The NP who makes it go

Advanced practice nursing (APRN) has always provided clinicians with wide opportunities for impact. With a team of highly-trained clinical nurse specialists, nurse practitioners, certified nurse midwives and certified nurse anesthetists, superior medical care is applied daily by U-M Health nurses.

One such member has taken the best of the nursing and the advanced practice worlds and combined them into her personal treatment utopia in Chelsea.

Annette Sandretto, M.S.N., APRN-BC, has been an integral part of Michigan Medicine’s Chelsea Health Center for over 13 years. In her everyday duties, she works in long-term care, skilled nursing and family medicine, while also coordinating patients within the family medicine’s retirement community component. Those patients tend to be in need of long-term or end-of-life care.

In her words, “It’s my ideal job.”

Sandretto has also taken it upon herself to serve in other professional development roles including the APRN committee on nursing governance, DEI committee for medical school curriculum and on the professional letter and review committee for the NP clinical ladder, which she is climbing. 

If it seems like she does it all, well, it’s because she kind of does.

“She eats, sleeps, and breathes this job,” said Paul Ranella, AGACNP-BC, co-director of Advanced Practice Nursing.

A family devoted to service

Certainly, Sandretto loves her job. Her passion exudes in a simple conversation, but she’s quick to deflect.

“If you ask my husband, he will say I’m ‘ornery, tenacious, and won’t back down.’” Sandretto said with a laugh.

Growing up in a family that revered service to others, Sandretto learned early on she wanted to go into care. Her parents volunteered the family for all sorts of activities. That idea of service continues today and fuels the work she does with her team.

“My duty is to do the best I can with what I can to help [my patients],” Sandretto said. “That drives me. I have enormous love for what I do. I love my colleagues and they help drive that passion and they support each other.”

Finding her true calling

Sandretto’s path into the APRN structure wasn’t always evident. Her first college experience landed her in a cinema studies program at Ohio State. Eventually, she landed at U-M, got her bachelor’s in nursing, and became an ICU nurse at a local hospital. After a few years, Sandretto enrolled in Wayne State’s master’s program, which she described as “the best decision I ever made.”

Sandretto tried her hand in hospice care and found a true calling. Although there were stints in emergency medicine and stroke care, treating geriatric patients, long-term care, skilled nursing, and engaging in palliative care became the most engaging aspects of her profession.

“Today, the most rewarding part has been helping patients make decisions about their end-of-life care,” Sandretto said. “I have patients who express their desires to avoid the hospital and avoid any more interventions. Patients want to be home with their families, and helping those families navigate what is a complicated health care system is so important.”

It’s not just the patients who cherish Sandretto’s expertise and recommendations. Chelsea’s Medical Director Jill Fenske, M.D., has known her for more than a decade and recognizes her impact.

“Annette’s skill and experience are invaluable at our clinic and our Chelsea nursing home service,” Fenske said. “Patients and families love and trust her, and she is a valued colleague for all of us in Chelsea.”

And Sandretto represents just one of many dedicated advanced practice nurses who are being honored during APRN Week, which continues until Saturday, Nov. 13.

“APRN Week is a time to recognize those of us who stepped up and answered the calling,” Sandretto said. “We’ve done work that pushed ourselves to the next levels and challenges. Physicians are embracing the value that we have. Chelsea is a great example of that — we have two NPs and two [physician assistants] and we get thanked every day because we are trusted and give good care. Chelsea Family Medicine is a great example of how it all works together.”

Making her voice heard

While Sandretto gives much to her patients, she also improves her craft professionally. At a local level, she runs monthly meetings, intaking ideas from colleagues and trying new methods. From her point of view, she sees her roles on various committees as representing the many nurses in ambulatory care whose voice doesn’t always get heard often. 

“I like having the ability to have the nurses and NPs work at places that aren’t at the hospital,” Sandretto noted. “I have always felt like I was on the frontier here in Chelsea. It’s really important that the ambulatory units have a voice and are represented.”

One such project that Sandretto has pride for is the creation and implementation of the NP clinical ladder for U-M nurses. It took nearly 18 months to get off the ground and was nearly halted by the COVID-19 pandemic in March 2020. Ultimately, the first cohort, which included Sandretto, made their advancement and saw through the second cohort into the program. It’s made her appreciate all that the university is capable of doing.

“It’s really amazing what the NPs do in this system,” she said. “They’re doing incredible work in medicine, in research, in patient education and health system operations. It makes [our committee say], ‘Who else is out there? Who else can apply?’”

That combination of curiosity and care has set Sandretto and so many of her NP colleagues apart. And the patients are all the better for it.

Happy APRN Week! For a list of special events to be celebrated this week, click here.