LET’S VOTE!

Watch out for politicians showing so much interest in our profession.  I don’t think it’s a good idea to be mandated or lead by the government to make decisions for our patients.  Everyone in healthcare knows that patient’s are individuals and no one law applies to everyone clinical decision equally.  I’m not talking about just abortion, but all medical decision should be made between patients and providers.  Not patients, governors, public citizens who might sue and activists who don’t agree.  We need law to protect from fraud, and keep citizens from discourse and violence.  However, when it comes to clinical decision making it is personal, multi factorial and highly individualized based on medical, emotional and physical needs. Finally, we are the ones trained to advocate for our patients, not most voters, and certainly not most politicians.  We are trained to assess and educate on guidance for treatment plans, follow up and ethics regarding patient choices.  We are not motivated by public opinion or polling numbers, but patient safety and improved health outcomes.  Get out and vote. 

Covid coping and thoughts to maintain your sanity

Covid coping and thoughts to maintain your sanity

    Inauguration tensions are up and spread of infection concerns the nation. Watching numbers in my area, the seem to be going down, the positivity rate was heading toward 12% and is now down below 10%.  On tv all the channels are crying "total disaster!" and none of this has made sense from the very beginning. First, there was division over mask mandates and I think next, it will be about the vaccine.  We are all just doing the best we can with the information we have in front of us at the time.  This is what I always tell my patients when they are frustrated with the answers they get from their providers that sometimes lead nowhere. 

The best thing we can do is wake up each day and tell the people closest to us that we love them.  Wash your hands often (pandemic or not), routinely, but not obsessively. Stop it with the hand sanitizer already. Say a little prayer each day and take a few minutes to reflect. Reflect for the people who didn't make it out this year.  Be kind, sympathetic, and set an example for peace.  No matter who is president, we have the choice to unite and be the wonderful country loved so much by the people who reside here.  Ultimately, we are all fighting for the same thing and it's not easy.  How are you coping?

Wrinkle Relaxers do just that!

Do you know what neurotoxins do and will they meet your expections? Many people think that drugs like Botox, dysport and xeomin will erase wrinkles.  Truth is they will not.  They are fabulous medications to help slow the aging process, but if there is a wrinkle they will only slow the progression and prevent new ones.  Many times after injecting someone new, we will get a phone call in a day or two or even a week that the medication is not working because the wrinkle is still present.  The medication works just fine.  I injected correctly, I reconstituted properly and it is impossible to erase a wrinkle.  This complaint is, of course, after an extensive consultation of setting expectations and thoroughly explaining how the medication works.

So, what happens when our clients go home?  Did they forget?  Did they listen? Do they think I was not truthful?  What do neurotoxins actually do?  They freeze the muscle to prevent a repetitive movement that will cause or deepen a wrinkle.  If you fold a piece of paper in half 100 times, there will be a crease.  If you stop folding the paper there will still be a crease.  If you stop folding the paper the crease will no longer deepen.  The crease will always be there.  Luckily we have skin, and it is different from paper.

So, if you inject the muscles to paralyze them, the wrinkle will soften over time.  Eventually, the crease will be barely noticeable, but only if you inject on a regular basis.  The recommendation is every 3-4 months.  The medication will not work if you only inject once every 3 years.  Lotion will not moisturize your hands or face if you apply it once and never do it again.  Neither will Botox or Dysport soften a wrinkle if you only do it once. Not even if you do it twice.  You must keep up on it to see the benefits of this wonderful product.

Back again...again.

What a journey this has become.  Last blog post was in regards to my transition from private practice to retail in corporate to private consultant.  Funny how things work out.  I went on a journey of a lifetime, learned a huge amount and took a bit of a left turn, and have settled nicely.  I attempted to start up a business as an independent nurse practitioner.  I learned about functional medicine, IV hydration, anti-aging treatments and the harsh reality of business.  I made friends, unveiled fake friends, and networked my butt off.

In this state of Florida it is tricky becoming a nurse entrepreneur.  First of all, Medicare doesn’t recognize you as an independent provider.  Once you have finally completed all the hoops to jump through to get paid by Medicare you only get 80%.  Secondly, collaborating physicians can charge you as much as they want.  Rent is expensive.  Products are expensive.  Advertising is a mystery. Oh, and liability insurance is expensive.  Investors are plentiful, but they want high percentages and it leaves you with little profit.  Hats off to those who have over come!

I, on the other hand, put on the brakes, put it in reverse and changed directions.  With all the training that I was getting in aesthetics, I decided two work for a business that was already established.  I am again an independent contractor and I think this is where I like to be.  There are places for everyone and thank goodness for that.  So, now I am an aesthetic nurse practitioner. I am committed to blogging about aesthetics in this world of mine.  Continue to follow me and stay tuned for my new series of posts in the aesthetic industry.

I'm Baaaaack

Hello world!  I decided to stop blogging and focus on other things.  What I have learned in my time away from here is that I missed blogging!  I have transferred from private practice to corporate convenient care.  It's nice enough and it pays the bills.  I get to have some regular patients and build a small rapport, but it's not private practice.  There are many perks of working for a giant corporation, like benefits, matching 401K and paid time off (which I haven't had in 10 years!).  It is very reminiscent of hospital nursing with shifts, trading and competing time off and lots of paperwork.  However, there is no, I mean no office politics(love!love!love!).

A new demention I have ventured into is the front office.  As a retail nurse practitioner, you are the front, middle and back office.  I now get to check in, assess and treat and collect the copy at the end.  I take vitals, which I never have to question or ask to be repeated.  I don't have to wait until my patients are checked in by the front, and while checking in I can start screening.  I have been able to learn how to basically run my practice with the outline layed out for me.  I wouldn't recommend this position to a new grad, although many of my collegues have only worked in retail.  I feel like the experience I gained in private practice has helped me to develop my skills working in the retail clinic on my own.  It makes me a better practitioner recognizing the warning and danger signs and knowing when to refer to ER versus, urgent care, versus we can handle this over the weekend until you get into your primary physician on Monday.

Retail gives you guidelines, but having practiced in other settings, they truly are guidelines and not the holy grail of practicing medicine.  However, many nurses have also developed these skills in their previous settings as well, not just being an NP in private practice.  But, for me I think that helped.  I want to start consulting and branching to other fields of nursing now and I thought blogging would be a nice way to get some attention and make some more headway.  Hope you enjoyed this one and there should be a steady stream to follow.

A Nurse Practitioner's World: Things they never teach you

A Nurse Practitioner's World: Things they never teach you: Now that my collaborating physician may be going VIP, this gives me the opportunity to learn how to do my own marketing.  These are the thin...

Things they never teach you

Now that my collaborating physician may be going VIP, this gives me the opportunity to learn how to do my own marketing.  These are the things they never teach you in school, whether you graduated from nursing or medical school.  I have been researching and reading websites like never before.  I have been taking blogging classes and reading tips for free and cost effective advertising.  Just when you think you can't think of anything else you find out there is more.  Take a few deep breaths, collect yourself and keep going. Here are a few things I picked up along the way.
1.Facebook is free, connect with your friends and hopefully they will tell their friends and so on.
2.There are free websites out there and you don't have to know computer language or codes.  It will do all the work for you and you fill in the rest to customize.
3.There are blogs for people who are trying to start a business and they have done more research than you.
4.Get people's opinions and have them proofread your stuff.
5.You are a nurse practitioner or other professional, a spouse, and probably trying to raise your kids, and you are not an expert at everything. It's ok to get a little free help from family and friends.
6.Everything is better after a good night sleep.