Friday, July 22, 2011

Checking out the "real" NP world

I have to admit, as a military FNP, I am a little sheltered from the “real world” of NPs. In our community, FNPs usually work in primary care and, occasionally, pediatrics. We don’t typically specialize in areas such as surgery or dermatology. There are programs in the military for our PA counterparts to branch into specialty practice—most common is surgery or orthopedics—but they are not available to us. Why this is, I cannot answer. I would think it has much to do with the current shortage of primary care providers, but if that is the case, why do PAs occasionally specialize?

Over the last few months, I have met more and more civilian FNPs and am frequently surprised by their ability to specialize. One works in general surgery at the Veterans Administration (VA) facility in town, and prefers to specialize in breast surgery. I was thrilled to hear this because, historically, the VA has been a “man’s world” where there were few services tailored to the female veteran. Another friend works in oncology, both inpatient and outpatient. She talks about how removed she feels from “regular” medicine, and my head spins thinking of all the complicated medication regimens she prescribes.

The one that surprised me the most? A friend who is a women’s health NP recently interviewed for a job in pain management. My first question was, “Can you really do that? Take care of men, too?” And, apparently, she can!

As my time to leave the military slowly approaches—I have just three years left!—it is a little overwhelming to think I will have to go looking for a “real job” and that there are more options than family medicine. I still don’t know that I would choose something else. I enjoy the variety of what I do. But, you never know what door might open when the time comes!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Tuesday, July 5, 2011

Buckle up!

To quote the much-missed Jerry Garcia, “What a long, strange trip it’s been!”

The roller coaster that I call life is still going full speed, with the occasional quick turn and corkscrew thrown in (just to keep me on my toes, I think). In the last month, we moved into our new place, Mom arrived for the summer and I spent a week at the American Academy of Nurse Practitioners (AANP) conference in Vegas. Throw in the last weeks of school and all the programs, typical summer turnover and staffing woes and the day-to-day of sporting events, and I sometimes forget to breathe!

First, the house. It is fantastic! The choice was the right one. The size is great, things are fitting into their places and the cul-de-sac is fantastic! Great neighbors and other kids, as good or better than I had hoped for. The landscaping is moving along, and we should have a back yard within the week. I spent lots of spare time looking for plants to create the low maintenance but enjoyable backyard space it needs to be, and I think we have achieved that.

Now, Mom. What would I do without such great parents?! Both my folks arrived shortly after school ended, then dad returned home after a week. He left mom and her car here to get me though the summer, which is so fantastic! The kids can hang out with friends, go to the pool, attend Vacation Bible School and sports camps, and just relax without going to all-day care, while I rush off to work. And Mom gets to beat the Arizona heat for the summer, which I think she enjoys as well. The three of us as so happy to have her here!

Now, the conference. What a great week! I saw some old friends, both Air Force contacts and friends from graduate school. The lectures were interesting, the Venetian Resort was HUGE—anyone else still getting lost the last day?—and the evenings entertaining. There were some drawbacks to such a large attendance and some things missing I had enjoyed in years past but, all in all, I gleaned some new concepts and ideas to implement in practice.

Since returning to the clinic this last week, there were several times I had to stop and think about lectures I had attended and how to use that new information in practice. I took in the four-hour ECG lecture and, when I did a 12-lead this week, was able to quickly assess for axis deviation and bundle branch blocks. Yes, prior to this I considered them but, after the lecture, they actually made sense!

I have also been working harder to match depression symptoms to medications, considering more dopamine stimulation for those who need it. What I wish I knew more about are herbals, supplements and vitamins. I heard a bit about this, but there does seem to be a connection between some deficiencies and depression, headaches and many other things. It would be nice to be able to support this as an early or additional option for patients. Maybe, a good idea for my next conference choice?

So, summer is off to a roaring start. I am looking forward to some afternoons at the pool, a vacation in August and maybe getting the pictures hung. Oh, and soccer camp, sleepovers, baseball games and can’t forget work. There goes the roller coaster again. Guess I better strap in for the ride!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.