The Day the Med Students Cried

That's right. They cried. Because they felt they were in the way.
They were in the way, but we shouldn't have made them feel in the way.

The really interesting part was that I went to another medical office in town and saw a med student in the hallway - and she was CRYING! What is this school putting in the water? Are they flu shots laced with hormones? Wow!

How do I feel about helping train the med students? I love teaching, and have a lot to offer; most of them come in with the idea that they won't learn much, but by the time they leave, I make sure they can tell me something valuable they have learned. Like where to listen for CAROTID bruits, and the difference in Tylenol and Aspirin. Yes, I thought they should know that by third year, but I was wrong. Lord help us. And I mean that sincerely.

Working Weekend (old post re-posted)

I worked in the hospital this weekend
Convincing people
That they really did not need to be there.
That a hangnail could be treated as an out-patient;
And that going out to smoke every 30 minutes
Well - probably was having a negative effect on the outcomes of the care I was Trying to provide.
That swallowing a toe ring
Probably had nothing to do with the abdominal pain.
What did you do this weekend?

p.s. don't try to figure out who these patients were, I made it all up.

"He Saved My Life!"

Nurse Practitioners are becoming more recognized by healthcare organizations because of our financial contributions to the bottom line, and salaries are finally starting to reflect that. However, if you think for one minute that you will be recognized for your excellent exam and diagnostic skills, you might consider getting your head out of the sand. Granted, there will be that one physician, and the handful of patients who notice when you are able to diagnose and treat something other than a sinus infection or UTI, but beyond that, most people we care for would prefer if you call an emergency consult with the pulmonologist for their community acquired pneumonia, or the gastroenterologist for their chronic abdominal pain cause by too many narcotics and blocked plumbing.
So you diagnose this CVA, after the patient was admitted with sinusitis and "cant swallow," you start Plavix, order a swallowing study and rehab, and for safety's sake, you order a Neuro consult because it's expected. Nothing will kill an ego quicker than for a family or patient to say " yeah, that Dr Saint saved my life, I know he did, he's really good ." the appropriate response to this is NOT " oh, actually I did that!" Although that's exactly what we want to say, it's not very good PR for when you really need the neurologist. Just agree and "manage up" your specialists, it will get you much more respect and the patient will at least realize that you, the nurse who "almost made a doctor," are part of the TEAM that has provided the best care possible. This is the part where you take a deep breath, roll your eyes (don't let them see you,) and smile.

Low Carb

Since it's the beginning of a new year, I usually try to start out by making some healthy changes. I'm happy to say I stuck to a healthier diet for the most part last year, more than previous years. UNTIL the last couple of weeks of December, then I ate everything in sight it seemed. Diabetes runs in my family, so since I am not getting any younger or thinner as each year passes, I am trying to ward it off as long as I can.

If you or someone you know is diabetic, I'm sure you have seen all the conflicting information out there regarding diabetes. As a nurse practitioner, conversations with diabetics or pre-diabetics are a part of my day - every day. What I have found is:

1. diabetics are confused

2. too much information is bad sometimes

3. due to time constraints, there is no way to get into all the "details" of dieting.

How do I know who to believe, what to read, what to eat/not to eat? If you will follow a few simple rules, whether you are diabetic or just want to lose a few pounds, glucose levels will come down; and, even if they are not "normal," I'm sure you will see a major improvement in your energy level and lab results.

When I have 5 minutes to share with someone, I advise them to follow the "No White Diet"  In other words, if it starts out white and powdery (cocaine doesn't count), it will "run your sugar up" and cause you to deposit fat around your abdominal area. So what's considered "white?"
*flour
*sugar
*corn meal
*pasta
*rice
*potatoes (ok, they are not powdery but they ARE EVIL)
Remember, if it CONTAINS any of these ingredients, it's high-carb.

That means NO SODAS unless diet

No JUICE unless tomato or V8 vegetable (not the fruity kind) - fresh fruit is ok in moderation, but avoid over-doing it with the bananas. No canned fruit.

If you eat bread, limit it to one or two slices of very high fiber bread : I like this one:

(note it says "double fiber")

The good news: EGGS are white and they are ok - eat up! Try an omelet made with your favorite cheese and salsa, or do what I did and stuff it with your left-over New Year's Eve Spinach Artichoke dip - Amazing!


I will post more of these notes and low carb ideas if anyone is interested. Feedback is welcome.


Here's a link to a reputable medical journal research study in case you are interested:



http://www.annals.org/content/153/3/147.abstract

*Pink shirt above is available HERE

Hello World of Healthcare Blogging!

Since I'm such a nerd, I thought I'd start a little blog for my nurse practitioner (NP) peers in cyberspace (or any others who may be interested, but I'm not so crazy to think this will be of interest to non-medical field geeks). Anyway, just when I thought I was finally in my comfort zone in primary care, an offer came along that I couldn't refuse and I found myself back where I belong - the hospital. Working as an NP is never dull, and with the changes, I have had the opportunity (a.k.a. requirement) to look up more "stuff" than I've had to in other jobs. When I look things up, I must write them down to help remember them (did I mention I think I have early onset dementia from banging my head against a brick wall in primary care?) So, I figure if I'm writing them down, I should share them with you, and maybe when/if the situation comes up in your practice, you will remember something we discussed here and can move on (and you can remember you read it here - on the nerdy nurse blog). 

I hope to come here weekly or at least bi-weekly and post some random facts (or opinions). Sometimes I may not have the answers, only questions, and I look forward to your feedback and opinions.

Please introduce yourself under comments if you are here reading this. Otherwise I will have no clue that you were here and I will feel ignored, my feelings will be hurt and this blog will be a mere dream...the dreams of a nerd nurse will be smashed. History. So, thanks  in advance for your comments.