Real World NP

What does it mean to “clear” a patient for surgery? Every patient needs to have a visit with a healthcare provider before their surgery in order to assess their health and verify that it is relatively safe to proceed with surgery. When they end up on your schedule, it’s up to you whether or not they will get the go ahead (no pressure). If you are wondering how, as someone who has not been trained to perform surgeries, you are supposed to understand a patient’s ability to tolerate a surgery or procedure, this video should help.

Patients and surgeries each have varying levels of risk (low, medium, high), and the preop visit is the place to get an understanding of how the pairing of the patient and the surgery is most likely to pan out. Many times, your judgment will be adequate and you can determine whether or not the patient should proceed with surgery; other times, more information will be needed, and it may be wise to send them to a specialist for the final word.

In this week’s video, we will talk about the particulars of the preop patient and the preop exam.

• The elements of a preop exam in primary care
• Relative risk levels of surgeries, and how to understand them for the purpose of a preop exam
• How to factor in the comorbidities when considering the patient’s safety for surgery
• The role of preop testing and imaging
• How to get feedback from a collaborating physician for tricky cases

Not all preop examinations are created equal, and so much of it depends on the surgery the patient is planning. Try not to get overwhelmed by the prospect; improving your understanding of the patient and assessing them for surgery, and when you should send them somewhere else, gets better with time and practice.

Read the full blog post here.

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

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The thought of your Nurse Practitioner job not being the right fit can be scary. You’ve invested a lot of time, money, and energy – not to mention all the things that you have sacrificed – to get to this point, and now?

You may have spent a lot of time imagining what it would look like to be working as an NP, and this isn’t it. Whether you are working with a collaborator or on your own, whether you are in primary care or a specialty, whether you have your own panel of patients or not – sometimes it’s just not the right job for you, and the grass is looking a lot greener on the other side.

Scary as it may be (and as surprising as it may sound), this is very common, especially for new grad Nurse Practitioners. In this week’s video, we will talk about not being in the right job for you, and how to know when it’s time to change jobs. We’ll discuss:

• Questions to ask yourself if you are considering a job change
• What a normal first-year experience as a Nurse Practitioner looks like
• What to expect from the transition from student to clinician
• When to consider a job change

Sometimes the need to make the change is very clear, other times it is not. If you are feeling like the assistant to your more experienced colleague or collaborator (and don’t want to), or if you are feeling like the setting is not right for you, or if you are feeling completely over your head every day and wondering whether you will always feel this way – consider whether what you are experiencing is standard first year growing pains or something deeper.

Read the blog post here.

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

Wrist pain is a SUPER common chief complaint in primary care. Most of the time, luckily, it’s chronic wrist pain that’s from overuse (versus the more acute, dangerous differential diagnoses with injuries), but it’s still a lot to work through as a new nurse practitioner.

In this week’s episode, I’m covering the overview approach to diagnosing wrist pain in primary care for new nurse practitioners:

✅ What first triage questions to ask

✅ Red flags to watch out for

✅ History questions, physical exam and special tests to perform

✅ When to refer and when to consider getting imaging

Read the blog post here.

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Don't forget to grab your free Ultimate Resource Guide for the New NP

Sign up for the Lab Interpretation Crash Course

Grab your copy of the Digital NP Binder

Get your medication management right with the Diabetes Medication Workshop

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Come follow along for even more tips and inspiration:

Instagram: https://instagram.com/realworldnp

Facebook: https://facebook.com/realworldnp

© 2020 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

When you're a new nurse practitioner, you need to make thousands of decisions a day.

(Which usually translates to thousands of questions).

I made mistakes as a new grad, and luckily for me, I had a very patient colleague who was there to help guide me.

In this video, I'll share:

• Some of my mistakes (I'm a little embarrassed)
• Three easy steps to make sure you ask questions the right way (so you get the answers you're looking for and build and maintain your colleague relationships)

Leave me a comment below, what are some of the strategies you use to collaborate with your colleagues and supervisor?

Read the full blog post here.

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Don't forget to grab your free Ultimate Resource Guide for the New NP at https://www.realworldnp.com/guide

More Resources:

Lab Interpretation Crash Course: https://www.realworldnp.com/labs

Digital NP Binder: https://www.realworldnp.com/binder

Diabetes Medication Workshop: https://www.realworldnp.com/diabetes

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Come follow along for even more tips and inspiration:

Instagram: https://instagram.com/realworldnp

Facebook: https://facebook.com/realworldnp

Hosted on Acast. See acast.com/privacy for more information.

Syphilis lab interpretation can be confusing, and it’s a BIG topic, but in this episode, I review the most common scenario that I see in primary care.

I cover treponemal and non-treponemal tests, how to interpret them most specifically in the context of slightly abnormal, asymptomatic patients (the most common scenario in primary care), as well as the treatment and follow up, and when to refer to a specialist.

How to cold call a specialist (you can do it!!): https://www.youtube.com/watch?v=xoFAYS0YN_U

Read the blog post here.

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Don't forget to grab your free Ultimate Resource Guide for the New NP

More Resources:

Lab Interpretation Crash Course

Digital NP Binder

Diabetes Medication Workshop

------------------------

Come follow along for even more tips and inspiration:

Instagram: https://instagram.com/realworldnp

Facebook: https://facebook.com/realworldnp

Hosted on Acast. See acast.com/privacy for more information.

When it comes to choosing which oral contraceptive pill to prescribe, there are SO many options. How do you know which one is the right one? As a new nurse practitioner, you’ll usually get different recommendations from different providers.

In this video I’ll be covering:

• The first step to prescribing that’s easy to forget
• What criteria to consider when choosing
• The two main routes to follow (and how to know which one to go down)

Plus, check out the resources I reference in this video to help you decide:

CDC Medical Eligibility Criteria

List of Progestins by Androgen activity

Read the blog post here.

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Don't forget to grab your free Ultimate Resource Guide for the New NP

More Resources:

Lab Interpretation Crash Course: https://www.realworldnp.com/labs

Digital NP Binder: https://www.realworldnp.com/binder

Diabetes Medication Workshop: https://www.realworldnp.com/diabetes

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Come follow along for even more tips and inspiration:

Instagram: https://instagram.com/realworldnp

Facebook: https://facebook.com/realworldnp

Hosted on Acast. See acast.com/privacy for more information.

It's 2 p.m., the medical assistant comes to your office and lets you know your next patient is ready, and they're here because they "need antibiotics"...

... But do they? Or don't they?

They've "had a cold" or "a nasty cough" for over three weeks now.

... they've "tried everything," and "got an antibiotic last time."

Are you seeing this every day now, too? 'Tis the season. 

This week's case study is all about that sticky situation--

✔️ Productive cough for over 3 weeks ("subacute")

✔️ What the differentials are, and 

✔️ What to do about it (and who actually needs antibiotics).

Please note that this case study was made pre-Covid pandemic so does NOT include Covid/long Covid as a differential.

Read the blog post here.

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Don't forget to grab your free Ultimate Resource Guide for the New NP at https://www.realworldnp.com/guide

Hosted on Acast. See acast.com/privacy for more information.

So many things in primary care are deceptively complex. There may be a few genuinely simple things that we treat, but so many things that come into our exam rooms are complex and sometimes downright confusing.

Anticoagulated patients are one of those situations. While the concept itself is pretty simple – medication that thins the blood so that they don’t get clots, got it – the reality of managing an anticoagulated patient is something else. In primary care, we are often either inheriting the patient who is on anticoagulation, or we are following up after someone else started them (maybe after a trip to the emergency department).

It is completely normal to question yourself with anticoagulated patients. If you have been there, or if you would like to be prepared before you see your first anticoagulated patient, this week’s video is for you. We will talk about:

✅ Where to start with the anticoagulated patient – and then where to go

✅ Different types of anticoagulants

✅ Everything you need to consider to prescribe anticoagulants safely

✅ How long to keep a patient on anticoagulants

✅ How to monitor the anticoagulated patient, and what to watch for

Anticoagulation has so many benefits for the patients that need it, but like anything else in medicine, it comes with risks. Building up your knowledge about what to look for (and what to do if you find it) when working with anticoagulated patients will make such a difference in building your confidence as a provider.

Read the blog post here.

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Don't forget to grab your free Ultimate Resource Guide for the New NP

______________________________

Please note: This episode is intended only for medical providers and students learning to be medical providers. 

While anyone is welcome to view and listen, for legal and safety reasons, we are unable to diagnose, treat, or answer medical questions for individuals through this channel. We always refer individuals back to their primary care providers for medical care.

If you’re a medical provider or student and have specific patient cases you have questions about, I cannot answer those here but would love to help you inside our mentorship program! Join the waitlist at https://www.realworldnp.com/mentoring.

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

It’s not unusual to be taken by surprise when you see microscopic hematuria on urine dip results. The patients who end up with this as part of their presentation are often asymptomatic, and may even be giving you a urine sample for another reason – which can make chasing down the cause even more of a mystery.

If you don’t know where to start when it comes to determining the cause of microscopic hematuria, you’re not alone. In this video, we will cover a high-level approach to investigating a finding of microscopic hematuria. We will go over the workup for microscopic hematuria, and lots more:

✅ What is the difference between microscopic and macroscopic hematuria?

✅ When a urine dip is enough, and when you need to send the sample out

✅ What white blood cells and protein in the sample can tell you

✅ Essential history and symptom questions to ask

✅ When to repeat the urine dip at another time

Having a simple framework for approaching the sometimes mysterious microscopic hematuria will increase your confidence and help you to take the best care of your patients. Getting to the root cause of microscopic hematuria is another critical part of taking great care of the patients you work with. 

Read the blog post here.

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Don't forget to grab your free Ultimate Resource Guide for the New NP at https://www.realworldnp.com/guide

______________________________

Please note: This episode is intended only for medical providers and students learning to be medical providers. 

While anyone is welcome to view and listen, for legal and safety reasons, we are unable to diagnose, treat, or answer medical questions for individuals through this channel. We always refer individuals back to their primary care providers for medical care.

If you’re a medical provider or student and have specific patient cases you have questions about, I cannot answer those here but would love to help you inside our mentorship program! Join the waitlist at https://www.realworldnp.com/mentoring.

_______________________________

© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

Getting comfortable talking with patients or other healthcare professionals about disabilities can be challenging. It’s not something that is typically covered in school, and if you don’t have personal experience with the subject, you may find yourself floundering trying to find the right thing to say – or to avoid saying the wrong thing. And when you don’t feel comfortable, how can you expect your patient to feel comfortable?

We asked our Real World NP community their questions for working collaboratively with disabled patients. In this week’s episode, we got answers from Andrea Dalzell, Disability Rights Influencer to those questions and more.

·    What is person-first language, and why it is so important

·    Things that you may not have considered about accessibility

·    What workplace accommodations are – and are not

·    How to advocate for people with disabilities

Words matter. The way that we, as clinicians, receive and interact with our patients with disabilities translates to how they (and their disability) are perceived in so many other aspects of their life. Working to develop an understanding, in a deep way, of how a patient’s disability impacts their overall life is a vital part of this. Likewise, improving understanding of how the language we use can positively or negatively impact patients, along with the ways that we interact with those same patients, is an important part of our roles as clinicians.  

Read the blog post here.

-----------------------

Don't forget to grab your free Ultimate Resource Guide for the New NP

Sign up for the Lab Interpretation Crash Course 

Grab your copy of the Digital NP Binder

______________________________

Please note: This episode is intended only for medical providers and students learning to be medical providers. 

_______________________________

© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details

Hosted on Acast. See acast.com/privacy for more information.