Clinical Hack: The Ring String Trick

Working in the emergency department, one of my favorite cases to treat is rings stuck on swollen fingers. While it doesn't happen everyday, there's something gratifying about the opportunity to grind through a ring on a finger that is steadily turning bluer and bluer.

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Pharmacogenetics: Have You Heard of This New Way to Prescribe?

Last month I chatted with Emily, a psychiatric nurse practitioner practicing in California. Emily has recently started a new job, and was excited to fill me in on the details of her position. One thing she loves about her new employer, is the integration of technology into the practice. The practice, for example, offers genetic testing to psychiatric patients, helping Emily select the most effective medication for each individual patient. Such testing falls under the realm of pharmacogenetics, the study of how an individual's genome affects his or her response to medications. 

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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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Clinical Hack: Kissing Trick for Nasal Foreign Body Removal

Whenever I notice a toddler has checked into the emergency department waiting room for some sort of foreign body situation, a feeling of dread sends shivers throughout my body. Attempting to remove french fries from the noses of wiggling kids and beads from the ears of screaming infants has never been my forte. Performing procedures on children, especially those involving foreign body removal, just isn't part of my job that I enjoy. Fortunately, there are a few tricks that make removing foreign bodies a bit easier.

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A Pharmacist's Top Drug Resource Recommendations for NPs & PAs

This week, nurse practitioners in our inaugural Midlevels for the Medically Underserved class sat in on a presentation from pharmacist Dr. Jon Pouliot about medication interactions in the primary care setting. With so many of our patients taking multiple medications, it can be tough as NPs and PAs to keep track of interaction considerations, as well as drug side effects and dosages. So, helpfully, Dr. Pouliot ended the presentation by suggesting a few practical resources nurse practitioners and physician assistants can use for prescribing. 

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How to Present a Patient to Your Preceptor with Style

Oh the dread! If you're a nurse practitioner student going through a tough round of clinicals, one cause of your education-related anxiety is likely presenting patients to your preceptor. Summing up a patient in a brief on-the-fly presentation is tricky. Although you've written plenty of SOAP notes, nurse practitioner students often struggle with communicating this kind of information verbally. So, how do you neatly package your next patient encounter and deliver the message in a svelte manner? 

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The Nurse Practitioner's Guide to Handling Upset Patients

Security! Working as a nurse practitioner in the emergency department, I've encountered my fair share of upset patients. Sometimes, these interactions escalate and require intervention from hospital security staff or are unfounded and based on psychiatric illness or substance abuse to name a few. Most often, however, frustrated patients have a legitimate concerns that deserve acknowledgement. 

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Ask These 6 Questions Before Agreeing to Call as a Nurse Practitioner

On-call responsibilities can be a major burden as a nurse practitioner (the dread!). They mean bringing work home with you and the obligation to be on duty after hours, on weekends, and even holidays. Although managing patients by phone can be an inconvenience, the way in which this responsibility is delegated within a practice is the make-or-break factor in determining if taking call is reasonable. If your employer or soon-to-be boss is asking you to accept call responsibilities, ask these six questions first. 

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6 International CME Conferences for Spring 2017

It's about that time of year. Yes, I've got the winter travel itch. Dreary weather has me longing for spring although warm sunny days are still a few months away. Nothing takes the cold weather blues away like having an exciting trip to look forward to. And, nothing makes trip planning more enjoyable than knowing you won't have to fund the vacation on your own. So, why not put your employer-funded continuing medical education allowance to work and get an international vacay on the calendar?

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CT Scans: When Do You Need Contrast?

Working in the emergency department as a nurse practitioner, I order CT scans in my evaluation of patients every day. When I was newer to my role, I had a lot of questions about diagnostic imaging, when it was indicated, and what test to order. One of these questions that came up frequently related to CT scans was "Do I need contrast?". If you're a nurse practitioner who struggles with the same question, check out the following guide to contrast and CT scans. 

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