Category Archives: Random NP Thoughts

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

Cancer is the Worst.

Standard

We recently studied over cancer in Pathophysiology. Reading the content really made me think about possibly working in oncology as a nurse practitioner. I’ve started looking at possible preceptors in the area that could give me some exposure, as well as potential employers. MD Anderson is in Houston… that would be AMAZING, only I’d have to live in the one Texas city I despise most. Traffic, pollution, crime… not that appealing. But to work at one of the most innovative, ground breaking facilities in the world? Dream. In fact, they’re internationally known for cancer treatment of Leukemia, which I just did a concept map on and found really interesting. I love analyzing lab values and understanding just what happens to instigate cancer.

But it’s the saddest job I’ll ever have! I’m not one of those nurses who can help diagnose something like Cancer, and then walk away the same person. I think that’s why I’d love it.

At one point, I had the meanest, most obnoxious patient I’ve ever loved. There was a lot of push and pull: hiding his medications from me, arguing with me about taking his medications, calling me on my personal phone asking to run errands (how he got it, I don’t know), dealing with destructive family members, and then… calling the last ambulance for him that ultimately led to hospice. I was so taken by this man!  He hollered at the unit nurses until I reasoned with him to stay by offering to buy him whatever meal he wanted when he got home. So he went home, and died hours before I came with dinner. Dagger. To. The. Heart. I’ve never cried so much! Before he died, I picked up his medications once with his direct instructions to “ask the pharmacist to go on a date with me!” Usually, we don’t pick up the prescriptions, but family issues left him with no one to do it for him. I met the pharmacist, told her what he said, and we had a great laugh and swapped stories! When he died, calling her was the hardest phone call I’ve ever had to make. I still think about him.

I think of the man who’s neck pain turned to thyroid cancer. The young man who just got his life together when his extremity numbness turned to brain metastases. The elderly woman who had gone a year knowing she had undiagnosed breast cancer, never sought treatment, or told her family because she didn’t want to hurt them. I think of the man who showed me a picture of him jumping out of a coffin, laughing because that’s how he wanted his family to remember him: not scared of death. And I remember my very first death as a nurse’s aid, when I gave a patient a diet coke and she laughed and said “honey, I’ve got cancer– think I could get the real thing?” and she passed peacefully before I came back, sneaking her a real coke. But, I think of all the lives we saved. I think of all the lives we didn’t save– I know that I gave the best care to them that I could, but I still carry them around with me. I mean, I really do. And it hurts.

So, why would I think to choose a career that is emotional sabotage? For the same reason it hurts: I carry those people with me. This consideration just came to me this week and I’m becoming more passionate about it every day.

In other news, I’m going to Maine in July for my physical exam course!! I’ll also be doing a skills workshop with suturing, I&D, EKG & X-ray interpretation, etc. I’m so excited! Housing includes lobster bakes, welcome parties, and weekend trips to certain areas of Maine. Here’s a picture of the campus, it’s beautiful!! They say the best day to buy plane tickets is on a Tuesday, so we shall see tomorrow!

As a reminder, these stories might be made up, they might be real. I might have added or subtracted facts. They might be stories from coworkers, or fake stories from coworkers. If you feel that these stories are about you or someone you know, this assumption is seriously mistaken. Cancer is the second most common cause of death in the United States and affects millions, so stories like these are unfortunately all too common and may resemble your experiences or someone that you know. I take confidentiality very seriously! Please see disclaimer.