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BostonFNP Guide 36,078 Views

Joined Apr 4, '11 - from 'Northshore, MA'. BostonFNP is a Primary Care. Posts: 4,251 (59% Liked) Likes: 9,796

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  • 10:04 am

    I do I&D's as a clean procedure. I do not culture or script abx unless there is a complication.

  • Aug 24

    Quote from cleback
    Nurses do not get the same rigorous science background, which would also be a batrier to such a program.
    That isn't always true; many NP programs require similar science pre-requisites including organic and inorganic chemistry, biochemistry, microbiology, biostatistics, genetics, etc.

  • Aug 23

    Quote from cleback
    Nurses do not get the same rigorous science background, which would also be a batrier to such a program.
    That isn't always true; many NP programs require similar science pre-requisites including organic and inorganic chemistry, biochemistry, microbiology, biostatistics, genetics, etc.

  • Aug 23

    Quote from cleback
    Nurses do not get the same rigorous science background, which would also be a batrier to such a program.
    That isn't always true; many NP programs require similar science pre-requisites including organic and inorganic chemistry, biochemistry, microbiology, biostatistics, genetics, etc.

  • Aug 23

    Quote from Cat365
    I'm confused. My hospital recently had a shingles patient that we placed in an isolation room on airborne precautions. I understand that a shingles patient can cause chicken pox in someone who has not previously had the disease and I followed all precautions when entering or leaving the room. However my concern was not for myself, it was for my other patients. I have already had chickenpox and had a titer drawn recently to check my immunity. My coworkers on the other hand were in my mind overly anxious. Am I missing something about the risks?
    There has been some data that has shown possible airborne spread of zoster, so most all hospitals take airborne precautions. This is especially true in the immunocompromised where disseminated infection can occur.

  • Aug 22

    Quote from Sykadia
    Anyway, my main question is- ladies, do you find male nurses attractive? Or does it seem unmanly and unattractive?
    They all find me very manly and attractive and I have to beat them all off with sticks and break at least 100 hearts a day.

  • Aug 22

    I don't know any state that will allow you to either obtain an APN license while on a restricted RN license or work on an APN license with a revoked RN license.

    From the CA BON:

    IV. REPORTING PRIOR CONVICTIONS OR DISCIPLINE AGAINST LICENSES/CERTIFICATES
    Applicants are required under law to report all misdemeanor and felony convictions. "Driving under the influence"
    convictions must be reported. Convictions must be reported even if they have been adjudicated, dismissed or expunged
    or even if a court ordered diversion program has been completed under the Penal Code or under Article 5 of the Vehicle
    Code. Also, all disciplinary action against an applicant's nurse practitioner, registered nurse, practical nurse, vocational
    nurse or other health care related license or certificate must be reported. Also any fine, infraction, or traffic violation over
    $1,000.00 must be reported.
    Failure to report prior convictions or disciplinary action is considered falsification of application and is grounds
    for denial of licensure/certification or revocation of license/certificate.
    When reporting prior convictions or disciplinary action, applicants are required to provide a full written explanation of:
    circumstances surrounding the arrest(s), conviction(s), and/or disciplinary action(s); the date of incident(s), conviction(s)
    or disciplinary action(s); specific violation(s) (cite section of law if convicted), court location or jurisdiction, sanctions or
    penalties imposed and completion dates. Provide certified copies of arrest and court documents and for disciplinary
    proceedings against any license as a RN or any health-care related license; include copies of state board
    determinations/decisions, citations and letters of reprimand.
    NOTE: For drug and alcohol convictions include documents that indicate blood alcohol content (BAC) and sobriety date.
    To make a determination in these cases, the Board considers the nature and severity of the offense, additional
    subsequent acts, recency of acts or crimes, compliance with court sanctions, and evidence of rehabilitation.

  • Aug 22

    Quote from Cat365
    I'm confused. My hospital recently had a shingles patient that we placed in an isolation room on airborne precautions. I understand that a shingles patient can cause chicken pox in someone who has not previously had the disease and I followed all precautions when entering or leaving the room. However my concern was not for myself, it was for my other patients. I have already had chickenpox and had a titer drawn recently to check my immunity. My coworkers on the other hand were in my mind overly anxious. Am I missing something about the risks?
    There has been some data that has shown possible airborne spread of zoster, so most all hospitals take airborne precautions. This is especially true in the immunocompromised where disseminated infection can occur.

  • Aug 22

    Quote from khinlicky
    I'm quite thrilled when male nurses are around because they can lift better than I can.

    a young male nurse thinks its okay to put off (for example) cleaning up a patient because he is "busy" doing something else.
    What if they are busy helping you lift things instead?

    Not to sound snarky, but when I worked bedside, this became a pet peeve of mine. I always said "yes" to helping colleagues, and often it was with something more physically demanding. Inevitably I would be helping someone, a bell would go off, and another colleague would just leave the patient for me to help when I was done instead of returning the favor. I always felt a little arrgavated it was more than ok for colleagues to say "you should do this because you are a man" but if I said the opposite I'd be fired.

    Quote from khinlicky
    I have run into many male nurses that don't have the compassion and interest in their patients that females do, and I feel that is a no-go.
    You think males are more likely to not have compassion for their patients? Really? We can lecture the OP about stereotyping and at the same time say this?

  • Aug 22

    Quote from Cat365
    I'm confused. My hospital recently had a shingles patient that we placed in an isolation room on airborne precautions. I understand that a shingles patient can cause chicken pox in someone who has not previously had the disease and I followed all precautions when entering or leaving the room. However my concern was not for myself, it was for my other patients. I have already had chickenpox and had a titer drawn recently to check my immunity. My coworkers on the other hand were in my mind overly anxious. Am I missing something about the risks?
    There has been some data that has shown possible airborne spread of zoster, so most all hospitals take airborne precautions. This is especially true in the immunocompromised where disseminated infection can occur.

  • Aug 22

    Quote from khinlicky
    I'm quite thrilled when male nurses are around because they can lift better than I can.

    a young male nurse thinks its okay to put off (for example) cleaning up a patient because he is "busy" doing something else.
    What if they are busy helping you lift things instead?

    Not to sound snarky, but when I worked bedside, this became a pet peeve of mine. I always said "yes" to helping colleagues, and often it was with something more physically demanding. Inevitably I would be helping someone, a bell would go off, and another colleague would just leave the patient for me to help when I was done instead of returning the favor. I always felt a little arrgavated it was more than ok for colleagues to say "you should do this because you are a man" but if I said the opposite I'd be fired.

    Quote from khinlicky
    I have run into many male nurses that don't have the compassion and interest in their patients that females do, and I feel that is a no-go.
    You think males are more likely to not have compassion for their patients? Really? We can lecture the OP about stereotyping and at the same time say this?

  • Aug 21

    Quote from pixierose
    Well, I for one am *exhausted* from throwing myself and my panties at the hot, hunky physicians today. I couldn't bother myself with the male nurses because, you knowwwwwwww.....
    This is why I can't even wear my doctor's stethoscope anymore.

  • Aug 21

    Quote from Sykadia
    Anyway, my main question is- ladies, do you find male nurses attractive? Or does it seem unmanly and unattractive?
    They all find me very manly and attractive and I have to beat them all off with sticks and break at least 100 hearts a day.

  • Aug 21

    As a prescriber, I do feel like I am part of the problem (all people who prescribe narcotics should). I also hope I am part of the solution, or at least I try to be.

    First and foremost, I follow all of the federal and state recommendations for opioid prescribing which includes discussing/documenting potential side effects including physiologic and psychologic dependence, single-prescriber-single pharmacy, reviewing the prescription monitoring database at each visit, concurrent therapy, periodic testing and random testing, attempts to taper the dose to the lowest possible effective dose, etc.

    Second, I have candid discussions with patients prior to writing a script that includes mention that it is my job to do what I think is best for them even if it is not what they think is best and often that means tapering off and discontinuing medication. I ensure they know it is for short-term use only.

    Third, I don't prescribe opioids for more than 7 days without objective evidence of the etiology. I don't continue other providers scripts without repeat tesing.

    Fourth, I don't prescribe opioids chronically for younger patients (under 40) for non-oncologic pain.

    Fifth, I refer all patients for evaluation with a pain specialist prior to chronic opioid management (longer than 6 weeks).

    I still feel part of the problem after all these efforts to avoid inappropriate prescribing. To be honest, all it does it ruin my day most of the time to get into debates with patients about these meds and I often wish I didn't prescribe them at all. I wouldn't if it weren't for the patients I know need the medication to survive because there is no other option.

    That being said, if I am attending a patient in the hospital and I write orders for an opioid, I don't expect the RN taking care of the patient to insert themselves into the issue by not giving the medication as ordered, without an objective concern.

  • Aug 21

    Quote from pixierose
    Well, I for one am *exhausted* from throwing myself and my panties at the hot, hunky physicians today. I couldn't bother myself with the male nurses because, you knowwwwwwww.....
    This is why I can't even wear my doctor's stethoscope anymore.


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