The Nurse Practitioner's Place

Happy Anniversary to Change Of Shift

2009-07-12T02:09:00.002-04:00

I'm just a little late, but never to forget Emergiblog's Change of Shift. Kim is one of the premier nurse bloggers on the internet and still going strong. There are few nursing blogs that I frequent and she's the cream of the crop! I envy her writing style and laugh until I almost pee my pants at some of her posts. One day, I would love to meet her in person and say hello. Till then, I can admire her from afar.

I can really say that if I ever end up in the ER, I hope that the nurses who take care of me care half as much as she does about her patients and her blogging friends. I hope that she continues to keep Emergiblog going strong and continues her education and becomes a fellow NP when she finishes her BSN.

Top Colleges.com Gets It Totally Wrong

2009-07-11T21:36:00.002-04:00

Why is it so hard to figure out what nurse practitioners actually do? It's really not that hard. Pick up a telephone and call one if you really want to know. You can google the question and be brought to several sites, including mine, that can explain what we do and how to become one if you want.
The following is the explanation that Top Colleges.com has come up with for a nurse practitioner.

A nurse practitioner is an RN who has undertaken further training (such as a Masters degree) to provide similar care as a doctor (such as carrying out the same sort of non-emergency tasks that a physician may perform). In many states, nurse practitioners are able to write prescriptions for patients.

Go on over and leave a comment here and give your explanation like I did. Maybe they will change their definition.

10 Ways for Nurses to Unwind and Veg Out

2009-06-29T20:03:00.002-04:00

Nurses are everyone’s caregiver, from seniors to expectant moms to patients in the ER to sick kids to surgery patients. But who’s there to take care of you when you shed your scrubs and head home after a long day – or night—of work? Whether or not you have someone to come home to, here are 10 ways for nurses to unwind and veg out after spending hours patching other people up.

1. Treat yourself to a manicure. Have someone else buff, paint and trim your nails. Having someone else look after your physical needs is a real treat, even if you know the manicure won’t last long at your regular job.
2. Head to the movies. It’s one of the few places that’s dark, quiet and you don’t have access to your pager.
3. Watch nurse and hospital shows on TV. No matter how bad you’ve got it, you most likely didn’t have to deal with a burning school bus, a helicopter crash, a tornado, and a murdering nurse’s assistant on the same day.
4. Burn your scrubs. If you’re planning on throwing out a pair of scrubs anyway, go ahead and burn them. It just feels better.
5. Challenge yourself to avoid using any kind of medical lingo in everyday conversation. It’ll be hard at first, but you’ll feel more like a regular human.
6. When someone calls and asks for help, just say no. On your day off, it’s okay to stop being the hero every time someone needs one.
7. Go out with friends who aren’t nurses. You’ll finally get a chance to talk about things other than your job and free yourself of the everyday stresses that plague you.
8. Go out with your nurse friends. Every once in a while, have a party or go to happy hour with your nurse friends to rant and vent about the little things no one else will get.
9. Sit by the window. If you’re locked up in a hospital all day, you may not get a chance to monitor the weather or even tell if it’s day or night. Spend as much time outside or at least by a window on your days off.
10. Go shopping. Go shopping for clothes you can’t wear to work, and then plan out the trips and activities you’ll wear them to.
This post was contributed by Kathleen Baker, who writes about the ultrasound tech school. She welcomes your feedback at KathleenBaker3212 at gmail.com

Change of Shift

2009-06-27T13:36:00.003-04:00

Change of Shift is up over at RehabRN. Boy am I a little behind! I need to start writing again!

What Part of Heart Attack Don't You Understand?

2009-06-25T22:23:00.002-04:00

Too often I have patients who show up to the office with reports of symptoms that have been occurring over several days, weeks, months, and even years. With the amount of medical information that is blasted over the television and on the internet, it still is amazing how much patients still do not understand about certain medical conditions.

Patient X shows up to the office and reports having chest pain, sweating, nausea, pain radiating down the left arm but didn't think that it was REALLY a heart attack and just wanted to come see me to make sure. The pain had stopped by this time.

I asked the patient why they didn't call 911 during this episode. "I thought it would just go away."

Hmmmm. Yep. You almost "just went away yourself!" Now go to the hospital and get your enzymes checked to see if you are finished with your heart attack and get a cardiac cath preferably by ambulance from here.

"Oh I can't go right now. I have too many things to do!"

Are you too busy to die? What part of having a heart attack don't you understand?

Sigh....

Nurse Practitioner Has Some Awesome HomeGrown

2009-06-13T18:23:00.003-04:00

What???
Oregano, basil and thyme of course. You certainly didn't think that I was talking about marijuana, did you? Jeez... I started a victory herb garden a while ago and am reaping the benefits. They smell so good and I'm experimenting with the best way to dry them. I also have some yellow squash, banana peppers, and tomatoes growing as well. It's been years since I've dabbled with a garden and my hubby and I are loving it.

Other news on the home front is that there is another grandson on the way and is due in October from the oldest son and his wife. I can't wait! The first grandson William is walking now and is just the cutest thing with his big blue eyes and blonde curls.

Work is going well and busier than ever. I am eagerly awaiting electronic charting so that I can stop taking charts home to work on otherwise I would be drowning. We are in the process of merging with a fellow federally qualified rural health company making us the largest in North Florida. I'm looking forward to seeing how it helps my patients and how it may benefit me as an employee of the practice.

I did find out while trying to sign up for student loan payback on the federal level that you can't have accepted a sign on bonus. That really blows because I did when I signed a three year contract. Unless I can find a loop hole, I'm pretty much out of luck. Anyone know of any other programs or changes? Let me know.

Till the next time, keep up the great work as primary providers and mentors to fellow health care providers be they MA, CNA, LPN, RN, ARNP, PA, or MD.

Nurse Practitioners As Primary Medical Homes

2009-05-31T14:09:00.002-04:00

Over at DB's Medical Rants there is an entry regarding the primary care medical homes and whether NPs are capable of taking total care of their patients.

"We do not measure long tail events as a quality measure, because it would be very difficult to enumerate such events. So we have a classic important concept which is not easily measured. I will continue to insist that diagnostic errors are extremely important. I heard a colleague state that diagnostic errors are the most common reason for malpractice lawsuits. Yet our current quality measures ignore diagnosis.

Well trained physicians excel at diagnosis. I remember during training that the greatest praise for one of our heros was that he was a great diagnostician.

Our primary care debate often ignores this issue. I doubt that many NPs have the diagnostic acumen of well trained internists and family physicians. I might argue that long tail diagnosistics define a different level of expertise than the concept that primary care currently represents."

The following is my response to the above:

I think that any provider is only as good as their capacity to learn and evolve. I have seen both NPs and MDs who were content not to expand their knowledge base and therefore become stagnant. I pride myself in being an excellent diagnostician because that’s what I am most interested in. Not every doctor or NP or PA picks up on the nuances of patient’s complaints and there will be mistakes made. We are all human with weakness and false senses of pride. It needs to stop being a turf war and become about taking care of the patients in the best way we know how which is through collaboration.

What say you?

Just When I Think I've Seen It All

2009-05-30T17:39:00.003-04:00

I was poking around on the computer today and saw the promo for Nurse Jackie (played by Edie Falco) At first I thought "Oh goody, another nurse show to watch" then wham! I can't even tell you about it because it will give it away.

Click here to watch and then come back and tell me what you thought. Is it a total slam against nurses once again or will be a guilty pleasure that you won't be able to avoid watching...

Nurse Practitioner Finds The Best Cake I've Ever Tasted!

2009-05-09T22:54:00.002-04:00

The doctor that I work with at the office gave me an Amish Friendship cake starter. I figured if I didn't screw it up, I'd see how it went! OH MY GOD! I made my first cake today and it tasted like heaven! Anyone else ever tried one? It tastes like a spice cake and also like a cinnamon bun.

This is not good! I'm trying to lose weight and don't see any way of becoming tired of this cake!

I'm sitting here with the new laptop and loving it! It's a Toshiba and the keyboard is really smooth. I will be getting caught on some chart work this weekend after I get back from tomorrow's visit with my oldest son and his wife. (who's pregnant with my second grandchild, a boy we think)

Sorry this isn't a nursing post, but I haven't been in the mood. Blogging is like that. Dry spells happen. Next week, I'll get cracking! Any suggestions for posts will be appreciated!

A Great Edition of Change Of Shift Is Up!

2009-04-30T20:20:00.001-04:00

Change of Shift is up over at Codeblog. Get something great to drink and cozy up to the computer for a wonderful read! Click here.

How To Stay Busy In A Nurse Practitioner Office

2009-04-28T20:10:00.005-04:00

I stayed pretty busy today dealing with patients who are coming into the office with the same symptoms that I had Thurs-Sunday. It's not been overwhelming yet, but I can see it getting worse in the next few weeks.

I know that Swine Flu is supposed to be a respiratory illness, but I wonder if it's changed. I tried to talk to the health department about what I noticed in my office area, but they are not interested unless it's respiratory related with fever over 100.4.

I will swab the next pt with these symptoms and put a name to the one I'm seeing locally if I can.

I find it interesting that suddenly there is this much GI flu symptoms suddenly erupting?

Stay tuned!

The New Potential Pandemic-Swine Flu or How the NP Spent Her Weekend!

2009-04-27T20:14:00.002-04:00

Well folks, I think that I have been the unfortunate victim of this illness. The sudden onset of low grade fever, body aches from hell, nausea, vomiting EVERY hour, chills, sweats, and now on day two the stuffy nose and slight cough. It's pretty bad when you base what you try to eat consists of "will this taste as good coming back up in the next hour?"

After seeing a patient with the above symptoms, within 22 hours, three people in our office came down with the same symptoms with varying times of exposure. I was the lucky one with the longest contact so I ended up with the full force of the illness. I am going to propose that this is an airborne virus as well and contact.

The good thing is that the process doesn’t last more than three or four days (I’ve heard and pray!)

I hope that you all don’t have to experience this illness for yourselves. Protect yourself and your families by washing your hands frequently and avoid obviously ill people if you can do so.

Since the post above, I've recovered completely and hope that no one else I know gets this. It was pretty bad! Please, please, please use proper precautions and pay attention to others who are sick around you. Hang in there!

Human Responses From A Family Nurse Practitioner

2009-04-22T22:23:00.005-04:00

Nurses and Nurse Practitioners are human beings and it's our responses that make us that way. Often, as a nurse practitioner, I have to catch myself and avoid making snap judgments about the patients that I see at the office on first sight.

We've all done it.

The patient who walks in covered in tattoos and scraggly clothes reporting a bad back is a drug seeker. You know the type. Probably smokes weed and hasn't worked a day in forever and is just mooching the crap out of the system. What a loser! Right?

The patient who presents time after time with screaming high blood pressure is non compliant with their meds. I'm mean really! How hard is it to take a pill every morning for God's sake!

The patient who asks for Xanax for nerve problems is a psycho bipolar chick. She's antsy and must be on her manic stage and says she can't sleep. Wonder how much she was taking of the stuff before. Don't providers screen these people. Come on!

The mom who brings in her dirty, smelly barefooted kids crawling in head lice is a bad parent. I'm mean this one for sure is a loser and needs to have HRS called in and have those kids carted off to Foster parent land. Who does she think she is anyway? There are people who would love to have her kids and she doesn't deserve to have them if she can't take care of them.

Wait a minute: Here's the real story:

The man with the tats is a very nice, polite patient who's MRI shows multiple degenerative discs and has spinal cord compression issues. He gets pain meds and shows up to any appt that I make for him. Yes, he's a biker but he can't ride for those charity events like he used to and has a full time job that just about kills him to go to every day.

The screaming high blood pressure is stress related. His wife of 56 years is dying of cancer and he is having to drive her back and for to the next big city for chemo. He sometimes forgets to take his meds but once put on an anti anxiety med, his blood pressure responds. I have to remind him to take care of himself so that he can continue to help her.

The patient with the nerve problem survived physical and sexual child abuse for years and has extreme PTSD. She trialed several meds and I had to finally give her Xanax in a small dose and she is able to hold a job and be functional. She is getting counseling as well and is able to open up to me because I have been there myself. (That's another post)

The mom with kids that are dirty, smelly and have head lice are homeless and have just moved to the area to get away from an abusive boyfriend who was hurting her and the children. She doesn't do drugs, loves her kids and just needs someone to steer her in the right direction. She came in because she heard that I was a compassionate provider who really loves the kids in my practice and takes time to listen. She's been given the numbers for local shelters and is working on job training to better herself.

We all need to be careful not to judge a patient by their cover and take the time to get to know them before making snap decisions. There are true drug seekers who appear very put together and know exactly what to say to get what they want. Some are actually lovely little old ladies that you would find in any church social. Clean cut businessmen who you would take home to Mama are out there selling on the streets and making a killing.

You may even find health care providers wearing jeans and a tee shirt shopping at Walmart who aren't "all done up and representing". (I'm just a regular Mom type person, sorry!) I've been made comments to from other nurses that have seen me shopping and cattily mentioned that I didn't "look like a nurse practitioner that day." Too bad for you!

What types of snap judgements have you made?

Nurse Practitioner's Place Grandson's First Birthday

2009-04-12T00:35:00.004-04:00

I had one of the most wonderful days in a long time today. My grandson's first birthday party was held today and was great success. All of the grandparents and some of the great grandparents were there to share the joy. We all cooked out and watched him open his presents and get into his birthday cake.

A Great Video Explaining What Nurse Practitioners Do

2009-03-29T10:36:00.002-04:00

Thanks to Barbara Phillips for drawing my attention to this wonderful video! I hope that everyone will watch and learn just what we do for a living and understand that we are primary care providers who influence positive outcomes for patients.

Change of Shift Is Up At Emergiblog!

2009-03-19T20:34:00.001-04:00

A huge turnout for this edition of Change of Shift. I sure hope that the next time I host I will actually receive some submissions instead of having to go ahunting myself. Enjoy this week's episode and please consider sending some submissions when it's my turn next!

Trust Is A Huge Responsibilty

2009-03-16T20:11:00.004-04:00

I had a patient who came to me after having a stroke. His mood was being affected and his wife was having a hard time dealing with the damage (both emotional and physical). I put him on medication which evened him out and things have been going well.

Blood pressure controlled, taking his meds, coming in for follow ups and labs... Sounds great! Normally I would be singing his praises for finally getting the health care that he needs. So many of my patients have not seen a provider of any kind in years because of lack of funds or having had a bad experience with the last provider. (Note I'm saying provider, not doctor or NP, both can be equally bad.)

Enter the patient looking grey, pasty, and sweating followed by his wife and daughter. They were upset and worried and while the nurse was getting him set up for an EKG, I was getting a 18 gauge IV in his arm with saline and O2. I was asking him questions about location, intensity, exacerbating factors, shortness of breath etc and asked why he hadn't called an ambulance from home! His wife and daughter both piped up and said, "We tried to call. He wouldn't let us because he wanted to see you first."

The patient proceeded to tell me that he wanted to get my opinion on the matter because he trusted me. He said that if I told him that it was okay to go, he would but not until. I told him that yes, he needed to go into the hospital for evaluation and that he shouldn't have come to the office to ask my opinion because he could have died. Off he went by ambulance...

Well.. after the morphine was given in the ambulance, he got combative and a little belligerent. He got to the emergency room and after he settled down a bit asked "where the hell I was." The hospital told him that I didn't have admitting privileges and that I couldn't be the one to take care of him there. Wrong answer for him!

He checked himself out against medical advice and came to the office the next day.

Oh My God!!! I told him that he should have stayed in the hospital and been evaluated for his chest pain and reminded him that he could have finished having a heart attack and met his maker sooner than he wanted. He said that he knows that he should have stayed but he didn't trust anyone else but me to care for him. "No one listens to me like you do!"

I told him that I was humbled that he trusted me so much, but I didn't want to feel like I was responsible for his falling over dead for not seeking help from other providers. I told him that if he ever got into distress again, to call for an ambulance. He promised to do that in the future.

I told him goodbye and that I would see him after his cardiac evaluation.

"Okay Doc!", with a grin!

"You know that I am a nurse practitioner and that I will always remind you of that when you call me doc."

"I know, but you're MY doc anyway."

Sigh....

Google Ads Privacy Change on The Nurse Practitioner's Place

2009-03-12T23:03:00.002-04:00

Google is soon coming with a new program that will track visitors to sites in order to serve the site owner's with more targeted ads.

"Interest-based advertising will allow advertisers to show ads based on a user's previous interactions with them, such as visits to advertiser website and also to reach users based on their interests (e.g. "sports enthusiast"). To develop interest categories, we will recognize the types of web pages users visit throughout the Google content network. As an example, if they visit a number of sports pages, we will add them to the "sports enthusiast" interest category."

What does this mean to you? Probably not much. Most sites track traffic in order to better serve you the reader.

What it means to me? Hopefully, more clicks on the ads from my readers so that I can pay off my student loans. I have actually done pretty well with the ads and hope to do even better with current and future readers. So, if you have been puttering around the idea of using Google Ads, do it and I'll support your endeavors as well..

The Nurse Practitioner's Place Interviews Stephen from NP View

2009-03-10T20:08:00.004-04:00

1. What drew your interest into becoming a NP?
Conceptually, I loved the role nursing played as a patient advocate, educator and care-taker. I wanted to bring those aspects to the next level and thought that the NP role was an ideal synthesis of advanced practice. I always had a deep appreciation for the sciences and knew that I wanted to be in health care.

2. What is your worst pet peeve with the health care system?
Our health care system is in desperate need of reform. My biggest pet peeve? Oh there are so many. I would say that it really isn’t a “system” at all. I am not certain if a single payer system is the answer. However, our current mix of federal, state and privately funded insurance simply isn’t working. Trying to get anything done for our patients seems like an inherent road block. Pre-authorizations, pre-certifications and the like detract from patient care.

3. What do you think of the continuing NP vs PA issues?
I truly believe there is room for all of us. We are in desperate need of primary care providers and NPs and PAs alike can help fill that gap. I do think there are nuances in our practices that distinguish the two professions. This doesn’t make one better than the other, merely different. I think we need to be supportive and sensitive to one another.

4. Same for the NP vs MD?
Again, there is room for us all. I think a lot of physicians don’t understand the NP role (nor do some care to). I come across a handful of physician blogs that constantly put down the NP role and it is getting very tired. I make it very clear that I do not practice medicine, nor purport to, nor want to.

I have been extremely fortunate to work with physicians who understand and support the role of the NP and aren’t looking to “supervise” me. I collaborate with my physician colleagues and we exchange meaningful dialogue that is in the best interest of our patients.

I think what is even more important for the NP profession is to stand united and to truly advocate collectively for the profession. We must constantly strive for practice that is not with arbitrary barriers and is autonomous. There are some groups constantly looking to further limit our practice. For this reason, I feel it is imperative for us to be politically involved and unified.

5. If you could go back and change something about your education as a NP, what would it be?
I think the natural thing for most to say is that they wanted more clinical time and more experiences. I think it is normal for a lot of us to feel that way. However, it is impossible for our education to prepare us for every clinical encounter. I would say that I wish my clinical experiences were better focused and structured.

6. Do you feel that you were prepared for practice by your program?
I feel that I definitely had the knowledge base to build upon as I started my practice. I had a good grasp of what I knew and what I didn’t know. A new graduate NP needs support and guidance just as any other young professional needs.

7. What advice would you give those who are considering NP?
Being a NP is a wonderful profession and has unlimited opportunities. Please don’t enter this profession for the money since the level of responsibility doesn’t equate with the salary. Being a NP is hard work and one must be dedicated to life-long learning. However, it is very rewarding to work with patients, their families and the local communities in which we practice. I am fortunate to work with my patients recommending treatments, providing health education and making decisions with them in a patient-centered approach. Try spending some time shadowing an NP and understanding what the role consists of. Very few NP roles are identical which I think is a benefit. Finally, join your state and/or national NP organization as a student NP. They are of great benefit to network and will help to ensure barrier-free practice.

8. Do you still enjoy your work? Burn out an issue?
I still enjoy my work. Burn out certainly is an issue when there are never enough hours in the day to do all of the tasks that we are expected to do that goes along with patient care. I have the unique opportunity of being able to hold a management as well as clinical role and am involved in many different aspects of patient care. When I held strictly clinical roles, burn out certainly was possible.

9. How many hours do you actually put in a week vs how many you actually get paid for?
I probably put in about 60-65 hours of work per week and get paid for 40 weekly hours.

10. Do you have hospital privileges or do you even want them?
No and I don’t want them. I see myself as an outpatient primary care provider and my job is to keep my patients healthy and keep them out of the hospital.

11. Do you have narcotic prescription ability or do you wish that you didn't?
I do have this ability and believe it is essential requirement to practice and adequately care for my patients. Every NP that has the ability to apply for a DEA license should have one.

12. What is one thing that you would change about yourself as a provider?
As I am enrolled in a DNP program, I have learned to perform more self-reflection and to question aspects of my practice. I hate sounding pompous but I strongly feel that my FNP education prepared me for my role as a nurse practitioner. I wasn’t looking to go back to school for a program that was going to review what I already knew in practice. I was looking to bring my practice to a new level and to round out my experience. I am proud to say that I have already started looking at aspects of my practice from an evidenced-based and culturally competent perspective. Doing things the way we always have isn’t necessarily the best way to care for each of our individual patients who bring their unique perspectives and issues.

13. Why do you blog?
I blog because I love the opportunity of sharing my thoughts and opinions with others. Blogging is an amazing medium to accomplish this. I also discovered that there were way too few NP authored blogs and wanted to share my views on topics from a NPs perspective. I also felt the need to represent healthcare in a society that is often dominated with just one perspective.

14. How much time do you spend reading other's blogs?
I try to view my favorite blogs on a daily basis. Having tools such as Google Reader and my iPhone makes it possible to quickly glance at blogs and check them for current updates. I like to be aware of current health care issues and trends.

15. Do you find yourself looking at your sitemeter (if you have one) too many times a day?
This is a great question! Yes, I do check my site meter at least daily! Although I don’t have that much traffic to my site, I love being able to see what key words people are searching and how my blog comes up in that search. I’d also like to thank everyone (yourself included) that lists my blog on their blog roll and links to me. The sitemeter helps me to validate blogging.

16. Do you respond to your commenters on your blog? Is it important?
I will respond to commenters if they ask a particular (non patient specific) question. I think it depends on the particular comment as to whether it’s important to respond back.

Thanks to Stephen for taking the time to type an interview for me! It took me a while to post it and for that I apologize! Any other NPs out there who would like to be interviewed? Copy the questions, answer and feel free to ad lib and send it to npssavelives@npplace.com
I look forward to your submissions!

Oh No You Didn't! Change Of Shift Is Up!

2009-03-05T22:03:00.036-05:00

Welcome to The Nurse Practitioner's Place's first attempt at the Change of Shift!
Due to not having very many submissions this week, I went surfing for something to put on this edition. Thanks to those took the time to submit and without further ado, here's this week's entries.

I've heard of some smooth moves, but this is a great one!
Over at Mitch's Mom, here's a tale of what NOT to do to a laboring woman.

Image by stephenccwu via Flickr

Ethics in nursing is an important subject. Anyone offered to "help you out" during a test?
Disappearing John wonders what would you do if you are stuck in such an ethical quandry.

Are you wondering if the knowledge that you packed into your brain is just oozing away?
Pop over to New Nurse Insanity, Fundus Chop and find out how to remedy that problem.

Image via Wikipedia

A grumpy RN shows us once again that teamwork is alive and well in the hospital that he works in.

Are you a hypochondriac? Check out the nice list of tips to follow so that you can help yourself not to be so concerned about your health. Even if they used the term doctor
instead of health care provider (Sorry! It's one of my pet peeves!) That's a whole other topic!

Max E Nurse over at It Shouldn't Happen In Health Care says
"It’s flattering, but please don’t come and see me every time you sniff, just so you can flirt outrageously with me and then be happy when I say you don’t need any medication or advice you don’t already know, and just because I’m male and a nurse doesn’t mean I am gay…and even if I was…YOU wouldn’t be my type (real gay men don’t wear eye shadow and their mums perfume!!)!! If I was gay I’d be a lesbian!!"

Oh no he didn't!!!! Too funny!

Over at Nurse Ratched's new digs, she's talking about some doctors are asking patients to agree to what amounts to a gag order that bars them from posting negative comments online.

Ever been standing in front of your copy machine and thought "Oh no! Did I just send this to the right number?" Candy Goulette gives us advice about it here.

Image via Wikipedia

Alvaro Fernandez presents Centre for Brain Fitness at Baycrest: Interview with Dr. William Reichman posted at SharpBrains: Your Window into the Brain Fitness Revolution.

Chris presents Medical Tourism - 5 Reasons to consider Goa posted at nomad4ever.

Cory presents Exercising in a Recession posted at Eating Healthy.

Ashley presents Quick Home Meal Ideas posted at Frugal Girl Blog.

So ends this week's edition. I hope to host sometime when I'm in a better frame of mind. Please excuse.... Till then, get writing and submit something to the next carnival and make it easier on the next host.

Change of Shift Will Be Delayed By One Day

2009-03-04T22:24:00.002-05:00

Image by Denis Collette...!!! via Flickr

Hello everybody. Due to an unexpected death in our extended family, Change of Shift will be delayed by a day. I will post it on Wednesday late evening or Thursday late afternoon.

Tosh Tucker (almost two) died in his sleep due to aspiration. We are awaiting the autopsy report and are praying with every bone in our body that there was no foul play involved. His father is devastated. Please keep them in your prayers and keep me there as well because I have to make it through his funeral tomorrow afternoon.

It's been especially hard on my 11 year old son who's not understanding why someone so young had to leave us so soon.

U Promise- A Program To Help Pay Down Student Loans

2009-03-01T19:56:00.004-05:00

Hello to all.. I have been thinking about using the U Promise program to get some of my student loan paid down. Have any of you used it?
There are several vendors such as CVS, Publix, Winn Dixie, etc who list it and also several online stores such as Walmart, Victoria Secret, Home Depot etc. so it must be a legit program.
To help a student save for college or one who has already graduated, you can also go online at this link and if you buy something from one of the many vendors, a percentage gets put toward paying the loans down.

crazy miracle called * life *: Change of Shift - Valentines Edition! 3.17

2009-02-20T19:34:00.002-05:00

Change of Shift is up at Crazy Miracle Called Life and it's a great compilation. I did notice that there weren't as many entries as before and part of that fault is mine because I haven't submitted any entries myself lately. BAD GIRL!!!!

Change of Shift is a compilation of all things nursing and will be hosted here on March 5th. With that said, please make sure that you get your entries in early so I can get working at it! You can email me entries at npssavelives@yahoo.com.

The theme will be... "Oh no you didn't!" Tell us some of your more memorable times. It can be a funny tale of things gone haywire or a terrible tale of something that has happened between a co-worker, doctor, NP, or patient etc that just burned your toast! Of course, remember to abide by privacy and change the details!

Till then, I look forward to all of the great entries!

My Son Joined The Navy!

2009-02-19T00:22:00.002-05:00

Dad and I are so proud of Michael. He left for basic training at Great Lakes Naval Training Base in Illinois yesterday. He will be in Panama City for about a year for further training once he's finished with basic. Dad took all of the great pictures except for the ones he's in of course! Pop over to his site and check out his other great pics. Please remember to leave a nice comment if you have time on either or both sites. Thanks!

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Notes From The Florida Senate Interim Report On ARNP Narcotic Prescribing Authority

2009-02-14T01:14:00.002-05:00

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The following excerpt is from The Florida Senate Interim Report on ARNPs and Narcotic Prescription Authority.

Proponents of giving ARNPs the authority to prescribe controlled substances argue that such authority will increase access to needed health care services in areas of the state where there are underserved populations and shortages of physicians; increase convenience for patients and physicians; and improve the quality of patient care. The proponents argue that ARNPs have the education to safely and effectively prescribe controlled substances and that the evidence from the 47 states where advanced practice nurses currently prescribe controlled substances supports this claim. Opponents of giving ARNPs the authority to prescribe controlled substances argue that ARNPs do not have adequate training to make the appropriate diagnosis and suggest proper treatment options relative to controlled substances. They argue that increasing the number of persons prescribing controlled substances will lead to further opportunities for abuse of prescription drugs and diversion of prescription drugs from legal distribution systems. Opponents also assert that there is no indication that patients who need controlled substances have problems getting these drugs.

I think that Florida needs to finally get on board with the rest of the country and realize that ARNPs are not irresponsible prescribers. There will be a few that will get into trouble, but there are doctors who get in trouble in the same capacity.

Click here to read the rest of the paper.