NP Jobs Red Flags
I know times are tough in the NP job market, but you are more “stuck” in NP roles as opposed to nursing roles so you should do your due diligence when considering your next job. In this article I discuss the big red flags I feel you should look out far in regards to money, people, terms, contract, and the interviewing process. I share the top 3 questions you can ask to illuminate whether those concerns are valid or not.
How To Use Your CME $
I’m writing this blog post as I sit in a hotel in New Orleans. I’m looking out over the Mississippi River and contemplating getting dressed for the early morning lecture or spending this time with you. This won’t be your run of the mill discussion about medical conferences. I intend to share with you the good, the bad, and the ho hum ways a conference can contribute to your knowledge base and suggest the many ways you can utilize this precious resource to elevate your practice.
What To Look For In An NP School
A simple google search for your desired nurse practitioner program will yield multiple pages of results. Starting with paid ads. Some seem legit, some seem sketch. So you go to FB forums only to see mixed results and lots of heated online arguments. So you ask people you know at the hospital, turns out they all go to the same one or two in your area that maybe doesn’t fit your needs. You do some deep introspection and honestly aren’t sure what you need anyways. Why is there no objective checklist out there in the world? Some tool that allows for school comparison and advice about what to choose? This is the blog for you my friend. In this discussion I’’ll give you the big list of variables to consider.
Clinical Pearls: Intubation Starts Here
Beyond practicing the technique of intubating, nurse practitioners should spend time learning to identify the patients at risk of cardiac arrest. If you can put a finger on the major risk, there are definite strategies you can employ to improve odds of success without decline. In this article, I discuss specific approaches to: GIB/vomiting, hypoxia, shock, asthma, and metabolic acidosis.
The Perfect NP Student
If you are a student reading this, you are already in the top 5% my friend. How am I so omniscient you ask? Well, after serving as a preceptor for the last five years or so I’ve seen all sorts of students. We all are unique and bring different skills, backgrounds, and personalities to the learning space. This should be celebrated, the world would be awfully boring if we all were the same. Having said that, there are trends I see amongst nurse practitioner students, and some of them are not so great. I’m going to tell you what IMO I believe makes for a fabulous student in clinical rotations; one we want to hire. Arguably one of the best qualities is beginning with the end in mind. Those who prepare in advance are not amongst the majority, so congratulations for being an elite! Clinicals are your #1 source for job acquisition, so you want to show up with your A game!
Clinical Pearls:What’s up with the lactate?
In 2001 a research article was published expounding early goal directed therapy as a treatment strategy for sepsis. Key points in the article suggest that physical exam findings are subpar for directing resuscitation and that measures such as lactate, SCVO2, base deficit, and pH are more accurate measures of adequate treatment. There were certainly other factors, and the take home message was to find the source and start antibiotics early, but volume resuscitate until tissue hypoxia improves was the practical application of this research. As a result lactic acidosis has become a bad omen to be feared by all. Several guideline updates have since been published, the most recent in 2021 with weak evidence to suggest using lactate as an end-point measurement. Practically speaking though, the word is out that a high lactate = bad bad badness. I’m not saying it isn’t bad, but there are plenty of reasons why an elevated lactate alone is not the end of the world. In this post we’ll discuss causes for lactate elevation, what should be cause for alarm and what shouldn’t, and how to manage it.
Mentors: Game Changers?
What is the most insightful thing someone ever told you? When I try to narrow down my answer to this I struggle. I lost my mom when I was twenty four years old. It was traumatizing and also character building. She was my mentor in all ways and without her presence I have struggled in my life, particularly with making hard decisions. Thankfully I have had some career-guiding, life-changing people come into my life at exactly the right moments. The story I share most often is in regards to deciding to go back for a masters degree. A friend of my moms (who happened to be a nurse at the hospital where I worked) said “Briana, what’s your hangup?” I told her the big issue was the burden I would put my husband and children through for two straight years. Especially the girls who wouldn’t see as much of me. Her response “Honey, two years will pass whether you are in school or not, where do you want to be in two years? And what will teach your girls more, being present for all the events or role modeling how hard things are done?”
Okay universe, I hear ya.
In this post I will discuss the difference between a mentor and a coach, what they can offer you, how to find one, and how to make the most of your time.
Clinical Pearls: VBG vs ABG
There is a legitimate reason why ER providers consistently order a VBG over an ABG and the ICU provider then may or may not believe the VBG choosing to tack on an ABG instead.
Many patients in the hospital require assessment of their acid base balance and oxygenation/ventilation status which is best quantified from serum arterial samples. Additionally, the ABG provides expedited lab results such as hemoglobin, potassium and other electrolytes, and lactic acid. These values are very helpful in making a rapid diagnosis and treatment plan. A venous blood gas seems to be the standard replacement for an arterial blood gas in the emergency department. It does offer some benefits, but has limitations as well which should be acknowledged.
The focus of this article is to describe the pros/cons of using a VBG as a surrogate, the exclusion criteria, and the method of converting a VBG to an ABG.
Nurse Practitioner Salary Expectations
The wide range in what you will find when typing “how much does a nurse practitioner make” into google is astronomical. It’s so hard to make big decisions about school, career change when you have no idea what the ROI will be. In this article I break it down into two categories: Salary by field of study (population/role) and Specialty/Sub Specialty.