Saturday, January 28, 2012

Psychological disorder or chemical exposure

I wanted to share this story. 12 students at one school have become suddenly stricken with symptoms of tics and outbursts that resemble Tourette's.  10 of them are being treated by the same neurologist, and he diagnoses them with a psychological condition.  The school swears there is nothing wrong with the environment, the superintendent is backing this claim.

One thing I don't understand is how easy it was for Erin Brockovich, with no medical background, to link their symptoms to a past chemical spill, but the neurologist has "ruled out any medical and environmental factors." What are the motives of the neurologist? I think that, as a nurse practitioner, if I had 10 patients walk into my clinic with the same symptoms, I would start trying to connect the dots. I feel like this "conversion" diagnosis, might be a bit hasty and more research is warranted before these kids get straddled with a psychological "disorder."

 According to the U.S National Library of Medicine "Conversion disorder symptoms may occur because of a psychological conflict. Symptoms usually begin suddenly after a stressful experience."  It states that, the symptoms are: blindness, paralysis, inability to speak and numbness.  Nowhere does it state that there are tics involved or Tourette's like symptoms. So, you mean to tell me that all these kids have been exposed to some major psychological conflict and everyone of them are suffering from the same symptoms as a result? I am only family nurse practitioner, I didn't specialize in psychology, so maybe it is more difficult for me to understand.

As a parent, I would start by taking my kids out of this school.  Second, I would take them to another neurologist for a second opinion.  As a nurse practitioner, I would certainly look at the the links that these kids had in common: same school, same town, same drinking water???  I know as a provider when you are in a situation it may be a little murky up close.  It is always easier to see things more clearly as an outsider.  Even if these symptoms are not directly linked to the chemical spill where the school is located, the chemicals have a laundry list of other adverse conditions they can cause.  These are certainly enough reasons to get these kids into another environment or at least another school district until things are sorted out.

Sunday, January 22, 2012

Well...NOW you tell me

I think this explains a lot.  It isn't that there aren't openings, the retired nurses and nurse practitioners are eating them up because they have to come out of retirement.  They come equip with experience and tons of knowledge.  How can newbies compete???  I don't envy them either, though.  After I worked for 20 or 30 years, I would be ready to take it easy and enjoy some quiet time, not return to the jungle and work my ass off some more.

Sunday, January 15, 2012

Nurse Practitioners and birth control

Check this out:

 State clinics report success providing contraceptives to high school students
"This is about preventing sexually transmitted diseases and teaching about healthy relationships and abstinence and postponing sex, and preventing some high-risk behaviors," said Ruth Goldbaum, nurse practitioner at the school-based health clinics in ...
See all stories on this topic »

Are we teaching the right thing or sending the wrong message?

Starting out

My first job I landed as a nurse practitioner was working in women's health.  I was very fortunate to get that experience.  I had a blast too.  What better patients to relate to?  They have questions that I may have asked myself, they have parts that I can certainly relate to and they have concerns that I can sympathize with.  I spent my years in nursing in Cardiac, so the physical exam took a little while to learn how to do efficiently.  I was used to listening to lung and heart sounds, managing IV lines and monitors for the heart.  I could do an EKG in no time flat, but a pap smear, endometrial biopsy, interpret a transvaginal ultrasound?  That was going to take some getting used to.  We had to learn how to do paps in clincials during our last rotation in school, but there was always someone in the room there to help guide you to the correct angle to get the cervix into view.  There was an instructor there to hand you the instruments in the right order.  What am I going to do when I have to remember the order in which to proceed and find that retroverted anatomy with the difficult cervix that doesn't want to come into view without a fight?

My first week on my own was a rapid progression of successes and failures.  I think I did about 3 pap smears on my first morning before I was able to get the cervix to pop into view on my first try.  I was pretty impressed and I think I startled my patient a little bit with my outward celebration of identifying her anatomy without any assistance.  I was quick to reassure her that things were fine and her pap was a success(and that I wasn't a weirdo just happy that I did it on my own and I knew what I was looking at).  Other nurses and nurse practitioners know how it feels to have sat through hours and hours of lectures and clinical rotations watching others show you what to do and guiding your hands. It is only when you are in a room by yourself and run into difficulties and finding a solution for the first time while everything that you have learned is falling into place.  Those are the special moments that your patients may or may not realize that they are a part of.  It is about your patient and delivering the best possible care, but until that light goes off and everything that you have read about is finally making sense that you start to become the practitioner that you have been preparing for.

In my previous posts I have complained and put down nursing and the medical field, but ultimately I do think it is a calling and a special touch that you have to possess in order to make this work.  Nursing is one of those special fields where you are able to touch people's souls, but what you don't realize is that they are going to touch yours too.

Wednesday, January 11, 2012

Great Website

A great website that is free and offers a ton of tips and webinars on jobs, bosses and other situations.  Advance for NPs and PAs.

Saturday, January 7, 2012

100 Reasons

  Advance for NPs&PAs puts out their job outlook for 2012. There is a supposed bright future for nurse practitioners and PA’s. They state that there is “cause for celebration,” but could they be “speaking too soon?” There are plenty of projected job openings for 2012, but where are they? We keep hearing about Obama’s affordable care act and the projections on the shortages for physicians, Nurse Practitioners and PAs, but I do not see anything actually changing.

I feel like I have a better chance of getting traffic to my new blog than actually uncovering that hidden enigma of the “average salary for an Nurse Practitioner” of which this newsletter speaks. I would love to hear how others are faring out there. I remember my professors coaching us and saying not to settle for “less than…” When I actually got out there on my own, it seemed like the people hiring were not quite sure what to do with me, or what the exact duties a nurse practitioner should consist of, never mind what my actual salary should be.

I just found this website advertising schools for nurse practitioners and it listed 100 reasons to become a nurse. Each time I scroll down the page I ask, “are these 100 good reasons to become a nurse?” I need something to help me crawl out of this funk and learn to appreciate my profession the way others say that I should. Where is this prosperous, wondrous, fulfilling field they call nursing? And what am I missing?

"You want to make a positive contribution," and you want to "do something that matters." I would say those are two good reasons most of us become a nurse. Those are the top 2 reasons on the website list too. After about 6 months of nursing at the bedside that you realize, you are grumpy and over worked. There is nothing positive about your contributions and if feels like nothing you do matters. Now that you have established feelings of unhappiness with the health care system, you find the drive to become something more. Here is where the nurse practitioner starts to penetrate your thoughts and leads to the illusion of an escape.

There was a time when I was starting my classes for the nurse practitioner program when I would ask the nurse practitioners how they felt about their jobs. They loved it. They were so happy and they were motivation for me to keep going even when things were really tough. I was balancing school, work and home, and it was not easy. That's how most nurse practitioners do, though. It is not an easy process. I think that most people perceive nursing easier to get into than medical school and maybe it is. I will tell you that most doctors do not complete their schooling while working full time and raising their families. So, one would think that the end results would consist of mutual respect and understanding for one another. Where are those nurse practitioners that kept me ticking and where is the fountain that they drank from?

The 2012 Job Outlook for NPs and PAs.  Advance for NPs&PAs.  Accessed January 6, 2012.

100 Reasons to Become a Nurse.  Nurse Practitioner Schools, 2009.  Accessed January 7, 2012.

Wednesday, January 4, 2012

A Nurse Practitioner's World: Not "just" anything...

A Nurse Practitioner's World: Not "just" anything...: Happy New Year, and welcome to 2012, nurse practitioners. We have another year to educate the public and our colleagues regarding nu...

Not "just" anything...

Happy New Year, and welcome to 2012, nurse practitioners.  We have another year to educate the public and our colleagues regarding nurse practitioners’ roles in the medical field. I realize I am a nurse and always will be.  That makes me happy, I don’t claim to be anything other than.  I do, however, get a little miffed when I am not acknowledged as a provider because there is “nurse” in my title. 

How often are other professionals asked if this is the best they are going to do with their career?  “So, when are you going to become a doctor?  You only want to be a nurse?  It can’t be that much more to go back to school.”  Is that supposed to be some sort of motivating speech to make me think about doing better with my life?  Thank you for bringing to my attention how unhappy I should be with myself at this moment.

It is also frustrating when other professionals in your field offer positions that you have gone to school to move up from.  There is nothing wrong with being an RN.  I went to school to become one.  I was one for many years and I could not be an NP without that.  I do, however resent the fact that I should be happy working as one after having completed my training to be a provider now.  RNs are great, but they do not have the same rights and responsibilities for which I have completed my training. 

I am a provider.  I am not “just” anything.  I want the position for which I applied, not something that you need to fill and think that I might be okay with.  If other professionals in my field don’t get it then how can I hold it against the regular public to understand why I am here?  My background is a nurse, now I am here as a provider to treat and manage medical conditions.