Juliefin

The 21st century is an amazing, yet potentially overwhelming, time to be a healthcare consumer. With the vast amount of health-related information that is as close as a few clicks on a keyboard, several swipes on a phone, or surfing through a few television channels, most patients have multiple avenues to find out information about becoming healthy, staying healthy and managing acute and chronic medical conditions. However, with so many routes to access health information, one can easily get confused or lost on the journey to ideal health and disease management. There is good news though: with a good roadmap on how identify and differentiate between high- and low-quality information, as well as an experienced guide (one’s healthcare providers) to help along the way, one can use the numerous sources of media information to augment their health knowledge and assist them in being an informed and engaged health care consumer. Nurses are in an ideal position to help educate the healthcare consumer, our patients, on how to safely navigate the maze of information available to them. There are several steps simple steps to take to make sure that the health care information one is consuming is truthful and high quality and may be beneficial. Step One: Seeking and Finding Consistently Dependable Sources of Information One important first step is to take time and identify several websites that are from trusted healthcare sources and focus the bulk of one’s search for information on these websites or sources these trusted sites recommend for further reading. Examples of these types of sources can include the National Institute of Health’s website, NIH.gov, or healthfinder.gov. Healthfinder.gov is a site with a wealth of information for consumers of healthcare on topics such as the prevention of disease (cancer, diabetes, heart disease), recommended preventative health services and screenings, vaccines, pregnancy, nutrition, and physical activity. Additional sites to consider can include healthcare system-specific sites, either the local system where one seeks healthcare, or sites of well-known systems such as the Mayo Clinic, Johns Hopkins, or The Cleveland Clinic Foundation, to name a few. Nurses can help patients identify which types of sites may be useful sources of information for them to start looking at on their journey to becoming more informed about health and disease management. Accessing the information on the types of sites above can provide a good starting point for improving health knowledge and avoiding pitfalls of erroneous or dangerous information. Step Two: Asking the Right Questions The next important step is to recognize that if one watches television, reads magazines (virtual or hardcopy), participates in any social media sites (facebook, Twitter, Instagram, TikTok, etc.), or even talks to friends and family, one will undoubtedly come across information at some point on the topic of health and illness that will need to be scrutinized to determine if it is helpful or harmful. NIH.gov provides a great and easy-to-remember framework for analyzing online sources that can be applied to about any source of health-related information. Their framework uses the concept we all learned in grade school for information to ask about a topic: Who, What, When, Where, and Why. Here are the basics of what the NIH.gov source referenced below recommends one asks when deciding if information is quality and can be considered dependable by healthcare consumers: Who is putting out the information and what is their role (sales, health system, etc.)? Are they trustworthy? What does the source claim is true? Does it sound reasonable or too good to be believable? When did the information come out? Is the information up to date? Where did it come from? Is it based on science or opinion? Why is the source putting this information out there? Are they trying to sell something? Are they an insurance company trying to keep its participants healthier? Think, “What is their motive in putting this information out there?” Lastly, while one’s best friend or colleague or aunt (or anyone really) may have strong opinions about something in healthcare or know someone who has experienced something similar to what one is going through, it is critical to remember that each person is an individual and allowing someone else’s opinions or experiences to strongly dictate what one does with their personal health care decisions can be detrimental. It is okay to value and respect someone without adopting their opinions about what is right for one’s own health, and nurses can help patients to understand this and to think of ways to help decline unsolicited health advice without damaging important relationships. Step Three: Securing Healthcare Providers Willing to Discuss Health Information from Media Sources A final but especially crucial step in getting the most out of health information in the media without falling prey to false, dangerous, or low-quality health information is to have a healthy, collaborative relationship with one’s healthcare providers. A good healthcare provider will strive to stay up to date on the latest medical and nursing information necessary to keep their patients optimally healthy and, when disease does occur, manage that disease with updated, evidence-based care. They should also be comfortable with their patients asking questions about the health information the patient is consuming in the media, and they should be good communicators to help the patient determine which information may be helpful to their care and which information would not be, and why. Finding a healthcare provider that one has this type of collaborative relationship with can help a patient safely navigate their health journey and maintain control over their healthcare decisions. As nurses, many patients place trust in us, and supporting the patient to honestly share their questions without fear of being judged or dismissed is an important part of our role. Again, it is an empowering time to be a healthcare consumer given the availability of such a wealth of health-related information to guide patient care and help consumers be well informed about their healthcare. However, consumers of health-related information should keep the following in mind: How to Use Health Information in the Media to Make Healthcare Decisions Find several trusted sources (websites, news outlets etc.) to get the bulk of one’s health information from. Evaluate all information to determine if it is high quality, from trusted sources, and based on science. Remember, other people's experiences and health issues are theirs, not one’s own, and can provide information to consider but each person experiences health and disease individually. Having good and open communication with one’s healthcare providers is critical to helping one consider which health information should inform their healthcare decisions and which should not. Using the above guidelines as a map to help evaluate health information in the media and inform decision-making can help one arrive safely at the destination of optimal health, wellness, and disease management and nurses can and should empower patients to learn these and other techniques for finding high-quality health-related information in the media. References National Institutes of Health, “Finding and Evaluating Online Resources,” Accessed 11/21/22 US Department of Health and Human Resources, My Healthfinder, Accessed 11/21/22

Hi, honestly, I would recommend that you go to National Guideline Clearinghouse | Home and download /print the most common guidelines you'll use in primary care... JNC 8, cholesterol guidelines, ADA diabetes guidelines, GOLD for COPD, etc

Has anyone had any experience working as a NP in the VA (Cleveland); I'm considering a position there, have interviewed and it looks good but it's a 45 -50 minute commute in good weather...trying to decide if benefits etc would make it worth the drive...

Hi, can you clarify what you mean by "independent?" I'm assuming you mean from other states as Ohio still requires collaboration. That being said, I have a collaborating physician but have actually only ran a case by them once in the last 10 months. They do chart reviews but don't work in my clinic. If you can give more details as to what you are looking for we can hopefully all chime in and help you!

Recommend Bates assessment book, great!

I did not do a live review either and took and passed tHe AANP exam with a good score on the first try less than 3 weeks after graduating. Here's what I did.... Bought CDs from Fitzgerald (used on Amazon) the summer before graduation, put them on my iPod and listened to them all the time over the next 9 months or so. Suffice it to say I wouldn't be sad if I never heard that voice again. I also bought a used version of Hollier's CDs and did the same. They seemed to complement each other...where I felt one was weaker, the other was stronger. I had multiple question books but the only one I would recommend is Fitzgerald. She is most similar to the style of questions on the exam. The others were not helpful and it's too easy to get used to someone's style of writing ?'s and your test questions may be very different, making it more difficult. Also, print a copy of your guidelines for chol, HTN, and diabetes and know them well.

What textbook are you using? If it's not Bates I would recommend getting a copy and reading it.

If you ever get a chance, I recommend the skills workshop by Denise Ramponi. She does it a few times a year out of Pittsburgh area. Costly but excellent (I just attended last month).

I work at a clinic inside Walgreens and they don't require 5 yrs. in fact, they are hiring and training new grads (for 6-10 weeks , I think, which is a great orientation).

Hi everyone, to answer a few more questions. Patients can make appointments online or at our Kiosk but the system limits appointment slots to four a day to save the space for walk ins. The NP can override the system at any time and add additional appointments if needed. We don't have an official referral network set up yet but I'm pretty fortunate that I work in the Cleveland area so we have pretty easy access to specialists through the referral centers of both The Cleveland Clinic and University Hospitals of Cleveland. We have a few primary care groups that refer their patients to us for acute visits and I often refer patients without a PCP to those groups to get established with a PCP, when needed. Labs etc for uninsured remains a problem which I've been brainstorming about he to manage. I'm considering us contacting our labs we usually use to see if we can get some discount for private pay patients to help ease the burden but so far no good answer on that. We do get some prior auths and would be responsible for doing those ourselves (although I did that at my old office practice too). Also, you are right- no admitting privileges so any pt we see who needs hospitalization would have to go through the ED and be cared for by a hospitalist (same in my old practice as well). It definitely is new ground for us and i don't think it will ever be a large part of our patient base but I'm glad it's an option for some people. It still needs some clarification, in my opinion, but I think it's a good move. Just remember, if you want to try working in convenient care clinics but are like me and don't want algorithms, consider Walgreens because we do NOT have them!

So, I work in one of the clinics at Walgreens and feel I can therefore address this topic. First. walgreens is just beginning to delve into chronic care management and it is not something they have done without a lot of thought. Yes, we do emergency refills etc but the chronic care management is beyond this, obviously. As we all know, nurse practitioners are well trained to manage chronic conditions. Just because it is being offered in a convenient care setting does not mean the standards change. NPs at Walgreens have the capability to order labs, order EKGs, make referrals, do POC testing in addition to outpatient labs etc. I am not limited in my ability to appropriately manage a chronic care pt because I work there (I cannot speak for other convenient care companies). Also, my patients can make appointments and they can choose to see me or my coworker. Our clinic is managed by 2 NPs and we rotate days. So, there is consistency in providers for our patients. We are there EVERY day of the year except Christmas and Thanksgiving so we are very available. Our patients have a call center to call if they need to talk to a provider and they get a call back the same day from the NP working. Also, the particular clinic I work at is the most busy (for Walgreens) in our area and I still feel this is manageable. Keep in mind that, despite the ACA, there are still a lot of uninsured or underinsured patients out there and we are often a more affordable option for patients that will not go to a physician practice because they cannot afford it. In addition, because we work in the community, a lot of people get used to us and feel comfortable coming to us instead of a physician practice. Obviously, if a patient is beyond what I feel comfortable managing, I do encourage them to get hooked up with a PCP. We are NEVER trying to take patients from their PCP, we simply are offering another option for those who would otherwise not go anywhere. Having said all of that, I feel like I should "confess" that when I first took this job out of convenience a few months back (got married, moved an hr away from my previous practice) I felt like I was taking a "lesser" job because it was located in a store. I could not have been more wrong. Again, I can only speak for Walgreens, but I will say that they really, really push evidence based practice and guidelines, following HEDIS guidelines, appropriate billing and coding etc. I get weekly chart reviews from my collaborating physician, quarterly peer reviews, weekly reviews of my billing practices etc. In addition, Walgreens does NOT use algorithms to tell the NP what to prescribe, labs to order etc like some other companies do. I decide how to manage my patients, no one else tells me what to order, pressures me to order antibiotics etc (in fact quite the opposite). I'm actually glad I made the change and work here! I