PA Founds Company to Help New Parents Build Perfect ‘Nest’

October 27, 2020

By Divya Williams

Nidhi Reva, MPH, PA-C

Nidhi Reva, MPH, PA-C, didn’t discover the PA profession until she was 20 years old. But ever since then, her passion for women’s health has driven her career and taken her role as a PA to new heights. From starting her own business to volunteering overseas, Reva has built her career on providing high quality care to expectant parents and underserved populations.

Discovering the PA profession
When Reva was in her undergraduate program at Michigan State University, she knew she loved science and caring for people, but she didn’t know where that would lead. During her senior year, she was in the hospital with a severe concussion after a car accident, and she heard a voice that she remembers to this day. “This voice was the most calming thing. She explained everything about what was going on and that my parents were on their way. She was wonderful, but I never saw her face or knew who it was.”

Two months later, when Reva went back to the hospital for a physical exam, a woman entered the examining room, and Reva immediately recognized her voice. This was the PA from the emergency room after Reva’s accident. “I told her that I was so scared and that she was the only person who walked me through things and reassured me. I was really grateful,” Reva says. “And then I was like, ‘What’s a PA?’ And that’s how I found out about the career, and once I did, that was it.”

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Reva (middle) with one of her patients through the Migrant Farmworker Project, Carmen, and Carmen’s husband

Reva went on to get her Master’s in Public Health at Emory University, then enrolled in Emory’s PA program. “I only applied to one school, and it was the best decision of my life.” She gives credit to three aspects of Emory’s program: the professors, the Migrant Farmworker Project, and her tremendous friends & classmates. “The professors are super invested in their students,” Reva says. “And the Migrant Farmworker Project gave us the opportunity to visit farms that allowed us to treat the migrant farmers and their families.”

Her favorite patient through the project, Carmen, talked to Reva about her family’s journey from farm to farm and how they were grateful to be able to help their family in El Salvador. Reva was honored and humbled when Carmen invited her to her home for dinner. “Although the space and offerings were small, I felt the immense love that made Carmen’s place a home,” Reva says. “For decades, students have always said that they gain more from the patients they meet through this project than they can reciprocate.” Reva says that she felt the same way, and this experience solidified her plans to work with underserved communities.

Finding her passion for women’s reproductive health
After graduating from PA school, Reva was working at an immigrant and refugee clinic in Boston when she realized her passion for working with expectant parents. “New moms are scared and really anxious,” Reva says. While at the clinic, she found herself spending more time with her patients who were expecting and new moms because she wanted to be able to provide them with accessible, educational information. “Patients really want nonjudgmental and accurate information.”

On the first of what would become many medical missions, Reva had the opportunity to practice women’s health in Ecuador with Partners for Andean Community Health (PACH). “I was talking to all these generations of women, including a 13-year-old daughter, her 30-year-old mom, and her 50-year-old grandmother, all of whom didn’t know about their reproductive systems or how to have a healthy pregnancy.” She realized these women had the same concerns as women in the U.S. “No matter where you are, you want to build the best nest possible for your family,” Reva says. “That’s how Nested was born! I got back and said, ‘let’s do this.’”

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Reva and her friend Nicole Hakenson, now a PA herself, on a medical mission trip to the Ecuadorian coast in 2017 after a devastating earthquake; these girls and young mothers waited in line for hours to be seen as this was the only building left standing. Patients came by foot and horse from 70 small communities for medical care.

From PA to PA business owner
Since 2008, Reva has been practicing at the Ob-GYN offices of Reiter, Hill & Johnson (RHJ), an Advantia Health, LLC affiliate practice serving the D.C. area. In 2017, in addition to her clinical work, she founded Nested LLC, located in Arlington, Virginia. “I’m super passionate about educating parents-to-be, regardless of how they have become a parent (e.g., single parent, same sex couples, adoption, or surrogacy). I really love talking to and educating them about the process of what happens at the hospital, what they should expect, and demystifying things that may be scary for them,” Reva says. So she tied her passion for serving families to her mission to provide accessible information and built a company on that foundation.

Nested currently offers three types of in-person group and online video classes – Childbirth Education, Newborn Care and Infant CPR, and Breastfeeding Preparation – all taught by licensed practicing medical professionals. Nested adheres to a team-based approach – the team of instructors consists of physicians, nurses, a PA (Reva), an NP, a physical therapist, and a team of doulas. There are one to two instructors per class so they can keep each class interactive. “Every single time I teach a class with another instructor at Nested, I learn something new,” she says.

Nested also participates in annual medical missions, called Project Nido (Project Nest), with PACH. There have been three so far to Ecuador. Last year, Nested took a team of 20 consisting of Nested staff, friends, and family. Reva was able to bring her daughter, Leela, and worked with her daughter’s school to help develop dental videos and coloring books for the children. The group treated almost 700 patients, surpassing their goal of 400.

[Meet Clair Kuriakose: PA Overseeing 500+ Also Owns an Indian Bollywood Dance Studio]

Pivoting because of COVID-19
With her public health background, Reva knew long before the stay-at-home orders that COVID-19 would have a huge impact on daily lives. Since she’s continuing to practice at RHJ while also running Nested, she felt the impact in both roles: as a care provider and a business owner. The clinicians at RHJ continued seeing patients in the clinic and via telehealth. “It was scary to figure out how to see patients when we didn’t have the information we have now about COVID-19,” Reva says, but she wanted to be there for her patients nonetheless. “I felt that this was a time where our pregnant patients needed us the most.”

Reva teaching a Nested class

And, as a business owner, she felt the pressure to keep her business afloat while keeping her clients safe. “This was my first endeavor. I have a team of instructors and other business team members as well as clients I didn’t want to let down.” But the risk of the virus spreading to a vulnerable population outweighed the financial hit she knew Nested would endure. She had meetings with local health departments and organizations to put in place science-based health protocols to help protect the clients and the instructors. “My role as a clinician came first and canceling in-person classes was the right decision,” Reva says. “I didn’t know if we would still be viable as a small company, but keeping everyone safe was more important.”

[Visit AAPA’s COVID-19 Resource Center for up-to-date tools and resources]

In early March, Nested began canceling and providing refunds for their classes booked through June. Reva had to pivot quickly and creatively to continue delivering classes. “I’m a big advocate of access. There are a lot of communities where childbirth education classes just stopped.” So, Reva booked time at a studio to create professionally produced, HIPAA compliant videos to be used as online classes — Childbirth Education and Newborn Care & Infant CPR. The online video classes, which have the same curriculum as the in-person classes, provide clients with one-month access to the course video (available 24/7) and two online Q&A sessions facilitated by Nested instructors to answer further questions.

Nested was very pleased to be able to resume small group in-person classes in mid-June, and before doing so created new safety COVID protocols for all class attendees (clients as well as Nested team members). And just this fall, Nested launched a new Interactive Live Online Breastfeeding Preparation Class.

To PAs with similar aspirations of owning their own business, Reva says: “Allow yourself some grace. As clinicians, we’re not necessarily taught business operations and management or marketing skills. It’s going to be a learning curve every step of the way.” She says mistakes are to be expected, but one good thing to come from them is that, “You’re not going to make that mistake again.”

Importance of PAs in women’s health
Reva believes there is a big opportunity for PAs in women’s health and is surprised there aren’t more in the field. “When you think of women’s health, you might think NPs or midwives, but PAs have this wealth of knowledge that makes them great for women’s health,” Reva says. She encourages more PAs to look for women’s health jobs, not only because of their strong knowledge base in women’s health but because they are trained in all aspects of medicine. “We bring a breadth of knowledge, and we can treat the whole patient.”

Divya Williams is an associate in AAPA’s Communications Department. Contact her at [email protected].

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