In this conversation, Liz Rohr interviews Jennifer Carlquist, a physician assistant with extensive experience in cardiology, who discusses the assessment and management of chest pain.

They covered: 

- Assessing cardiac versus noncardiac chest pain

- Assessing risk for MI and when to send patients to the ED or not

- What EKG findings to watch out for, and how to learn more to build your ekg reading confidence (and what’s new!)

- What we can do for patients to assess and manage heart disease risk, including labs and tests to check in primary care (including the coronary calcium score, LPa, and homocysteine)

- How to communicate and collaborate effectively with ER providers

- Further resources to learn if you’re in cardiology or interested in making the switch from primary care

Takeaways

- Consider both cardiac and non-cardiac causes of chest pain, especially in female patients with atypical symptoms.

- Take a detailed history, including risk factors and family history, and be aware of red flags that may indicate a more serious condition.

- Recognize the limitations of certain diagnostic tests, such as EKGs and troponin levels, and consider a CTA with FFR for outpatient testing.

- Collaboration between primary care providers and the ER is crucial, and concise reporting of findings is key to effective communication.

- Differentiating between hyperkalemia T-waves and hyperacute T-waves can be challenging, but hyperkalemia T-waves are pointy and hyperacute T-waves are more blunted and broad-based.

- Inverted T-waves in leads other than AVR and V1, especially if they are symmetric, can indicate the need for urgent evaluation.

- Q-waves can form within an hour of an infarction, and a small Q-wave in lead III without other abnormalities may be a normal finding.

- When learning EKG interpretation, it is important to start with understanding what a normal EKG should look like and then focus on high-risk findings.

- Inflammation is a significant risk factor for heart disease, and non-traditional risk factors such as psoriasis and early menses should be considered.

- Lab tests such as the coronary calcium score, LPa, and homocysteine can provide valuable information in assessing heart disease risk.

- Magnesium supplementation can be beneficial for patients with palpitations and hypertension, but the specific type and dose should be tailored to the individual.

- Primary care providers play a crucial role in assessing heart disease risk and can collaborate with cardiologists to order appropriate tests and make informed decisions.

- The three-day EKG challenge and the Cardiology Fundamentals Mentorship program are valuable resources for learning and advancing in cardiology.

- The importance of fostering a supportive and collaborative environment in healthcare to provide the best care for patients.

For a full transcript and conversation chapters, visit the blog https://www.realworldnp.com/blog/assessing-chest-pain

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© 2024 Real World NP. For educational and informational purposes only, see https://www.realworldnp.com/disclaimer for full details.

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In this conversation, Liz Rohr and Shelby Pope discuss the importance of taking a comprehensive history of substance use, and how to assess and treat stimulant use disorder. They cover the challenges healthcare providers face in asking the right questions, and emphasize the need for open conversations and non-judgmental approaches.

They cover screening for addiction, how to elicit a substance use history, including types and routes of substance use. Shelby covers the mechanism of action of cocaine and methamphetamine in the brain, the withdrawal symptoms associated with stimulant use disorder, and the next steps for primary care providers in managing patients with stimulant use disorder. They also explore the use of psychosocial interventions and off-label pharmacologic treatments for stimulant use disorder.

Takeaways

• Open and non-judgmental conversations are essential when discussing substance use with patients.
• Screening practices, such as using screeners like PHQ-2, SBIRT, and DAST, can help identify substance misuse or struggles.
• Taking a comprehensive history of substance use, including the type, amount, frequency, and motivation, is crucial for providing appropriate care.
• Healthcare providers should be aware of the different routes of administration and the potential risks associated with each.
• Stimulant use disorder, particularly cocaine and methamphetamine use, can have significant adverse effects and poor outcomes. Cocaine and methamphetamine are both monoamine neurotransmitter reuptake inhibitors, increasing serotonin, norepinephrine, and dopamine levels in the brain.
• There is a withdrawal syndrome associated with stimulant use disorder, characterized by depression, fatigue, and sleep disturbances.
• In managing patients with stimulant use disorder, primary care providers should consider triage based on severity and acuity, and refer patients to appropriate resources such as rehab or the ER.
• Psychosocial interventions, such as cognitive behavioral therapy and contingency management, are the mainstay of treatment for stimulant use disorder.
• Off-label pharmacologic treatments for stimulant use disorder include mirtazapine, bupropion, injectable naltrexone, topiramate, and psychostimulants.
• It is important for healthcare providers to be aware of state regulations and their own comfort level in prescribing off-label medications for stimulant use disorder.

For a full transcript and conversation chapters, visit the blog: https://www.realworldnp.com/blog/treating-substance-use-disorder 

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© 2024 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

Are you a nurse practitioner feeling lost, uncertain, or unfulfilled in your career? This raw, honest, and needed conversation with Amanda Guarniere, the founder of Resume RX, explores:

• The career challenges NPs are facing
• Alternative career paths many NPs are considering
• Changing power dynamics between employers and employees
• How to think about career changes and honor YOURSELF in the process

We dive into the growing concerns among NPs regarding stagnant wages, shifting power dynamics between employers and employees, and the desire for personal fulfillment beyond traditional clinical settings.

We chat about the rise of entrepreneurship, side hustles, and non-clinical roles that allow NPs to leverage their expertise and pursue their passions.

We encourage NPs to challenge societal expectations and professional scripts that may stop them from doing what they love.

If you liked this post, also check out:

• New Nurse Practitioner Survival Guide 
• New NP: Q&A - Is This Normal?
• Primary Care Nurse Practitioner Roundtable: How Are We Doing After Covid?

Timestamps:

00:00 - Introduction

02:45 - Practical Strategies on Navigating NP Clinical and Job Search

03:55 - Are Nurse Practitioners Okay?

05:25 - Dissatisfaction and Desperation Among NPs

07:55 - How Can ResumeRX and Real World NP Support NPs

12:39 - Personal Reflection on the Impact of COVID

13:29 - Challenges Faced By Nurse Practitioners

17:04 - Evolving Career Landscape for NPs

25:29 - NP Burnout

28:36 - Self-Judgment and Criticism 

34:35 - What’s The Next Best Thing

Read the blog post here.

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© 2023 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

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Dizziness alone accounts for about 5% of all primary care office visits in the US. 

5%! That's a huge number. 

But as a chief complaint, dizziness is somewhat nebulous. The causes of dizziness can run the gamut from annoying-but-benign to yikes-let's-get-you-to-the-ER. So how do you sift through all the possibilities and uncover what’s really going on with your patient? 

In Diagnostic Approach to Dizziness, we walk NPs through the basics of assessing patients who are experiencing dizziness. We talk about:

✅ The four buckets of ideologies that your patient’s dizziness might fall into 

✅ The critical patient history questions. (And why it's important to drill down on what patients mean when they say they're CONSTANTLY dizzy.) 

✅ The diagnostic steps and key physical tests to run (and how to do them in a not-scary way for your patients!)

🚩And the red flags you absolutely need to watch out for 

Read the blog post here.

Stressed about labs? Watch our free Top Three Mistakes New NPs Make Interpreting Labs training at realworldnp.com/training

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Back pain — it’s truly one of the most common issues you come across in primary care. That’s why you need to have your diagnostic approach to it down pat as a nurse practitioner. 

And the sooner you get comfortable diagnosing back pain in primary care, the sooner you’ll feel confident helping your patients on their road to recovery. 

In this week’s episode, we talk about why you should really take a triage-based approach to back pain — among other chief complaints — plus other hot takes on assessing back pain such as:

✅ Red flags that are critical — if sometimes tricky — to uncover when taking a patient history 

✅ Key tests to consider when you're doing a physical exam 

✅ Should you order imaging or further testing?  

✅ And how to advise patients and set expectations for recovery

Read the blog post here.

Stressed about labs? Watch our free training: 3 Mistakes New NPs Make Interpreting Labs for what to avoid and do instead at realworldnp.com/training

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It’s super common for new NPs — and experienced ones — to get anxious when encountering orthopedic complaints. 

It’s a conundrum — on one hand, it seems like it should be simple. After all, you can feel all the musculoskeletal body structures right there. 

But at the same time, there are so many (SO MANY!) nuances to each body part. And there’s a lot of ortho lingo to wrap your head around. 

That’s why it’s helpful to understand exactly what an orthopedic nurse practitioner does — and what that means for working in primary care.

So sit back and enjoy — this week, orthopedic nurse practitioner, Yessica Salazar, has stopped by to talk ortho with us...and left behind so many great clinical pearls that I just know will help you in your daily practice: 

✅ How to order knee X-rays the right way

✅ Her approach to medications for orthopedic complaints

✅ Non-invasive treatment options for patients 

Read the blog post here.

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Do you ever find yourself spending an ENTIRE 20-minute visit just getting a history?

And even with all that time, do you still leave the room feeling like you didn't even get the info you needed?

In this episode, I'm sharing my top tips for not only a FASTER history, but also a more accurate one — so you can take great care of your patients while saving time and, quite honestly, health care dollars.

You'll learn:

• My top tip to keep your patient visits moving
• Pitfalls of where you could be missing info (and how to ask questions to get the answers you're looking for)
• The most important question to ask to save you TONS of time in each visit

Read the blog post here.

Need more support? Check out the Lab Interpretation Crash Course for Nurse Practitioners

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Seeing "lower leg swelling" as the chief complaint for patients as a new nurse practitioner was incredibly stressful. What’s the best course of action? Should you give diuretics for symptom control? Is this something serious...or something totally ordinary?

I had a super interesting case the other week and knew immediately that I had to share it with you — and it was one that I actually got a double-check from my colleague on!

In this episode, you'll learn:

• The top DDXs - most common and red flags
• What important history questions to ask
• Two clinical pearls of patient histories
• Differential diagnoses
• How to manage patients in this common scenario - re: testing & treatment

Read the blog post here.

Need more support? Check out the Lab Interpretation Crash Course for Nurse Practitioners

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Urine microalbumin: you need to check it once a year for patients with diabetes. But interpreting the results — and knowing what to do with them! — can be tricky. 

In this episode, you’ll learn:

• When to order urine microalbumin labs
• How to interpret the results and what to do with them
• How to treat abnormal levels
• 4 steps to elevated microalbumin management

Read the blog post here.

Need more support? Check out the Lab Interpretation Crash Course for Nurse Practitioners

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I saw a meme recently that compared hyponatremia to folding a fitted sheet— you can watch a million videos on how to do it, but in the end you'll probably just crumple it up and hope you never have to deal with it again. 🤯

Luckily in primary care low sodium is easier to deal with outpatient, and doesn't have to be super complicated. In this episode, I talk about low sodium, which is one of the top abnormal labs in primary care.

Hyponatremia involves understanding kidney function, but I've broken it down into the simplest, clearest, most digestible way to give you the most helpful insight to take into your practice. I'll bring you through the step-by-step process to implement for the vast majority of patients you'll see, and if you need to go down the rabbit hole of workup further, you'll have the tools to do so!

You'll learn:

• How to know when your patient needs to go to the ER, and when you can work them up outpatient
• The simplest way to remember low sodium
• The #1 lab you should always think of when you see low sodium
• How to know if your patient needs IV fluid (or if that'd be the worst possible thing to do for them)

Read the blog post here.

Want more lab goodies? Check out the Lab Interpretation Crash Course for Nurse Practitioners

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Feeling uncertain about referring a patient? That’s super common. You might wonder things like:  

Are there other tests you could do first?

Should you wait it out?

At what point can you be sure?

In this episode I will answer ALL of these questions. I will also walk you through my 3-step process, the pitfalls and mistakes to avoid (that I learned from experience!). Plus, I’ll give you my NUMBER ONE resource to help you:

• Feel more confident with your referrals
• Deepen and broaden your knowledge base
• Take excellent care of your patients

Read the blog post here.

Need more support? Check out the Lab Interpretation Crash Course for Nurse Practitioners

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You've seen high WBC counts as a nurse, but what about leukocytosis that's only 13 or 15? And it's chronic? And what about peripheral smears? How do you know if it's urgent?

In this episode we are going to talk about this super interesting case study to give you the step by step approach to interpreting these labs, and teach you how to manage a high WBC count safely and confidently.

Together, we will cover:

• Knowing when to order what labs
• Three main components of working up a high WBC
• The differential and the peripheral smear 
• Absolute lymphocyte count 
• The Flow Cytometry Test

Read the blog post here.

Check out the Lab Interpretation Crash Course for Nurse Practitioners

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There are many facets when it comes to interpreting Elevated Liver Enzymes (LFTs). In this episode we will be going through the most common presentation and primary care so that you will feel confident in knowing what steps to take when you come across these abnormal labs, and as a result, put your mind at ease and keep you from freaking out!

Together, we will cover:

• Key anchors of LFTs that you need to remember
• Two main factors to know what labs to order and when 
• Three points to start with during your initial approach to LFTs
• Four main questions to ask with every lab
• Symptoms, causes, evaluation, and algorithm specifically for mild AST and ALT

Read the blog post here.

Check out the Lab Interpretation Crash Course for Nurse Practitioners

Download FREE Ultimate Resource Guide for the New NP

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In this video, I sit down with two incredible NP colleagues and friends, Kara and Heather, for a candid conversation about the rollercoaster ride of being a nurse practitioner.

We delved deep into our shared experiences, tackling everything from the highs of fulfilling our calling to the challenges that can sometimes leave our compassionate hearts feeling a bit weary. Burnout, boundary setting, and the beautiful power of teamwork — it's all on the table.

💖 Join us for a heart-to-heart chat that's raw, relatable, and peppered with a good dose of humor. Because, let's face it, sometimes laughter is the best medicine.

🌈 Whether you're a seasoned NP or just starting your journey, this episode is a virtual hug, a reminder that you're not alone.

👂 Tune in, share your thoughts, and let's keep the conversation alive. In this community, your story matters, and we’re in this together.

Timestamps:

00:00 - Introduction

07:32 - Kara’s NP Background

11:10 - Residency Program

13:41 - Heather’s NP Background

19:00 - What is it like after Covid?

25:02 - New Grads Challenge

28:51 - Real-World Experience In Covid

36:14 - Changes That Were Advocated

43:35 - Funny NP Stories

56:51 - Parting Thoughts to New Grads NPs

Read the blog post here.

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© 2023 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

It happens to all of us. Those questions and self doubts we get in the back of our minds, “What did I get myself into? Do I even know what I’m doing? Should I even be in this field?” 

The list goes on. If you are struggling with these fears, then you need to know a few things. First, you are not alone! And second, you are in the right place, because I’m giving you the strategies I use to deal with imposter syndrome. 

Imposter syndrome is especially common among New Grad NPs, but in all honesty imposter syndrome is something that many of us experience whenever we move to take that next step in our career or any time we explore something new. (Yes, even I still experience this!) So even if you are not a New Grad NP, you’ll still want to check out this episode because these tips are beneficial to everyone.

Read the blog post here.

Download FREE Ultimate Resource Guide for the New NP

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When you’re a new nurse practitioner, there can be a lot of overwhelming, high-stress situations that you may find yourself in. 

A big contributing factor are lab interpretation resources — they’re scattered, hard-to-use, and don’t cover enough information. I used to DREAD opening up my lab results, but over time I went from avoiding my inbox to being obsessed with labs. 

How did I get there? I found the right tools and techniques to use. In this episode, I’m going to help eliminate the overwhelm as we walk step by step through a case study of a patient with high TSH levels. Together, we’ll:

• Go over the three main steps of hypothyroidism assessment and management
• Review components of holistic care
• Talk about medications that can affect thyroid levels
• And share pearls of practice

Get out your pen and paper because this episode is jam-packed with information, and I know you will walk away feeling more confident and prepared for your next high TSH-level patient! 

Read the blog post here.

Download FREE Ultimate Resource Guide for the New NP

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Welcome to the first episode of the Real World NP Podcast! Let’s dive right into the good stuff. 

I’m giving you my top three survival tips to help you get through your first year as a Nurse Practitioner. 

As a student, you’re always looking to your preceptor for approval and feedback. You have someone to tell you, “Yes, that was right,” and “No, that was wrong.” This relationship sure makes things easier, but we don’t remain students forever! 

There comes a time when we have to take that leap and make the transition from student to professional. 

I know that leap can be a scary one filled with anxiety, self doubt, and a lot of questions. That’s why I’m giving you these three tips that I learned from personal experience. I can’t stress enough how important it is to get the adequate support you need from the very beginning so that you can avoid burnout and stay in this career for years to come.

Download FREE Ultimate Resource Guide for the New NP

Read the full blog post here.

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

Hi, I’m Liz Rohr: family nurse practitioner, wife, mama and founder of Real World NP, a medical education company for new nurse practitioners in primary care. 

I’m on a mission to guide and support new nurse practitioners so they can feel confident and capable through comprehensive, concise, and hyper-relevant educational resources, without the fluff. 

Real World NP is also here to provide an approachable, supportive community in order to bring about a new generation of healthcare providers who know that they can make an impact and disrupt the healthcare industry. 

Each week you’ll hear a mix of clinical pearls and practice tips, guest interviews with specialists and allied health professionals, and guidance on navigating the role transition from RN to NP. Make sure you subscribe and leave a review so you won’t miss an episode. Plus, you’ll find links to all the episodes, plus extra goodies over at realworldnp.com/podcast.

Read the blog post here.

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I am thrilled to introduce you to Midge Bowers.

Not only is Midge a Clinical Professor and Director of the cardiovascular specialty at Duke University School of Nursing, she practices as a nurse practitioner in a Heart Failure Access Clinic.

She’s an expert in cardiology, a seasoned healthcare educator, and shares so much incredible knowledge in this jam-packed episode.

In this episode, we covered:

• The importance of looking beyond creatinine levels
• How to focus on practical aspects of echos
• Demystifying anticoagulation choices
• Practical tips on adjusting Warfarin dosages
• Reversal agents and safety measures

This barely scratches the surface of the wealth of information Midge provides.

• 0:00 - 3:35 - Introduction and Overview
• 3:36 - 8:39 - Importance of Monitoring Creatinine and GFR
• 8:40 - 15:06 - Impact of New Medications on Kidney Function
• 15:07 - 20:30 - Understanding Echo Results: Akinesia, Hypokinesia, and EF
• 20:31 - 25:01 - Interpreting Trends in Echo Reports
• 25:02 - 31:17 - Anticoagulation Choices: Warfarin vs. DOACs
• 31:18 - 38:15 - Adjusting Warfarin Dosages and INR Monitoring
• 38:16 - 42:42 - Assessing Bleeding Risks with CHADS-VASc and HAS-BLED
• 42:43 - 46:03 - Reversal Agents and Safety in Anticoagulation
• 46:04 - 53:41 - Managing DOACs in Different Clinical Scenarios

Read the full blog here.

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Please note: This episode is intended only for medical providers and students learning to be medical providers.

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This week, I have an episode for you that I think is even MORE important than the clinical knowledge that I share — navigating NP burnout.

Meet Cait Donovan, an International Keynote Speaker, host of “Fried – The Burnout Podcast,” author of the book "The Bouncebackability Factor", and an acupuncturist with a master’s degree in Chinese medicine. Her creative burnout recovery solutions have been featured on podcasts and online magazines such as “Forbes”, “NPR,” and “The New York Post.”

We chat not only about recognizing NP burnout but also about understanding, navigating, and bouncing back stronger than ever.

In this episode, we cover:

• How Burnout Impacts Your Brain: Unveiling the neurological aspects of burnout and how it affects our cognitive functions.
• The Surprising Factors Causing Burnout: Exploring the unexpected factors that contribute to burnout, both for seasoned professionals and new grads.
• The Role of Trauma in Burnout: Recognizing the impact of trauma on burnout and understanding how it influences us.
• The Burnout Recovery Process: Providing actionable steps for recovery and discussing how embracing self-compassion can transform your experience as an NP.

I hope this episode can provide a little comfort, knowing that you're not alone, and maybe a little permission to take the best care possible of YOU, not just your patients.

Resources mentioned in this episode:

• Adverse Childhood Events (ACE) questionnaire
• Fried the Burnout Podcast

If you liked this post, also check out:

• Nurse Practitioner Stress, Burnout and Compassion Fatigue

Read the blog here

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© 2023 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

Whether you're a recent NP graduate or someone transitioning between specialties, this video will help ease that overwhelming feeling and help you discover your unique approach to practice.

If you liked this post, also check out:

• Pillars of NP Practice
• Leukocytosis Case Study

Timestamps:

• 00:00 - Introduction
• 01:22 - Purpose of the Episode
• 02:35 - Understanding Philosophies of Practice
• 04:23 - Evolution of Practice
• 08:21 - Navigating the Transition

Read the blog post here.

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© 2023 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

If you’re a new NP grad making your way into practice, I think you’ll find today’s video super helpful.

(And even if you’re not a new grad, it’s still worth the watch — both to understand what we’ve been through and to help us mentor students and new grads ourselves.)

In this episode, I talk about the challenges new grads face — from sneaky imposter syndrome to the overwhelming clinical knowledge demands.

It can feel like an absolute rollercoaster from one moment to the next.

It wasn’t until I started to mentor new grads myself that I understood what was so challenging and why.

It seems obvious in one way — learning medicine is endless. But there are some other sneaky things that make it SO much more intense.

If we can orient ourselves to what is actually happening, we can:

• Make a plan to get support
• Help our NP mentees and students adjust better, and
• Understand the role transition challenge on a high level.

I truly believe we can all contribute to making this profession better and it starts on an individual then interpersonal level.

Which is why in this video, I talk about the three pillars of practice that can help you:

• Tackle the fear of the unknown and build a foundation for continuous learning in real-world practice.
• Navigate the system beyond diagnosing and treating illnesses.
• Embrace the unexpected leadership role and the skills you need.

And remember, you're not alone - we see you and we're cheering you on!

Timestamps:

00:00 - Introduction

00:46 - Pillars of Nurse Practitioner

01:30 - First Pillar: Clinical Knowledge

02:30 - Second Pillar: Navigating the HealthCare System

04:40 - Third Pillar: Role Transition & Stepping Into Leadership

06:31 - card link: Challenges of Primary Care playlist

08:39 - Recap

10:38 - RWNP Mentorship (card link: mentorship waitlist)

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© 2023 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

Welcome to our brand new podcast season! We're absolutely pumped to bring you a fresh wave of episodes that will be a game-changer for Nurse Practitioners (NPs) on their journey. Whether you're a seasoned pro or just starting out, we've got you covered.

In this season, we're introducing some exciting changes behind the scenes to make your listening experience even more rewarding. Expect enhanced content, engaging interviews with healthcare experts, and an interactive community that fosters connection and learning.

Timestamps:

00:00 - Intro

00:47 - Seasons

01:42 - Life of A Nurse Practitioner

02:58 - Specialist Interviews

Read the blog post here.

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

Hello there, we are actually going to be taking a season break on the Real World NP Podcast. But don’t worry, we’re coming back!

We’re taking some time to do some regrouping, work on some things behind the scenes, and get ready for a whole new season of episodes for you. If you want to be involved with us, in the meantime, myself and the Real World NP team, I definitely recommend that you head over to the Real World NP email list. And you can join over at realworldnp.com/guide.

What we’re going to be doing because we don’t want to leave you hanging, and we love to give support and connect with you. We’re actually going to be sending out weekly emails of a Tip Of The Week instead of a podcast episode. If you’d like to join us for that, definitely head over to that site, realworldnp.com/guide.

And then also know that we’re still around for all of our products and services – the Lab Interpretation Crash Course, the Diabetes, Hypertension and CKD Course Management course, as well as Mentorship Programme. We are doing all of those things while the podcast is on its little season pause. If you want to check out any of those things, head over to realworldnp.com/shop and you can find all of those products. And then when it comes to the mentorship, you can join our waitlist, if you’d like to and if you’re interested in that and if you’d like to be a part of that – it’s realworldnp.com/mentoring. And so as we form new group, small group cohorts, we can definitely let you know about that as well as any one-on-one mentorship opportunities that we have.

Thank you so much for being a Real World NP podcast listener. I so appreciate you, the team so appreciates you, and I’m definitely looking forward to releasing some new episodes in a couple of weeks.

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

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It’s hard not to worry about malpractice when you’re taking on new levels of responsibility as a new nurse practitioner.

Irnise Williams is not only a health law lawyer, she now focuses on the education and legal work to help prevent malpractice cases in the first place.

AAAAAND she’s a nurse herself! Still taking care of patients as a covid float nurse while also running her legal practice, she’s truly a unicorn.

She and I sat down and discussed the questions nurse practitioners and students had in the Real World NP community!

(PS. if you want the chance to submit questions for future interviews, join the email list at https://www.realworldnp.com/guide)

We covered so many things, including:

• Most common reasons for malpractice cases
• How to document appropriately
• Should I have my own malpractice insurance?
• Scope of NP Practice and more

Note, some of the audio came out uneven, so apologies about that. 

Read the full blog post here.

Download the FREE Ultimate Resource Guide for NP

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

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One of the biggest fears I hear from new nurse practitioners and students is not knowing the answers when you're in the room with a patient.

In this video, I'll tell you the many reasons why this is actually okay (and why we should probably even celebrate it), and the simple strategies I use to handle it.

Leave me a comment below, what is a strategy that you use to handle these situations? Or, what is one of the major insights you took away from this video?

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Timestamps:

00:00 - Intro

00:42 - Reason 1

01:57 - Reason 2

03:20 - Reason 3

03:56 - Simple Strategy

Read the full blog post here.

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

In this episode, Liz Rohr interviews Shelby Pope, DNP, APRN, FNP-BC, they discuss the stigma around addiction, the importance of supporting patients with opiate use disorder while exploring Shelby’s journey into addiction medicine and impacts of this field. 

This episode includes discussion of various treatment options for opiate use disorder, including naltrexone and buprenorphine, including the importance of medication-assisted treatment (MAT) for opioid use disorder, while emphasizing the effectiveness of methadone and buprenorphine in reducing the risk of overdose and mortality. 

Liz and Shelby explore the process of induction and the importance of assessing withdrawal symptoms, ongoing monitoring and support for patients on MAT, including addressing cravings and harm reduction strategies. 

Key takeaways: 

• Exploring the stigma around addiction, and the importance of supporting patients with opiate use disorder.
• Addiction medicine is a beautiful and impactful field that can be accessible in primary care.
• Naltrexone and buprenorphine are two treatment options for opiate use disorder.
• Open conversations with patients and providing support and resources are crucial in primary care.
• Methadone may be necessary for some patients with extreme cases of opiate use disorder. Medication-assisted treatment (MAT) with methadone and buprenorphine is highly effective in reducing the risk of overdose and mortality in individuals with opioid use disorder.
• Assessing withdrawal symptoms is crucial before starting buprenorphine to avoid precipitated withdrawal.
• Ongoing monitoring and support are essential for patients on MAT, including addressing cravings and providing harm reduction strategies.
• Tapering off medication should be done slowly and on an individualized basis, considering the patient's stability and goals.
• Individualized care and empathetic communication are key in building trust and supporting patients on their recovery journey.

For a full transcript and conversation chapters, visit the blog: https://www.realworldnp.com/blog/opiate-use-disorder. 

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© 2024 Real World NP. For educational and informational purposes only, see https://realworldnp.com/disclaimer for full details.

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If you're feeling like you don't know enough, and still have to see patients with ortho complaints (especially in telemedicine) -- here are the "hacks" of primary care ortho management.

You'll learn:

• The main 4 steps to managing almost all ortho complaints in primary care
• The top red flags overarching most ortho complaints
• How to triage ortho complaints
• When to send to ortho (and what to do first)

If you liked this post, also check out:

• Diagnostic Approach To Back Pain
• Interview with an Orthopedic Nurse Practitioner
• Interview with a Physical Therapist

Read the full blog post here.

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

As a new nurse practitioner, I used to find shoulder pain pretty overwhelming. While you can *see* all the musculoskeletal structures and how they work together, there’s a lot more going on beneath the surface and dealing with orthopedics can require a real depth of knowledge. 

But I’m going to help give you a jump start on that! In this week’s video, I’m taking a high-level view of diagnosing and managing shoulder pain for new nurse practitioners. We’ll talk about:

• Which history questions are most valuable to ask
• Why traumatic vs. non-traumatic presentation differentiates treatment
• The four steps to treatment used to treat *most* musculoskeletal issues in primary care (and why you might to reconsider them)
• And one clinical pearl that blew my mind when I learned it!

Want to follow up on the resources I mentioned? Find them 👇

• Shoulder Anatomy Animated Tutorial
• Shoulder Exam Maneuvers

Read the full blog post here.

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

Atopic dermatitis may not be the most glamorous topic in medicine, but you've got an enormous opportunity to change lives for the better in primary care.

It can feel frustrating for both the patients and providers when they keep coming back without getting any better.

I got to chat with a pediatric dermatologist and added a TON of clinical pearls to my arsenal of "real world" NP knowledge-- which I'm sharing with you in this week's video.

You'll learn:

• What treatment ACTUALLY works, especially when they've told you they've "tried everything"
• What skincare to recommend, which steroids, and what unconventional treatments can help keep flares at bay
• Answers to popular questions these days: who actually need food allergy testing, to bathe or not to bathe, and more.

Download the cheat sheet here: https://www.realworldnp.com/pl/237660

Read the full blog post here.

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

Walking into an examination room and seeing a patient hunched over with labored breathing, audible wheezing, and an oxygen tank can be intimidating for any nurse practitioner.

And if you’re a nurse practitioner in primary care, it is essential to understand the management of COPD exacerbations to provide the best care you can to patients.

COPD exacerbation can look scary, but the management is fairly straightforward. So is the choice of whether or not to prescribe antibiotics (and which ones!)

This week, we’re sharing a case study about the management of COPD exacerbation in primary care. We’ll cover:

• How to know who should go to the ER
• When to give antibiotics (and which one, for how long)
• The general management you should be doing in primary care as a PCP for someone with COPD

PLUS! You can also download the COPD Management Cheat Sheet that you can keep at your desk to help you in your clinical practice! 

Read the full blog post here.

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

Some people feel really uncomfortable talking about anything that has to do with reproductive health. Some of these people are patients, and some of them are healthcare professionals. Are you one of them?

If you thought that you might be off the hook because you work in primary care - you’re not. It’s a part of taking care of the entire patient. When you know and understand your patients’ goals for family planning a lot of other pieces of the clinical picture can become more clear.

Having a plan for the conversation is a good way to get more comfortable. If you get stuck just trying to think of where to start, there are tips in this week’s video that will help with the conversation. Imagine having just three questions to ask that not only guide the whole conversation, but that make the whole thing easier and less awkward for both you and the patient.  

In this video, we will cover easy-to-use strategies for contraceptive counseling in primary care. Including:

• How to actually talk with primary care patients about contraceptives
• Questions to ask the patient about contraceptive methods
• How to match contraceptive options with the patient’s preferences
• How having this conversation actually empowers patients

You don’t have to know the perfect thing to say when it comes to contraceptive counseling. But having a roadmap for the conversation will make a big difference for you and your patients. 

💫 A presentation I reference in the video is here: http://www.ctcfp.org/wp-content/uploads/APPROVED_Cason_Patient-Centered-Reproductive-Goals-and-Contraceptive-Counseling-pc-edits.pdf 

💫 And here are two other websites to help with patient reference: 

Reproductive access project: https://www.reproductiveaccess.org/resource/bc-fact-sheet/ 

💫 Bedsider.org: https://www.bedsider.org/

If you liked this post, also check out:

• Pap Screening In Primary Care
• Discussing Sexual Health With Your Patients - An Interview With A Sexual Health Educator 
• Your Urology Questions - Answered!

Read the full blog post here.

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

It’s easy to think the worst when your patient mentions abnormal bleeding. It can mean so many things! Context is everything for the patient with abnormal uterine bleeding. Their age, their history, when it started, how long it lasted, their other diagnoses, even their other medications. These are all factors to consider in the patient with abnormal uterine bleeding, and will point you in a starting direction for your assessment and help you to build your differential.

Abnormal uterine bleeding often doesn’t mean the same thing for a young person in their twenties compared to someone who is past menopause. Do you know when people tend to start having periods (menarche)? Do you know when people tend to stop having periods (menopause)? Are you solid on what stopping having periods even means? Once you are solid on what is normal, you will get up to speed with abnormal things much faster. 

This week, we will cover the history questions to ask, the labs to order, and the imaging to order - and we will go even deeper. We’ll also talk about: 

• Normal versus abnormal uterine bleeding
• The anatomical factors that are key to your assessment
• Potential causes of abnormal uterine bleeding
• Other conditions that could cause or contribute to abnormal uterine bleeding
• Pearls related to imaging (what to order, and how)

Like so many other concerns in healthcare, abnormal uterine bleeding can be scary, for patients as well as providers. Increasing your knowledge level will increase your comfort level. This will help you to build a strong differential, guide your patients, and address their concerns effectively. 

If you liked this post, also check out:

• Discussing Sexual Health With Your Patients - An Interview With A Sexual Health Educator 
• Pap Screening In Primary Care 
• Pelvic Floor Dysfunction for New Nurse Practitioners 

Read the full blog post here.

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

Burnout is a hot topic in all aspects of healthcare. You might be thinking that it’s something that affects other people. You might think it’s something that impacts Nurse Practitioners who are more established in their careers. You might think it’s one of the last things that you need to think about as a new grad Nurse Practitioner. Until you start to experience symptoms of burnout. 

This week, we are talking with Diana from Catalyst for Self Care. She’s a well-seasoned Nurse Practitioner and a self-care strategist. What makes her an expert? Because she also has experienced burnout as a Nurse Practitioner. In this interview, we will cover:

• Recognizing the signs and symptoms of burnout
• The benefits of addressing burnout
• Resources for preventing, assessing, and/or managing your burnout
• The importance of regular reflection as a part of your practice as a Nurse Practitioner
• Self-care and why it is so important

Learning about burnout sometimes happens the hard way, but it doesn’t have to. Watch this interview and get tips that you can start using right away. Understand what boundaries are, how to define yours, and why they are so vital to preventing and treating burnout. Self-care can mean a lot of things and is very unique to each of us. One thing is universal: we need to identify what works for us in a constructive way and make a plan to implement it for ourselves. When we care for ourselves, we can take the best care of our patients.  

If you know a colleague who is being stretched really thin, suggest this interview. 

If you liked this post, also check out:

• How To Know When To Change Jobs As A Nurse Practitioner
• When You Want To Give Up As A Nurse Practitioner
• Does It Get Better As A Nurse Practitioner

Read the full blog here.

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

Have you ever wondered how best to manage your patients with pulmonary diagnoses? How much steroid use is too much for these patients? What happens after you refer your patients to pulmonology? How do we bridge the gap between primary care and pulmonology?

You gave us all the questions that you have for pulmonology – and we have answers. In this high yield interview, we will go over the answers to all of your questions and a lot more. We talk in depth with pulmonologist Dr. Daniel Seifer about your questions and more. From what to be thinking about when referring your patient to pulmonology to patient teaching techniques, we cover a lot in this interview. We talk about:

• What your patient’s steroid use can tell you about the status of their chronic condition
• Which tests to order for your patients, and what they mean for your patient
• The right way to use inhalers, and common mistakes many patients make
• Inhalers versus nebulizers – which is right for my patient?
• What to be thinking about when you refer your patient to pulmonology

This interview is like a crash course in next-level care for your patients with a pulmonary diagnosis. If you have felt pulmonology is a growth area for you, this interview should help. If you want to have better strategies for patient teaching, this interview should help. Grab a notebook and get ready to learn a lot in a little time – and improve the care that you give to your pulmonology patients in primary care.

If you liked this post, also check out:

• Interview With A Pharmacist 
• Ask A Cardiology Nurse Practitioner   
• Your Urology Questions - Answered

Read the full blog here.

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

Have you had to give a patient bad news? Did you feel prepared or scared? It is a necessary part of being a Nurse Practitioner, and it’s always going to be challenging, but it is better if you are prepared.

Not all bad news is created the same. In some cases, bad news is life changing information, but in other cases, it might be life limiting information. What we might consider serious news, like a new diagnosis of diabetes, might be catastrophic to the patient. Doing our best to understand and anticipate the patient’s perspective will benefit us both.

This week, we have a video that covers so much of the ins and outs of delivering bad news to your patient. We will talk about all of the things to consider when you have these conversations with your patient. We’ll cover:

• How to prepare yourself
• How to prepare the setting
• How to have the actual conversation with the patient
• The difference that trauma-informed care can make in having these difficult conversations with patients
• A framework to guide the experience for you and the patient
• Some specific language to use in these conversations

Getting and giving bad news is always tough; having a plan for the visit will make a big difference. Develop a plan for follow up and next steps with the patient before you give them the news will also make a big difference. Using as much empathy as you can, keep the patient at the center of the conversation and give space for any emotions that might show up.

If you liked this post, also check out:

• How To Make A Plan of Care For New Nurse Practitioner
• Chronic Care Conversations 
• Medical Decision Making and Referral for New Nurse Practitioners 

Read the full blog here.

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Timestamps:

00:00 - Introduction

01:06 - Establish Framework (SPIKES)

02:12 - Setting Up

04:41 - Perception

05:56 - Invitation

07:48 - Knowledge

13:12 - Emotions and Empathy

13:41 - Strategy/Summary

15:32 - PEARL of Practice

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

Diabetes might be one of the most challenging chronic conditions to manage. It definitely requires a lot of partnership between provider and patient; you may find yourself spending more time with your diabetic patient than any other group of patients in your practice.

We talked with Nurse Practitioner and Registered Dietitian, Meghan Kavanaugh, about her work with diabetic patients. The interview was such a hit that we brought her back again to answer all of your questions about the nutritional aspects of helping your patients with diabetes. This week, we get answers to your questions, and more, including:

• Where to start with nutritional counseling for diabetic patients
• How motivational interviewing can help with nutrition counseling
• Realistic strategies that patients can start using as soon as they leave your visit
• The importance of understanding the patient’s lifestyle in order to optimize their diabetes management

Diabetes can be a tough condition to manage; nutrition is at the foundation of good management, but not all patients have the same experience when it comes to food. Patients that travel, patients that have limited access to certain foods, patients who have religious reasons for eating or not eating certain foods, patients who simply have preferences for certain foods over others – all of these things must be kept in mind as we create strategies to help our patients manage their diet and their diabetes.

If you liked this post, also check out:

👉 Ask A Diabetic Educator Nurse Practitioner

👉 Diabetes Case Study in Mentorship for Nurse Practitioners

👉 Chronic Care Conversations

Read the full blog here.

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

We’re expanding our course catalog at Real World NP! This time, we’re collaborating with specialists, making courses tailored for primary care providers. Our goal is to provide comprehensive and practical courses for nurse practitioners and PAs, and to bridge the gap between primary care and specialty care. We want NPs to have the knowledge and resources to provide the best care within their scope of practice.

Share your input about what courses you want to see first! Head over to realworldnp.com/blog/courses-nurse-practitioner to share your thoughts

For a full transcript, check out the blog.

Timestamps:

00:00 Introduction and Background

02:12 Expanding the Course Catalog

03:34 Addressing the Gap: Primary Care and Specialty Care

05:45 Creating Comprehensive and Practical Courses

08:06 Community Input and Feedback

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Don't forget to grab your free Ultimate Resource Guide for the New NP at https://www.realworldnp.com/guide

Sign up for the Lab Interpretation Crash Course: https://www.realworldnp.com/labs 

Grab your copy of the Digital NP Binder: https://www.realworldnp.com/binder

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Come follow along for even more tips and inspiration:

Instagram: https://instagram.com/realworldnp

Facebook: https://facebook.com/realworldnp

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Please note: This episode is intended only for medical providers and students learning to be medical providers. 

While anyone is welcome to view and listen, for legal and safety reasons, we are unable to diagnose, treat, or answer medical questions for individuals through this channel. We always refer individuals back to their primary care providers for medical care.

If you’re a medical provider or student and have specific patient cases you have questions about, I cannot answer those here but would love to help you inside our mentorship program! Join the waitlist at https://www.realworldnp.com/mentoring.

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© 2024 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

As a nurse practitioner in primary care, there are SO many things I’ve wanted to ask a cardiology nurse practitioner. This week, I had the lovely pleasure of interviewing Scott Pasquale, FNP and cardiology nurse practitioner, with questions from the RWNP community. 

In this episode, we covered:

• What cardiologists wish primary care providers knew
• A breakdown of common cardiovascular tests, how to explain them to patients, and how to choose between each one!
• Review of how to order holter monitors the right way!
• Common cardiovascular topics like atrial fibrillation, anticoagulation, and heart failure
• Resources for nurse practitioners interested into going into cardiovascular medicine

If you liked this post, also check out:

• Heart Failure in Primary Care
• Approach to Resistant Hypertension Part 1
• Approach to Resistant Hypertension Part 2

Read the full blog post here

Timestamps:

00:00 - Introduction

03:13 - How Scott Pasquale choose Cardiology

04:14 - What NP Cardiologist Wish That Primary Care Providers Knew

06:51 - Ordering a Stress Test

11:57 - Other Names for Nuclear Scans

12:54 - Example Situation

18:57 - Type of Monitor to Use 

24:45 - EKG Learning Resources

29:14 - A-Fibrillation

31:14 - Anticoagulation

33:56 - Cold Calling

35:20 - Coronary Calcium Score/Scan

36:54 - Hypertension Management and Their Side Effects

39:55 - Resources/Recommendations for New Nurse Practitioners Getting into Cardiology

41:32 - Heart Failure

44:24 - Diuresis Management

48:20 - Time in Specialty Practice vs Primary Care

Download the FREE Ultimate Resource Guide for NP

© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

Feeling comfortable with treating type 2 diabetes can be overwhelming as a new grad Nurse Practitioner – and even as a seasoned Nurse Practitioner, especially if you don’t have a lot of diabetic patients in your practice. Some patients will be able to improve their diabetes and get their A1C down with lifestyle changes alone; others will need to add oral medication; others will need to add insulin to get optimal control of their diabetes.

When the time comes to have a conversation with your patient about starting insulin, they are likely to have lots of questions. If you want to be sure that you have answers, you have come to the right place. This week, we will walk through what you need to know when you have a patient who will be starting insulin for diabetes management. We’ll talk about:

✅ The other options for treating type 2 diabetes before you start insulin

✅ How much improvement you can expect with various approaches to diabetes treatment

✅ A framework for when to start insulin, and how to adjust the dose

✅ Managing hypoglycemia after starting insulin

✅ Why in-person visits are so beneficial for managing diabetes

Diabetes is a complex diagnosis for providers and patients. When you feel confused and overloaded with information, imagine how your patient feels. Being prepared for these conversations and clinical scenarios will help you to feel more confident, which will help you to be an even better resource for your patients.

✨ If you'd like support learning about how to manage Diabetes, including medication management, most recent guidelines, when to refer and examples of real-life patient cases, join us for the Managing Diabetes, Hypertension & CKD Review Course. Comes with 10.35 hours of continuing education, including 2.8 pharmacology hours, downloadable cheat sheets and lifetime access! Click here

Read the blog post here.

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Don't forget to grab your free Ultimate Resource Guide for the New NP

More Resources:

Lab Interpretation Crash Course

Digital NP Binder

Diabetes Medication Workshop

Hosted on Acast. See acast.com/privacy for more information.

What does it mean to “clear” a patient for surgery? Every patient needs to have a visit with a healthcare provider before their surgery in order to assess their health and verify that it is relatively safe to proceed with surgery. When they end up on your schedule, it’s up to you whether or not they will get the go ahead (no pressure). If you are wondering how, as someone who has not been trained to perform surgeries, you are supposed to understand a patient’s ability to tolerate a surgery or procedure, this video should help.

Patients and surgeries each have varying levels of risk (low, medium, high), and the preop visit is the place to get an understanding of how the pairing of the patient and the surgery is most likely to pan out. Many times, your judgment will be adequate and you can determine whether or not the patient should proceed with surgery; other times, more information will be needed, and it may be wise to send them to a specialist for the final word.

In this week’s video, we will talk about the particulars of the preop patient and the preop exam.

• The elements of a preop exam in primary care
• Relative risk levels of surgeries, and how to understand them for the purpose of a preop exam
• How to factor in the comorbidities when considering the patient’s safety for surgery
• The role of preop testing and imaging
• How to get feedback from a collaborating physician for tricky cases

Not all preop examinations are created equal, and so much of it depends on the surgery the patient is planning. Try not to get overwhelmed by the prospect; improving your understanding of the patient and assessing them for surgery, and when you should send them somewhere else, gets better with time and practice.

Read the full blog post here.

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

The thought of your Nurse Practitioner job not being the right fit can be scary. You’ve invested a lot of time, money, and energy – not to mention all the things that you have sacrificed – to get to this point, and now?

You may have spent a lot of time imagining what it would look like to be working as an NP, and this isn’t it. Whether you are working with a collaborator or on your own, whether you are in primary care or a specialty, whether you have your own panel of patients or not – sometimes it’s just not the right job for you, and the grass is looking a lot greener on the other side.

Scary as it may be (and as surprising as it may sound), this is very common, especially for new grad Nurse Practitioners. In this week’s video, we will talk about not being in the right job for you, and how to know when it’s time to change jobs. We’ll discuss:

• Questions to ask yourself if you are considering a job change
• What a normal first-year experience as a Nurse Practitioner looks like
• What to expect from the transition from student to clinician
• When to consider a job change

Sometimes the need to make the change is very clear, other times it is not. If you are feeling like the assistant to your more experienced colleague or collaborator (and don’t want to), or if you are feeling like the setting is not right for you, or if you are feeling completely over your head every day and wondering whether you will always feel this way – consider whether what you are experiencing is standard first year growing pains or something deeper.

Read the blog post here.

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© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

Wrist pain is a SUPER common chief complaint in primary care. Most of the time, luckily, it’s chronic wrist pain that’s from overuse (versus the more acute, dangerous differential diagnoses with injuries), but it’s still a lot to work through as a new nurse practitioner.

In this week’s episode, I’m covering the overview approach to diagnosing wrist pain in primary care for new nurse practitioners:

✅ What first triage questions to ask

✅ Red flags to watch out for

✅ History questions, physical exam and special tests to perform

✅ When to refer and when to consider getting imaging

Read the blog post here.

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Don't forget to grab your free Ultimate Resource Guide for the New NP

Sign up for the Lab Interpretation Crash Course

Grab your copy of the Digital NP Binder

Get your medication management right with the Diabetes Medication Workshop

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Come follow along for even more tips and inspiration:

Instagram: https://instagram.com/realworldnp

Facebook: https://facebook.com/realworldnp

© 2020 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

When you're a new nurse practitioner, you need to make thousands of decisions a day.

(Which usually translates to thousands of questions).

I made mistakes as a new grad, and luckily for me, I had a very patient colleague who was there to help guide me.

In this video, I'll share:

• Some of my mistakes (I'm a little embarrassed)
• Three easy steps to make sure you ask questions the right way (so you get the answers you're looking for and build and maintain your colleague relationships)

Leave me a comment below, what are some of the strategies you use to collaborate with your colleagues and supervisor?

Read the full blog post here.

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Don't forget to grab your free Ultimate Resource Guide for the New NP at https://www.realworldnp.com/guide

More Resources:

Lab Interpretation Crash Course: https://www.realworldnp.com/labs

Digital NP Binder: https://www.realworldnp.com/binder

Diabetes Medication Workshop: https://www.realworldnp.com/diabetes

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Come follow along for even more tips and inspiration:

Instagram: https://instagram.com/realworldnp

Facebook: https://facebook.com/realworldnp

Hosted on Acast. See acast.com/privacy for more information.

Syphilis lab interpretation can be confusing, and it’s a BIG topic, but in this episode, I review the most common scenario that I see in primary care.

I cover treponemal and non-treponemal tests, how to interpret them most specifically in the context of slightly abnormal, asymptomatic patients (the most common scenario in primary care), as well as the treatment and follow up, and when to refer to a specialist.

How to cold call a specialist (you can do it!!): https://www.youtube.com/watch?v=xoFAYS0YN_U

Read the blog post here.

-----------------------

Don't forget to grab your free Ultimate Resource Guide for the New NP

More Resources:

Lab Interpretation Crash Course

Digital NP Binder

Diabetes Medication Workshop

------------------------

Come follow along for even more tips and inspiration:

Instagram: https://instagram.com/realworldnp

Facebook: https://facebook.com/realworldnp

Hosted on Acast. See acast.com/privacy for more information.

When it comes to choosing which oral contraceptive pill to prescribe, there are SO many options. How do you know which one is the right one? As a new nurse practitioner, you’ll usually get different recommendations from different providers.

In this video I’ll be covering:

• The first step to prescribing that’s easy to forget
• What criteria to consider when choosing
• The two main routes to follow (and how to know which one to go down)

Plus, check out the resources I reference in this video to help you decide:

CDC Medical Eligibility Criteria

List of Progestins by Androgen activity

Read the blog post here.

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Don't forget to grab your free Ultimate Resource Guide for the New NP

More Resources:

Lab Interpretation Crash Course: https://www.realworldnp.com/labs

Digital NP Binder: https://www.realworldnp.com/binder

Diabetes Medication Workshop: https://www.realworldnp.com/diabetes

------------------------

Come follow along for even more tips and inspiration:

Instagram: https://instagram.com/realworldnp

Facebook: https://facebook.com/realworldnp

Hosted on Acast. See acast.com/privacy for more information.

It's 2 p.m., the medical assistant comes to your office and lets you know your next patient is ready, and they're here because they "need antibiotics"...

... But do they? Or don't they?

They've "had a cold" or "a nasty cough" for over three weeks now.

... they've "tried everything," and "got an antibiotic last time."

Are you seeing this every day now, too? 'Tis the season. 

This week's case study is all about that sticky situation--

✔️ Productive cough for over 3 weeks ("subacute")

✔️ What the differentials are, and 

✔️ What to do about it (and who actually needs antibiotics).

Please note that this case study was made pre-Covid pandemic so does NOT include Covid/long Covid as a differential.

Read the blog post here.

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Don't forget to grab your free Ultimate Resource Guide for the New NP at https://www.realworldnp.com/guide

Hosted on Acast. See acast.com/privacy for more information.

So many things in primary care are deceptively complex. There may be a few genuinely simple things that we treat, but so many things that come into our exam rooms are complex and sometimes downright confusing.

Anticoagulated patients are one of those situations. While the concept itself is pretty simple – medication that thins the blood so that they don’t get clots, got it – the reality of managing an anticoagulated patient is something else. In primary care, we are often either inheriting the patient who is on anticoagulation, or we are following up after someone else started them (maybe after a trip to the emergency department).

It is completely normal to question yourself with anticoagulated patients. If you have been there, or if you would like to be prepared before you see your first anticoagulated patient, this week’s video is for you. We will talk about:

✅ Where to start with the anticoagulated patient – and then where to go

✅ Different types of anticoagulants

✅ Everything you need to consider to prescribe anticoagulants safely

✅ How long to keep a patient on anticoagulants

✅ How to monitor the anticoagulated patient, and what to watch for

Anticoagulation has so many benefits for the patients that need it, but like anything else in medicine, it comes with risks. Building up your knowledge about what to look for (and what to do if you find it) when working with anticoagulated patients will make such a difference in building your confidence as a provider.

Read the blog post here.

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Don't forget to grab your free Ultimate Resource Guide for the New NP

______________________________

Please note: This episode is intended only for medical providers and students learning to be medical providers. 

While anyone is welcome to view and listen, for legal and safety reasons, we are unable to diagnose, treat, or answer medical questions for individuals through this channel. We always refer individuals back to their primary care providers for medical care.

If you’re a medical provider or student and have specific patient cases you have questions about, I cannot answer those here but would love to help you inside our mentorship program! Join the waitlist at https://www.realworldnp.com/mentoring.

_______________________________

© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.

Welcome back to Season 3 of the Real World NP Podcast!

This episode is an interview with yours truly - I want to share a bit of a “reset” with what’s going on with Real World NP, where we started, where we’re going, and how you can be involved. I also want to share a bit that has changed behind the scenes, and how we’re incorporating more of a social justice and equity lens— not just inside the clinical teaching, but overall practices inside the company. 

One of the core reasons behind the company is not just to make the transition to practice for nurse practitioners easier, but also make an impact on the healthcare and education industries. We want to do continuing education for nurse practitioners differently than the status quo.

Some real talk: I feel like I repeat myself a lot, and part of me is like “they know this already.” They know that it’s important to be a whole human, and that they get to do that in their personal and work lives. That they’re not just a machine in the cog of healthcare, and things are starting to change. That they deserve to be supported and held in safe spaces while they learn this extremely important and difficult field of medicine. It’s old news.

But I’m reminded of the number of times I’ve counseled patients on their medications - at LENGTH and REPEATEDLY - and they still need to hear it again.

Like the time my patient with new-onset afib needing anticoagulation still ended up in the ER for overdosing his meds. Or after three visits for my patient with diabetes, they still did not understand their diagnosis and what it meant.

I truly, truly believe that even when things feel daunting and overwhelming, whether it’s the clinic day ahead, the severity of illness of the patient in front of you, or the state of the healthcare industry, individual actions make a big difference.

I’d love for you to be a part of the movement of change to make healthcare and education better — listen in to this episode to get a sense of where we’re going and what you can expect from us going forward. It’s also a helpful introduction to the backstory behind the company if you’re new here!

More from Louiza “Weeze” Doran:

https://www.instagram.com/accordingtoweeze/?hl=en

https://louizadoran.com/

https://louizadoran.com/podcast

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Don't forget to grab your free Ultimate Resource Guide for the New NP at https://www.realworldnp.com/guide

Sign up for the Lab Interpretation Crash Course: https://www.realworldnp.com/labs 

Grab your copy of the Digital NP Binder: https://www.realworldnp.com/binder

For the full transcript, and for this conversation’s topic chapters, see the blog.

Hosted on Acast. See acast.com/privacy for more information.

It’s not unusual to be taken by surprise when you see microscopic hematuria on urine dip results. The patients who end up with this as part of their presentation are often asymptomatic, and may even be giving you a urine sample for another reason – which can make chasing down the cause even more of a mystery.

If you don’t know where to start when it comes to determining the cause of microscopic hematuria, you’re not alone. In this video, we will cover a high-level approach to investigating a finding of microscopic hematuria. We will go over the workup for microscopic hematuria, and lots more:

✅ What is the difference between microscopic and macroscopic hematuria?

✅ When a urine dip is enough, and when you need to send the sample out

✅ What white blood cells and protein in the sample can tell you

✅ Essential history and symptom questions to ask

✅ When to repeat the urine dip at another time

Having a simple framework for approaching the sometimes mysterious microscopic hematuria will increase your confidence and help you to take the best care of your patients. Getting to the root cause of microscopic hematuria is another critical part of taking great care of the patients you work with. 

Read the blog post here.

-----------------------

Don't forget to grab your free Ultimate Resource Guide for the New NP at https://www.realworldnp.com/guide

______________________________

Please note: This episode is intended only for medical providers and students learning to be medical providers. 

While anyone is welcome to view and listen, for legal and safety reasons, we are unable to diagnose, treat, or answer medical questions for individuals through this channel. We always refer individuals back to their primary care providers for medical care.

If you’re a medical provider or student and have specific patient cases you have questions about, I cannot answer those here but would love to help you inside our mentorship program! Join the waitlist at https://www.realworldnp.com/mentoring.

_______________________________

© 2022 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.