malapata

It's true that making an appointment when you are suffering with mental illness can be a huge undertaking. I didn't ask the patient what the reason for being late was on that particular day.

Thank you to everyone for your responses. I appreciate the advice and will definitely take it with me into practice (especially the recommendations to separate emotionally -that's a hard one). I feel better about the choice I made. I am very thankful for this forum and for those who share their wisdom!!

Does anyone out there have a lab interpretation book or other resource they really like?

Hi all, I am a new NP working in the primary care setting and have a patient who was recently transferred to me from another clinic. The patient has multiple comorbidities including but not limited to hypertension and psychiatric illness. The first time I saw the patient I referred them to the ER because of an acute issue. The second time I saw the patient I ended up refilling some prescriptions (based on medical charts I received from the previous clinic) and told the patient they would need to come back in for labs and also to show me all the medication they were taking at home. I would have done labs that day but the phlebotomist was out and I didn't have time to do it myself. After that appointment, I tried contacting the patient nearly every week to get them into a f/u appointment, get some baseline labwork done, and get a handle on the prescriptions. The pt showed up unannounced once and then no-showed on an appointment for blood work after that. Most recently (after I called the patient and prompted them to make an appointment with me), they showed up 90 minutes late to a scheduled appointment. I was busy with another patient and told them they would have to reschedule and that I could not do anymore Rx refills until we got some baseline labs and I was able to take a look at all the medications the patient was taking at home. I had to turn the patient away and I felt bad but I didn't want to continue the cycle of no-shows and non-compliance. I did not feel safe simply handing out meds without at least having a grasp on labs and the meds being taken at home. Was it wrong of me?

Penguins10, wow thank you for all of the advice and encouragement! It means so much to me! I will definitely look into the resources you mentioned. THANK YOU!

Sadly we have no protocol book and I get no feedback from anyone. I really wish I had either one of those things or both. The physician who practices with us is so busy that it's really hard to sit down with him. When I do get the chance I feel very rushed (not that he is rude or mean, he is very nice).

Thanks, sauce! That is good advice.

Thanks, evolvingrn! That is great that you have those quick lab resources. I work with an undeserved population and lose a lot of patients to follow up. Sometimes I'm even unable to get labs on them because they refuse or want me to try to get records from elsewhere before poking them... It also seems that practically every primary care pt I get is also a new pt and so they come to me with a LOT of problems. It can be overwhelming. And then, like I said, many times they never come back after that initial visit I'm totally stressing out about!

Thank you, orangepink. That is very true and very good advice.

Thank you so much for these suggestions. I appreciate it. I'm not going to say which program I attended but I will say that if I had the chance to do it again I would not go there. I feel they did not prepare us. Thank you for responding.

Hi everyone, I am a recently graduated NP. I started my first job about 3 months ago at a specialty and primary care outpatient clinic. There are only three providers at the clinic including myself, one of whom is not always at the clinic the days I am. I'm reaching out to the allnurses community because I wanted to vent/express concern or frustration over not having a mentor or someone who is guiding me in my learning as a new practitioner. Our clinic is not extremely busy but when I see primary care patients I feel lost. I use online resources such as Uptodate and other clinical guidelines but it is cumbersome and time consuming. For example, I had a patient come in with possible UTI the other day and I struggled figuring out how to properly rule it out. Luckily, I have a lot of time to spend with these patients but I don't know if I'm learning good practice by having to figure things out on my own without the help of a mentor or seasoned provider. I worry I will create bad habits as a self-learner. I do compile information on a drive that use as a reference but I feel there might be other ways I could be conducting my examination or other secondary diagnoses I could be considering that I don't think of due to my lack of experience and expertise. These are things I feel a good mentor might help to nurture in me... Has anyone every felt this way as a new NP? What did you do? How did you get through it? Does anyone know of any resources for new grads who are struggling? Any other comments/experiences welcome!! Thanks!

Hello! Could you tell me what the Q-bank is? I'm also looking for study materials and haven't heard of this. THANKS!

I like the variety of working both day and night shifts! We do self-scheduling at my job though and I can group my nights together so I'm not flip flopping back and forth between nights and days... More resources and things to see on days, but nights provide an intimate environment to get to know your coworkers and also opportunity to practice skills such as blood draws and IV insertion. Good luck whatever you decide!

I only did one set of Kaplan questions which was a 180-question test on a CD that came with a review book I checked out from the library. I also did some Saunders questions but not that many (maybe 100 total). The resources I mainly used were ATI and Lippincott's. I did find the questions on the exam to be similar to all of those resources. When I sat down to do the test, I felt like I was taking a practice test. Do you find a difference in formatting between Kaplan and Saunders? I think it's good to use a number of resources because it exposes you to a variety of formats. That way when you sit down to take the test you won't feel "used to" a certain style of questions and be thrown off by how NCLEX is formatted. I hope this is helpful!

I just wanted to share with you that... I PASSED THE NCLEX!!!!! I guess the scores I was getting were good enough :)