NP in Progress – Details, episodes & analysis

In this episode of NP in Progress, I sit down with orthopaedic registrar Dr Dan Brimm to break down the septic joint ; a limb- and sometimes threatening diagnosis you can’t afford to miss.

We work through real ED cases, including a swollen knee after a “pimple squeeze” and a 30-year-old with a history of Intravenous drug use and severe wrist pain at 3am. We cover when to aspirate, when not to, why X-rays still matter, what bloods can and can’t tell you, and how metal in a joint changes your risk calculation.

We also talk bias, pain management, and the importance of collaboration between ED and ortho.

Practical. Case-based. No fluff

Sometimes the diagnosis hiding in plain sight is the one everyone keeps missing. NP Dr. Leanne Brown breaks down what really happened to the young CKD patient and shares a humbling case where “musculoskeletal pain” fooled an entire team. This episode is a masterclass in staying curious when the answers seem obvious.

Peptide clinical trial : https://clinicaltrials.gov/study/NCT06383390

In this episode, Amy Bowen shares her journey from registered nurse to nurse practitioner, offering her perspective of the challenges and rewards of working in aged care. She explores the importance of hospital avoidance, for patients in residential age care facilities and continuity of care. We also discuss the critical role of teaching and mentoring for nurse practitioner students. Amy delves into the complexities of dementia care, the nuances of family palliative care communication, and the delicate nature of end-of-life discussions. With a strong emphasis on empathy, understanding, and effective documentation, she also highlights the necessity of upskilling nursing staff within aged care to enhance patient-centred care. This conversation underscores the vital role of healthcare professionals in advocating for their patient's dignity, wishes, and overall well-being.

Dr. Nicola Cooper author of ABC of Clinical Reasoning joins NP in Progress to explore clinical reasoning, medical education, and diagnostic decision-making. They discuss the role of deliberate practice, illness scripts, and the differences between forward and backward reasoning. The conversation delves into cognitive biases, diagnostic errors, and the limitations of tests, highlighting the importance of precise language in problem representation. They also examine effective teaching strategies, including microlearning, checklists, and positive reinforcement, while advocating for compassionate leadership and systematic approaches to clinical reasoning to improve patient care.

Creme website: https://www.creme.org.uk

Case studies:

https://pmc.ncbi.nlm.nih.gov/articles/PMC10281853/

https://pmc.ncbi.nlm.nih.gov/a

https://pmc.ncbi.nlm.nih.gov/articles/PMC9979919/

Join me as Sarah Hall takes us through her journey from RN to paediatric nurse practitioner, sharing the lessons learned in critical care and chronic disease management. She delves into the art of clinical reasoning, the value of mentorship, and the role of gut instincts in diagnosing complex cases. From assessing what normal is to persistent fevers and finally recognising unusual symptoms, Sarah breaks down key paediatric diagnostic principles, including the three I’s—infection, inflammation, and injury. Whether you’re an aspiring NP or an experienced clinician, this episode offers valuable insights into career growth, patient advocacy, and the evolving role of technology in healthcare.

This conversation explores the significance of effective communication in healthcare, the evolution of medical education, and the role of simulation training in developing clinical skills. Doctor Victoria Brazil explores the importance and concept of clinical reasoning, the need for feedback in clinical practice, and the potential for reimagining medical training to better prepare healthcare professionals for real-world challenges. This conversation delves into the critical aspects of patient follow-up, the role of simulation in medical training, and the integration of learning with practice. It emphasises the importance of understanding clinical biases and learning from both mistakes and successes in clinical reasoning. The discussion also highlights strategies for healthcare professionals to enhance their learning and improve patient outcomes. This episode is not to be missed

In this conversation, Lynne Willis shares her extensive journey as a nurse practitioner, detailing her experiences from training in the UK to working in Australia. She discusses the challenges she faced in transitioning to a new healthcare system, the importance of cultural competence in Indigenous healthcare, and the evolution of her clinical reasoning skills. Lynne emphasises the significance of mentorship, reflection, and continuous learning in nursing, while also sharing real-life clinical scenarios that tested her skills and decision-making processes. In this conversation, Yasmine and Lynne discuss the importance of continuous learning and experience in the medical field, particularly for nurse practitioners. They explore the challenges of effective problem representation in clinical settings, the significance of learning from past mistakes, and Lynne provides some valuable advice for aspiring nurse practitioners. The discussion emphasises the need for clear communication, thorough patient assessment, and the importance of seeking help when needed.

In this episode, Yasmine Sherriff sits down with Kate Dale, a nurse practitioner with a specialty in trauma care. Kate takes us through her inspiring journey, from her roots in emergency nursing to the creation of a unique role as a trauma nurse practitioner. She shares insights into the critical importance of trauma follow-up care, the structured approach to trauma assessment, and the complexities of balancing responsibilities in both emergency and trauma settings. Kate also reflects on impactful clinical experiences and offers invaluable advice for aspiring nurse practitioners, highlighting the importance of practice, patience, and lifelong learning in the nursing profession.

Professor Gerben Keijzers discuss critical themes in clinical practice, focusing on clinical reasoning, evidence-based practice, and traditional methods. They highlight the importance of understanding likelihood ratios, cognitive biases, and problem representation in diagnosis, alongside the effective use of clinical decision tools. The conversation underscores the value of incorporating patient perspectives into decision-making and balancing evidence with experience. Gerbern shares practical strategies to minimise biases and encourages clinicians to refine their decision-making styles while staying adaptable to patient needs. He emphasises the detective-like role of clinicians, combining reasoning with patient-personalised care. Website links discussed in show https://first10em.com/clinical-decision-rules/ https://onlinelibrary.wiley.com/doi/abs/10.1111/1742-6723.13126 Chapters 00:00 Introduction and Acknowledgments 04:15 Clinical Reasoning in Practice 11:07 Evidence-Based Practice vs Traditional Medicine 17:51 Understanding Likelihood Ratios 26:14 Using Clinical Decision Tools Effectively 30:12 Understanding Clinical Decision Rules 31:01 Clinical Reasoning vs. Critical Thinking 34:55 The Importance of Problem Representation 39:50 Navigating Cognitive Biases in Clinical Practice 45:15 Strategies to Minimize Bias in Decision Making 53:18 Evidence-Based Medicine and Patient-Centered Care

In this episode of NP in Progress, I sits down with Clinton Morgan, a dynamic Nurse Practitioner whose career journey spans emergency nursing, general practice, and pioneering sexual health care. Clinton shares his path to becoming an NP, the inspiration behind his innovative telehealth clinic, PrepConnect, and the challenges of working in prison health care. From breaking barriers in HIV prevention and sexual health to navigating the complexities of starting a healthcare business, Clinton’s story is a testament to resilience, creativity, and patient-centred care. Whether you're an aspiring NP or curious about improving access to healthcare, this episode is packed with insights on clinical reasoning, healthcare innovation, and making a difference in people experiencing barriers to healthcare. Tune in to hear Clinton’s advice on balancing passion with practicality and his vision for the future of sexual health in Australia.