Floating Doctors

Plans are in the works to join Floating Doctors this year.  I will keep you posted on the details because I really want to spread the word about this amazing organization.  Plus, my family and I are going to be working hard to fundraise for them.

I've always wanted to join a medical mission and my brother in law who will begin his 3rd year of internal medicine residency went to Panama last year and worked with Floating Doctors.  He came back dedicated to help and to do more.  He twisted my arm and now I couldn't be more excited to join him later this year.

Resume Writing

I spent most of the early morning yesterday rewriting my resume.  Luckily, my latest edition was fairly up to date but after doing a bit of online research, it was apparent that I had to change my strategy.  I am no longer applying to RN positions, but to NP postings- it's a totally different story.   

The other issue that I found tricky is how to really sell myself even though I have absolutely no experience as a nurse practitioner.  Oh, and not to mention that I haven't even completed the Acute Care NP program- that happens in August of this year!

One thing that I learned, thanks to NP Career Coach is that including my clinical rotations and a few specifics about each rotation is important, including the total hours at each site.  This information gives my future employer an idea of my interests and capabilities.  So far, I've almost completed two very different ICU rotations.  My next clinical rotation will be at a much smaller hospital working with a NP who sees patients both in the inpatient and outpatient settings.

Also, making and keeping connections, like in most fields is important and I am finding that to be very true in health care.  My former preceptor was the NP director at her hospital and the clinical faculty at my current clinical site is also the NP director at this hospital- jackpot.  So far, I think that both of these connections will pay off immensely.

The director of the NP program I attend sends our class daily emails about current job postings, some are local but most of them are outside my area.  She sent a job posting on Friday that sounds like a great fit so I wanted to send in my resume as soon as possible.  I have a feeling that the job market is fairly competitive but I am hoping that the connections I've made will help.   

a nurse practitioner career

I only have two more weeks left in this semester and I could not be more excited about taking a break from school and clinical.  During my break, I am going to get very serious about my job hunt.  I have already looked around in my area and there are a few positions that look interesting to me.  If I were to expand my search to Philadelphia then the options are almost endless, but I think I want to stay closer to home- we'll see.

I find it very timely that MidlevelU is dedicating several blog entries on how to begin the job search.  I have found the information to be very helpful.

I also came across this graphic below about 'How to Become a Nurse Practitioner' and thought I would share.  Even though the NP profession is more prevalent that it was even 5 years ago, I still find myself explaining the NP role to people I meet.  This graphic is a great snapshot of the career. 

How to Become a Nurse Practitionerthe
Courtesy of: Schools.com

Heart disease and Red Meat

Just thought you guys might want to read this article before heading out to dinner this weekend for a big steak dinner.

I was born and raised in Texas and believe me, I have had my fair share of red meat.  I eat it probably a few times a month now (no great BBQ in New Jersey) but I might even eat it less frequently now.

History and Physical

Monday morning was our last SimMan practicum of the semester.  I was not very nervous about it this time but it turns out that perhaps I should have been.  I prepared by brushing up on my cardiac assessment and 12 lead EKG interpretation skills.  This time, instead of a team of students, there were only 2 of us.  Nicole was my partner- she's wonderful.  What we thought was initially a myocardial infarction (heart attack) ended up being heart failure.  Fortunately, we did figure that out based upon his diagnostics and decided to give him Lasix and put him on a Milrinone drip to support his heart and blood pressure.  

What was disappointing to me about our/my performance of this SimLab was that we did not pick up on his heart failure much sooner.  We failed to do a thorough history and jumped quickly to the physical exam.  If we/I had spent more time asking a detailed history, we would have found out that the patient has a history of stage IV heart failure.  I think we were a bit distracted by his need for almost immediate intubation.  We should have thought to call his 'wife' into the room for a more detailed history.  Overall, we managed to diagnose him correctly and ordered the proper treatments.  

This experience reminded me of something my brother-in-law once told me, he's an internal medicine resident in Baltimore.  He said that a physician once told him, "Nine times out of ten, if you do a thorough history and physical, you will correctly diagnose your patient."  Of course, there are always exceptions but this statement definitely held true during our SimLab. 

I hope that when I begin my career as a NP, that I will not forget this valuable lesson.  Never underestimate the importance of a detailed history and a thorough physical exam. 

RN experience before NP school

  Image via Ecophon Acoustic

Is RN experience before NP school a must?  Before I share my own opinion, I will first start out by saying that there are two camps and most people are not interested in hearing what the other camp has to say about this topic.  So, the purpose of this blog entry is not to persuade or dissuade anyone, but to simply share my own experience.

There was nothing that I learned in nursing school that could have prepared me for what it would be like to be a bedside nurse in a busy trauma hospital in the ICU.  Nothing can prepare you to take care of someone who was just shot in the face several times.  Nothing can prepare you to see a mother who kissed her son goodbye that morning and is now seeing him for the first time in the ICU after a motor vehicle collision with a severe traumatic brain injury.  Nothing can prepare you to witness a husband making the decision to withdraw life support from his wife who he has been married to for a lifetime.  Nothing can prepare you to see a 25 week old fetus be delivered stillborn because the mother was in a terrible motor vehicle collision.  Nothing can prepare you to manage two patients who are hemodynamically unstable.  Nothing can prepare you work closely with dysfunctional families.  Nothing can prepare you to be in a heated disagreement with a physician.  Nothing can prepare you to multitask, problem solve and troubleshoot like someone's life depended on it. 

So, what's my point?  My point is, that the skills I learned in nursing school meant almost nothing to me.  What has been most valuable to me are the skills that I learned as a bedside nurse.  It was through those experiences, those countless hours working in a hospital with physicians, with patients and with families that will be of value to me as I begin my career as a nurse practitioner.  What I have learned from a textbook or in a classroom is important, but the real value comes from within the hospital walls- from experience.  

Healthcare Startups

Healthcare related startups are hot topics these days.  With the influx of several million newly insured patients as a result of the Affordable Care Act and an ever aging population, finding ways to innovate and improve our current system is garnering a lot of popularity and attention. 

My ultimate dream job would be to work for a healthcare startup.  I think that helping to create something that improves lives or makes access to information or access to healthcare easier would be a pretty exciting contribution to society. 

I enjoyed reading this article and learning about the 13 companies that Startup Health selected to invest in and take to the next level.

It's exciting to be involved in an industry- healthcare- that is finally creating ways to innovate and improve.   

What's in my Lab Coat?

Okay guys- stop with the jokes already-- this is a serious post about what I’m packing in my lab coat pockets these days when I am at clinical. 

Well, before I continue, I have one confession-- I hate wearing my lab coat to clinical.  I wore it during my first clinical rotation in the Neuro ICU but in the current Medical/Cardiac Surgery ICU where I’m rotating now, only the attending wears a lab coat.  The fellows and the NP who is also my preceptor all wear black scrubs.  The med students and I wear the green operating room scrubs.  I definitely prefer the green, so comfy I could wear them to bed scrubs over any white, but very dirty if you look closely lab coat any day. 

So, what am I carrying around in my green scrub pockets?  Glad you asked.

A pen: no explanation needed.

A penlight:  I used this penlight several times/day on my Neuro ICU rotation.  I still use it daily in the Cardiac Surgery ICU but it definitely needed a battery change after all of those pupils I checked on the stroke patients.

Littmann Cardiology III Stethoscope:  When I first started out in nursing school I purchased a budget friendly stethoscope that seemed to work just fine.  After I began my first job as a bedside nurse, I noticed a variety of stethoscopes and wondered if the ones that looked more expensive were actually worth the money.  After borrowing this one from a fellow nurse it was obvious that this Littmann Cardiology III stethoscope was definitely worth the investment.  I am a firm believer in the value of a great stethoscope.  I can appreciate heart mumurs much more easily and can hear breath sounds loud and clear- it's a definite must in my opinion.  

Pocket Medicine Handbook:  I use this book daily at clinical.  It is well organized and incredibly easy to use.  If I have a basic question about management of common diagnoses found in the ICU or even on the floor, this quick guide gets me on track. It covers everything from infectious disease to status epilepticus.  It also fits easily in my back pocket.

Cardiac Surgey Manual: When I started working in a cardiothoracic ICU several years ago, my preceptor recommended I purchase this book so that I could familiarize myself with how to take care of patients immediately post-op cardiac surgery.  At the time, the book overwhelmed me and I don't think I spent as much time reading it as I should have.  
Now, as a NP student in the Cardiac Surgery ICU I use this book daily.  It is written by Robert M. Bojar, M.D. a cardiothoracic surgeon.  He goes into just the right amount of detail about every pertinent topic as it relates to cardiac surgery.  He even includes sample ICU order sets for the management of these patients immediately post-op.
Even though this beast (820 pages) doesn't fit into my scrub pocket or lab coat pocket (if I wore one)- I always keep it close by. 

How about you, what do you keep in your lab coat or scrub pockets?

AANP National Conference

So far, the only professional NP organization that I have joined is the American Association of Nurse Practitioners.  I receive their daily emails and will often read the articles that they post on FB.  This organization is very active when it comes to NP policy and legislation- something I would like to become involved with in the future.

Each year, the AANP hosts a national conference.  This year, the conference is in Las Vegas.  The schedule looks extremely comprehensive and covers everything from dermatology, to the Affordable Care Act, a critical care workshop and everything in between. The student rate for the conference is a huge steal at only $75.

If I can work out the logistics, I would love to go this year.  I think it would be a great learning experience and a wonderful opportunity to network with many experienced nurse practitioners. 

Have you ever attended the AANP national conference?  Should I really make it happen?

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