A Little About Me (And How I Got Here)

From Blinking Red Lights to Brain Surgery

My name is Nicole Carissimi, and I grew up in a tiny town in Pennsylvania — so small that our one intersection had a blinking red light instead of a real stoplight. Like a lot of kids, I went through phases: marine biologist, veterinarian, nurse anesthetist. Each one got crossed off the list after I actually shadowed someone doing the job. Lesson learned: always shadow before you commit.

Drexel Graduation

Nursing stuck. I loved how many directions you could take it. I chose Drexel University partly for their co-op program — which meant real clinical experience during school — and partly because I fell in love with Philadelphia. My final co-op landed me in the Neuro ICU at Jefferson University Hospital, and I genuinely loved it there. The brain fascinated me, but more than that, I loved the community. These jobs have a way of becoming something bigger than work — tight-knit, family-like — and some of my very favorite people in my life came from those units. After graduation I stayed on in their step-down neuro unit, then moved to the Neuro ICU at Pennsylvania Hospital, where I continued to grow both clinically and as a person.

"I loved how many directions you could take it."

It was during my time in the ICU that something started to shift. We were doing everything right — good intentions, excellent care — but I found myself increasingly affected by the suffering we were sometimes prolonging. When you're in critical care long enough, you start to grapple with the gap between what medicine can do and what patients and families actually want. That tension eventually led me to an assistant nurse manager position at Penn Medicine's inpatient hospice unit, and it turned out to be one of the best decisions I ever made. Same family-like culture I'd always gravitated toward, but a different kind of care — one focused on comfort, dignity, and being truly present with people at the hardest moments of their lives.

My Pennsylvania Hospital Family

All while working through the PMHNP program at the University of Pennsylvania — full-time nurse, part-time student, zero free time.

Then 2020 happened. COVID hit right as my supervisor went out on medical leave, leaving me suddenly running an inpatient unit during a pandemic. My clinical hours were cancelled and I scrambled to finish my degree, ultimately graduating in May 2020 via PowerPoint presentation — on the same day my dog went into emergency surgery. It was a lot.

Starting Over (Sort Of)

I passed my boards, reached out to the small private practice where I was already a patient, and — miraculously — they said yes. They welcomed me with open arms and gave me all the support I needed to find my footing as a new provider. After paying off my student loans, my husband and I started thinking about starting a family. In the middle of fertility treatment, our practice got acquired by a large corporation. Staying zen while learning new systems, manually migrating patient data, and working until 9pm every night was... a challenge. We welcomed our son in June 2022, and I returned from maternity leave straight into back-to-back appointments, pumping every two hours, and daycare calls about the sniffles. He made a few cameo appearances in telehealth sessions. No regrets.

After a few years in the corporate model, I started to notice the shift — more productivity metrics, more "clinical care guidelines," less time to actually be with patients. It wasn't the kind of medicine I wanted to practice. Around the same time, I discovered integrative psychiatry: the idea that herbs, supplements, and lifestyle changes can work alongside traditional psychiatric care, not against it. We're trained to be skeptical of these approaches, but the research is there if you look for it — and interactions can be safely managed. It opened up a whole new way of thinking about patient care.

And Then We Moved Across the Country

My family had also started to outgrow Philadelphia after nearly 20 years. We moved across the country to Nevada, fell in love with the scenery and the parks, and appreciated the distinct lack of snow. With 4,500 miles between me and my old office, it felt like the right time to do things differently. I opened my own practice so I could practice psychiatry on my own terms — integrative, unhurried, and actually centered on the person in front of me.

If you've read this far: Hi, I'm glad you're here.

The Stuff That Doesn't Fit Anywhere Else

A little more about me that doesn't fit neatly anywhere: I joke that I'm equal parts secret 13-year-old boy (video games, questionable eating habits) and 70-year-old woman (knitting, cross stitch, and yes, bingo). I have rampant ADHD, which means my hobby list is long and ever-expanding — rock climbing, hiking, puzzles, running when the mood strikes, and biking with my son. I also color, badly, because it relaxes me.

My goal is simple: I want to help you thrive, not just survive.