tag:blogger.com,1999:blog-109540312024-03-08T10:45:46.690-05:00The Nurse Practitioner's PlaceA nurse practitioner blog/website. Information relevant to nurse practitioner practice. Links to other nurse practitioner, nurse, and medical professional sites.Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.comBlogger463125tag:blogger.com,1999:blog-10954031.post-49293670658721454762015-10-14T00:35:00.001-04:002015-10-14T00:35:13.508-04:00So How Has Your Day Been Going At Work?<div dir="ltr" style="text-align: left;" trbidi="on">
I was thinking of something to blog about and the following question popped into my head!<br />
How has your day been going at work? Are you satisfied with the time you get to spend with your patients? Do you have enough time to chart properly? Do you often take work home to complete? Do you feel that your staff helps you get through your day and that the front desk staff respects you as a provider? Does your employer treat you as a valued provider and include you in decision making? <br />
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I think that many NPs are struggling with the above issues. I see many NPs complaining on the boards about all of these issues. How are you dealing with these issues? Give us some suggestions and we'll try to help any new NPs through the stressors of a new role. <br />
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Chime in everyone!<br />
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Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com3tag:blogger.com,1999:blog-10954031.post-70568648541186176932015-09-09T20:38:00.001-04:002015-09-09T20:38:55.242-04:00Johnson and Johnson Must Be Really Anti-NP<div dir="ltr" style="text-align: left;" trbidi="on">
Well, I got to work today and received a notice from our Patient Assistance Program rep who informed me that effective immediately today that only a MD may sign the scripts and paperwork for their program. <br />
<br />Wow... So all of the independent Nurse Practitioners who don't require any collaborative agreement with any physician can no longer get their patients meds through the program. Talk about being anti-NP! Such a delay in care for our patients. This will even possibly make patients have to schedule an additional visit with a doctor in order for them to complete this requirement. <br />
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When are the big pharma companies going to realize that we are here to stay? This is such a step backwards. I also get steamed when I see all the medication commercials who say "Ask your doctor!" instead of ask your health care provider. Some are getting the hints and changing their wording ever so slowly. <br />
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What say you?</div>
Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com0tag:blogger.com,1999:blog-10954031.post-87995108173752344612015-04-27T19:17:00.001-04:002015-04-27T19:17:34.001-04:00How Do You Feel About Being Called A "Mid-level"?<div dir="ltr" style="text-align: left;" trbidi="on">
Hello all,<br />
<br />
It's been a while since I've posted. First off, an update on my sister Denise who is doing well and made it back home due to a few donations on Go Fund Me. I really appreciated the donations. Keep them coming if you have an inkling.<br />
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Back to the subject at hand.. How many of you NPs are bothered by the term "mid-level". It personally drives me bananas! I think we need to come up with an alternate term. My collaborating MD asks why I'm bothered by it since that's what I am...<br />
I just wonder if I am "mid-level, who's the "low level provider"? I don't feel that I give "mid care" to my patients.<br />
<br />
Some NPs don't mind the label but some of us hate it! What say you?</div>
Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com4tag:blogger.com,1999:blog-10954031.post-20421822046630296532015-04-10T21:27:00.001-04:002015-04-10T21:27:44.280-04:00Help My Sister Get Home To Florida<div dir="ltr" style="text-align: left;" trbidi="on">
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<br />
<br />
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<br />
Hello to all of my readers. My sister Denise is currently stuck in Seattle, Washington in a hospital post quadruple bypass surgery. She's hanging in there but needs a plane ticket home and money during her recovery period. I appreciate any help you may be able to provide. Please share this link!<br />
<blockquote class="twitter-tweet" lang="en">
Dimes For DeeDee <a href="http://t.co/IyQqKtfghP">http://t.co/IyQqKtfghP</a> via <a href="https://twitter.com/gofundme">@gofundme</a> This is my younger sister who is 42. Please help me get her home to Florida.</blockquote>
<br />
This is one reason why it's so important to understand your genetic potentials for bad health issues.<br />
My mother also has had a quad bypass and my sister's father died of a myocardial infarction. I speak to many patients who don't know a thing about their family's medical history and it's a sad situation.<br />
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My goal for you is to do your homework. Be a super sleuth and ask those important questions!<br />
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Have a great day!<br />
<br />
<br />
<script async="" charset="utf-8" src="//platform.twitter.com/widgets.js"></script></div>
Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com0tag:blogger.com,1999:blog-10954031.post-65873775719636169092015-03-01T00:11:00.000-05:002015-03-01T00:11:38.098-05:00Ramblings of A Nurse Practitioner<div dir="ltr" style="text-align: left;" trbidi="on">
Often people ask me what I missed the most while I was in NP school. I would have to say my family time and my hobbies. I used to read voraciously, but now find myself playing on Facebook and reading other people's comments on posts there rather than picking up a book and plucking myself in a cozy chair next to my husband while he watched TV.<br />
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I also didn't realize that it would continue into my career. It is what we do as providers. We sacrifice so that others can be healthier people and hopefully they listen to our advice. Unfortunately, some won't and we lose them along the way. Hard to watch at times and so hard not to just lay it all on the line and tell them what we really feel when they say that they cannot afford their meds while having a pack of cigarettes in their pockets or their nails done at the local nail salon.<br />
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My problem is that I often say what is on my mind and what I'm really thinking. I have been lucky in my career to have some pretty great patients who appreciate my candor. I've probably made a few cringe along the way but so far so good. I also stopped blogging once I got out of NP school and I realized that there aren't many of us doing it anymore due to HIPPA worries so I have to remember my Ps and Qs.<br />
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It's a sad situation in life that we can't practice medicine the way the old country docs did in the day. They were truly their towns providers and attended the same functions, went to people's home for dinner and socialized with their patients. I've had patients invite me to their functions and I've declined at times so that I don't get caught into the trap of having to attend everyone's activities.<br />
I don't go to funerals of my patients either unless they are tied to our company as an employee. I don't do funerals well because I tend to cry and look like an idiot blubbering on the widow's shoulder when it's really her turn to grieve. I plan to have a living funeral so I can party before I go and really see who gave a crap for real. I actually thought of attending my own funeral like the great Oz behind a curtain but I probably couldn't keep my mouth shut if I heard someone say something I didn't like.<br />
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I definitely will not be stared at as I will be cremated. I am a organ and tissue donor so there won't be much left over. I hope to help as many people as possible when I go.<br />
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Strange ramblings today but I haven't written in a long while.... See ya around!</div>
Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com6tag:blogger.com,1999:blog-10954031.post-85984867979667588182014-11-19T20:08:00.001-05:002014-11-19T20:08:42.836-05:00Am I Invisible Or What?Just a question... How many NPs have been excluded from company parties that Docs are invited to? I would certainly hope not many. Do you get included in company meetings? This still boggles my mind considering that NPs bring in quite a lot of revenue for practices and have very high patient satisfaction scores.<div>Are you included in your company or do you feel like your input makes no difference?</div><div>I've heard various responses from full involvement to none. Where do you land in the spectrum? Do you feel like it matters? How would you go about changing the perceptions?</div><div>Go!<br><div><br></div></div>Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com5tag:blogger.com,1999:blog-10954031.post-13263861745419669882014-05-26T09:46:00.001-04:002014-05-30T20:50:07.656-04:00Nurse Practitioner Burnout<div><span style="font-family: 'Helvetica Neue Light', HelveticaNeue-Light, helvetica, arial, sans-serif;">Why do NPs burnout? Much the same reasons as Doctors. Constant pressure to produce and keep everyone happy including patients, their family members, our bosses, our co-workers, insurance companies, and our own families. At the same time, trying not to kill anyone.</span></div><div><span style="font-family: 'Helvetica Neue Light', HelveticaNeue-Light, helvetica, arial, sans-serif;"> The good thing is that has resolved itself with a job change. I just spent a long weekend at the beach and never opened my computer to work. For the first time in 6 years...</span><div><div>That's not saying that I haven't taken time off, just that I've always had to open my computer and work at some point during the event. </div><div>You need to find ways to unstress your life or both components will fall apart. Read a book for pleasure. That doesn't include trade magazines! I'm talking about a good, juicy romance novel or some trash mags and just unwind. I also watch certain television shows and don't work while I'm enjoying it. Even if it's an hour or two a week, go for a walk or try to garden. </div><div>These tips will prevent burnout for a little while. </div><div><br></div></div></div>Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com2tag:blogger.com,1999:blog-10954031.post-84783574595468277042014-05-03T18:35:00.001-04:002014-05-03T18:35:40.298-04:00Once Again FL Is Behind The TimesUnless there is a special session, once again Florida Nurse Practitioners have been left in the Dark Ages of medicine. I have been watching the House and the Senate closely during this year's sessions. I was so hoping that this would be the year prescription authority at least would be granted. After all, we are the LAST State left! <div>Really! Do you actually think that we will start running willy nilly writing narcotics for every patient who asks for them? Am I that stupid and untrained that I can't figure out who truly needs pain medications? You don't think that I can tell when patients are trying to pull a fast one? I use appropriate screening tools including online that can tell me Statewide where and when a patient has received narcotics anywhere in the State. </div><div>Does anyone care about the delay in care? I had to wait three months at a new practice site to write for sleeping pills for well established, upstanding patients because my collaborating MD was delayed in arriving and the temp collaborator didn't want to cover until the regular one was here. </div><div>Until patients start writing their congress and senate and demand that we become recognized as top notch competent providers, nothing will change. </div><div>Just like this year....</div>Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com0tag:blogger.com,1999:blog-10954031.post-40953568642959324162014-02-22T00:18:00.001-05:002014-02-22T00:18:52.987-05:00Changes in Practice LocationsApparently, after I left my previous employer to go to Shand's Primary Care West in Lake City, I have been "just booked up, sick, or out of the office." <div>I understand that the previous practice does not want to tell my patients where I went in order to try and keep them from following me. But it's pretty sad when they lie to patients and not just tell them that I've moved on. Don't they realize that it makes people mad and make them want to leave? </div><div>I have always thought no compete clauses were stupid anyway. Adults will follow a provider if they can because they have built a relationship and trust. I can't make them follow if they don't want to. </div><div>I will be glad when the new doctor joins the group so the advertising goes out and it all can be clarified. </div><div>Otherwise, I've been on the longest vacation of my life?</div>Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com1tag:blogger.com,1999:blog-10954031.post-70254626239929225252013-12-22T09:24:00.001-05:002013-12-22T09:24:33.064-05:00Cha Cha Cha Changes!It's been a while since I've posted due to some changes in my career setting. I'm still a FNP but moved to an office closer to home with better hours. This was a sudden thing as the opportunity fell into my lap. <div>This is the first chance I have had to blog in a bit that didn't feel like a complaint yet again. I had a wonderful weekend without my computer attached to my hip and wasn't quite sure what to so with myself. I'm sure the quiet timd will once again be few and far between but I'm catching up on some reading.</div><div>I plan to go through my links and clean those out and pop over to some of my old blogger haunts and say hello.</div><div>Hope to become more motivated to write! See you around after I catch up on some sleep!</div>Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com1tag:blogger.com,1999:blog-10954031.post-72391265226670638802013-10-27T20:39:00.000-04:002013-10-27T20:39:09.893-04:00Should You Shadow At A Location Before Working There?<div dir="ltr" style="text-align: left;" trbidi="on">
Some NP new graduates are asking whether or not to shadow at a location before accepting or talking terms with an employer. I say yes because it can give you an invaluable look at a practice and it's style before you commit.<br />
I would not do it for more than a few days and be very specific about what constitutes shadowing. In my view, it means that you follow the different providers in the practice on their busiest days and see how they interact with patients and staff members. Don't pass up a chance to eat lunch with the nurses as they will usually give you the real lowdown.<br />
If the provider wants to use your services, make sure that there is a legitimate offer on the table.<br />
I also recommend that you use your preceptorship hours as a way to do the same thing. That's what I did and figured out really fast which offices I did not want to work. I definitely don't recommend working in an office setting where a spouse is the office manager. I won't expound on that subject but understand that I will work for Wal-mart before that EVER happens again.<br />
What say you? Any experiences?</div>
Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com4tag:blogger.com,1999:blog-10954031.post-91573793968902155642013-10-13T21:12:00.001-04:002013-10-13T21:12:10.489-04:00Why A NP Thinks ObamaCare Will Not Work<div dir="ltr" style="text-align: left;" trbidi="on">
Everyone is yelling and screaming about the government shutdown over the Democrat's and Republican's refusal to come to an agreement regarding the funding of ObamaCare. So.....what are we going to do about all of this. As a health care provider, I agree with some of the basic ideas. Patients should be covered by insurance regardless of previous medical conditions. I agree that everyone should be able to be covered by some form of medical coverage. We must make it affordable. How do we do this?<br />
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The problem universally is two fold.<br />
1. Can and should we force people to be covered? Some say that we live in a free society and that to force us to pay for something we might not want is against our inherent rights. Some say that if they don't want to pay for insurance that they should not have to. When they get sick, they will pay for services then. Ideally, patients should be able to pay cash for services rendered but some provider's offices do not take cash pay patients. The worry is that if you accept them and they cannot pay, you are still obligated to take care of them. I don't believe this is true. If you give a patient 30 days of emergent care and a notarized letter stating that you will no longer accept them, it's a done deal. We don't live in a prison society where medical providers are forced to care for patients that they may not gel with just as patients have a right to change providers as well.<br />
In a utopian society, everyone would feel obligated to pay their debts. Years ago, people would feel severe shame for going to the hospital or a medical provider and not pay the bill. They would feel less of a human being and would make the effort as soon as possible. If they couldn't pay in money, it would be done in trade for goods. Ah the good old days! But that was the time when we didn't have such high costs for medical care. Medicine is big business. Why should we make it more affordable for people to be diagnosed and treated? I can see a treatment being more expensive when it first comes out. We have to pay for innovations. But years later, we are still paying thousands of dollars for technology that has been out such as CTs and MRIs. Why should it cost thousands of dollars now for those diagnostics? Because medical imaging is big business, because research is big business. What would happen if we cured the common cold? How many shelves of cold remedies would not be needed and how many pharm companies would lose millions of dollars? My gosh! Add any the other medical ailments that may actually be cured and we could almost have a conspiracy theory. But, I digress.....<br />
Who will pay for this coverage?<br />
Everyone who works at a legitimate job. Yes, this means you and me. People are telling me that the new plans are expensive and that they cannot afford them. Some are saying that they are going to opt out but are finding out that the penalties are too high. So they will be forced to buy the insurance in order not to be penalized. Great.<br />
What about all the other patients who are below the poverty range and cannot afford to pay for their insurance. They get it for free. Wait! It's free to them but it's not to us who have to pay higher taxes in order to maintain the Medicaid system. So we're getting doubly slammed. We HAVE to pay for ours because we have a legitimate job.<br />
My solution? Do away with the ability to walk into any ER and get care for free, ESPECIALLY when it's not an emergency. If they show up via private vehicle with a complaint that did not just happen within the last 24 hours, send them out to their new primary care providers who will take care of the regular issues that are not emergent. The same goes for the bogus EMS transports. If the patient is determined to be using the EMS system in order to get into the ER for quick issues that are not emergent, PENALIZE them by taking away some of their... Oh wait! They don't have a job so they have nothing to give as a penalty...BINGO! By Jove I think I've got it! If they have two legs and two arms and can follow directions, they can work on the side of the roads and in the fields right next to everyone else. Disability should only be given to those with HARDCORE, REAL medical problems!<br />
If you can walk, talk, sit, stand, bend over and breath without oxygen support, you can do something. I know! They can be trained to be sitters and caregivers for our elderly so that their families can get back to their jobs and become productive in their own lives. They can be trained to help take care of animals in the shelters and the zoos and National Parks. They can be trained to work at the homeless shelters and to help with childcare for those who are out there working for a living.<br />
What say you?</div>
Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com3tag:blogger.com,1999:blog-10954031.post-33120530024129500672013-07-29T19:40:00.003-04:002013-07-29T19:40:59.216-04:00Getting A Second Wind<div dir="ltr" style="text-align: left;" trbidi="on">
I have been dealing with some issues at work lately but I think that things are going to improve. It's amazing how tension can effect people and how both positivity and negativity can impact your life. <br />
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Most of my patients are very astute to my moods as well though I try to hide it. I have always been positive in the room and try not to bring outside influences into the exam room. Patients also try to hide when things are bothering them. Often, after a few minutes, I can pick up on it and some have broken down and admitted that there are pretty bad stressors in their lives. <br />
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A lot of medical providers don't care to ask a patient how their lives are doing. They just want herd them through like cattle and while the notes look good on paper, the patient didn't feel like they were listened to. I try really hard to interact with my patients and find out what the real issues are behind the headaches and the stomach problems. <br />
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Do you feel like your provider listens to you? </div>
Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com2tag:blogger.com,1999:blog-10954031.post-50883882992868101132013-06-15T09:13:00.001-04:002013-06-15T09:13:28.393-04:00Oregon Working Toward Equal Pay For Equal WorkOregon will become the first state to require insurance companies to pay at the same reimbursement rate once it gets signed into action. The biggest amount of complaint will of course be from doctors who are going to be unhappy about the situation.<div><br><div>The issue is that we are doing the same exact visit with the same exact treatment plan. So why wouldn't we be eligible for the same pay? Well. Doctors say its because they have more education and training and that if we wanted to practice medicine that we should have gone to medical school. </div></div><div><br></div><div>My mindset is why does medical school have to be so long if NPs and PAs can do the same with less training? I think that the college system is antiquated and needs to be changed in order to help bring more family doctors out into practice. I think that NP practice has evolved out of sheer necessity and things aren't going back to the good old days. </div><div><br></div><div>Collaboration is still the name of the game but the actual collaborative agreement is fast becoming a thing of the past as each state passes independent practice in more and more states. </div><div><br></div><div>Doctors are screaming that we are going to hurt patients and that "you don't know what you don't know". That goes for doctors too. Brand new MDs can be just as much a risk if they don't understand their limitations as well. I am sure that there are some that will cross the line and make mistakes. That's what the legal system is for. As more cases come up, the malpractice rates will also. </div><div><br></div><div>NPs have less lawsuit activity. Why? Is it because we make less mistakes? Probably not, but patients have the perception that we care more and we are more human so we are more easily forgiven. Studies have shown that if you acknowledge your mistakes to patients that they will less likely sue a provider. </div><div><br></div><div>I am watching the issues closely as will. are thousands of others. What say you?</div>Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com2tag:blogger.com,1999:blog-10954031.post-30482775858468309002013-06-11T21:58:00.001-04:002013-06-11T21:58:26.458-04:00IRS Steals Medical Records<p style="text-align: -webkit-auto; margin: 0px; padding: 0px; border: 0px none; outline: 0px; vertical-align: baseline; "><span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">The article below concerns me a lot and I hope that the doctors wins his lawsuit and I hope patients find out and sue as well. If you had asked me if I thought that this could happen with the privacy restraints that we have, I would have said no!</span></p><p style="text-align: -webkit-auto; margin: 0px; padding: 0px; border: 0px none; outline: 0px; vertical-align: baseline; "><br></p><p style="text-align: -webkit-auto; margin: 0px; padding: 0px; border: 0px none; outline: 0px; vertical-align: baseline; "><span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">The House Energy and Commerce Committee sent a letter Tuesday to acting IRS Administrator Daniel Werfel requesting information about a 2011 agency search and seizure of as many as 60 million medical records from a California health care provider.</span></p><p style="text-align: -webkit-auto; margin: 0px; padding: 0px; border: 0px none; outline: 0px; vertical-align: baseline; "><span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">The letter follows a recent lawsuit regarding the legality of the seizure of more than 10 million American patients’ medical information while executing a warrant related to a former employee’s financial records, leaders of the Republican-led committee said.</span></p><p style="text-align: -webkit-auto; margin: 0px; padding: 0px; border: 0px none; outline: 0px; vertical-align: baseline; "><span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">The letter, which gives Werfel until June 25 to respond, cites a news report this year that states the unnamed health-care provider is now suing the IRS and 15 unnamed agents in California Superior Court and that the suit alleges the agents stole more than 60 million medical records from more than 10 million American patients during a search conducted March 11, 2011.</span></p><p style="text-align: -webkit-auto; margin: 0px; padding: 0px; border: 0px none; outline: 0px; vertical-align: baseline; "><span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">The IRS could not be reached late Tuesday for comment.</span></p><p style="text-align: -webkit-auto; margin: 0px; padding: 0px; border: 0px none; outline: 0px; vertical-align: baseline; "><span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">The committee says the warrant authorizing that search was apparently limited to the financial records of a former employee of the company and did not authorize the confiscation of the personal medical records of those who had no connection to the initial IRS investigation.</span></p><p style="text-align: -webkit-auto; margin: 0px; padding: 0px; border: 0px none; outline: 0px; vertical-align: baseline; "><span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"> Members said the allegations are of particular concern considering “the IRS’s increased role in implementing health care under the Patient Protection and Affordable Care Act.”</span></p><span style="margin: 0px; padding: 0px; border: 0px none; outline: 0px; vertical-align: baseline; text-align: left; -webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><div style="text-align: -webkit-auto;"><br></div><div style="text-align: -webkit-auto;"><br></div><div style="text-align: -webkit-auto; "><font>Read more: </font><a href="http://www.foxnews.com/politics/2013/06/11/house-asks-irs-about-purported-seizure-millions-americans-medical-records/?test=latestnews#ixzz2Vxkax83y" style="outline: none 0px; text-decoration: none; cursor: pointer; ">http://www.foxnews.com/politics/2013/06/11/house-asks-irs-about-purported-seizure-millions-americans-medical-records/?test=latestnews#ixzz2Vxkax83y</a></div></span>Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com0tag:blogger.com,1999:blog-10954031.post-17366074762246057802013-06-07T23:31:00.000-04:002013-06-07T23:31:10.009-04:00How To Deal With A Hostile Work EnvironmentHow to deal with a hostile work environment? This is a touchy subject in the medical world. Nurses are often subjected to harsh working environments of forced overtime and heavy patient ratios. More experienced nurses often "eat their young" in the hospital arena.<br />
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One way to improve this is to further your education and move out of those areas of practice into a realm that offers more autonomy like becoming a Nurse Practitioner. This is the track that I took to improve my nursing career almost 6 years ago. For the most part, I have enjoyed my job taking care of patients and their families and watching the children grow up in our practice. The only thing that I have found to be aggravating is the rather massive amount of paperwork involved with doing my job.<br />
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Until now....................<br />
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As we've gotten bigger over the last few years, we added another provider who is the complete polar opposite of my personality. At first, when I found this person a little remote, I attributed it to lack of experience and trying to fit into their new role in the practice. I let it slide and tried to make small talk. Occasionally, I thought that things were warming up. Then, I started hearing comments that my patients didn't like their attitude, that they weren't being listened to, and that they felt that the provider was "mad at them" for some reason unknown to them. During their visits with me, complaints were taking up a lot of our visit to which I explained that if they had an issue, they should write it up and send it to our boss. I tried to explain to them that the provider is very competent and that we just have different practice styles. <br />
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They are having none of that! The hope was that when a second provider came into the practice that it would give me a little bit of a break in the load but now that provider's patients are coming to me complaining about their own provider's care and so it is adding to my load rather than helping out.<br />
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I tried to explain to the provider, with tact, that patients were perceiving that they weren't liked by the provider and that they felt that the provider wasn't really listening to them, the provider got very defensive and said that I didn't have to defend them and that the patient should just write up a complaint themselves and send it up the chain. Duly noted.....<br />
<br />
For a while, it was okay in the office. I am busy with my patients and we mostly pass in the halls but this provider has completely deadpanned me. Mostly won't meet my minor attempts at conversation beyond a few words. Doesn't say goodbye when they leave for the day and their nurse is also becoming more rude as well. This nurse has been reprimanded for their attitude, but the provider I have no control over. My earlier attempts at letting my bosses know that there has been an issue without going into details has not been very helpful.<br />
<br />
What does one do in this situation? If I go above the provider with further complaints, it will just look like I'm being petty since the provider and I haven't really confronted each other about this issue. I have tried not to make a big deal of it because it is a very small office and I can't avoid them. I feel trapped in a hostile working environment.<br />
<br />
What say you?<br />
<br />
<br />
<br />Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com2tag:blogger.com,1999:blog-10954031.post-23686717883938244472013-05-27T16:02:00.001-04:002013-05-27T16:02:54.359-04:00Turn Us Loose And Let Us Fly <div dir="ltr" style="text-align: left;" trbidi="on">
Nurse practitioners can practice independently in 17 states. Slowly, over time, things will change. Many doctors will comment saying that "if you wanted to practice medicine, you should have gone to medical school". Well, I went to nursing school and it involved a terminal degree of NP at the time and I can diagnose, treat, and manage MY patients without a MD behind my name just fine.<br />
<br />
Most doctors are used to working with us on an equal footing, especially in rural settings. The company that I work for treat us all the same. It's been over a year since they have been recruiting another family doc with no success. Most of the reasoning is the fact that we are such a small town. It doesn't even have a traffic light.<br />
<br />
My patients don't care and most have never seen the MD collaborator that I have for any reason anyway. The only reason I need one in the office is to sign home health orders and controls. If I need a second opinion, I ask fellow MDs in our practice, just like other MDs would do in private practice when they work alone. The biggest fear that is quoted is "we don't know what we don't know" as an excuse for keeping us from full practice. I also argue the same for doctors. I wouldn't trust any health care provider who doesn't understand when to ask for help.<br />
<br />
Just turn us loose and let us fly or fall as we may. Patients just need SOMEONE to help.</div>
Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com2tag:blogger.com,1999:blog-10954031.post-14212479949743142682013-05-04T11:29:00.000-04:002013-05-04T11:29:21.332-04:00RN Nursing Graduation<div dir="ltr" style="text-align: left;" trbidi="on">
Last night was my soon to be daughter-in-laws's RN pinning ceremony. It's hard to believe that it was all the way back in 2001 that I received mine. I was so proud and nervous. I had no clue what my career and life would be like as a nurse and now as a nurse practitioner.<br />
<br />
I have formed several friendships over the years as a nurse and a nurse practitioner blogger. Surprisingly enough, most have been through the blogosphere. I have always loved surfing through my nursing buddy's blogs and seeing how their careers and lives have been going. Unfortunately, for me, blogging has been put on the back burner for far too long.<br />
<br />
So.... I will be making a concerted effort to blog more often. It will still be random, but more often. I also hope to have more time to read and comment more on your blogs. Hopefully, I will start getting more REAL comments instead of all the junk spam that I've gotten in the last few months.<br />
<br />
Here I come! Watch for my comments and come back here and leave some again and let's see if we can get the blog roll started again!</div>
Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com5tag:blogger.com,1999:blog-10954031.post-14771433231221975252013-03-22T20:34:00.001-04:002013-03-22T20:34:46.216-04:00Nurse Practitioners Walk The Line<div dir="ltr" style="text-align: left;" trbidi="on">
I often find myself wishing for the good old days when your family doctor was truly a part of your community. Back in the prairie days, docs and teachers would rotate staying in family's homes and often ate dinner with people in their community. People appreciated their care and the medical provider had a vested interest in helping people. Too often, many health care providers don't really know anything about their patients and aspects that influence the decisions they make in life. We are such a litigious society and providers are all about the numbers game. I have socialized with patients outside of taking care of them at work. (My husband and I have gone to the movies with a patient and her daughter, and they have come to our home for dinner) That doesn't mean that I would ever do something for them extraordinarily or outside what the normal care would entail. They know that once I leave work, I don't cross that line again until I clock in the next morning. You have to make hard fast boundaries such as I NEVER write any controls for anyone that I have ever seen outside work. I don't show favoritism in scheduling or callbacks. I don't discuss their healthcare outside of the office. If they need a script for something, they have to see me in the office and it's all documented in their chart. <br />I work in a very small community and every day people ask me how so and so is doing or that so and so sent me to see you because you take such great care of them and you really listen to their concerns. I find it stupid that I cannot officially acknowledge that fact, due to privacy laws, that I do take care of people here. It's not like they don't know already. They just passed each other in the waiting room for God's sake. Whatever happened to the good old days when people proudly proclaimed that you were their healthcare provider and you didn't have to look around to see if anyone else heard them? I have constantly remind them that if they try to ask me a medical question about their care outside the office, that they are officially breaking their own privacy because it could be overheard by others at the restaurant that I was eating lunch at.<br />
What you do think about it?</div>
Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com3tag:blogger.com,1999:blog-10954031.post-19505665399782541172013-03-15T20:22:00.001-04:002013-03-15T20:22:34.232-04:00Top 25 Websites For Nurse Practitioners & Nurse Practitioner StudentsI love when I find my blog listed as one of the top NP blogs on the net! I am really trying hard to get back to blogging and finding my voice again. The office has been really busy and we still haven't found another MD to work in our small town. I'm getting tired but am hanging on! Enjoy looking through their links and I will be doing it too so I can find some more great NPs to follow myself!<br />
<br />
<a href="http://onlinefnp.com/2012/top-25-websites-for-nurse-practitioners/">Top 25 Websites For Nurse Practitioners & Nurse Practitioner Students</a>Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com0tag:blogger.com,1999:blog-10954031.post-92018982429908347572013-03-04T22:46:00.000-05:002013-03-04T22:46:19.864-05:00Speaking about Cold and Flu Differences On The Radio<div dir="ltr" style="text-align: left;" trbidi="on">
Hello to all who are reading my Nurse Practitioner blog! I had a busy week at the office and helping my husband on <a href="http://www%2Cretroclubshow.com/">The Retro Club Show</a> on 96.5 The Jet Saturdays from 1-3. To listen, go to the Retro Replay tab and click on the links. I've been enjoying myself and hope to get some feedback on the website from listeners. I am trying to be totally conversational like I am in the office.<br />
<br />
What is your style in the office? Most NPs are interested in the entire patient. This makes me run behind in the office. I guess as long as I'm worth the wait, I will continue to do it. I tell my patients to tap their watch at the beginning of the visit to signal if they are in a particular hurry so I will know.<br />
<br />
Medicaid is opening up for the next three years, according to Governor Rick Scott. What does this mean? I'm not really sure, but I hope that it makes it easier to qualify for older patients who aren't old enough for Medicare and can't afford insurance. We will see! I do know that it will make for several more patients in the office that I work in and we need help! Can't seem to find a doctor who wants to work in a small rural town.<br />
<br />
Till then, I will keep on working as hard as I can to take care of them all. Cheers!</div>
Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com0tag:blogger.com,1999:blog-10954031.post-30315219838727663412013-02-20T21:02:00.001-05:002013-02-20T21:02:54.438-05:00Geez At The Spam!<div dir="ltr" style="text-align: left;" trbidi="on">
Great Gatsby! I turn my back for a second and my comment box is FULL of spam comments! Doesn't anyone leave legitimate comments anymore? It seems like most of coming from overseas too. Ugh!<br />
<br />
Since I haven't personally updated about me in a while, here goes....<br />
<br />
I am to be a Noni again soon and it's a girl! My daughter has picked out Virginia Lynn as the name so far. She's due on her brother's birthday.<br />
<br />
Work is a crazy as ever and we are still looking for a physician to join the practice but haven't found any that want to work in a small rural town. Since we are one of two offices that are left, we are getting swamped with new patients. I think that my personal panel is full but we keep accepting more and more. This makes for a crankier me and a more tired me. But, I will prevail.<br />
<br />
The hubby is starting a new radio show on Saturdays from 1-3 on 96.5 The Jet called <a href="http://www.retroclubshow.com/">The Retro Club </a>Show and it will include a health tip segment hosted by me and I'm looking forward to it. Feel free to pop on over sometime and check it out.<br />
<br />
If you enjoy this blog, please leave a real comment and not some random bullshit link filled spam. Thank you!<br />
<br />
<br /></div>
Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com6tag:blogger.com,1999:blog-10954031.post-61411398530455261132013-01-15T18:32:00.000-05:002013-01-15T18:32:43.766-05:00Certified Medical Assistants Calling Themselves Nurses<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<br />
I was recently seeing a patient in my office and a family member was in during the visit and was asking some very interesting questions. Since she was knowledgeable, I asked if she was in the medical field somewhere. She said that she was a nurse. I asked her what type of nurse she was and she told me that she was a CMA (certified medical assistant). "Ah, I said, you aren't actually a nurse," and I told her to be very careful about giving the impression that she was one without an actual degree as such. I explained, in a nice way, that it is illegal to portray yourself as a nurse when you are not and that you can get into trouble. " As clearly stated on
<a href="http://emedicalassistants.com/" title="http://emedicalassistants.com/">emedicalassistants.com</a>" , a medical
assistant calling herself a nurse is not just confusing patients but also
committing a crime." I told her it was the same as if I told people that I was a medical
doctor rather than a Nurse Practitioner and that I could lose my
license. <br />
<br />
In fact, it's a pretty hot topic on some nursing forums. Below is a response to the same question by an LPN.<br />
"It's very simple, really. If you are not a licensed nurse--you are not a
nurse. The title carries with it a certain level of responsibility and
education (not time, but content). A CMA/MA should identify themselves
appropriately, and then docs and patients will catch on. I drew blood
and ran lab tests but never called myself the lab technician. Same with
taking xrays. I am a nurse because I went to school to be a nurse and
took my boards and passed, earning my title of RN or Nurse. I have been
taught the nursing process as well as disease process. I can function
in a doctor's office or a hospital. The same cannot be said for a
CMA/MA. CMAs/MAs should be proud of what they do and also be protecting
their title as they earned it. Badges should include title so the
public is aware of who is caring for them."<br />
<br />
Below is the legal definition for this issue: <br />
<br />
<b>Title "Nurse" Protection <br />
</b>Restricting use of the title "nurse" to only those individuals who have
fulfilled the requirements for licensure as outlined in each state's
nurse practice act is a protection for the public against unethical,
unscrupulous, and incompetent practitioners. Nurse practice acts
describe entry level qualifications such as education, practice
standards and code of conduct for continued privilege to practice
nursing. Limiting use of the title "nurse" to only those who have
satisfied the licensure requirements ensures the protection the public
deserves.<br />
<br />
At least 37 states are known to have language in their Nurse Practice
Act; either explicit in restricting use of the title "nurse" to only
those who are licensed or implicit language restricting use of any words
implying the individual is a licensed nurse<b>.....</b><b><br />
AR, AZ</b>, <b>CA</b>, <b>CO</b>, <b>DE</b>, <b>FL</b>, <b>GA,</b> <b>HI</b>, <b>ID</b>, <b>IL</b>, <b>KS, KY</b>, <b>MD</b>, <b>MN</b>, <b>MS</b>, <b>MO</b>, <b>MT</b>, <b>NE</b>, <b>NV, NM</b>, <b>NY</b>, <b>NC</b>, <b>ND</b>, <b>OK,</b> <b>OR</b>, <b>RI</b>, <b>SC</b>, <b>SD, TN</b>, <b>TX</b>, <b>UT</b>, <b>VA</b>, <b>VT</b>, <b>WA</b>, <b>WV</b>, <b>WI, WY</b></div>
Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com26tag:blogger.com,1999:blog-10954031.post-30227550064238438122012-12-19T23:33:00.000-05:002012-12-19T23:45:42.499-05:00Standing Guard on the Front Line of your Patient’s Health<div dir="ltr" style="text-align: left;" trbidi="on">
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<strong>Standing Guard on the Front Line of your Patient’s Health</strong><br />
Not only does a nurse practitioner play a vital role into the wellness of their patients, but also their passion for the field keeps them abreast on the latest and greatest resources that their patients can benefit from. When patients begin the search for a <a href="http://phoenixfamilymedical.com/aboutus/qa-with-dr-stephen-graham-md.html">family care physician</a>, knowing the candidates, their personalities, reputations, backgrounds and the amenities and services provided by their hospitals will help nurse practitioners pair patients with the perfect match.<br />
<strong>Top of the Class May Be Bottom of the Barrel </strong><br />
Finding a great physician is not as easy as shopping for a new TV with surround sound—you just can’t sit in front of them for 20 seconds and determine if they are a winner. In an article by <a href="http://www.nytimes.com/2008/09/30/health/30find.html?_r=0">The New York Times</a>, finding Dr. Right can be a hectic journey pitted with disappointment. The author states that there are very few good quality measures in place to asses individual doctors so that consumers can do research on what they hope to find in a physician they feel comfortably towards. Some patients may want a doctor who was at the top of his graduating class, while others want someone with rave bedside manner reviews. Some patients even look for a doctor who actively publishes and attends seminars as part of his/her continuing education. Knowing the various physicians in your industry will not only be an asset to them, but you will be helping your patients in finding the right doctor by avoiding many hurdles.<br />
<strong>Tips for Promoting and Pairing </strong><br />
Of course it goes without saying that you would recommend a patient-physician pairing based on the patient’s individual chart and family life. These days, women are seeking out doctors who are affiliated with a women’s wellness center. Whether they are about to start a family, or they need emotional / psychological health care, women’s wellness centers are becoming increasingly popular. Consider these treatment types and how they play a role into your patient:<br />
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· Fertility treatment<br />
<br />
· Hormone replacement therapy<br />
<br />
· Weight loss<br />
<br />
· Chronic Fatigue treatment<br />
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· Well Woman exams and pap smears<br />
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· Emotional and psychological care<br />
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· Nutrition<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhMM6cXyawdo5cp1EtVErSm6n7KHPpu3scTUE5gjOexyMHFzh5RSJfSyuc9P2ZTloy_OckQyOhnUTkpdffP8rLD8q07NYvzmkjX8SOGUEEhL7YCsnX-V9UMphoEv5dkhIXbjcpg2A/s1600/4355.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="276" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhMM6cXyawdo5cp1EtVErSm6n7KHPpu3scTUE5gjOexyMHFzh5RSJfSyuc9P2ZTloy_OckQyOhnUTkpdffP8rLD8q07NYvzmkjX8SOGUEEhL7YCsnX-V9UMphoEv5dkhIXbjcpg2A/s320/4355.jpg" width="320" /></a></div>
Female patients utilize almost all of these preventative and re-occurring therapies. Knowing the doctors and their reputations who offer these services will help you pair your patient to a doctor as if you were selecting the perfect wine to go with that wedge of brie.<br />
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<strong>Build Better Relationships </strong><br />
If you are truly fortunate, your workplace will have that family-orientated feel to it where doctors, nurse practitioners, techs and the nursing staff all work together in harmony while providing the best care to their patients. Unfortunately, this is a rarity, as the hierarchal pyramid of entitlement still stands. However, this atmosphere does exist in some places. You can help strengthen ties with your colleagues by taking the time to learn about them and what their patients are saying. When you refer a patient to a doctor, not only are you strengthening that relationship with the patient, you are reinforcing the links that bind you to the physician. It doesn’t take a lot of time to read up on the inner workings of your health care institute, and know the medical roster. By taking the time to do some research, you are standing even firmer on the front line of your patient’s health.<br />
<em>Image source: <a href="http://alghad-ls.ly/Images/Nurses.jpg">http://alghad-ls.ly/Images/Nurses.jpg</a></em><br />
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Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com3tag:blogger.com,1999:blog-10954031.post-39008716932096701792012-12-19T23:21:00.000-05:002012-12-19T23:21:08.372-05:00Signs and Symptoms Of Teen Drug UseUnfortunately, I see signs and symptoms of teen drug use in Family practice. It causes so many repercussions that can last a lifetime. One of the biggest ones is the loss of trust between a child and a parent. Once it is figured out that your child is using drugs, you will have a serious issue with being able to trust that person again. Even if they want to start over, it will be difficult for you to tell if they really mean it. This can cause hard feelings on both parts. It's important that you use a professional to help you through the situation. I often tell my patients that it is a two way street and that it will be a long hard road to recover from. But..it CAN be done!
<a href="http://www.newportacademy.com/signs-and-symptoms-of-teen-drug-use/"><img src="http://www.newportacademy.com/wp-content/uploads/HowtoTellYourKidIsUsing.png" style="max-width:100%"/></a><br/>Via: <a href="http://www.newportacademy.com/">Newport Academy</a>Anonymoushttp://www.blogger.com/profile/03879069463960748178noreply@blogger.com1