Graduate nurse aims to close the gap between physical and mental healthcare

Madeline Bleier can't pinpoint exactly when or how she decided to become a nurse, but she knew she loved working with people and had a passion for science. Bleier, the only nurse in her family, chose the profession simply because she thought she would enjoy it.

She never looked back, obtaining a bachelor's degree in nursing from Case Western Reserve University in Cleveland while working as a critical care nursing tech.

After graduating in 2014, Bleier worked as a registered nurse (RN) in a medical intensive care unit (ICU) at a trauma center in Cleveland, where she found she had a passion for critical care nursing. With one or two patients at a time, Bleier could develop strong relationships with the patients and their families.

Combining healthcare and mental healthcare speaks to the holistic aspect of nursing, and it's this holistic approach to a patient that is unique to nursing. Nursing in general is a good fit for providing mental and physical healthcare.

Madeline Bleier, MS '24

As Bleier spent the next several years working in ICUs in hospitals in Ohio, New York, New Mexico and Pennsylvania, she noticed a gap between mental healthcare and physical healthcare.

"The healthcare system has always separated physical health and mental health, but the truth is, our physical health needs and psychological health needs are going on at the same time," Bleier said.

"Mental healthcare shouldn't be looked at differently than going to your regular doctor," she added. "It should be treated the same as any other healthcare issue, but for most people, it's easier to share their physical healthcare concerns than mental healthcare concerns. I wish it weren't that way. I would like to bring those closer together for people."

The healthcare gap

Despite having performed CPR in the hospital many times, Bleier felt like she saved someone for the first time when she took a break from the ICU to work as a nurse in a rural health clinic providing HIV and Hepatitis C care. There, she administered long-acting antipsychotic drugs to patients, working with psychiatric mental health nurse practitioners to titrate doses and monitor symptoms. She observed that with improved mental health stability, patients engaged more in their primary care and were better able to keep their HIV stable.

"This experience confirmed what I had already known from working with patients in the ICU: mental health is the cornerstone of healthcare," she said.

Bleier returned to critical care nursing during the COVID-19 pandemic and again saw the mental health theme, but this time, among her colleagues. As a result, she transitioned to a nurse educator role in the ICU, supporting patients and the nursing staff.

However, a firsthand experience with the mental healthcare system after losing her brother to gun violence in 2016 solidified Bleier's desire to return to school for a degree in psychiatric mental health nursing.

"I was surprised at the difficulty in receiving mental health support from the justice system," Bleier said. "My family was fortunate enough to be able to seek mental healthcare on our own, but I frequently think of victims of trauma who do not have easy access to mental healthcare. 'What happens to them? How do they survive?'"

A new kind of nursing

Bleier entered the Family Psychiatric Mental Health Nurse Practitioner (FPMHNP) program at Binghamton University's Decker College of Nursing and Health Sciences in August 2022.

"I liked that I could connect to rural and urban communities at Decker," Bleier said. "And it has a fantastic reputation!"

Madeline Bleier is a member of the International Society of Psychiatric-Mental Health Nurses, American Psychiatric Nurses Association and American Association of Critical Care Nurses. Image Credit: Jonathan Cohen. Bleier, who works as an RN on an inpatient psychiatric unit at a Binghamton hospital while studying full-time, was apprehensive about returning to a rigorous nursing program after almost a decade. She found support - and sometimes a much-needed push out of her comfort zone - among Decker faculty, particularly her faculty advisor, Susan Glodstein, coordinator of the FPMHNP program.

Glodstein also graduated from Case Western Reserve University and joined Binghamton around the same time Bleier began her studies, which helped the two form a close bond.

"Dr. Glodstein is a big supporter of my critical care background and has strived to understand where I'm coming from. Her clinical experience and expertise have influenced me," Bleier said. "But she's not only supportive of me in a warm, empathetic way, she also pushed me to improve my writing in a way that I didn't think I was capable of."

"Maddie is a dedicated learner who takes her work seriously and strives to increase her knowledge," Glodstein said. "Her experiences working as an acute ICU nurse, assisting infectious disease patients and colleagues during the COVID-19 pandemic, led her to investigate mental health concerns for both patients and nurses."

Glodstein added that Bleier is a deeply compassionate individual. Despite the many challenges faced by those in the nursing profession, she continues to expand her knowledge and skills to better serve her patients.

Looking ahead

Following graduation and successfully gaining certification to become a psychiatric mental health nurse practitioner, Bleier hopes to find a role where she can combine her passion for medical and mental healthcare. She can also see herself returning to the classroom for a doctorate in nursing at some point to share her clinical expertise with nursing students.

"It's the impact I'll have had on my patients that's important to me when I look back on my career someday," Bleier said.

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