Jennifer Gross, CRNP: Bringing the Skills of a Nurse to Primary Care Medicine

Jennifer Gross CRNP

The borough of Columbia in Lancaster County sits just across the shallow Susquehanna River from Wrightsville, York County. Jennifer Gross, CRNP,  was born in the 62-bed Columbia Hospital. Her parents, together since they were in high school and married at 18, started their lives in the same small facility. Where were her grandparents born? Why, of course, in the very same place (the hospital was founded in 1895 and closed in 2003). Jenny’s father went to Franklin & Marshall College in Lancaster and became a CPA. Her mother worked as a medical technician and went back to school at 40 to become an LPN. 

For a few summers while in high school, Jenny volunteered at York Hospital as a Candy Striper, assisting the nurses with small non-medical tasks. She, with her friend,  proudly wore the classic red-and-white pinafores. But after she graduated, she decided to study business (like her father) instead of medicine (like her mother). So she went to Elizabethtown College in Lancaster County for a business degree. She didn’t like it, and quit after a year and a half. And, as she said,  she “wanted a career” and “loved being around people,” and she turned to nursing. 

Becoming and Working as an RN

Jenny decided to study for her RN degree at York College of Pennsylvania. On weekends, she worked as a Nursing Assistant at nearby York Hospital (caddy-corner to the current boundary of the college campus).  She signed up for her shifts on different floors to see what she liked, what suited her personality. She spent time in the various ICUs, medical and surgical floors, the nursery (where she rocked the babies), and the OR (where she stood around watching–not her cup of tea). 

York College of Pennsylvania Campus (Credit: York College)

After graduating from the program, she worked on 6-Main, the oncology floor, with Drs. Miodrag Kukrika and Eamonn Boyle.  She carefully administered chemotherapy drugs that often made patients violently sick and, as their white blood cell counts dropped precipitously, terribly vulnerable to life-threatening infections. Jenny said she did this emotionally demanding nursing “for nine or ten years” before she “wanted something different.”

She then rotated monthly through four different intensive care units for a year and a half. But it was “too depressing” taking care of patients with devastating strokes or traumas that precluded meaningful recoveries. This type of nursing was not for her, and she moved on. 

Returning to cancer medicine, Jenny then worked in outpatient Radiation Oncology for the next nine years. She helped people cope with the side effects of the treatments. And, for example, she assisted with so-called conscious sedation when patients had to be mechanically immobilized for precise radiation of localized brain tumors. As she did “all kinds of things” and worked closely with patients one-on-one, she began to feel the pull to be “more autonomous” and to make her own decisions about how to take care of people.

Transition to Nurse Practitioner

So she decided to further her training by becoming a Nurse Practitioner, a defined medical role created in 1965 to address the shortage of primary care physicians as Medicare and Medicaid were created to provide health insurance for low-income women, children, the elderly, and those with disabilities. Jenny enrolled in the NP program at Millersville in Lancaster County. 

Old Library at Millersville University (Credit: universityicons.com)

Because she continued to work full-time (ensuring that 75% of the tuition was covered by her employer–WellSpan), it took her five years to complete what was designed as a three-year program. Jenny said she didn’t see much of her husband during that busy time as work and study kept her occupied, and Dodd (an icon in the adult sport kite world) was spending four or five weeks at a time in China (where kite-flying was invented around 500 BCE) overseeing the manufacturing of beautiful dual-line stunt kites. 

As a nurse practitioner, Jenny needed to pick a specific field in which she could practice. Like the vast majority (nearly 90%), she chose primary care family medicine. Most of the program was spent doing academic work, including writing papers that had to (for some reason she couldn’t quite get) adhere to a precise format. There were three hands-on “clinicals” (she saw low-income patients in Lancaster and York, and spent time with Dr. Ben Hoover), totaling just 700 hours (less than 20 weeks) during the five years. Looking back, Jenny said she would have liked to have had a lot more than that; she thought there should be much more attention to practical matters.

She Joins a Medical Mission to Ghana

(Such “practical”l matters surely arose when Jenny joined a medical mission to the small fishing village of Apam, Ghana in 2006. She worked as a nurse practitioner, seeing grateful patients in the local clinic while the surgeons on the trip did long-awaited procedures and others on the team were busy digging wells, hoping to find water. Jenny said the trip was an “amazing experience.”  Though our system has flaws, the high-tech things we mindlessly enjoy and take for granted are often intensely sought after by people in less privileged parts of the world.) 

Women selling fish in Apam, Ghana (Credit: Jean-Bernard Cabana)

Working with Dr. Beekey as a Nurse Practitioner

Anyway, when she finished her NP studies 20 years ago (as of this writing in 2026), there was “not a lot of opportunity” for her primary care skills in York. Jenny feels that she was fortunate to have found a position with Dr. Cyrus Beekey, as her (required) “collaborating physician.” Dr Beekey is a nephrologist who had recently decided to practice general internal medicine in addition to his specialty. He was, said Jenny,  “wonderful” and “an excellent mentor.” 

But there was one problem: oddly, as a graduate nurse practitioner, there was no “eight to twelve week preceptorship” to ease into her new role of seeing patients on her own, as there is for medical assistants, LPNs, or RNs. Thus. after she spent just a week following Dr. Beekey around from patient to patient, she was on her own. 

Though Jenny met with Cy “every Tuesday to go over things,” the first few years (yes, years) “were really hard” and she “felt like an impostor.” Aware of her limitations, she was “scared.” She said it would have been helpful to have had at least a month or two of a closely supervised preceptorship to gain the confidence she lacked. As it was, it took several years, but the self-assurance gradually came as she took care of her patients in the office alongside Dr. Beekey, who saw his. 

And they practiced together for six years until he retired. “He took mentoring seriously,” said Jenny. She recalled, for example, that he carefully advised her to pay attention to her gut, to see “the gestalt,” when there was nothing definite, but things just didn’t seem right with a patient. 

Joining Dr. Harootunian

Dr. Harootunian

The next transition was to join Dr. Richard Harootunian at Pine Grove Internal Medicine. The private practice was eventually folded into WellSpan at Freedom Way, and Jenny has stayed with him for the past eleven years. She is quite confident in her abilities, but when she has a question about a patient, she relies on his vast medical knowledge and accumulated wisdom (he graduated from Penn Medical School in 1968, and as of this writing in 2026, he still works three days a week and has no plans to stop).

Jenny freely admits that as a nurse who “didn’t go to medical school,” there are things that she doesn’t know. She feels that it is critical to be aware of this gap and to “not be afraid to ask questions.” She is humble enough to not let her ego get in the way of doing what is best for her patient. 

Over the years, she has served as a preceptor for an NP student “nine or ten times.” She noted that when she started her program twenty years ago, you had to have had at least three years of nursing experience (she had 16). The current requirement is only a single year. She’s not sure that’s enough time to know how to be “a nurse first.”

Nursing is holistic, and one of the foundational and essential tasks of a nurse is teaching. Explaining complex health issues to anxious patients and concerned family members requires experience and, of course, time. She used to be allowed 60 minutes for a new patient, but that has been reduced to forty (it is twenty for an old patient, down from thirty), and that isn’t always enough. So Jenny “often runs late” as she tries to give her patients as much of her time as they need. And that effort is greatly appreciated, as judged by the online comments she has received. 

Using AI in the Exam Room

Fortunately, Jenny has been helped in this regard by the recent evolution in large language models of machine learning. She is happy to make use of a so-called ambient AI medical scribe developed jointly by Microsoft and Nuance (of Dragon NaturallySpeaking fame). 

This proprietary program listens to the conversation in the exam room, is able to “filter out chitchat,” and generates a polished medical report of the encounter (suitable for submission to the insurance company, if needed, to justify the charges) in seconds. There is no requirement for the clinician to be busily entering data; often with their back to the patient. (This will almost certainly turn out to be an unexpected solution to some of the annoying EHR-created problems noted in earlier stories in this series.)

As nursing has always focused on the whole patient, including the context of the family, the diligent nurse practitioner follows in this tradition. This is especially important as many medical specialists have progressively narrowed their practices to very specific problems within their fields (for example, one cardiologist might only see patients with rhythm disturbances while their colleague may only see those with coronary disease). The primary care provider is then responsible for putting things together, especially as the visit with the desired specialist may be (inexplicably) many months off. 

But there is even more, as AI programs to answer phone calls from patients who need to make appointments or reschedule or pay a bill or ask a medical question are starting to be deployed. These systems can easily manage the non-medical issues and will route other types of calls to a real person.  Jenny said she currently has to answer as many as twenty messages a day; there could be much less for her to do as these new programs are more widely used. But will we be okay with the progressive loss of simple human contact? Will we be okay talking to an emotionless robot who never tires? 

And when Jenny needs to quickly learn about something she’s not familiar with, she doesn’t need to search out Dr. Beekey or Dr. Harootunian as she simply turns to the comprehensive “Open Evidence” app on the computer and gets an answer in seconds. She can even peruse the relevant clinical and scientific articles online; the York Hospital’s physical library with neatly organized shelves of printed texts and bound journals, you see, only exists as a quaint and rapidly fading memory. 

After Work

Outside of her practice? Jenny said she enjoys reading. She has always liked mysteries, but has recently been getting into historical fiction. She just started The Calamity Club by Kathryn Stockett (author of The Help), an epic 656-page novel about two strong women in male-dominated Oxford, Mississippi in the 1930s. 

And Jenny has always loved animals. So, in her free moments away from the medical office, where she takes care of appreciative patients and their families, she takes care of chicks and geese, her dog, and the few itinerant ducks who stop by every so often. And at this time of year (it’s a steamy mid-July, as this is being written), she and her husband spend time together at their “summer home,” a small camper that they park by the creek that runs through their property, one county over from where she was born. If the wind is just right, they might decide to fly a colorful dual-line kite.

A "New Tech" Dodd Gross Diode Stunt Kite (Credit: kitestop.com)

Suggested Reading:

Topol, Eric. Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again. New York, Basic Books, 2019. (A detailed, but already somewhat dated, discussion of what AI is and is not, and how it might or might not improve healthcare. The final chapter is titled "Deep Empathy." In it, Dr. Topol argues, for example, that no machine will alleviate suffering; this essential task "relies on human-to-human bonding: it requires time, and its basis is trust" p. 292). 

By Anita Cherry 7/18/26