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TXRenaNP

TXRenaNP

NP-Women's health
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  1. TXRenaNP

    Opinions on Chamberlain College????

    I had a friend who was looking into different programs. Chamberlains was one. She was accepted, they gave her a lot of credit for past classes, however they were quite expensive. What she did, before she made her final decision was to look at some of the local colleges who also had online programs. She called and sent in transcripts. They would give her as many credit hours AND it was 1/3 of the cost. Plus if she needed to, the college was within traveling distance. Many of the colleges/universities now have online RN to BSN/BSN to MSB/RN to MSN programs.
  2. TXRenaNP

    bioidentical hormones safety

    As a prescriber of hormones, I think that many times they get a bad rap. They aren't for everyone. But for many women, they help them get through a challenging time in their life. The WHI study opened a huge can of worms. Gave us some good information but at the same time scared the heck out of a lot of women needlessly. Almost 40% of the women had hypertension and were being treated and about the same number admitted to have smoked at some time in their lives. What about family history? Diet/exercise programs?The estrogen/progestin arm and the estrogen arm had different outcomes: Compared with the placebo, estrogen plus progestin resulted in: Increased risk of heart attack Increased risk of stroke Increased risk of blood clots Increased risk of breast cancer Reduced risk of colorectal cancer Fewer fractures No protection against mild cognitive impairment and increased risk of dementia (study included only women 65 and older) Compared with the placebo, estrogen alone resulted in: No difference in risk for heart attack Increased risk of stroke Increased risk of blood clots Uncertain effect for breast cancer No difference in risk for colorectal cancer Reduced risk of fracture Many of the hormones that are prescribed are "bioidentical". Estradiol/Prometrium, the gels, creams that the providers prescribe are technically BIH. Compounded hormones can also be prescribed and be distributed by the pharmacists which can consist of Biest, natural progesterone and testosterone. Women should only be on hormones so see them through the "tough" times, the vasomotor symptoms. But many choose to stay on them longer. Should be on lowest dose to control the vasomotor symptoms. It has been theorized that they don't cause breast cancer but there may be cells already present and the hormone cause the abnormal cells to grow faster, therefore detected sooner.
  3. TXRenaNP

    What's your long term goal?

    I think that you keep reaching for the stars professionally, even though it may be one step at a time. It may take years to reach the next rung, but you keep on going. I started out as a nursing assistant, then became a LPN. I then became an RN after 25 years. Now I am a nurse practitioner. My next step? A nursing educator. We need more nurses, but have not enough instructors to see them through. It may take me a while to get there ($$$$$), but at 55, I'm not in a huge hurry. The kids are finally grown and gone. It's just me. Have to pay off divorce debt first. Then..... watch out!!!!
  4. TXRenaNP

    RN refusing MA assignment

    TuTonka-Yes, my first post, and I started the thread. I just wanted some advice from some other nurses, since I don't get alot of contact with other RN's since I work in private practice and have for many years. I wasn't sure if my expectations were out of line and if current practice had changed or was I reasonable to expect some help from my team mate. If I did wrong here, I sincerely apologize to ya'll!!!
  5. TXRenaNP

    RN refusing MA assignment

    In reply to some of the messages I have received- We have no union here. While she was asked to fill in as an MA, that was the only position she was expected to fulfill at the time. Me, however, as the NP/Supervisor, filled in as the triage nurse for her, AND saw my patients as well AND served as my own MA (cleaning my own rooms, filling out lab slips, washing specs etc.). We always have had an RN/LVN in the role of triage and MA's to assist the docs. Where I came from in the west, no MA's, only RN's/LVN's in the office setting. It took getting used to MA's. If I can, at times, I clear my schedule and assist the docs. I enjoy it. Change of pace, but I don't like to inconvenience patients. Makes more sense on those RARE occasions for her to fill in rather than me.
  6. TXRenaNP

    RN refusing MA assignment

    Thanks to all for the kind replies. This is my point. Regardless of our position, you do what ever it takes to get the job done and take care of your patients. As the NP/supervisor, if have stepped it and helped out on the floor when the girls need the help. When I walk down the hall, I will help clean the rooms. If in the bathroom, I will tidy it up. It is not beneath me to do so. I don't say that to give kudos to myself, its just that's the nurse in me just like its the nurse in you. I can understand not wanting to float in hospitals to other units that are beyond skill sets but even then, when I worked in peds and was floated to ICU I was given the easiest patient, not the one with the vent/swanz etc. She is supposed to be my backup and I am hers. Yet, I can and do back her, bet she never can back me up. She refuses to do catheters, IV's, give methotrexate (RN only). Leaves these things to me. The docs need to make a decision.
  7. TXRenaNP

    RN refusing MA assignment

    I am a nurse practitioner/back office manager in an OB/GYN office. A few weeks ago, we had to let go my medical assistant so we are work short handed until a replacement is found. She was also the "float" in the office. One of the other MA's this past week was off on vacation as she was getting married. THEN, another was out because her son was admitted emergently to the hospital. That left us with 2 for 4 physician's. The good thing is that usually there is one physician off per day and I can handle my own patients. SO-We had asked our triage RN to fill in and help be an MA for the day. She refused, initially, stating that it was against her licensure to be an MA (and go downward?) The position includes getting weights, blood pressures, stand by assist if needed. Clean the rooms. I have even filled in when the situation has arisen. I don't ask anyone to do anything that I, myself, am not willing to do. This particular day, I was to do my job, my MA's job, and by the phone triage person as well. She was angry because she also stated that such duties were not in her job description, however, the "clause" is performs other duties as necessary, especially in effort to assist, learn from and take direction from managers. Also included in the job description is clinical duties which are not performed by this nurse which now she states she is unable to perform because she has "now not been a clinical nurse for 35 years." "I was hired to be a triage nurse and a triage nurse only." She called in sick on Friday. This woman will be asked to fill in only one day this next week, as the MA that got married will be returning and the one with the ill child will still be out for another week. Any thoughts? Am I out of line in my expectations?
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