CBIS Spotlight: Mary Voegeli

Mary Voegeli, FNP-BC, MSN, CRRN, CBIS is a nurse practitioner in the department of Physical Medicine and Rehabilitation at Froedtert and the Medical College of Wisconsin. She is part of the traumatic brain injury (TBI) inpatient consultation service providing input to maximize patient recovery, many times following patients from the ICU setting to the rehabilitation unit. She is a core member of the Mild Traumatic Brain Injury Clinic. Mary has worked in the field of traumatic brain injury for over 35 years and is a member of the ACBIS Board of Governors. She was born and raised in Milwaukee, Wisconsin, and attended UW-Milwaukee University for her graduate studies in nursing. She is an avid Green Bay Packers, Milwaukee Bucks and Milwaukee Brewers fan.

Why is being a Certified Brain Injury Specialist (CBIS) important to you and how has it benefited your practice and career?

CBIS is more than just a title. I am asked frequently what CBIS stands for and I am proud to say Certified Brain Injury Specialist. In the field of rehabilitation practice it is a title that is valued. It is worth taking the time and effort to enhance the specialty of brain injury care.

What are some of the latest trends for the treatment of individuals with concussion that you have implemented in your practice?

Every patient is seen jointly in the Mild TBI Clinic by a Physical Medicine and Rehabilitation provider and a Neuropsychologist. There is an extensive interview to address physical and cognitive deficits related to the mild TBI (mTBI) which provides a more complete assessment. The patient is given a neurological based physical examination, undergoes an abbreviated battery of cognitive testing and a mood assessment is completed. A multidisciplinary approach is crucial. Imaging is also reviewed to assess for further ongoing cranial pathology such as bleeding or ventricular enlargement. If there is concern regarding intracranial issues, we have the expertise of neurosurgery to offer input. The patient is provided feedback at the end of the visit thus improving patient satisfaction. We strive to return patients back to work, school, driving and recreational activities in a timely fashion. The Medical College of Wisconsin’s cutting-edge research is reflective of evidence-based practice.

Have you seen the field of concussion treatment evolve in recent years? What are some challenges still facing the field?

Extended brain rest is no longer recommended past the first 2-3 days of injury contrary to prior approach of isolating the patient from all physical, cognitive activities for weeks on end. Clinicians and Neuropsychologists are at the fore front of the latest research that supports this new approach for the acute management of the mTBI patient. The biggest challenge is establishing a uniform approach in the community as this paradigm shifts to a more active approach in the treatment of the mTBI patient.

How did you end up working in the field of brain injury, more specifically concussion?

For many years I cared for patients with severe TBI in an acute rehabilitation setting. When I completed my graduate studies, I was given an opportunity to work in a mTBI clinic as a nurse practitioner. Concussions are vastly different than severe TBI. It is rewarding being able to send a patient on their way with the appropriate recommendations and treatments to go on with their lives. Education with emphasis on prevention is key.