Flaring

Thank you everyone. I was discouraged by some of the responses but appreciate the insight from most of the posters. To clarify, I am nervous because my program set up my clinicals with ALL physicians. I learned a lot from them, but physicians do not often follow national guidelines and rely on their own way of doing things. That's why I was taught to start with an ARB or ACEI and skip the hctz class. I'm sorry if I offended anyone by asking for guidance from my colleagues, I am just nervous and would like to know where practicing new nurse practitioners go for guidelines and when they are treating something new to them since I never learned from NPs in school.

Thank you Boston. That's a helpful way of phrasing it. So a hypertensive patient who went from normal to high very suddenly would be abnormal, or if they already have some target organ damage, or were incredibly young I would ask for advice because it's not really a typical presentation. And a rash that was growing rapidly, or was associated with systemic symptoms, I would ask someone. Like that?

Thank you trauma. Those are helpful. In clinical I often used up-to-date as my sole resource when treating patients. Example, if someone came in with a rash I would loosely follow the up to date guidelines for a rash combined with my own clinical judgement. Any other newbies agree with this strategy or is there another good resource i should add?

What? I'm not trolling I'm asking for advice. I'm confused.

You sound ridiculous. You have no business asking anyone to delete my thread when I am asking for some tips so I can ensure I have good resources as I enter practice.

Yes, but I don't want to ask them about every single patient and look incompetent. I just want some good sources for thorough guidelines . It is party because I'm a bit OCD and can't rest if I feel I missed something.

Deleted

Hello everyone! I am a new nurse practitioner and have been offered my first job in a general medicine outpatient clinic. I will be seeing 15-20 patients daily (at my max) and there are a few others nps and physicians who work there. Salary and benefits seem great (everything paid, 5 weeks vacation, salary 100k + productivity) Thing is, I am terrified. I feel like I wont know what to do when I see patients. Even if I have a vague idea of what to order I feel like I might miss something. like if someone comes in with high BP, maybe I prescribe an ace inhibitor but what if I should have also done a more thorough workup for hidden causes? If I tell someone to put hydrocortisone on a rash when I should have checked for another disease? I feel like I just need access to big book of guidelines to help me get started. Can anyone help? 1. What's a good resource book or website that can help me follow best care guidelines for patients so I don't miss anything? 2. Does anyone else feel this way at first? Aren't you scared of really screwing up and losing your license? Does it get better? What's the best way to gain confidence? I'm freaking out, sick to my stomach about starting next week. Need advice please!