An unexpected journey to nurse practitioner

Meet Sandra Milena Cucanchon Gomez 

By Tracy Murphy, Course Coordinator, Graduate Certificate in Primary Care Nursing, Department of General Practice and Primary Care, The University of Melbourne 

Nurses in general practice are acutely aware of the need for more nurse practitioners in primary care. However, the pathway to nurse practitioner for nurses in general practice may seem daunting and unrealistic. In this article, we hear from Sandra Cucanchon Gomez, a general practice nurse whose dedication and persistence in pursuing her dream to become a nurse practitioner was awarded by her endorsement in March this year. 

Sandra has always wanted to help people and make a positive impact on their lives, so it was no surprise when she decided to become a nurse. What was surprising was how it happened. 

When Sandra started Year 11 in Columbia, she was considering a career in medicine and had her eyes set on the prestigious Universidad Nacional, Colombia’s national university. Admission to the program, however, was highly competitive and spots were limited.  

‘I was fascinated with the whole selection process, so my father enrolled me to sit the nursing entrance exam (rather than the medicine exam) to help satisfy my curiosity. The idea was that it would give me a good understanding of what was required and would help prepare me for when I graduated high school,’ she says. 

To her surprise, she not only passed the test, but was offered a place to start her nursing education immediately.  

‘It was such a shock! I was still in high school and yet they were offering me this incredible opportunity. I just had to take it,’ she says. 

Sandra spent the next six months carefully balancing the demands of university coursework with her existing high school requirements. ‘It was a lot of work and a lot of late nights, but it ignited a profound passion for nursing in me and I’ve never looked back.’ 

After completing her Bachelor of Nursing in 2005 at Universidad Nacional de Colombia, Sandra worked in a variety of roles across the healthcare field, including in emergency, acute care and ICU. To develop her language skills and further her career, she decided to migrate ‘temporarily’ to an English-speaking country. 

After a few months of studying English in Melbourne and reaching an advanced level, Sandra was determined to become a registered nurse in Australia. She achieved this goal by registering in New Zealand first, as the competence assessment program had more intakes. 

Nurse practitioners can play a key role in alleviating the current GP crisis by providing healthcare for those who may otherwise face barriers to access.

Since arriving in Australia, Sandra has worked in emergency, oncology, clinical management positions and general practice. Her extensive experience also extends to advanced clinical practice in primary care, where she has led the development and oversight of several intravenous infusion clinics. She also participated in a specialised training program for cancer survivors at the Peter MacCallum Cancer Centre.  

In 2021, Sandra completed the Graduate Certificate in Primary Care Nursing at the University of Melbourne, and has recently graduated with a Master of Advanced Nursing Practice – Nurse Practitioner. 

Sandra first became interested in becoming a nurse practitioner because of the level of autonomy and expanded responsibilities that the role offers, including being directly involved in clinical decision-making, diagnostics and treatment planning.  

‘I really appreciate the holistic approach to healthcare that nurse practitioners embody. By focusing on prevention, education and patient-centred care, we play a crucial role in promoting overall health and wellness. You are not just a healthcare provider, you’re also a leader, an educator and an advocate for your patients,’ she says. 

‘One of the best parts of the course was the hands-on clinical placement, where I had the chance to apply theoretical knowledge to real-life patient situations with my mentor. Building trust and rapport with individuals from diverse backgrounds and guiding them through their healthcare journeys was a profound and humbling experience.’ 

During mentored consultations, Sandra was encouraged to take the lead and conduct comprehensive patient assessments, including history-taking, physical examination, diagnostic interpretation, rational prescribing and patient education. 

While a positive experience, Sandra’s journey to becoming a nurse practitioner has not been without its challenges. She was required to take an unpaid day every week to complete supernumerary hours with mentors at practices in Dromana and Phillip Island, which involved a lot of travel. 

Another challenge was gaining support from her colleagues. Some doctors view nurse practitioners as a potential threat, and navigating this dynamic has required patience, persistence and effective communication; however, Sandra received invaluable guidance, particularly from her mentors, and realised that to flourish as a nurse practitioner in general practice, nurses need the committed and ongoing support of their medical colleagues. 

Now that she is qualified as a nurse practitioner, Sandra is eager to continue expanding her role in healthcare. She is looking forward to providing her community with high-quality, holistic and integrative care that considers not only the patient’s physical health but also their mental, emotional and social wellbeing.  

‘As nurse practitioners, we can play a key role in alleviating the current GP crisis by providing essential healthcare services to individuals who may otherwise face barriers to access. We are trained to diagnose and treat a wide range of acute and chronic conditions. We can order diagnostic tests, prescribe medications and manage overall patient care. By offering a holistic approach to healthcare we can help close the gaps in the health system,’ she says. 

Nurse practitioners are trained in managing chronic conditions, such as diabetes, hypertension, asthma and oncology, as well as other speciality areas, such as women’s health, mental health and paediatrics. According to Sandra, they are a vital but often underutilised part of the modern healthcare team. As Sandra says, ‘Hopefully, Victoria will follow South Australia’s lead in actively growing the nurse practitioner workforce, as it means more people can be treated more often in primary care, keeping the emergency departments free for critically ill patients.’  

For her fellow nurses who may be looking to become nurse practitioners, Sandra recommends connecting with experienced nurse practitioners or other healthcare professionals in their desired specialty area as early as possible for mentorship and guidance. She also suggests building professional connections within the nursing and healthcare community, attending conferences, joining professional organisations and participating in networking events, as these are all valuable opportunities for learning, collaboration and career advancement. 

In addition to successfully completing the Master of Advanced Nursing Practice, Sandra has completed 5,000 advanced practice hours and 300 supplementary hours to gain endorsement as a nurse practitioner. She was also required to submit a logbook of cases and a detailed narrative to the Australian Health Practitioner Regulation Agency that clearly demonstrated she was working at an advanced level. Sandra encourages all nurses who are looking to follow this pathway to document how their practice differs to the practice of a registered nurse and to keep concise records. 

Sandra is currently working as a nurse practitioner in her own practice and in the infusion services that she co-owns. She is also currently looking for further opportunities to advance her career as a nurse practitioner as part of a multidisciplinary general practice team. Her remarkable career reflects a profound commitment to innovation, leadership and compassionate care. It has evolved significantly from her unexpected and early start to her current role as a highly skilled nurse practitioner. Her journey underscores the transformative impact of embracing unexpected opportunities and highlights Sandra’s continued dedication to advancing patient care and improving Australia’s healthcare system.