Elevating Palliative Care: UNH AGACNP Program Fuels Nurse’s Ambition
Amy Tremblay-Totte ’24G has built a career on investing in herself—from a management role in retail to leading the palliative care program at Concord Hospital. Her latest investment was completing the Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) master’s program at UNH, which has set her up to pursue her doctorate.
Launching A Career in Nursing
After a few early detours and a management job in retail, Tremblay-Totte's now-husband encouraged her to pursue her dream of nursing. She started as a Licensed Nursing Assistant (LNA), earned her associate degree in nursing, and completed her bachelor’s degree while gaining experience in acute and critical care settings. She then literally “fell into her job” in palliative care after an unexpected injury.
“I was working in the OR at the time, and after a night shift, I slipped on my icy stairs at home and broke my ankle,” Tremblay-Totte says. “After three major ankle surgeries, I couldn’t keep up with the physical demands of working in the OR, so I needed to take on something less physically demanding while I recovered. That’s when I found a palliative care position and it became my passion.”
Palliative care focuses on supporting patients with serious, life-limiting illnesses. It involves expert symptom management and helping patients define their goals of care.
“We get to know our patients on a human level—who they are, what makes them tick, and what’s truly important to them. From there, we help them determine how to live with their serious, life-limiting illness,” Tremblay-Totte says. “Take a patient with cancer, for example. It’s a textbook palliative care case but also incredibly complex. We help patients navigate their illness, make decisions about their care, and figure out what an acceptable quality of life looks like for them.”
Tremblay-Totte currently leads the palliative care program at Concord Hospital, where she has implemented new protocols and policies to improve patient care.
What Made UNH’s AGACNP Program the Right Fit
Tremblay-Totte knew she wanted to earn an advanced nurse practitioner master’s and heard positive things about UNH programs. She chose the AGACNP track because it’s closely related to palliative care in the hospital setting.
“There are so many strengths to this program, but one of the biggest is the faculty. From the very beginning, it was so easy to talk to them, and they understood the demands of working nurses,” Tremblay-Totte says.
With help from her instructors, she customized her clinical rotations at Concord Hospital to focus on hospital medicine and ICU critical care.
“I spent time with the hospitalist group, the internal medicine providers who care for admitted patients, and dedicated three semesters to working in the ICU. The faculty fully supported my plan, recognizing that it fit well with the program’s structure and my long-term goals,” Tremblay-Totte says.
Planning for the Future
Tremblay-Totte’s next goal is to work on an ICU critical care team while continuing her education in UNH’s Doctor of Nursing Practice program. Building on her palliative care experience, she plans to expand her quality improvement protocols for end-of-life care in hospitals into her doctoral thesis.
“I encountered cases where end-of-life care didn’t go well, often due to communication breakdowns or a lack of protocols,” she says. “This inspired me to create a policy, workflow, and education plan to guide the withdrawal of life-sustaining measures while prioritizing symptom management and family communication. I want to refine and publish this work so hospitals everywhere can adopt it.”
For those considering an advanced degree, Tremblay-Totte encourages taking the leap and staying focused on long-term goals.
“One quote from a teacher stuck with me: ‘Begin with the end in mind.’ Every day, I kept my end goal in focus—to become a provider, work in critical care, and continue helping people while driving meaningful change.”
Learn More About UNH’s AGACNP Program
