Showing posts relating to: The Rounds: Clinical Considerations

How to Tell a Patient "I Don't Know"

How do you react when you don't know the answer to a patient's question? Does your face flush? Do you reply with an answer that doesn't directly address the question asked? Do you abruptly end the conversation? Experts say that the words "I don't know" might be some of the hardest to say, even more so than "I love you". Admitting uncertainty or lack of knowledge isn't easy - just ask children and Alzheimer's patients who confabulate rather an utter a simple "I'm not sure". As nurse practitioners, however, we inevitably find ourselves in situations where we don't have the answers. 

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Summer Medicine: Evaluation & Treatment of Snakebites

Hailing from the Pacific Northwest, where snakes are common, but not a health hazard, I rarely think about the possibility of snakebite emergencies. Now, living in Tennessee, things are different. There are a number of venomous snakes indigenous to the United States. Summertime, when outdoor activities, like wading in creeks and working in fields is common, snakes do pose a potentially serious danger. The other day while I was working in the emergency department, a patient arrived with the first serious snakebite we have seen this summer, prompting me to brush up on my envenomation know-how. 

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5 Online Trauma CME Resources for Nurse Practitioners

The hospital where I work has recently upped it's trauma level status. So, it has come to my attention, there is now a trauma-related continuing education requirement for nurse practitioners working in the emergency department. My continuing education hours necessary for certification have already been completed, so, in the interest of maximizing my budget, I prefer to meet this new trauma requirement at low or no cost. Fortunately, I was able to identify a few budget-friendly trauma CME resources available to nurse practitioners online. 

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Laceration Repair Round Up: Best Posts for Learning to Suture

Mastering procedures was one of the more difficult parts of life as a new grad nurse practitioner. Procedures take practice. Not to mention, there are additional factors to consider compared with less involved patient interactions. The risk of complications, for example, is much higher with procedures. So, these interventions must be approached with careful consideration. If you could use a brush up on your laceration repair skills, the following blog posts will help. 

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The Clinical Hack Link Pack

One of the things I like most about my job as a nurse practitioner is continuing to learn. Given that I am a more experienced NP at this point, it seems that my life in the emergency department has become more routine, with significantly less day to day learning. While it's comfortable to be confident in my skills, and capable of caring for higher acuity patients, I still relish 'aha!' moments. If you're in the market for learning a few new clinical tips, tricks, and pearls, check out the following clinical hack link pack for our favorites. 

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This TED Talk Will Change How You Treat Chronic Pain Patients

Pain management has taken center stage as a hot topic in medicine recently. With prescribing of opioids at an all time high, we've seen an increase in deaths related to overdose as well as a spike in the number of patients addicted to these medications. As nurse practitioners, we struggle with the prescribing of pain medications as we treat our patients. Pain is real, and part of our responsibility as healthcare providers is to alleviate it. On the other hand, we must do so in a manner that mitigates the negative side effects and consequences of providing these drugs

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Is Administering Chemotherapy Putting Nurses at Risk?

By Ariel Jacoby from Medelita

Nurses are attempting to save the lives of cancer patients when administering chemotherapy drugs, but how how do these treatments affect the nurses administering treatment? A study from 2011 found that nearly 17% of nurses were unintentionally exposed to toxic chemotherapy drugs through skin or eye contact while working in an outpatient facility.

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Are You Following These 4 Practical Prescribing Principles?

Most often, when I read research articles, I find them interesting, but not directly applicable to my practice. Or, the article presents an interesting perspective, however the research is young and not widely tested. Recently, however, a journal article was recommended to me that proved to be practical and directly applicable to my work as a nurse practitioner. The article? Principles of Conservative Prescribing published in the Archives of Internal Medicine

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Tricks of the Trade: Epistaxis Management

Raise your hand if you hate treating nose bleeds! Whenever I see 'epistaxis' pop up as a chief complaint on my computer in the emergency department, I head straight for the restroom...maybe by the time I return, another provider will have picked up the chart... Some nose bleeds resolve quickly with just a few sprays of Afrin, but those that don't can be tricky to treat. Not to mention, patients generally don't appreciate having tampon-like devices shoved up their nares. Here are a few tips and tricks for treating epistaxis in your practice.

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Prescribing Controlled Substances: The Course for NPs & PAs

Protect your license, prescribe appropriately

Prescribing controlled substances as nurse practitioners and physician assistants is challenging. Medications for treatment of pain and anxiety, to name a few, are often the key to helping patients find the much needed relief they deserve. However, given the addictive nature of most controlled substances, these drugs are widely sought after and highly regulated. At times, prescribing controlled substances can feel like a morally or professionally compromising situation. 

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The ABCDEFGHI's of Chest X-Ray Interpretation

Do you really know how to read a chest X-ray? It's important that as nurse practitioners and physician assistants we can scrutinize the quality of chest X-rays an have the skills to interpret this important diagnostic tool. With so many crucial body systems encompassed in one test it's necessary to have a systematic method for approaching chest X-ray interpretation. Fortunately, simply following the first few letters of the alphabet can help.

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5 Helpful Pocket Orthopedic Guides for Nurse Practitioners

Diagnosing orthopedic symptoms can be tricky. X-rays, for example, don't tell you a lot about tendons and ligaments that are often responsible for joint pain. More advanced testing, like MRI, is costly, and often requires prior authorization from insurance companies leading to a delay in treatment. While there are a number of clinical orthopedic exam maneuvers that indicate the exact type of injury and help lead nurse practitioners to a diagnosis, the specifics of these exam techniques can be difficult to recall on the spot. 

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