It's Time For Change of Shift at Emergiblog!

Once again, Kim at Emergiblog has put together a great compilation of nursing stories at Change of Shift!

How A Nurse Practitioner Makes A Pap Smear Fun!

I knew going into a family practice that I would be the one doing the pap smears. In my job interview that was actually mentioned. That is one reason why I did several clinicals in an OB/GYN office. There was still a learning curve though. One tip.. don't use too much lubricant. I was trying to make the process as comfortable as possible but had to redo a few due to contamination from it. Second tip.. Use a large enough speculum. The vaginal walls will fall too far into your line of sight if you use one too small. While this is a process that most women will tell you is NOT their favorite thing to do, a nurse practitioner can make the visit much more pleasant.

I introduce myself and ask all of the usual questions about dryness, vaginal discharge, menopausal symptoms, etc. BEFORE the patient gets undressed. I tell them that I know that this is not their favorite thing to do, but that I will try and make it as easy as possible. I leave them to get undressed and let my office nurse know that I'm ready to do the deed.

At this point, I walk into the room and say " I know that you were hoping that I forgot about you!" in a joking manner to break the tension and start the small talk while I'm actually doing the exam part. I ask if they have been told that their cervix is tipped or turned to one side or the other before I go digging around. All the while, I'm talking to myself while I'm looking at the insides and asking if the patient is doing okay and whether I'm hurting her in some way.

The trick is in the small talk. It helps relieve the tension to distract the patient.
I can usually find some way to make them laugh.

I was actually told today by a patient "while I hate having to do this every year, you just made it fun because you have personality!"

How cool is that?

Nurse Practitioner Rounding In Nursing Homes

Hello to all! I have been pretty busy at the office and I rounded in the nursing homes this week. I saw 59 patients between the office and two nursing homes. WHEW!

I decided to start a new blog called NP Notes and put some of my nurse practitioner notes from school there. It's a way to get some of the stuff off of my personal computer and hopefully help fellow students!

Let me know what you all think. I'd love some suggestions for content. While your at it, some suggestions for content here are always welcome too!

Nurse Practitioners Listen To Their Patients

I've been very busy in the new office. One of the things that I'm hearing from my patients about various doctors is the complaint that they often feel rushed during their visits. This is nothing new because I heard it on a daily basis at the hospital as well.
I've been told recently that I needed to speed up during my visits with the patients at the office. While I understand the need to maintain productivity, I also have found that patient satisfaction is a little more important right now. Cases in point....

If a patient comes into the office complaining about various areas of numbness and weakness in upper and lower body I would check lab work which may or not be normal and ran the scenario by the doctor. These symptoms could be mistaken for a psychosomatic illness but I would decide to do an MRI anyway because my intuition would bother me. While it may be "all in the patient's head", it may be a brain tumor or multiple sclerosis.

Similar scenario..Pt complains of numbness and tingling in one arm. Pinched nerve versus brain tumor?

If I don't take the time to listen to the patients thoroughly, without rushing them, I could miss diagnoses.

I'm glad that I didn't..