Category Archives: Helpful Student Resources

Apr29
Posted on by
Aside

WordPress has a creepy feature that allows me to see what search terms bring you to my page.  Turns out, quite a few want the generic drug list links… so I’m going to post as many as I can here.

  1. Walgreens  Last updated 3/2013.  $20 initial enrollment fee.
  2. Wal-Mart  Last updated 4/2013
  3. H-E-B  Last updated 2/2013.  Initial enrollment fee- I believe it’s $5?
  4. Kroger’s  Last updated 1/2013
  5. Target  Last updated 4/2013
  6. Texas Medicaid/CHIPS  Last updated 01/2013
  7. CVS  Last updated 4/2013.  $15 initial enrollment fee.

***You can typically find your own state’s Medicaid list by googling “[state] medicaid formulary list.”

Again, remember these facts:

  • Drug lists are typically updated quarterly.  You’ll notice, doxycycline has dropped off most, if not all, lists.
  • Write the prescription EXACTLY as it’s written on the drug lists:  30 tablets, 90 tablets, 180 tablets, etc.  ”27 tablets” won’t fly.  This is IMPORTANT!
  • Some lists may have membership fees: CVS, Walgreens.  HEB has cheaper membership fee.
  • Costco does not have a generic drug list available.  However, I have found that their medications are MUCH cheaper than others.

Hope this helps!

Follow-up to $4 generic drug lists

May18

6 Mistakes That Could Ruin Your Nurse Practitioner Career

Posted on by
Standard

Again, not my content. Sharing what I’ve found while searching the internet.

References

Brandi. (2012, May 16). 6 mistakes that could ruin your nurse practitioner career. [Web log comment]. Retrieved from http://onlinefnp.com/2012/6-mistakes-that-could-ruin-your-nurse-practitioner-career/

 

6 Mistakes That Could Ruin Your Nurse Practitioner Career.

This is an exciting time to be a Nurse Practitioner.

As the need for accessible health care continues to grow so do the roles and responsibilities of Nurse Practitioners.

But beware, this growth and increasing focus on NPs puts them at increased risk for malpractice claims.

If you’re an NP, you must practice smart or risk ruining your career.

With the help of the Nurses Service Organization’s 10-year Nurse Practitioner Claim Study, 1994-2004, results, I’ve listed 6 mistakes that could ruin your Nurse Practitioner career and how to avoid them.

1. Working with the wrong physician – The “wrong” physician is any physician that doesn’t provide what you need to grow and thrive as an NP, i.e. leaving a new NP alone in a busy practice, setting unrealistic goals and expectations for NPs, not providing opportunities to learn and ask questions, and asking NPs to practice outside of their scope of practice.

2. Practicing outside of defined scope of practice – Stay up to date with your state Nurse Practice Act and revise collaborative practice agreements and protocols, based on clinical practice guidelines, annually. These are usually the first items the BRN and medical board will ask for if they show up at your practice.

3. Incomplete health information or documentation – A complete health information record is your best legal defense. Each patient visit documentation should include: Discussions with the patient and recommendations for treatment, patient response, informed consent or refusal of recommended treatment, receipt of test results and action taken, referrals for testing or consultation, prescription refills, revised patient problem list and medications with every diagnosis, educational materials given, missed appointments with all efforts to follow up with patient.

4. Failing to seek timely consultation and advice – I hear too many stories about NPs and PAs failing to seek advice when a patient has a recurring complaint that doesn’t respond to treatment and the stories usually don’t end well for the patient.  Listen to the patient and always error on the side of caution. Get another opinion sooner rather than later.

5. Seeing too many patients in one day – This cannot be overlooked. According to Nurses Service Organization’s 10-year Nurse Practitioner Claim Study, there were more claims against NPs who saw more than 18 patients per day at the time of the incident.

6. Not carrying professional liability insurance – This goes with saying. Protect your license, you, and your family’s assets in the event you are sued.

To read the full NSO Nurse Practitioner Survey, visit http://www.nso.com/npclaimstudy2009.

May17

NP Board Certification Tips

Posted on by
Standard

I wanted to share some helpful information that I found on the allnurses.com boards from a student (“Labbio”) that passed their boards (AANP). Just to clarify, I do not own this information: I’m just sharing it with you guys!

 

“This is just from my personal experience.

Materials: 
1. Both APEA and Fitzgerald disks (a classmate and I exchange them when we were done with the disks). 
Fitz-Excellent medication review for each system, but a lot of information; can be overwhelming. Inadequate review in the peds section.
APEA- Info is broken down into simplest form to understand; good review on peds and pregnant.
2. Fitzgerald review book (love this; very thorough with lots of questions)
3. Leik’s review book-concise and easy to read
4. APEA’s questions and answers book- did not use

My approach:
1. Listen to both sets of CDs once after school is done (I listened to some lectures during school already)
2. Read the entire Leik’s review book.
3. Study each body system using the review books that accompanied the CDs
4. Read the Fitz review book and answer the questions
5. Make flashcards of weak areas.

Bare minimum, I would recommend APEA’s review CD/course and Fitz’s review book. Ithink the sample exam from Fitz’s website is made up of the questions in her book and the sample exam from APEA is from the questions in her APEA’s questions and answers book.

Make sure you make a timeline of your studying goals. Good luck. I hope this helps”

 

Reference:

Labbio. (2012, February 25). Passed ANNP for FNP: Tips from my personal experience. [Web log comment]. Retrieved from http://allnurses.com/student-nurse-practitioner/passed-aanp-fnp-678932.html

May15

Imposter Syndrome

Posted on by
Standard

You guessed it, I’m now covering psychologic disorders in Pathophysiology! However, the book is limited to schizophrenia, mood disorders, OCD, anxiety, etc. While searching for reputable sources for a concept map on bipolar disorder, I came across Imposter Syndrome/Phenomenon. As a side note, it’s totally unrelated to bipolar disorder. Just another day in the life of searching EBSCO databases and not finding any articles you actually want for your paper… but finding everything else. I’m actually happy to have come across this topic. I found it very relevant to goal-oriented, motivated women seeking higher education in nursing. Of course, throughout Pathophysiology, I’ve determined I have every disorder until proven innocent, and this is no exception :)  (Just kidding… I’m totally not a hypochondriac. But Patho could make me be one, if I wanted to be!)

Imposter Syndrome

“Buried in the hearts and minds of many high-achieving individuals is the private sense of being an impostor or fraud… perceived intellectual phoniness that is held by certain high-achieving adults who, despite their objective successes, fail to internalize these successes” (Kolligian & Sternberg, 1991, p. 308). Did you catch that? Now, everyone raise your hands if that sounds like you (metaphorically, speaking). *Big gulp* Yeah, this includes me. My hand is raised so high, I might have dislocated my shoulder. Fortunately, musculoskeletal systems are next… so I’m covered.

Graduate students may feel like the admissions office made a mistake in admitting them into the program, feeling like other students are more qualified than them, high grades are due to luck, anxiety, poor self confidence, and setting extremely high self-imposed expectations (p. 308). This syndrome is largely populated in educated, successful women.

Now to be fair, I don’t believe that this syndrome is diagnosable. There aren’t medications for this phenomenon (although I’m sure the pharmaceutical companies may just eat this up: “Ask you doctor if *insert some generic medication reformulated* is right for you”).

But let’s take a minute and just remember where we are. Whether you an NP, NP student, or someone who happen to stroll across my blog, these feelings may be real. I have felt at times that my success was based on luck or timing, I set unrealistic goals for myself to push harder, and I feel that other students in my class may be more qualified simply because of their years of experience (which doesn’t make someone better than another).

Here’s what I suggest:

  • Identify your symptoms. What do they say in AA? Oh yeah… admit that you have a problem.
  • Remember, you are successful. If you’re here, you’re successful. Tell yourself a thousand times in the mirror. If you don’t believe it yourself, you’re going to limit yourself from amazing opportunities to teach, write a professional journal, take that once-in-a-lifetime job opportunity. You deserve to believe in yourself and allow yourself to stop believing that you’ve made a hundred “lucky” decisions. You’re where you are, because you got yourself here. YOU did.
  • You might tell yourself “I shouldn’t be here.” Why not? Why shouldn’t you be? Start believing. Why should you hold yourself back?
  • If you’re trying to hold yourself back from an opportunity because you don’t think you’re good enough, take the opportunity and prove yourself wrong.
  • Find a support system.
  • Make yourself some kind of vision board. Only, put up your accomplishments instead. Diplomas, certificates, papers you got an A on, some vacation you went on because you saved up and worked hard for it. Whatever you want. Something that you can look at everyday to remind yourself just how successful you are!
  • What would you tell someone you loved if they told you they felt like an imposter? Tell yourself THAT.
  • Write yourself a positive note everyday. Cheesey, sure. I don’t even need to tell you that I can find you a 100 research articles that demonstrate the efficacy.
  • Own your accomplishments!
  • Accept criticism and let it make you stronger. You’re not a failure, you just found something that you can fix to make yourself THAT much better.
  • Make your goals realistic.
Whew. I’ve got some work to do!

References

Kolligian, J., & Sternberg, R. (1991). Perceived fraudulence in young adults: is there an “imposter syndrome”?. Journal Of Personality Assessment, 56(2), 308-326.

May8

Stress Less

Posted on by
Standard

Just as I was starting to feel the weight of the world on my shoulders (patho will do that to you), I read my chapter on stress and disease. It reminded me of a course I took during my BSN on holistic health. I would encourage all of you to do a quick survey of yourselves here: http://www.stresstips.com/lifeevents.htm During my BSN course, I made a promise to myself to eat better, sleep more, and stress less. Ha. If you should take the above survey, you’ll see the profound effects on stress on your body’s immunity. Greater than 300 points, you’re at an 80% high probability of incurring a stress-related illness, 150-299- you’re at 50%, less than 150 and you have a 30% probability. The survey is not partial to eustress or negative stress. If you just got married, you’re only 3 points less than the person experiencing a physical injury. When I was in my BSN, I had a score of 350 (profound injury, move, change in sleep/eating habits, etc). Guess what happened? I had bouts of palpitations, bronchitis, and it took hours to calm my body down enough to go to sleep. I responded to that by doing more homework until my eyes couldn’t stay open… then I slept a few hours and went to work. It’s amazing that I didn’t have an MI at the age of 22.

Here’s a little snippet from my notes (for the sake of blogging, I decided to keep it short).

As it relates to pathophysiology, stress causes numerous alterations in cellular processes. The adrenal glands produce excess epinephrine and norepinephrine, increasing heart rate and blood pressure. The hypothalamus may alter sleeping and eating habits. The autonomic nervous system may cause muscle tension and shunt blood from periphery functions, diverting it to essential organs. CRF stimulates the pituitary gland to secrete vasopressin, increasing blood pressure. Glucocorticoids raise blood glucose levels to provide energy in response to the stress. Thyroxine increases energy consumption by cells and increases protein manufacturing. Aldosterone may increase, resulting in electrolyte imbalances. Increased production of fatty acids may increase triglyceride storage in the liver. The increased cortisol levels promote nonspecific immunity responses and increase presence of free radicals.

In other news, my car was wrecked by some lady doing an illegal, unprotected left turn in front of me. I thought it was going to be totaled, but it’s going to be salvageable! I worked a lot of extra hours to pay that thing off so I wouldn’t have that bill during my MSN! As a nurse and advocate for safety, I’m going to take this to the city. There have been NUMEROUS accidents, yet the city has still refused to put up a protected green arrow. This intersection is one block away from one of the ERs I work in.

I’m 300 pages into pathophysiology! I can do this! If I can ever finish this first unit, I can do anything. The next chapters are neuro, psych, cardiology, etc. I’m so excited to leave cellular biology in the dust. Imagine reading 300 pages and each paragraph has about 15 new concepts in it.

For those of you that are in pathophysiology, I have a few highly recommended resources:

Rapid Review of Pathology

Merck Manual

These little guys condense the information down to outlines and bulleted points. You won’t get all of your information this way, but it’s very helpful. I got to the point where I read so much, that I woke up the next morning and felt like I lost it all. These help me keep myself in check. The rapid review has online questions when you purchase the book. I have an iPad so I put both of these on there (the rapid review is available on nook, so you need to get the nook app for your iPad).

Have a wonderful week!

Cartoon from http://scrubsmag.com/nurse-cartoons-stress-tests/

Mar27

Panic Attack!

Posted on by
Standard

As I was looking into articles for my Ethics course, I began finding malpractice cases of nurse practitioners. Don’t get me wrong– I realize that doctors, nurses, pharmacists… EVERYBODY has a chance of getting sued. Then I started thinking… holy smokes! What if I don’t know anything when I graduate?! What if my seasonal-allergies-with-a-cough patient was a pulmonary embolism? My shoulder pain was a STEMI?

I realize that my experience and future education will teach me how to rule disease processes out… I also realize that I haven’t even started my “hardcore” classes yet. I’m still doing ethics and research before I even get to pathophysiology, pharmacology, and health assessment. I haven’t learned anything specific to being a nurse practitioner… yet I feel like I should have the knowledge base of a 30 year NP veteran!

I also found an medical resident website that created a lot of hate and negativity to nurse practitioners. Granted, I realize that some NP’s want to be recognized on the same level as an MD. I just want to work collaboratively- as a team. I didn’t choose NP school because I couldn’t go to medical school. I chose this route because I wanted to be a nurse practitioner since I was in sixth grade! I’m not trying to pretend that I’ll know everything that an MD gets in school and residency. How about a little bit of respect for each other and a little less bigotry (from all ends)? Fortunately, I haven’t worked anywhere with so much animosity. The MD’s and NPs/PAs work really well together in the ED’s that I’ve worked. The NP’s treat the non-urgent patients, screen urgent patients and order tests, and discharge those patients if they don’t require larger work-ups. This has DRAMATICALLY decreased door-to-discharge and door-to-provider times. Patients who would otherwise be in the waiting room for hours without pending tests now have had their ultrasounds and CT scans that were ordered by the NP prior to the patient seeing the physician. If the screening/exams warrant a discharge before they see a physician, this is completed. The MD’s don’t have to do the lacerations… the NP/PA is doing them so that the MD can see critical patients instead of spending half an hour suturing. There’s constant communication, a great flow.

I just hope my first NP job is with a supportive group of associates! If only there were more NP residencies…

Anyway, my panic attack is over :) Why am I worried about someone judging my career choice? And as for the rest… I guess it’s time that I embrace being “green” again. I still remember how “green” I felt when I was a nursing student watching a lap-chole for the first time or thinking I’d never make it through neuro or cardio when I first saw the syllabus. But I did… because I gave myself a chance to learn!

Here’s a cartoon that I found! Bring on computerized-provider-order-entry!

Image