Michael M. Heuninckx
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Currently in my program we are using the latest edition of Margret Fitzgerald's NP exam review. Something though that the director of my program is recommending to us as well, is a review course by the Advanced Practice Education Associates: A Nurse Practitioner Company, here is a link to their web site NP Students My plan is to use both of these resources and to do a whole bunch of questions and really divining the why and root of the questions to fully understand the concepts. GOOD LUCK!!! Michael M. Heuninckx RN-BSN
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1. My go-to appsUpToDate- I live in UpToDate. Any question I have, UpToDate is my go-to resource for the most current information and guidelines. Everything can be found there, in one, easy to use place. Also, if you are researching a possible diagnosis, it also offers you a list of differential diagnoses that can help aid in your clinical decision process. The best part is, this is a resource that should be free through your university or workplace. Check first before you buy a subscription. Medscape- I use the Medscape app mostly when I am looking up medication: indications, dosages, compatibility and side effects. The app also offers current news in healthcare, a calculator for medical formulas and is a reference for medical conditions. GoodRx- GoodRx is a unique tool allowing you to search for medication costs at multiple local pharmacies. A good habit to get into is to see how much you will be costing your patients and the overall healthcare system. Also, you will be surprised how many first-line medications are available to treat the same condition, but one could cost a lot more than the other. 2. Find a solid group of NP student colleaguesMuch like nursing school, in a nurse practitioner program, you will develop friendships that will last a lifetime. This will be the group that you study with, look forward to seeing in class, send out friendly reminders to, bounce ideas off of, work together in group projects, vent your frustrations, and have your back when you are in a pinch or when you need a place to sleep and take a quiz that is due at midnight because your power is out 3. Take A VacationTo be able to do this, first, know the calendar of the University you are attending. Find the dates of when one semester is ending and another is beginning. This is the time when it is the safest to travel. Also, it will give you something to focus on and look forward to when the semester is becoming unbearable. 4. Don't get behind in logging your clinical hoursAs much as this is "busy" work, it really is important that you do not fall behind in logging your hours for two reasons. First, once you get behind, forget it. You will only continue to get further behind and you will be spending countless hours trying to log them all in one sitting. Second, take the time to turn logging your hours into a learning experience. Use this time to fully understand billing and diagnosis codes, what they mean and when it is appropriate to use which one. Doing the leg work now will only help you down the road. 5. Make an appointment with the writing centerA resource that is frequently underutilized is your University's writing center. I learned this lesson very early as an undergraduate student. In one or two appointments, my grade could go from a B to an A. Also, they are APA wizards, something that will help keep you from losing easy points. 6. Be on top of your scheduleYour schedule is everything. This takes time, strategy, organization and double checking your work. Do not forget to place all quizzes and assignment due dates in your schedule as well. Classes are not designed with a ton of points to fall back on and if you forget to take a quiz or turn in an assignment, you can forget the entire semester. You will not pass the class if you forget to do one of the above and in graduate school, there are no redos. As a soon to be NP, it will be expected that you will be able to manage and handle your schedule with no excuses. 7. Eat right and exerciseNurse practitioner school is no excuse to let yourself go in the diet and exercise department. Your body will need the fuel to make it through the program. Eating fast food/highly processed foods will only make you feel worse and slow you down. Also, taking the time to get in your exercise will help you clear your head and relieve some stress. 8. Find your clinical sites yesterdayNot all NP programs find clinical sites for you. If your school requires you to find your sites, do this ASAP. This is something that you think you might be able to do last minute, but this process can be like a full-time job. It would be terrible to get this far in the program and not be able to move forward because you do not have a clinical site. 9. Get involved with Nurse Practitioner professional organizationsMeeting nursing colleagues that are currently practicing and who were once in your shoes is very comforting and exciting at the same time. You will meet people who you currently look up to and will be one day. Also, you will be able to gain knowledge from experienced practitioners about their current practice and what lessons they have learned that will prevent you from making the same mistakes. Only one semester left! Good luck to all of my soon to be Nurse Practitioner friends! If you like this article then you might want to check out Michael's new book for nurses... Code Blue! Now What? Learn What To Do When Your Patients Need You The Most!
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As I was catching up on this past season of Grey's Anatomy, Amelia Shephard is about to start a marathon of a surgical procedure. Right before she is about to go into the operating room, she clenches her fists, places them on her hips, puffs up her chest, and stands tall with a powerful look on her face. One of the residents who is confused by this behavior asks her why she is doing what she is doing, Amelia states, "a scientific study showed that if you stand in the superhero pose for 5 minutes before a job interview, presentation or difficulty task, you will not only feel more confident you will perform measurably better".1 After this fact is stated, the resident buys this fact, and joins her in the superhero pose. Here is the clip from the Episode Amelia and Stephanie are Superheroes Videos | Grey's Anatomy TV - ABC.com As most healthcare professionals can pick apart when medical shows are right on, stretching the truth a little and just flat out wrong. When I initially saw the "superhero pose" I immediately placed it in the, shake of the head, chuckle to myself and the, "come on really!?" response. Even though this was my initial response, I did stop and ask myself, "What if this is true?" It really is no cost, can be done anywhere and could be a tool nurses could use it to boost their confidence and have a positive impact on the patients they are taking care of. So my research began. . . Much to my surprise, after some digging around, I came across a TED Talk conducted by Amy Cuddy. Amy holds a PhD in Psychology from Princeton University and currently is a professor at Harvard Business School.2 In her TED Talk, Amy discusses how dominance and power is shown in the animal kingdom and how that is also reflected in humans. Amy shows this by giving examples of animals and humans show power and dominance by expanding their body.2 Followed by showing how animals and humans show feelings powerless by wrapping ourselves up and making oneself smaller.2 Amy's hypothesis was, if you stay in a high power pose for two minutes, to what degree does it affect hormone levels in your body.2 The hormones studied were the dominance hormone, testosterone, and the stress hormone, cortisol.2 In the study, saliva samples were taken, then participants either did a high power pose for two minutes or a low power pose for two minutes, offered a chance to gamble, then another saliva sample was taken.2 In the high power posing group testosterone levels increased by 20% and cortisol levels decreased by 10% and 86% were willing to gamble.2 In the lower power posing group the exact opposite occurred, the levels of testosterone decreased by 25% and the levels of cortisol increased by 15% and only 60% of participants were willing to gamble.2 Also when this was further studied, the concept was applied to candidates using high power poses or low power poses before an extremely difficult job interview. Can you guess what occurred? The group of job candidates who posed in a high power pose for two minutes were chosen for the job over the candidates in the low power posing group.2 I encourage EVERYONE who is reading this article to take the time to watch the TED Talk below of Amy Cuddy discussing her research proving the validity of power posing. Amy Cuddy: Wow, wow, wow! Who knew! I could not have been more wrong with my above skepticism! Every time I watch the above video, I simply am amazed, inspired and motivated. As Amy states, people only need "their bodies, privacy, and two minutes." I believe if nurses were to work high power posing into their daily routine, multiple times a day if possible, they would see an improvement in their own leadership ability and increase their overall feelings of courage to engage in difficult conversations with colleagues. A difficult task all nurses face every day. This will then organically weave its way into your daily practice as a nurse also. Improving the quality of care you are able to deliver to your patients, leading to, improvements in patient outcomes. Keep up the great work Shonda Rhimes and the entire Grey's Anatomy team! I have been a fan from day one and I look forward to all of the future seasons to come! Michael M. Heuninckx RN-BSN If you like this article then you might want to check out Michael's new book for nurses... Code Blue! Now What? Learn What To Do When Your Patients Need You The Most!
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I knew that after the list was posted that there would be, I was guessing about, 3 medication that I would later kick myself for not including in the list. Thank you for brining up Adenosine! It is given all the time and defiantly should be on the list without question. Good looking out and this is why these forums are such a valuable part of the allnurses.com community. Thank you again! Michael M. Heuninckx RN-BSN
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In my Emergency Nursing career I have only used Romazicon once. With that being said, when ever I am orientating a new nurses to the ER, and we are discussing medications, I always focus on drug classes of medications they are administering. Along with, potential side effects and what reversal agents are available. I agree with you that Romazicon is not frequently used, due to its potential side effects, but still is important for a novice ER nurse to be aware of. There could be a situation where a newer provider/rotating provider wants to use this medication and due to the nurses medication knowledge, offers a suggestion to reconsider the medication order due to its potential side effects, in turn, saving the patient from a potentially bad outcome. I always encourage and motivate nurses to questions/double check an odd/risky medication order, and this medication, even in my own practice, I would question. Hence the importance, I see, in being well versed in knowing this medication. Just because something is not frequently administered, there still is value in knowing about the medication. Michael M. Heuninckx RN-BSN
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Are you a brand new nurse that just obtained the first job in the Emergency Room? Or an experienced nurse that has decided to master a new specialty? Well, whichever boat you might be in, here is a head start for you. Below is a list of medications that I promise you will be using time and time again while working in the Emergency Room. This looks like it might be an extensive list, but as time goes on, you will know the entire list inside and out. In alphabetical order and not limited to. . . Acetaminophen Albuterol All of your fluids NS 0.9, Dextrose 5% NS 0.9, Lactated Ringers. . . Alteplase Amiodarone (Push and Infusion) Aspirin Ativan Atropine Atrovent Azithromycin Bacitracin Cardiac Arrest Medications (See your ACLS Textbook) Cardizem (Push and Infusion) Catapres Cefepime Ciprodex (Otic Drops) Ciprofloxacin D50 Push Decadron Dilaudid Diphenhydramine Dobutamine Dopamine Epinephrine (Push and Infusion) Esmolol Etomidate Fentanyl Flagyl Fluorescein Strips GI cocktail: Maalox, Donnatal & Lidocaine (PO Mixture) Haldol Heparin Ibuprofen Insulin Kayexalate Ketamine Ketorolac Labetalol Levophed Lidocaine (Injection, IV Push & Infusion) Magnesium Mannitol Metoprolol Morphine Narcan Neosynephrine, (nasal spray & IV Infusion) Nitroglycerine (Pills, Paste & IV Infusion) Ondansetron Pepcid Phenergan Plavix Prednisone Propofol Protamine Sulfate Protonix Rocephin Rocuronium 56. Romazicon Silvadene Cream Silver Nitrate sticks Sodium Bicarbonate (Push and Infusion) Solumedrol Succinylcholine Tetracaine (Ophthalmic Drops) Tylenol Unasyn Vancomycin Verapamil Versed Some of the medications are listed as the brand name and some of the medications are listed as the generic name. It is imperative that you are comfortable with both. Yes, I did do this on purpose, to not include both within this article. I am a teacher at heart, and I could not write this article without some homework involved! Also, know what your hospital's policy is for the administration of all of the medications listed above. What might be normal practice at one facility, could get you a write up at another. Along with that, as always, never forget the medication administrations safety rules we all were taught in nursing school. Oh yeah, and how could I forget the life-saving enemas! Saline and Mineral Oil. Lastly, I will leave you with another tip for all new Emergency Room Nurses. Go through all of the body systems and learn what the emergencies are for those systems. Master those and you will feel comfort in knowing that when you are drowning, you have ruled out all of the time-sensitive emergencies for your patients. Once this has occurred, go down that list again and prioritize your patients from there. The Emergency Room is a no joke place to work, very fast paced and stressful. Mastering this list will help take away some of the stress and improve your overall flow. Give the department some time though, when it gets difficult don't quit. It can be very overwhelming at first, but I promise it will get better. Extra Medication Safety Tip Set your medication pumps up for success, not failure. When programming your pump to administer a high alert medication, set the rate to match the volume to be infused. This will prevent the entire bag/bottle of medication being accidentally administered to the patient due to your programming error. If this safety measure is not in place, it could lead to a catastrophic and life-threatening event for your patient. Imagine if an entire bag of Cardizem was administered, or the whole bag of Insulin or the whole bottle of Nitroglycerin?! Yikes! It only takes an extra second and when the hour is up: go back to set the pump again, reassess your patient, ensure that they are improving and not getting any worse, and continue on with the rest of your patients that need your services.
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From first hand experience, I have gained a tremendous amount of knowledge by interacting with other healthcare professionals on social media. Given all of the negatives that have been pointed out in the article, and in this forum, lets not forget about all of the benefits as well. Michael M. Heuninckx RN-BSN
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This most certainly is a valid question. One actually that I get frequently and have no problem answering. A life goal of my has been to write a book. I never knew what that book was going to be about, but I knew that I wanted to write one. Once I graduated nursing school I obtained a job as a graduate nurse in the Emergency Department. Here, I grew up quickly, adapted to my new environment, and found myself in an educational role through precepting new nursing graduates to the department. Throughout my life, I have always seemed to find myself in these roles. For some reason I was always deemed the go to person to educate others. I truly enjoy being able to educate others for the betterment of their career and the overall care they deliver to their patients. Last year I accomplished that life goal of writing my first book! It is called, Code Blue! Now What? Learn What To Do When Your Patient Needs You The Most! It is written specifically to nurses in the last semester of school or the first year of their career. It is a compilation of all the lessons I would teach my new graduates. Placing an emphasis of developing skills both professionally and clinically to prevent the Code Blue! from occurring in the first place. I then walk nurses though how to prepare yourself for the event to occur, offer lesson about what to do when the event occurs and what to do/expect after the event. Code Blue! Now What? also integrates visual, audio and the books own personal Twitter page to connect readers and myself alike. Long story short to your question, if you googled my name, you would see my book and all of my writings. All of which I am very proud of. I kind of lost that when the book was published. I believe social media offers a tremendous amount of value, but with that value comes a ton of responsibility. Hence the reason I wrote the above article, specifically to those just graduating nursing school. I do not know if this topic is currently being covered in nursing school today, but, if not, the lesson is here. I do know that I see nurses making one or more of these mistakes quite frequently on social media. So somewhere there is a gap in either, knowledge or awareness, that this article was intended to fill. On top of that, the members of AllNurses.com have done a phenomenal job of adding their words of wisdom in the comments section of this article as well. The amount of knowledge, sense of family and community that AllNurses.com offers is priceless. Today, the technology is everywhere, social media is everywhere, like it or not, the generations growing up will not know what it is like to not have it in their lives. Due to this reality, I would be very disappointed to hear that a new grad lost their chance to be a Nurse because they were not aware of what their social media presence looked like. All of the new nursing graduates have worked to hard for that to be taken away from any of them. I am proud to be apart of this community of nurses, I am proud to call myself a AllNurses.com writer and use my real name accordingly. If anyone has any questions they would like to ask me, never hesitate to reach out. I will always do my best to answer your question or direct you in the right direction. We are all in this together and as nurses, we all have to stick together! HAPPY NURSES WEEK TO ALL!!! Michael M. Heuninckx RN-BSN
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This is very interesting, I recently saw a company like this on Shark Tank. It was a company that protected/made you aware of how your image was portrayed online to those who searched your name. Thank you for your suggestion, taking the time to bring this point up and reminding me of this. I defiantly am going to look into it. Michael M. Heuninckx RN-BSN
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According to the Money section of Time magazine, it is reported that 93% of hiring managers will review their candidates' social media accounts before making a hiring decision1. At the click of a button, a momentary lapse in judgment, could destroy your nursing career before it even begins. Soon, all of you will be applying for your first nursing job. Something that you have dreamed of and have worked so hard to obtain. Today, all employers have to do to know more about you, is simply Google your name. After a few clicks, your future employer will have gained their first impression of you. As the saying goes, someone's first impression is most lasting and takes a long time to change, if ever. To help this reality not become yours, here are some tips and strategies you can use to protect yourself and your career: Refrain from Reference to Any Illegal Drug Use If your future employer found any indication that you use illegal drugs, you can almost certainly count yourself out of a job. In fact, 83% of future employers saw this as a negative quality1. Not to mention this is a criminal activity that can put your nursing license in jeopardy, it will potentially endanger the lives of the patients you will one day take care of. Also, every day, you will be in direct contact will substances that have the potential for nurses to become addicted to. Do not Write about Excessive Alcohol Consumption 44% of employers also frown upon future employees posting on social media how they get drunk all of the time1. When you work for an organization, you not only represent them while you are working but outside of work as well. Also, they might assume that if you drink excessively, you might come to work drunk/hungover or frequently call in due to your self induced illness, both of which directly impact patient care. Avoid Illegal Activity First and foremost, don't break the law; you know better. Secondly, if you do break the law, don't brag about it on social media. This is a sure fire way to not get hired, but also will give the police the evidence they need to arrest you for the crime you committed. Use Proper Grammar Before you post something, read it to yourself and read it out loud. 61% of employers were not impressed by poor grammar2. You will be surprised how small errors can quickly decrease your credibility. Also, do not fall victim to autocorrect. It is amazing how one autocorrected word can make a non-offensive post, offensive. Refrain from Swearing On Social Media Nothing positive will come from using profanity on social media, 65% of employers feel this way2. Not even the censored to disguised words. Swearing is not a good representation of the professional you are. The last thing you would want is to have your application skipped because of a poor choice of words. Clean Up Your Past Posting History Go through all of your social media accounts, back to the day it was created and remove, delete, and edit any posts that could be perceived as negative or not becoming of a nurse. Untangle yourself, and if at all possible, remove any offensive photo or post. If the post is not yours, kindly send a message to your friend to remove the post. And fingers crossed, the post will be removed. Update Your Privacy Settings Update your privacy settings and remember that anything you post is public, even if you think it's not. Anything can be hacked, a picture can be taken in a second and redistributed just as easily. This article also applies to the most seasoned nurses as well. Seniority will no longer protect you from a social media post that in any way your employer deems inappropriate. Also, have your fellow nurse's back as well. If you see one of your colleagues post something that could be perceived as inappropriate, reach out to them and express your concern. There is a very good chance that they might not have even noticed or ever thought that what they posted could be jeopardizing their career. When all is said and done, if you choose to be active on social media, you must be very careful with what you post. Use the tips above to help guide your posting decisions and to take an active step to educate and protect yourself. Social media is a powerful tool, but, with power comes responsibility and as healthcare professionals, don't give anyone the platform or any reason to think less of the nurse you are or the one you will be. Congratulations again to all of the new graduates and welcome to the profession of Nursing! References 1. The 7 Social Media Mistakes Most Likely to Cost You a Job 2. The top three things that employers want to see in your social media profiles
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Sorry for the confusion! Currently I am in graduate school to become a Family Nurse Practitioner. Since I have started my clinical rotations, I have been feeling the pressure and responsibility, that one day I will have when prescribing medications. I was researching techniques that I could incorporate into my practice that were statistically proven and different than the traditional questioners that are currently in practice. Through this research I was able to find the screening tool mentioned above and thought that I would write and article about the topic. It has been phenomenal to read everyones feedback and THANK YOU to everyone who has posted. Your words are not going unread! Michael M. Heuninckx RN-BSN
