As the third year of the Nurse Practitioner Residency Program comes to a close, a running joke among some of Open Door’s executives is they can say goodbye to the program’s perfect, 50 percent retention rate. The 2019 cohort of three nurse practitioners will—in one way or another—have to break with tradition.

The current residents are Lara Celli, Lauren Karasek, and Angelo Alfano—three NPs for whom opting to dedicate a year after graduate school to further training was an easy and worthwhile decision.

Lara Celli, FNP

“In retrospect I don’t know how you would do it without a residency, especially in family practice,” said Celli, a native of Redding who earned her Master of Science in Nursing (MSN) from Frontier Nursing University. Karasek, too, completed her MSN through Frontier Nursing University while living in Portland and later Hawaii. The prospect of returning to the scenic Pacific Northwest was one of many draws for her in applying to our residency. Meanwhile, Alfano, who received his MSN at Yale University, has roots on the North Coast going back to a childhood in Willits.

Open Door manages its one-year residency program in collaboration with Community Health Center, Inc. (CHC), an organization in Connecticut that oversees NP residency programs across the country. Our residents are based at Eureka Community Health Center, but they train at sites across Humboldt County. Each week, Celli, Karasek, and Alfano spend two days reporting to a preceptor while seeing their own patients, one day working alongside an Open Door mentor, one day shadowing a local specialist, and one day learning through didactic sessions. These didactic days include lectures from CHC providers, case presentations, research journal club discussions, and similar activities designed to help the residents provide the best care possible.

Angelo Alfano, FNP

“It speaks volumes about this organization that they have invested the time and energy to develop something like this,” Alfano said of Open Door.

One program highlight shared by all three residents was the support provided by the residency’s staff. “We had an amazingly diverse group of core preceptors,” said Alfano. “And adding pediatric and internal medicine preceptors will likely make the lineup for next year even better.”

There’s no denying that the program is challenging, but the experience has been positive for the 2019 residents. “It’s been my life for the past year in so many ways, weekends and after hours,” said Celli. “I feel like the growth has been rapid. And the support has been really amazing—not only from preceptors, but from administration, and also our mothership in Connecticut.”

“No matter where you go to school or where you train,” Karasek added, “I think NPs should strive to do a residency.”

Open Door is always looking for ways to improve. When it comes to room for growth for the NP residency, suggestions from the 2019 cohort included longer specialty rotations, quarterly Epic training, and greater exposure to chronic pain patients who need opioid tapering.

With the 2020 cohort assembling in town, the program can start to leverage the expertise of its past graduates. Celli, Karasek, and Alfano all plan to continue their NP careers at Open Door, which will bring the number of program alum on staff up to six and break the 50 percent retention trend in the best possible way.

Lauren Karasek, FNP

“We want the new residents to know that we’re always there no matter what they need,” said Karasek. “It would be cool if the residency had that built in. You have the mentor who’s your preceptor, but having a previous resident mentor as well would be a good idea.”

Celli and Alfano will continue working at Eureka Community Health Center where they will practice part-time and share a panel of patients. Karasek, who welcomed her first child earlier this month, plans to sign on with one of Open Door’s health centers upon returning from maternity leave.

Open Door will host a graduation party for the NP residents on Friday, August 23. This event gives us a chance to celebrate the tremendous growth these providers have shown in their first year of advanced practice. We congratulate Celli, Karasek, and Alfano and wish them continued success.

Visit the Nurse Practitioner Residency Program page to learn more about the residency’s goals, components, and eligibility criteria. If you or someone you know is studying to become an NP and wants to provide team-based primary care in our rural community on California’s beautiful North Coast, please apply to our program.