the ways in which the disease might affect his care, and what we as nurses can do to improve it. For instance, we discuss the need to give medications on time and to look out for safety risks presented by PD, such as falls.

Initially, I used it as a teaching strategy for my own nursing students. But the QSEN website encourages nurses to share their ideas, so I submitted my case study for publication. It was recently published online and is available for all nurse educators to use in their teaching.

Q. Is there anything else you would like to share with readers?

A. As nurses, small changes in our practice — ensuring PD patients get their meds on time, protecting them from falls and helping them manage their symptoms — can have a huge impact on their lives. This makes caring for people with PD very rewarding.

I feel very fortunate to have had the opportunity to attend the EJS-VNF program to not only learn these lessons, but to also share them with nurse educators interested in learning and teaching about PD.

To learn more about The Edmond J. Safra Visting Nurse Faculty Program at PDF, visit

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