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jsapphire BSN, RN

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jsapphire has 12 years experience as a BSN, RN.

jsapphire's Latest Activity

  1. jsapphire

    First FNP Job in specialty, too limiting?

    Hi, I'm a recent summer FNP graduate. I've been fortunate to get a few very different job offers. One of them is an outpatient hepatology clinic at a major academic/research medical facility that is building a transplant program. I have never done hepatology and have little knowledge about the day-to-day management of these patients. The team is lovely (including 3 other NPs/PAs), and even after I shared these reservations, they hired me, saying no one graduates knowing they want to be a liver NP since it so specialized. They actually view my newness as an asset, as they can mold my practice. It's a great schedule, a great team...but I come from 6 + years as an ER RN and all the NP rotations that I loved were fast paced and dynamic. I actually got offered an ER position but the location and schedule were a deal-breaker. I am worried about pigeon-holing myself into a specialty and pace I may tire of. Any insight into working as either a hepatology NP or specializing as a first job?
  2. Working in a busy emergency department, I see chronic exacerbations of preventable health conditions. Asthma, diabetes, hypertension-- one thing all of these have in common is their negative correlation to obesity and increase BMI (body mass index). I know this, I took prerequisite nutrition classes, took epidemiology, and yet sneak bites of chocolates and chips at the nurses's station. I know from physiology class that physical activity decreases insulin sensitivity and reduces cardiovascular risk, yet it's so easy to skip my workout and stay in bed all day watching movies on my day off. If only, I could get overcome inertia... Enter the old fashioned nursing care plan to treat my noncompliance of healthy lifestyle choices. Nursing Diagnosis Noncompliance of healthy lifestyle choices related to stress level, desire for quick, tasty food, and exhaustion from grueling shifts. Goal Nurses will choose to take time to exercise, reduce stress, rest, and eat well-balanced meals. [Practical] Nursing Interventions Learn to say, "No," more often to help you manage workload and stress. Specifically, this is saying, "No," to over-time and swapping shift times more than is required by your job description. In the long run, Uncle Sam frequently takes more of your over-time than you do. Find some time to exercise. Pick a favorite television show- the more light-hearted, the better for this. Example: reality shows, show-downs, and sitcoms... MOVE, MOVE, MOVE while you are watching. Do jumping jacks, hops, run in place, or even dance to music if something comes on. Incorporate sets of lunges, squats, push ups, leg lifts, crunches during the commercial breaks so you can be upright and attentive who is voted off during the show. Make food shopping fun and fresh- go to the farmer's market. Too expensive? Open up your local grocery weekly advertisement and only buy what's on sale for produce. Chances are, it's usually what's in season now, which is generally the most fresh to eat. If you don't have time to fully cook all meals, "put together" meals from the semi-prepared section at the market. It's generally still cheaper than eating out. Aim to eat two servings of vegetables at lunch and dinner each. This can be done by adding a salad, vegetable based soup, or a side of raw vegetables for a snack in between meals. Have fruit as snacks and also as dessert. If you have craving for "junk food", it's okay. Have a couple cookies for that day, and share the calories with the nurses' station across the floor or even another floor when you drop off a patient. Take time to sleep- even if it means letting little things go undone. It makes you safer nurse and a sane human being. Evaluation I am getting 7-9 hours of sleep per night 5 out 7 days of the week. I am eating a minimum of 3-4 servings of vegetables and 2-4 fruits daily. I am moving for a minimum 30 minutes per day (excluding transporting at work). I feel that I am actually excited to wear jeans and not hide behind scrub pants because they actually fit right.

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