Dembitz 3,509 Views
Joined: Mar 5, '09;
Posts: 53 (40% Liked)
; Likes: 77
Nurse Practitioner; from
4 year(s) of experience
Our state law requires assent, not consent. .
Have you not heard of bilitool.org ?
This is kind of basic newborn stuff, to be frank. What sort of NP are you and did you not have newborn training? I would try to educate yourself on the topic a bit more.
To answer your question, again, frankly, you should not be asking internet strangers on how to manage a patient. Do you have an attending physician? They would be much more suitable to answer your questions. I couldn't without knowing more of the infant's history such as mom/baby's blood type, ethnicity, gestational age, bili levels drawn at which hour life, etc etc. I don't mean to be harsh, but not knowing how to treat a newborn with hyperbili could result in kernicterus, which is a "never" event in medicine and highly litigious, not to mention severe life altering for the patient and their family.
"Respectfully", at some point in life, I just might helping with hiring decisions just like right now I participate in the interviewing and hiring of RNs. Working on any team, group interviews are exceptionally common and a major factor for me and evidenced here a few others is experience that you bring to the team. And there's not "might not" help when it comes to rn experience. Any form of clinical patient interaction is infinitely more valuable than none. YOU may think you gain nothing from it, but you went direct entry yourself, so how would you know? You never took the time to work as and actually understand what it means to be an RN. You used the profession to fast track to primary care. Congrats on your ability to sell yourself in an interview and willingness to move anywhere. That's about all you needed to say in the original post.
To be fair, I don't see how nursing experience would help an outpatient primary care provider that much.
So the thread descends to the level of childish responses.
What do you think we do all day???
Call me naive, but maybe someone could explain something to me:
But then the BSN becomes an NP, and now they're practicing low-skilled medicine, which isn't nursing at all! But they are the "Advanced Practitioners?"
Seriously, wouldn't technical nursing certifications like ACLS and CCRN (or the other specialty certifications) really be what makes a nurse "Advanced."
I mean if my name looks like this:
EGspirit, MS, APRN, ACNS-BC, CEN, FAWM, FAAN
am I even a nurse anymore?
Why can't caring be the profession and leave medicine and surgery to the doctors, and the Ph.Ds to the Nursing school professors? Wouldn't being really good at running a code or starting an IV, or even being really effective at feeding and bathing a patient be the definition of the advanced nurse?
Unexpected Relocation with expiring insurance.
What was the urgency here besides your desire for a testosterone refill? Am I missing something?
Nurses, teachers and school administrators are obligated reporters. With children and vulnerable adults we are required to notify the authorities of suspected abuse. It's a little stickier with adults that don't fall into the "vulnerable" category. If we suspect abuse we are required to assess the situation if possible and provide resources.
I've said this before...we don't have a medical director so a standing order/protocol isn't available to us to stock epinephrine. I wish we did.
But my standing order is I answer to a higher authority than state law or district policy so if a child is having an anaphylactic reaction and God put me there to see it and there is no epi on the shelf for that child...I'm grabbing whoever's epipen that is the closest on the shelf, with the correct dosage or next best thing, and I'm using it.
As a pediatric ER nurse who has handed dead babies to parents to hold for the last time or tried to make dead teenagers presentable for parents to view and hug good-bye forever, and as a parent, I will do everything within my means to snatch a kid from the jaws of death. To Hell with rules and laws and nurse practice acts and district policies...this is where I stand.
Jen's post hit me between the eye's today as a reminder of how valuable School Nurses are as student and patient advocates and how valuable and functional this SN forum is...after wasting time and energy in participating in the attack thread today that was finally pulled by AN. OMG!! I love you guys like a brother or sister and appreciate what you do...just sayin. Keep on keeping on!!
The hospital I work at simply calls all NPs and PAs "midlevel providers", which to me, makes it sound like we're less educated.
I am also a Direct Entry grad, and feel that RN experience is not related to success as an NP. What is crucial, IMHO, is finding a first position where you have a slow ramp up and have support from a mentor. That is true for any new grad, whether you have years of RN experience or not. As I have said a gazillion times, I rarely use the vast majority of what I learned in the RN portion of my program.
I'm going to assume you're an FNP as you said you might explore working in the adult arena.I wouldn't want to work in peds as a FNP as we did not get a lot of depth in pediatric clinical and didactic. Peds primary care is tough. I've never seen a peds office, as a NP student or parent, that wasn't crazy-busy and hectic. Perhaps looking at an adult NP job or something like Urgent Care (except if you would be the only provider on duty) might offer you an environment that is more conducive to getting acclimated to this role. I'd look at a large medical group practice where you would have other providers to consult with, and might have a more structured orientation process.
If you feel you have knowledge base deficits, then hit the books again, and brush up on the areas where you think you need to know more. Don't give up on nursing, or yourself. Not every job is a good fit.
And, yet, there is Federal law that protects the right of healthcare providers to decline/refuse to participate in procedures/care to which they object on religious grounds (specifically written to protect anti-choice healthcare providers), so there is legal precedent and legal protections in place for individuals who have religious objections to particular aspects of healthcare.
I'm surprised at how many people here have posted that, if the OP has religious objections to some aspects of providing care, and his religious beliefs don't permit him to provide care for everyone, then he has not business going into healthcare. When anti-choice people come here to say that they want to go into healthcare but they have religious objections to abortion and are unwilling to participate in abortions, no one tells them that they shouldn't go into healthcare -- people practically line up here to assure them that they will be fine, there is law that protects their beliefs, they can't be compelled to participate, and all they have to do is work in a setting that won't involve abortion. That is all the OP is doing -- asking for suggestions about healthcare settings that would not conflict with his religious beliefs and observance.
Just as I don't believe that pharmacists should be able to refuse to sell Plan B due to religious beliefs, I don't believe health care providers should be allowed to pick and chose for whom they provide care based on religious beliefs. (That includes Catholic hospitals if they're getting government funding, but that's another issue, I suppose.) If your religion requires you to shun half of the population because of what does or does not dangle between their legs, you need to stay out of healthcare. Time for everyone to evolve.
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