Kim at Emergiblog has put out a request for our very first blog post for Change of Shift. I have been blogging since Feb. 2005 (has it been that long?) I started blogging after I was googling some nurse practitioner information and stumbled upon a few NP blogs and noticed that there weren't very many of them out there on the net.
My first posts consisted of answering questions like "What is a Nurse Practitioner?" etc. but further posting also included my aggravations of schooling and pictures of family life. I also tried to include some funnies on occasion. Imagine my surprise when I started to have regular readers (Lisa,Teresa, Azygous, Kim,Geena just to name a few. I felt so honored that some of my fellow nurses in the blogosphere would take the time to leave a comment and encourage me through the harrowing experiences of the times. Some of my readers have come and gone. Some don't blog anymore. I miss popping in and seeing what they've been up to.
Soon, I started to pick up traffic and decided to add yet another reason to blog.
Cold hard cash. Sounds rather materialistic, but when your student loans start stacking up (83,000), you start to look for ways to offset them. I added Adsense (which has been very good to me so far!) Then I got my very first paid advertiser Scrubs Gallery and now I am proud to be an affiliate of NP Business Owner.
School finished and it's been over a year now since I graduated as a FNP and am loving every minute of it. I really encourage anyone who is thinking of becoming a nurse or already is and is thinking of continuing your education, do it!
And don't forget to blog about your experiences so we can all enjoy and learn from them!
Sunday, June 29, 2008
Friday, June 27, 2008
20 Out Of 10: Change of Shift
20 Out Of 10: Change of Shift A great compilation of the different types of nursing in the profession. A must read for those considering joining our ranks!
Tuesday, June 24, 2008
A Day In The Life Of A Family Nurse Practitioner
Braden over at 20 out of 10 has requested that I submit a post about what a nurse practitioner does on a daily basis. I will attempt to break down my average day, but keep in mind the location that I am working in is a new branch of a Federally Qualified Health Clinic that is just starting over the last 6 months, so it isn't a typical regimen for a fully loaded practice.
08:15- Come into office. Check phone and desk for messages. Check the labs that came across from the day before, and write out instructions on lab letters to be sent back to the patients. Draw labs on patients that my nurse can't "hit".
08:30- First patient of the day. (new pt visit 30-45 minutes) Complete history, including medical, surgical, and family history. Head to toe review of systems. Head to toe physical exam. Address any new symptoms or chronic symptoms. Refill or write any prescriptions needed. Educate about all disease processes and about what each prescription is for. Review if any preventative care has been completed such as mammogram, Pap, colonoscopy, bone density, etc. Request record release so that I can obtain prior records to review. Ask is there is anything else that they wanted to ask me. Explain our "open access scheduling (same day) to set up follow up. Off they go!
09:15- Back to the desk to do paperwork, write referrals, review records, check messages, call back pts to answer questions.
09:30-Next visit (established 15 minutes)- Medication review, ask if any changes in ROS since last visit. Address new problem or review established problems. Review any test results since last visit. Reinforce education about disease processes.
09:45- See 09:15 slot.. This process happens throughout the morning until 12:00 when we break for lunch. I usually eat in 30 minutes (left over from the hospital days- eat fast whatever is available). Use the rest of the lunch break to do any of the never ending paperwork.. I REALLY HATE THIS PART!
From 1:00-4:15 see patients throughout day varying from pediatrics to geriatrics. I also see minor emergencies such as I&D, suturing, stapling etc. Refer to Emergency Department any cases needing such expertise (You're up all you emergency room nurses! Keep my patients safe and healthy!) We often get cases as a walk in basis that are serious because patients wait too long before being seen. That's a story for the next edition..
04:15-05:00- Email or call my collaborating MD to discuss any difficult cases dealt with during the day. Return other physician phone calls if arise. Read through consultation notes received. Discuss the cases encountered during day with my nurse to encourage her to expand her knowledge base as well as pick her brain when needed.
That's pretty much a day in the life of a Family Nurse Practitioner. I love my job and really enjoy building relationships with my patients and watching them respond to the treatments I recommend. I am taking care of entire families now and that's what it's all about!
08:15- Come into office. Check phone and desk for messages. Check the labs that came across from the day before, and write out instructions on lab letters to be sent back to the patients. Draw labs on patients that my nurse can't "hit".
08:30- First patient of the day. (new pt visit 30-45 minutes) Complete history, including medical, surgical, and family history. Head to toe review of systems. Head to toe physical exam. Address any new symptoms or chronic symptoms. Refill or write any prescriptions needed. Educate about all disease processes and about what each prescription is for. Review if any preventative care has been completed such as mammogram, Pap, colonoscopy, bone density, etc. Request record release so that I can obtain prior records to review. Ask is there is anything else that they wanted to ask me. Explain our "open access scheduling (same day) to set up follow up. Off they go!
09:15- Back to the desk to do paperwork, write referrals, review records, check messages, call back pts to answer questions.
09:30-Next visit (established 15 minutes)- Medication review, ask if any changes in ROS since last visit. Address new problem or review established problems. Review any test results since last visit. Reinforce education about disease processes.
09:45- See 09:15 slot.. This process happens throughout the morning until 12:00 when we break for lunch. I usually eat in 30 minutes (left over from the hospital days- eat fast whatever is available). Use the rest of the lunch break to do any of the never ending paperwork.. I REALLY HATE THIS PART!
From 1:00-4:15 see patients throughout day varying from pediatrics to geriatrics. I also see minor emergencies such as I&D, suturing, stapling etc. Refer to Emergency Department any cases needing such expertise (You're up all you emergency room nurses! Keep my patients safe and healthy!) We often get cases as a walk in basis that are serious because patients wait too long before being seen. That's a story for the next edition..
04:15-05:00- Email or call my collaborating MD to discuss any difficult cases dealt with during the day. Return other physician phone calls if arise. Read through consultation notes received. Discuss the cases encountered during day with my nurse to encourage her to expand her knowledge base as well as pick her brain when needed.
That's pretty much a day in the life of a Family Nurse Practitioner. I love my job and really enjoy building relationships with my patients and watching them respond to the treatments I recommend. I am taking care of entire families now and that's what it's all about!
Friday, June 13, 2008
Change of Shift is Up at Nurse Ratched's!
Check out this edition of Change of Shift! Was great pictures of the older nursing caps! Makes me want to go out and buy another of mine and wear it.. Kind of!
Sunday, June 08, 2008
Great Happenings in Nurse Practitioner Land!
I have some great news to tell everyone. We've been pretty busy over the last two weeks. Last weekend, my son Michael graduated high school. We are so proud of him. He is going to a community college and will be working on an Electrical Engineering degree (at least this week!).
He moved into an apartment across the street from the college so there won't be far to go and he got a job at Publix as a bagger. I'm sure that he will do very well. Grad pictures to be posted!
This weekend, our oldest son got married. It was a beautiful ceremony with lots of tears. I can't wait to get the pictures from the wedding downloaded. She was a gorgeous bride! The dress was so pretty and the church was all done up. The reception was fun though my side of the family were the only ones cutting lose and dancing except for her uncle and his wife. I look forward to more great looking grandchildren in the future.
The current grandson was so good and slept pretty much through the whole process. My daughter was one of the bride's maids. So pretty! Everyone from down south came up for the wedding and the graduation so it was really nice. No fighting! How great! We aren't known as "The Adam's Family" for nothing!
Work is going well. Trying to get the numbers up and most are coming in from word of mouth. The best advertising in my book! Nothing too interesting to report except for a little funny from one of my peds patients.
I'm standing with my back to Daddy and the 5 year old when I hear VERY quietly, "Can you hear really well?" I chuckled and said with my back still to him, "Yes I can. I have REALLY big ears, don't I?" I thought Daddy was going to fall off the table. From the mouths of babes!
He moved into an apartment across the street from the college so there won't be far to go and he got a job at Publix as a bagger. I'm sure that he will do very well. Grad pictures to be posted!
This weekend, our oldest son got married. It was a beautiful ceremony with lots of tears. I can't wait to get the pictures from the wedding downloaded. She was a gorgeous bride! The dress was so pretty and the church was all done up. The reception was fun though my side of the family were the only ones cutting lose and dancing except for her uncle and his wife. I look forward to more great looking grandchildren in the future.
The current grandson was so good and slept pretty much through the whole process. My daughter was one of the bride's maids. So pretty! Everyone from down south came up for the wedding and the graduation so it was really nice. No fighting! How great! We aren't known as "The Adam's Family" for nothing!
Work is going well. Trying to get the numbers up and most are coming in from word of mouth. The best advertising in my book! Nothing too interesting to report except for a little funny from one of my peds patients.
I'm standing with my back to Daddy and the 5 year old when I hear VERY quietly, "Can you hear really well?" I chuckled and said with my back still to him, "Yes I can. I have REALLY big ears, don't I?" I thought Daddy was going to fall off the table. From the mouths of babes!
Wednesday, June 04, 2008
Nursing Instructors Friend or Foe?
Over the years since I graduated from RN nursing school, I have been reading different student blogs all lamenting the trials and tribulations of their relationships with their nursing instructors. I remember mine very well for various reasons. Some were very helpful, some were nonchalant, and some were what I would call militant.
The ones that were helpful and informative I will always remember for those reasons, but the ones who really made it tough always stand out in our minds. In my early formative semesters as a nervous student, I had two instructors that come to mind.
Once while I was bending over a bed in a nursing home attempting to get the corners just right and was concentrating very hard, an instructor snuck up behind me and said in a very loud voice "what do you think you are doing?". She scared the crap out of me and while I was scrolling through my limited memory of nursing at the time attempting to figure out what she was so mad about, she said "Don't EVER let me catch you bending over a bed. You should always bring the bed up to you and save your back. Your back will literally be the breaking point of your nursing career (including your knees). If you injure yourself, you can no longer take care of your patients and yourself, besides losing your livelihood!" She stalked out of the room. I never forgot her words of wisdom and I have never injured my back.
Another instructor would cut you down like a knife and would literally breath down your neck while you were attempting to draw up meds into syringes. If you took too long or appeared to be fumbling a little, she would immediately start making comments like "I showed you that the last time, why can't you remember how?" with no words of encouragement. Once in post clinicals, she asked a question and no one volunteered an answer so I piped up with what I knew. She looked over at me and told me "You need to shut your mouth and open your ears. You only know part of the answer and you shouldn't run off unless you know the whole thing." Needless to say, the entire group stood there with their mouths open. I never spoke to her directly again unless she spoke first. I literally had a stomachache every time I had clinicals and actually thought of quitting because I doubted my ability to EVER learn all the things I would need to be a good nurse.
When I got to the end of the rotation, I thought for sure that she would fail me and I made ready to read the evaluation. As I read incredulously at what appeared to be a rave review, I slid the paper over to her and said "you must have me mixed up with someone else. This can't be my review." She asked my why. I went for broke and told her that she had ridden my ass all semester and I thought that she hated me. She chuckled... "When you didn't quit and didn't give up, I knew you would be a great nurse." I got up confused and relieved and never had her as an instructor again because she left the school to go back to the VA hospital. I was so happy at the time and went on the graduate and never really thought about her unless I was telling the new students about "that militant instructor" whenever I heard them complain about an instructor.
Time passed and I realized, in her own way, that she was trying to prepare me for a hard career in which you will never make everyone happy. People will yell at you and try to hurt you physically. It's not an easy profession to be in at times. I have to say that most of my career, while working in the hospital, was very rewarding though.
As I read the newspaper the other day, I saw a face I hadn't seen in years. It was a memorial picture in the obituary section of that militant nurse who taught me to be strong. I wish I could have thanked her before she died.
So I do it now.. Thank you Mrs. Dodds for being the one instructor who pushed me.
The ones that were helpful and informative I will always remember for those reasons, but the ones who really made it tough always stand out in our minds. In my early formative semesters as a nervous student, I had two instructors that come to mind.
Once while I was bending over a bed in a nursing home attempting to get the corners just right and was concentrating very hard, an instructor snuck up behind me and said in a very loud voice "what do you think you are doing?". She scared the crap out of me and while I was scrolling through my limited memory of nursing at the time attempting to figure out what she was so mad about, she said "Don't EVER let me catch you bending over a bed. You should always bring the bed up to you and save your back. Your back will literally be the breaking point of your nursing career (including your knees). If you injure yourself, you can no longer take care of your patients and yourself, besides losing your livelihood!" She stalked out of the room. I never forgot her words of wisdom and I have never injured my back.
Another instructor would cut you down like a knife and would literally breath down your neck while you were attempting to draw up meds into syringes. If you took too long or appeared to be fumbling a little, she would immediately start making comments like "I showed you that the last time, why can't you remember how?" with no words of encouragement. Once in post clinicals, she asked a question and no one volunteered an answer so I piped up with what I knew. She looked over at me and told me "You need to shut your mouth and open your ears. You only know part of the answer and you shouldn't run off unless you know the whole thing." Needless to say, the entire group stood there with their mouths open. I never spoke to her directly again unless she spoke first. I literally had a stomachache every time I had clinicals and actually thought of quitting because I doubted my ability to EVER learn all the things I would need to be a good nurse.
When I got to the end of the rotation, I thought for sure that she would fail me and I made ready to read the evaluation. As I read incredulously at what appeared to be a rave review, I slid the paper over to her and said "you must have me mixed up with someone else. This can't be my review." She asked my why. I went for broke and told her that she had ridden my ass all semester and I thought that she hated me. She chuckled... "When you didn't quit and didn't give up, I knew you would be a great nurse." I got up confused and relieved and never had her as an instructor again because she left the school to go back to the VA hospital. I was so happy at the time and went on the graduate and never really thought about her unless I was telling the new students about "that militant instructor" whenever I heard them complain about an instructor.
Time passed and I realized, in her own way, that she was trying to prepare me for a hard career in which you will never make everyone happy. People will yell at you and try to hurt you physically. It's not an easy profession to be in at times. I have to say that most of my career, while working in the hospital, was very rewarding though.
As I read the newspaper the other day, I saw a face I hadn't seen in years. It was a memorial picture in the obituary section of that militant nurse who taught me to be strong. I wish I could have thanked her before she died.
So I do it now.. Thank you Mrs. Dodds for being the one instructor who pushed me.
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