Friday, March 31, 2006

My pictures from our vacation to Murphy, NC


Hey everyone! I finally made a slide of our pictures from North Carolina. There weren't many leaves on the trees, but I still thought it was gorgeous.. The picture in this post is one of my favorites!
Off topic, but does anyone know why blogs look so out of whack in IE but look fine in Firefox?? I would like to fix the IE look because I think people are still using that browser.. I prefer Firefox myself..
Check out the NP NEWs link on my sidebar and tell me what you think should go on this one.. I thought just the boring educational stuff?? Or do you like the mix here?? I'm trying to make one at least more professional looking. Any thoughts??
Need input, need input.. must compute...

Wednesday, March 29, 2006

Your Favorite Nurse Practitioner Student is Back!

Hello all!! I survived my trip to the North Carolina mountains. The drive through Georgia is very long and filled with construction.. People were driving bumper to bumper for no reason. Rubbernecking galore and no accidents or strange sights to cause it..
The mountains are gorgeous!! The trees are still pretty bare but the views are to die for!! My visit with my friend was great.. We caught up like we'd never been apart. As I said before, she was a highschool teacher of mine. She was pretty surprised that I actually showed up because I had been promising for almost 20 years to go up and see her.
We stayed at a cabin on Wolf Mountain. It was reasonable (79 dollars a day) which is what most of the hotels in the area were charging and some were higher. I will NEVER stay in a hotel in North GA, Carolina or Tennessee because the cabin rental business is booming.. The place was completely furnished and all we had to bring was food.
When we first arrived, it started to snow lightly and the kids were thrilled. My youngest had never seen snow before and when they woke up, there was about a 1/4 inch on the deck. I normally hate cold weather but it was so pretty that I enjoyed it. It doesn't snow much in the area except for the higher elevations. Pictures to come!!

I looked up North Carolina nurse practice acts when I got home and we still need a collaboration agreement but we can write narcotic prescriptions unlike here in Florida. After I finish school, I am seriously thinking about moving to the area. I grabbed all the realty books I could find and was pleasantly surprised to find that some of the places are comparable to where I live and MUCH prettier.. I'll have to wait until my 10th grader is finished with highschool first and the youngest is young enough not to care... Until then...sigh....

I'm glad to be back home to the internet though!! I've got some homework and blogstalking to do in the next few days!!

Thursday, March 23, 2006

Nurse Practitioner Student is going for a little vacation..

Hello all!

I just took my second test and made a 96! WHOO HOO considering the class average is about a 76 on it
..

We are going to Murphy, NC for a few days to visit an old highschool teacher of mine. I haven't seen her in over 20 years. I kept telling her that I would come visit one day and she's getting up in her 60's now.. I would hate to have something happen to her and have never gotten to see her again.

She is one of those teachers that inspired me to go as far in life as possible..

I'll be away from the internet until Tuesday... withdrawals to commence!!

Wednesday, March 22, 2006

Nurse Practitioner Student's Son Needed His Mommy


Hello to all...
I got a call from my nineteen year old son who was crying hysterically into the phone. Of course, I almost panicked myself because the last time he cried was when he was little.. except for the time he was puking drunk but that's another story..

He has a horrible ear infection and was prescribed Lortab 5/500 for pain control. About an hour later, he started itching and broke out in hives. He said that he felt like he was dying. I asked if he was having difficulty breathing and he said no.. (Thank goodness!) I have a codeine allergy, but I have never had this severe a reaction before.

I was torn as to whether to have him call for an ambulance or revert to my nursing instinct and have him wait it out with supervision. I had him call his girlfriend to drive him home. I told him to take some Benedryl and to call me in 30 minutes and to call his doctor to let him know what was going on...

He called the doctor who agreed with my assessment and then he called me later to say that he was feeling a little better. WHEW! The doctor called in Tramadol for pain (Ultram)to which I told my son to take 1/2 the pill and wait 30 minutes and if no reaction to take the other 1/2... Why worry about Ultram??

I took two Ultram for knee pain last year and had every side effect at one time, except that I didn't break out in a rash and stop breathing. I felt like I was going to die!! Evidently, Ultram breaks down like codeine and can cause a similar reaction to those of us who are allergic.

My son was able to take Ultram without incident. Thank goodness!!! I told him to make sure that he put codeine down as an allergy in his wallet and to have the doctor's office make note..

A couple of hours later.. my son called me back and said....
"I'm so embarrassed that I cried, but I felt so bad that I wanted my Mommy..."

It still feels good to hear it........

Tuesday, March 21, 2006

Nurse Practitioner Student says visit Grand Rounds at Healthy Concerns


What a wonderful thing Great Rounds is!! Every week it's a thrilling synopsis of what's going on in the medical field. I am eagerly awaiting for more Nurse Practitioner's blogs... Come on guys and gals, get to writing!!

Friday, March 17, 2006

Nurse Practitioner Student Shocked and Appalled

Trusted therapist accused of molesting comatose children...

Wayne Albert Bleyle, a respiratory therapist, is accused of molesting brain-damaged, comatose boys and girls taking cell phone photos of himself in the act and posting them online.
Prosecutor Laura Gunn said "I don't know if we've ever seen a case like it before where the victims were so vulnerable." Gunn said that Bleyle molested many more patients over the past decade, preying on the hospital's weakest of the weak, including youngsters who would never be able to speak.
Gunn also said that when in an investigator asked how many children he had abused. Bleyle replied, "How many snowflakes are there out there?"
"Colleagues, some left almost speechless by the allegations said that he was an engaging , hardworking therapist who volunteered for extra shifts, reassured parents and served as a mentor to new hires."

Headlines like this just make me want to puke my guts out. I think the death penalty is too easy for this disgusting man. I cannot imagine the horror that those children, who could tell what he was doing, must have felt when they could do nothing about it.
I know some of what they felt. I too, as a child, was the victim of a child molester for many years. I have absolutely no sympathy for these sick bastards. I know that there are some who feel that they can be rehabilitated and that it's a mental disease.

Let me tell you from personal experience... Once a child molester.. ALWAYS a molester. They will repeat their crimes. It's not all about sex. It's a control issue. They revel in the chase and the manipulation of a child. You can castrate them and they will still molest. The man who molested me repeated his offenses against others, one of which was a three year old boy.

I don't know what the solution is for sick perverts like this one. Death would be my first choice..Some say that is a quick, easy way out.. Quarantine on a harsh desolate island.. Letting the parents have their way with them slowly and painfully..

One's mental health is very important. If you are a survivor of childhood abuse, you will never completely heal from the experience. You can go through therapy. For me.. talking about it is mine.. I hope that you never have to deal with this experience. It tends to make one very bitter..

As medical professionals, we must be alert for sexual child abuse. It's a very hard subject to broach and very volatile, especially in this litigious society we live in. If I had a doctor or nurse ask me about my situation, I may have been helped. I did tell my story to a lawyer once, but nothing was done. Client confidentiality.. But that's another story for another time. We must fight for the children who cannot fight for themselves!

Monday, March 13, 2006

Nurse Practitioner Student Is Having Trouble Staying Focused..

Help me!!!! I CANNOT focus on my homework!! Try as I may, I cannot stay focused on my task at hand.
I'm supposed to be working on a literature review for my Research class. It's very difficult to find articles that are relevant, full text and free.. Free being the key word.. Too many articles are inaccessible in some way. I guess people deserve to be paid for their work..
One reason I'm having a difficult time, is that I have found that I'm addicted to blogging.. or at least stalking for new ones that may have a link to me.. I know, I know... It's a ego thing.. But it's fun.. Too fun darn it!!!!
I also had my first physical therapy session today.. I'm totally out of shape again due to being off work. I have to say that I'm enjoying the time home. We need to win the lottery so I can finish school without racking up these huge school loan bills..
After the end of this semester, I will have 1 year to go. I can't make time more faster no matter how hard I've tried.... SIGH!!!
But... the outcome will eventually outweigh the aggravation that we must go through to get what we want. Satisfaction, recognition and just a little more in the piggybank...
Off I go.. back to work on my Lit review... I know.. I know.... There is a light at the end of the tunnel and I have no one to blame but myself and my perpetual student syndrome... Cheers!!!

Wednesday, March 08, 2006

Nurse Practitioner Student Says Leave A Message Please!

Hey everyone! Sitemeters can be a boon or a pain in the patootey.. Since I've submitted to Grand Rounds I've received over 200 hits to my site.

"That's great!" everyone is thinking...

Well... that generally would be... if anyone would freaking COMMENT on something!!!!!

Just a little note to say hi... kiss my ass..your site sucks...SOMETHING...

I feel a little like Charlie Brown waiting at his mailbox...

Sunday, March 05, 2006

Nurse Practitioner Student Notes Serious malpractice issues with military hospitals

I read this article today and was so disheartened by what I read. It's a sad and scary thing to realize that these doctors have almost no repercussions when they injure patients. According to the Feres Document, active duty personnel and their survivors cannot recover damages from the military when their injuries are incident to service. Judges have said that it applies to medical malpractice and medical negligence claims on behalf of service members. What this means is.. if you are in the military and something happens to you or your family member in a military hospital... you're screwed... It seems that most of these errors are happening due to no one reading the medical records of the patients or not heeding what has been written. The other reasons seem to be gross error on surgeon's parts.
I also find it very interesting to see that medical doctors were the only ones listed as defendants.... Not nurse practitioners. I would be very interested in seeing the ratios of nurse practitioner malpractice suits.

A Times-Union review of recent state and federal records found that the 60-bed Jacksonville Naval Hospital is sued for medical negligence at nearly five times the rate of civilian hospitals in Northeast Florida. And because only dependents and retirees can sue -- federal law forbids claims for active service members -- the hospital's true malpractice rate might be even higher.

The government has settled 15 medical negligence claims against the hospital since 2001. Eleven involved deaths. Two other cases are pending, and both involve patients who died. A sampling:
# Air Force veteran Wanda Lloyd, 40, died in 2003 after emergency room doctors misdiagnosed her chest pains and failed to call a cardiologist.

# Seven-month-old Michael Hugaboom died in 2004 after doctors mistook his meningitis for chickenpox.

# Christian Rivera died just after his birth in 2000 when doctors missed the warning signs of fetal distress. His mother hemorrhaged after delivery, went into a coma and died 10 months later.

Patterns in the court cases point toward a system-wide breakdown at Jacksonville Naval Hospital, the Navy's fourth-largest. Patients are killed or maimed when records disappear and doctors fail to communicate. Family practitioners perform procedures that should be done by obstetricians -- or shouldn't be done at all. And the Navy lets doctors go unpunished even when they make serious mistakes.

Unlike civilian doctors, military doctors aren't required to be licensed in the same state where they practice. And under federal law, they cannot be sued individually.

"They have no personal liability whatsoever. Never have. Never will," Roberts said. "It plays a role, I think, in the risks that they take and the calculations that they make."

The Times-Union reviewed the licenses of 18 current and former Navy and contracted civilian doctors named in negligence claims pending or settled since 2001. Four doctors were the subject of more than one claim. Yet the newspaper did not find negative marks related to any of the cases.

Only one doctor was cited for any reason, and that was for failing to report an address change.

Bono said negative incidents at Jacksonville Naval Hospital trigger a "strict and rigorous" quality review process: Questionable doctors are reviewed by their peers, who make recommendations on restrictions or other discipline. Larkins-Pettigrew herself headed one such review panel in 2001, even after the Navy was sued in a botched childbirth case that Larkins-Pettigrew said landed her on a national database of troubled doctors.

More serious mishaps are reviewed by the Navy's Bureau of Medicine and Surgery in Washington and an independent review team. The Navy surgeon general has sole authority to report the physician to the database or to state licensing boards, Bono said. The process can take years, and the database is hidden from public view. Citing privacy laws, the Navy surgeon general's office won't say how many of its doctors from Jacksonville have been reported to the database.

However, Vice Adm. Donald Arthur, the current surgeon general, told the Times-Union an estimated 10 to 15 doctors nationwide are reported to the database each year.

Computerized records will also improve continuity of care by letting military hospitals share information more efficiently, Bono said. The hospital rolled out its new electronic system in November.

But it won't work without careful doctors and records technicians. In a 2004 deposition, Navy gynecologist Cynthia Wilkes admitted she didn't read the medical records before performing a hysterectomy in 2002 that led to Jocelyn Foster's death.

Wilkes said that if she had read the records, the knowledge of Foster's abdominal problems would have prevented her from doing the operation and Foster would be alive. Instead, Foster died after Wilkes sliced through her bowel and injured her bladder. The Navy settled her family's lawsuit for $1 million.

Part of Wilkes' explanation was that she didn't have all the records. Though they were ordered, Wilkes testified, the Navy's outpatient record department never delivered them.

Wilkes admitted responsibility for the death. But the surgeon general told the Times-Union that Navy medical officials didn't refer her to the practitioner database because they didn't believe she was to blame.

To read the rest of the story, click the title....

DNP now being offered at University of Florida

This was sent to me from the DNP program at UF. I have posted this information for any who may be interested in taking your NP to the next level. I will be posting another entry in reference to the DNP at a later date. Enjoy!

After much work we will able to offer the Doctorate of Nursing Practice (DNP) at UF beginning Fall 2006 for those students who are seeking a post-master's.

The Nursing courses will be offered in Gainesville and Jacksonville. Some courses may be web-based but at this time we do not which courses.

The admission criteria to the program is as follows:
1. A minimum score of 500 on each of the verbal and quantitative sections of the Graduate Record Examination (GRE) General Test.
2. Completion of the GRE Analytical Writing Measure.
3. Current licensure (or eligibility) in the state of Florida.
4. A master's degree in nursing from a nationally accredited program.
5. A master's degree with a 3.0
We will be posting the application materials in the next 2 to 3 weeks. I will send out another e-mail once all the materials have been posted on our website. But if you wanted to get started here are the items that you will need:
1. Two letters of recommendation: one addressing clinical competency and one academic ability (forms will be posted on our website.
2. A 1-2 page (double-spaced) statement to include expectations of the program and anticipated goals for graduate education.
3. Personal Data Record (this will be submitted electronically through our website)
4. Resume/curriculum vitae
5. Official transcripts from all colleges and universities attended (not needed if you attended UF)
6. Professional degree application to the University of Florida admissions office (this will be posted in the next couple of weeks, do not attempt to submit at this moment.

Cecile Diaz Kiley
Coordinator, Academic Support Services
University of Florida
College of Nursing
PO Box 100197
Gainesville, FL 32610-0197
(352) 273-6331
(352) 273-6440 Fax
ckiley@nursing.ufl.edu

Fall PHC 6001 Principles of Epidemiology (3)
PHC 6050 Statistical Methods for Health Science (3)

Spring Elective To be announced (3)
NGR 7### Leadership and Role Development in Advanced Nursing Practice (3)

Summer NGR 7133 Ethical Theories and Rational Decision Making in Health Care (3)
NGR 7yyy Quality Indicators in Nursing Systems (3)

Fall NGR 7mmm Nursing Informatics and Data Management (3)
PHC 6406 Psychological, Social and Behavioral Issues in Public Health (3)

Spring NGR 7ooo Outcomes Research and Evaluation (3)
Elective TBA (3)

Summer NGR 7uuu Health Policy and Finance in Advanced Nursing Practice (3)
NGR 7ppp Advanced Topics in Pharmacotherapeutics in Nursing Specialties(3)*

Fall NGR 7xxx Advanced Diagnostic Reasoning (3)*
NGR 7sss Advanced Nursing Project (3)

Spring NGR 7rrrL Residency in Advanced Nursing Practice (6)
*Courses taken direct care tracks only, indirect care tracks take 6 credits as specified by that track.
Total = 48 credits

Saturday, March 04, 2006

Who runs The Nurse Practitioner's Place?

I was reading Emergiblog and noticed her post regarding the following questions suggested by Dr. Lei at Genetics and Health She encourages medical/health bloggers to answer the following questions recommended by The National Center for Complementary and Alternative Medicine, part of the U.S. National Institutes of Health. The purpose of the questions is to give readers of medical/health related blogs the ability to evaluate what they are reading.

1. Who runs this site?

The Nurse Practitioner's Place is run by a family nurse practitioner student who expects to graduate at the end of the Spring semester 2007. I received my RN in 2001. I received my BSN in 2004. I work as a floor nurse and standby charge nurse on a med/surg floor of a hospital.

2. Who pays for the site?

The site is provided for free by blogger.com. I help pay for my school costs and internet high speed connection by placing Google adsense ads pertinent to nursing. By clicking on those ads I receive checks in the mail on occasion.

3. What is the purpose of the site?

The purpose of The Nurse Practitioner's Place is to give me a forum to discuss my experiences as a nurse and my experiences as a nurse practitioner student.

4. Where does the information come from?

It comes from my years of nursing experience. All patients, staff and hospitals are either composites or have identifying information concealed or altered to allow for patient confidentiality. When applicable, links to information sources are given.

5. What is the basis of the information?

Please refer to question number four.

6. How is the information selected?

The postings are based on what I want to write about and what I feel will be interesting to read.

7. How current is the information?

It could be as current as a few minutes ago. I maintain archives on my page that one may wander through at their convenience. I manage my comments through Haloscan so that I can see any comments on any posts so feel free to comment on the older stuff. I will see it.

8. How does the site choose links to other sites?

My links are based on sites I have read and found interesting. Other links are reciprocal in nature in order to drive more traffic to my site. I always like to find links on sites that I haven't solicited. It's more gratifying that way.

9. What information about you does the site collect, and why?

The site collects no information about anyone other than what is recorded on the site meters.
That information is used just for my own personal interest in seeing where my readers come from .

10. How does the site manage interactions with visitors?

Hopefully they comment and I comment back! I use word verification to stop spammers. All opinions are welcome. Posts that are outright disgusting and demeaning will be removed at my discretion.

Wednesday, March 01, 2006

NPs Save Lives Goes Under the Knife

Hello to all from your favorite nurse practitioner student! I survived my knee surgery! I knew that things would be fine but it is a scary thing to go under anesthesia.

I got to the hospital around 10:00 and went to the lab for my PT and PTT draws. The nurse in charge of me got me settled in and did my assessment. She then started my IV using bacteriostatic saline which works like Lidocaine without the potential for allergic reactions. That is some cool stuff!! I will be asking our hospital if we can use it for our IV sticks on the floor. Starting IVs really suck when you have to hurt people! I'm really good at it, but always feel sorry for those patients who have bad veins.

My husband and I waited for approximately two hours before I was ready for surgery. That was my only complaint. The waiting to go under the knife can be very nervewracking. I brought a book to read to take my mind off the whole thing. I wasn't too nervous but my husband was getting a little antsy. His back was killing him due to his degenerative disc disease.

The anesthesiologist came by and asked me all the appropriate questions and asked if I had any questions for him. I told him that I didn't have any questions but that I did have one request. He said, "What's that?" I said "Well.. I want to wake up!" He laughed and thought it was funny. He said "that's the plan!" "You nurses are the worst patients! You know enough to be dangerous!"

The last thing I remember was having oxygen placed onto my face as they strapped my arms down. They were very calm and soothing. After that, I was being awakened in the recovery room..

My doctor came out and told me that he didn't put any cadaver parts in my knee but that he just left the peripheral menisci in place and took everything else out.. He said that this surgery should feel much better than the last one. So far so good!! I see him again in a week and I start physical therapy afterwards.

Anytime a medical professional can be on the "other side of medicine", it makes us more empathic. Unfortunately, I keep finding myself on the "other side" a little too often for my taste. And for those who thought I was faking my injury, you can all kiss my missing mensicus!!

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