Patients presenting with an acute diarrheal illness is one of the MOST common chief complaints in primary care. They’re also typically worried, wondering if they need antibiotics AND usually want some sort of testing.

My last episode was part one of assessing this chief complaint, and I focused on the important history questions, physical assessment and the most important risk factors and triage components. Definitely go back and check that out if you haven’t already here: https://www.realworldnp.com/podcast

In this week’s episode though, I’m covering:

• The most common presentation to watch out for in primary care
• What types of stool testing there are, and why you’d order them
• The most common pathogens you’re looking for, and how to order them
• Guidance for patients looking for antibiotics (and if they’re appropriate or not)

Here’s the reference I mentioned with the printable table! It’s a few years old but it’s free! Up-to-Date also has a great table resource but I don’t have rights to share unfortunately :) https://www.aafp.org/afp/2014/0201/p180.html#afp20140201p180-t1

Read the blog post here.

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Acute diarrhea is SUCH a common chief complaint in primary care. In this week’s episode I’m covering acute diarrhea diagnosis for new nurse practitioners in primary care. 

Including:

• The approach to diagnosis
• What “doorways” to keep track of
• The most important history questions
• Triaging the most dangerous presentations
• Whether to order labs or not!

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The transition from RN to NP is TOUGH. It's exhausting, stressful, but oh so worth it.

We need to be careful, though, because too much stress and not enough strategic prevention can lead to burnout and something called compassion fatigue, which can fizzle out our drive and passion-- and worse, may even lead to leaving the profession altogether.

In this episode, I'm covering:

- The risk factors, signs and symptoms of stress, burnout and compassion fatigue (it's not necessarily what you think)

- How to know if you're having any of these (or all three)

- And what to do about it (prevention AND treatment).

Take your ProQuol self assessment here: https://www.proqol.org/ProQol_Test.html

Definitely check out the book To Weep for A Stranger: Compassion Fatigue in Caregiving by Patricia Smith if any of this is resonating with you: https://www.amazon.com/Weep-Stranger-Compassion-Fatigue-Caregiving/dp/1448658691 (not an affiliate link)

Read the blog post here.

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Prescribing weight loss medications in primary care is SUCH a common challenge for new nurse practitioners. It feels like there are so many options and things to keep track of.

This week’s episode is a follow up from the last episode about weight management counseling-- all about weight loss medications in primary care.

This week I cover:

✅ Which patients are candidates for weight loss medication

✅ The three main types of medications, side effects to watch out for

✅ Goal setting and what to expect with patients

✅ Monitoring of patients and how often to have them come back to clinic

PS. I said most of the studies are heterogeneous but I meant to say that the studies are too homogeneous-- they’re not reflective of the diverse communities of patients we serve.

Read the blog post here.

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Weight management counseling in primary care is such an important skill, and it’s truly the foundation that patients need before we can start addressing weight loss medications.

In this week’s episode, I’m covering my approach to weight management counseling in primary care, that will hopefully help you feel more confident in your visits.

I cover:

✅ How to talk to patients, including actual easy scripted phrases to use so you get the information you need and they feel supported

✅ Special considerations with using the BMI calculator (who knew??)

✅ One key to actually move the needle forward in weight management conversations

✅ The hidden beliefs we need to address with patients that will set them up for success

✅ The mindset shift that will help you and your patients set realistic expectations and plans of care so they reach their goals

Read the blog post here.

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I’m SO excited to share this interview with you. I’m interviewing two pelvic floor therapists -- a family nurse practitioner who has gotten additional training, and a physical therapist with a specialty in pelvic floor therapy.

This is SO IMPORTANT. It seems like a hidden corner of medicine that we don’t learn about in school, or maybe it’s touched on when it comes to dyspareunia or urinary incontinence, but it’s so much more than that and we have the power to be so helpful for patients.

In this episode we cover so, so many gems, including:

✔What is pelvic floor therapy?

✔What is pelvic floor dysfunction?

✔When would someone need that?

✔What do you wish primary care providers knew?

✔What resources do you recommend to learn more or to get patients access?

✔Why should we not give exercise handouts?

Here are Melissa and Kathy's website and YouTube channel: 

http://www.instituteforpelvichealth.com

https://www.youtube.com/channel/UCVH9Cd-W5YPHoz4cFGZQ3Xw

Read the blog post here.

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Interdisciplinary collaboration is SO important in primary care. It’s a tragedy when we’re each rockstars in our own bubble of a profession, but aren’t collaborating or communicating enough to fully understand what each profession actually does.

I’m absolutely obsessed with physical therapy, and it’s a HUGE key to success for patients with musculoskeletal complaints in primary care-- but I didn’t really see how it worked on the other side until I was a patient myself.

In this week’s episode, I’m interviewing Stephanie who’s been a physical therapist for 10 years, and we’re answering questions from the email list about physical therapy. We cover:

✅ What physical therapy is and how they can help patients

✅ Who’s a good candidate (or not) and what patients should go that aren’t being referred

✅ The role of imaging before sending to physical therapy

✅ How to manage cost/time/insurance concerns patients have

✅ What we can do in primary care to counsel patients and prepare them to set them up for success with a physical therapist so they can finally feel better

Read the blog post here.

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When we’re nurse practitioner students, we’re so focused on the clinical aspects of our jobs that most of the time when we graduate, we’ve caught by surprise.

There’s an entirely new role we need to step into as well: delegating, supervising and managing staff members.

It’s especially tricky when you’re supervising someone, but you’re not technically their boss-- like medical assistants and nurses.

And it’s also difficult because as nurses, we’re so used to working as a team, pitching in, and it feels like we should just “do it ourselves” when it comes to delegating.

In this week’s episode, I’m interviewing executive and leadership coach Jackie Kindall with the questions from the audience about delegation and managing team members as a new nurse practitioner.

We cover:

✅ Why it’s actually a not helpful for us to “do it ourselves” and how delegation is actually helpful and important to do

✅ The common pitfalls new nurse practitioners and leaders experience when it comes to delegation and supervision

✅ How to effectively delegate and troubleshoot when things are not going well

Read the blog post here.

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When I became a new nurse practitioner, I was so focused on learning the clinical pieces that it never occurred to me to learn more about the business of primary care.

Once I was on the job, I realized how crucial it is to understand those pieces and how I fit as a clinician in the primary care office ecosystem.

This is particularly relevant when it comes to scheduling patients. It seems like a minor thing, but it causes a lot of nurse practitioners painful headaches, and can be tricky to both understand the problems and navigate out of them unless you understand the full picture of how it fits into the day-to-day running of the practice.

In this week’s episode, I’m building off of last week’s video where I talked about the business foundations of primary care. I cover:

✅ The foundational pieces to understand when it comes to scheduling patients

✅ The way that it can look ideally, and the less-than-ideal “real world” way it can look

✅ Examples of issues new nurse practitioners face, and ways to navigate out of them

Read the blog post here.

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As nurse practitioners, we primarily learn the clinical aspects of practice. For good reason-- we’re taking care of real patients’ lives. But there’s a whole lot more to learn on the job, from delegation and leadership, to navigating day-to-day challenges in the ecosystem of a clinic.

I was SO focused on learning the clinical parts as a new NP, that I was caught by surprise at my first job. I didn’t realize how primary care offices work-- the business of running a clinic -- and the role I now played.

Understanding how primary care offices work from a business perspective can help you in SO many aspects of your job as a nurse practitioner-- from asking the right questions during a clinic interview, to negotiating salary, to making improvements in clinic workflow or requesting more support.

In this week’s episode, I’m covering the foundations of how primary care clinics work from a business perspective, your role, and it will serve for the basis of a few upcoming videos where I address the “ideal world” and the “real world” of primary care offices, and how to navigate the common issues that come up.

Read the blog post here.

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