Pharmaceutical trailblazer and global medical mentor exemplifies the limitless possibilities of a nursing career

At first glance, the pendant given to Colleen Miller by her daughter looks like it has suffered a mishap. But the cracks in the circle of glass hanging from a silver chain are deliberate, and a tribute to how Miller’s career has taken her from bedside nursing in Buffalo to the position of Senior Medical Director of France-based biotech and pharmaceutical company Sanofi Specialty Care North America Medical – shattering glass ceilings along the way.

In the 25 years since earning her doctorate in nursing science from UB School of Nursing, Miller has become a trailblazer in the field of multiple sclerosis/neurology patient care and segued her brand of advocacy into a second career that is transforming how pharmaceutical companies engage nurses. Her path here began as a graduate of UBSON with her first masters as a clinical nurse specialist (CNS) in critical care. While at the time there were no open positions for this work, there was a job available in the SUNY Buffalo Department of Neurology for a rehabilitation CNS.

Larry Jacobs, MD, world-renowned researcher in the treatment of multiple sclerosis and head of neurology at both Buffalo General Hospital and the MS Clinic at Millard Fillmore Hospital, interviewed her. “He asked me, ‘What do you know about MS?’ – and I knew only that it was something I didn’t want to get,” Miller said. Jacobs’ reply would echo throughout Miller’s career: You are the right person if you’re willing to learn.

Miller credits Jacobs for his mentorship, through her days of caring for MS patients before drug treatments were available, and through learning neurology at his side (she was the clinical trial nurse on the dose-finding study for tPA to be used in stroke patients and on the trial of the first treatment for MS using interferon). “I went on rounds with him and learned so much, including neuro ophthalmology,” Miller said. “He always had me examine patients first. It was like I was his fellow for 11 years.”

During that time, Miller earned her NP certification with the enthusiastic support of Jacobs and went on to her PhD. Her dissertation topic was describing lived experiences, i.e., phenomenology and taking time to learn from her patients. “It was about being good at communicating and understanding what patients are afraid of,” Miller said.

She worked in neurology as a nurse practitioner and in critical care and home care; performed supervisory work; and gave clinical instruction in the care and treatment of patients with MS at the UB School of Nursing and Jacobs School of Medicine and Biomedical Sciences. She was also one of the founding members of the International Organization of Multiple Sclerosis Nurses (IOMSN) to create a space for MS nurses to find mentoring, education and networking.

Following Jacobs’ death in 2001, a huge personal loss for Miller, she stayed on with the team at Jacobs Neurological Institute (UBMD Neurology) for another decade.

IOMSN was born at the 1996 meeting of the Consortium of MS Centers in Calgary, where Miller was appointed chair of the nursing roundtable. Prior to the roundtable discussion, she presented her dissertation work in phenomenology to the attendees. During the roundtable, concern was raised about the need for an international network where MS nurses can learn from and support each other. “Nurses being nurses, we don’t want to sit around; we want to do something,” Miller said. “We decided to create that network and now there are over 5,000 members around the world.” 

The mission of IOMSN focuses on the needs of nurses caring for MS patients and on advocacy, both for the establishment and perpetuation of a specialized branch of nursing in multiple sclerosis and as a resource for improving the lives of all persons impacted by the disease. The convergence of phenomenology, bedside nursing, and a specialization in MS during the era when the first drugs for the disease were being tested in trials created a serendipitous opportunity for Miller when she prepared to move to Boston to care for her ailing mother.

“I had done everything in nursing by that time and needed a challenge outside of academia,” Miller said. 

A contact from her clinical trial days pointed the way to Sanofi, whose North American headquarters is in Cambridge, Massachusetts. They were launching an MS franchise and offered the right culture to innovate: “[In pharma], everything has been focused on the physicians, but I knew that the nurses, NPs and PAs shared in decision making,” Miller said.

Since clinical trials are focused on patients, she reasoned, being more inclusive of the people who were hands-on with patients would be transformative for the company’s goals. Sanofi agreed and brought her on as medical director in the MS division with the challenge to develop a strategy to work with nurses, nurse practitioners and physician assistants.

“We went out and simply asked the nurses, NPs and PAs, ‘What do you need? What can we do to be your trusted partner?’ Then we just listened, learned and gave them what they needed,” Miller said.

In response, Miller has developed several supports, including an advisory council that meets every year (nine to-date) where nurses, NPs and PAs gather to share information to develop a ­­best practice. The best practice is then published in monographs that are proactively shared by the medical team. These nurse-driven topics have included how to handle a challenging patient and what happens for the patient in the case of disease misdiagnosis. “It requires really good care, patient understanding and counseling – all the skills that nurses embody,” Miller said.

Her dedication to inclusion over the past 10 years at Sanofi has so permeated her learning approach that she has been nominated as co-chair of the company’s North America Medical Inclusion and Diversity Council and lead of their North America Medical Inclusion and Diversity Culture and Sustainability workstream.

Another innovation is a newsletter that distributes three times a year to more than 500 subscribers covering topics key to the advanced training practices scheme and nurses; recent issues covered burnout and telemedicine. Coming next is a study with NPs and PAs as Miller mentors them through interviews employing phenomenological techniques as they investigate nursing and advanced practice care roles across the specialty care therapeutic areas. “We want to raise awareness that nurses, nurse practitioners and physician’s assistants do research that finds answers to important questions,” Miller said.

These innovations have everything to do with educating nurses, NPs and PAs – as well as learning from them. Other pharmaceutical companies are taking notice and implementing their own strategies and initiatives to engage these health care professionals. Their direction from experts in the space is simply to ‘do what Colleen does.’

“My education and work in Buffalo allowed me to develop into the Colleen Miller I need to be to make an impact on this world and on patients,” she said. “I never thought about where my career would take me, but to be a nurse is probably one the hardest, but also most rewarding, jobs. And you can make opportunities.” 

Up next for Miller is leveraging the reach of the IOMSN to investigate on behalf of nurses in Europe who are not considered health care professionals and what that ultimately means for patients. Because for Miller, her learning-based work is global — wherever patients are and the nurses who care for them. 

-Terra Osterling