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At Cincinnati Children's Hospital, Bare notes that the opportunities for nurses to work with epilepsy are expanding by leaps and bounds. "We have 12 staff nurses in neurology and 10 NPs, including two working exclusively in research trials."

The research work being done in epilepsy is an opportunity for nurses. Marcia Hill, RN, is the epilepsy nurse coordinator for the Baylor Comprehensive Epilepsy Center at The Methodist Hospital in Houston. "I was eager to work in research and neurology's always been my favorite field." She's part of a weekly "epilepsy conference" (along with neurosurgeons, pathologists and other disciplines) that evaluates potential participants for various trials-surgery, vagus nerve stimulation, etc.

All the nurses interviewed agree that epilepsy programs offer a more personal connection to patients like almost no other area. "Patients see us as friends. They call and say, 'Can I talk to you? It's got nothing to do with epilepsy,' " Callanan said.

DiMarco cites independence as a major plus to the IES program. Married with two children, she'll be working late one night (running a booth with epilepsy information at a school district's health fair) and leaving early another day. She may make home visits to patients/families in the more rural areas of her district. "I don't have to punch a clock, the hours are flexible and there's a lot less politics" than in a hospital environment.

Breaking in

While many of the nurses interviewed had backgrounds in neuroscience, others like DiMarco came from more varied training. Ozuna offers this advice: "Get a good overview. I did med/surg in a hospital for five years first."

One obstacle today is that nursing or grad schools provide almost no training in epilepsy. Fortunately, Ozuna said, "There are lots of good CE programs and the mentoring among nurses already in the field is great."

But Callanan warned, "If a nurse has never worked in epilepsy, there can be a very steep learning curve," not only in the clinical areas but in the nonclinical as well. "A lot of it you learn by the seat of your pants," Callanan said.

But nurses looking to break into the specialty are not alone, the experts say. Callanan relied on social workers and various outside agencies. Ozuna recommends organizations like the American Association of Neuroscience Nurses (www.aann.org) and the American Epilepsy Society for advice and information.

Nurses were near-unanimous in their praise of the Epilepsy Foundation. The national organization often can provide videos and other educational handouts; local chapters are resources for guidance through the murky maze of state regulations relating to job discrimination, driving, low-cost medications, etc.

Ultimately, said Joan Austin, distinguished professor at Indiana University's School of Nursing, "Seizures are just a small part of the picture for nurses working in epilepsy."

Contact Wendy J. Meyeroff at wendy.meyeroff@verzion.net