Weekly Tips & Insights

Meet Tammy Nigh, Nurse Practitioner for Advanced Illness Management

Originally beginning as a certified nursing assistant (CNA) for five years, Tammy Nigh received her RN in 2007, and later a Nurse Practitioner (NP) certification. She’s worked in a variety of settings and roles from hospital settings, to teaching pharmacology, but her favorite setting to provide care is in the home. Lucky for Tammy, the bulk of her role as the Nurse Practitioner for our Advanced Illness Management program takes place in patients’ homes. She notes that “home” is where most patients hope to remain most of the time.


“Chronic illnesses can be very hard to manage. People may bounce in and out of the hospital and it gets exhausting for them. So we go into homes to focus on symptom management and try to catch things a little bit earlier before they progress,” she says.


Typically, Tammy is out in the community seeing four to five patients a day for lengthy visits, working to control various diseases that often include congestive heart failure, chronic obstructive pulmonary disease, advanced Parkinson's, cancer, and dementia. Beyond the practical nursing tasks, there are some less obvious responsibilities like discussions about care wishes. Though there are many challenging aspects of caring for those with chronic illness, Tammy reveals that one of the biggest challenges is miscommunication. For a comprehensive offering of support, nurses like Tammy are often joined by VNA social workers to collaborate with family and ensure everyone involved is on the same page.


“It can be challenging when families and patients have different objectives on how a disease can turn out. Those are hard conversations to have and not every patient wants to have them. So establishing a good rapport with patients and building a relationship where they trust you and your advice is important,” she reveals.


Though these discussions are not easy, Tammy’s experience in palliative care has served as great practice for having these conversations with her own loved ones. Beyond those more serious discussions about care wishes, Tammy’s conversations with family ultimately led her to the Visiting Nurse Association of Greater St. Louis.


“My grandfather is a physician and had great things to say about the Visiting Nurse Association. This is an organization that has been around for over 100 years. I did my research and I was drawn to the VNA’s reputation and what they do in the community. That stood out to me because, ultimately, that’s where I want to be - in the community,” says Tammy.


Throughout her career, she’s encountered many different people and learned many different lessons, perhaps the most impactful being how to appreciate life.


“Working in this field makes you take a step back in your own life and makes you want to live it to the fullest.”

Today, Tammy is doing her best to make the most of life by spending time outdoors and with loved ones, including her 6-month-old baby.



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