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What did you wish you knew as a new grad NP?

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Hi everyone! I am a new grad family nurse practitioner starting a job in primary care in a few weeks. I am so excited to start my journey as an NP. What are your go-to resources for primary care? What did you wish you knew as a new grad? I know that I will learn something new everyday and the first year may be rough. I just want to make sure I am providing the best care possible to my patients. I will have a month of orientation and then after that, I will be the only provider at the office. The doc will be at another office about 10 minutes away and said he is only a phone call away if I have any questions.

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5 minute clinical consult has been a great resource for me.  I adopt A lot of their plan info into my notes.  Easy to quickly reference. Also use lexicomp for medication reference and have this awesome quick reference for psych meds.  Occasionally use dynamed and essential evidence plus when I have more time to get detailed info. A colleague uses up to date and swears by it.   I don't care for the interface much.  

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Best to ask what your practice's or hospital's standard reference is. For one hospital, its Lexicomp, at another hospital its UpToDate and for my practice, its UpToDate. 

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honestly uptodate and 5minute clinical consult= pretty much universal coverage

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UpToDate is the google/wikipedia of the medical world AND you can trust everything and find almost everything on it. Pricey, but so worth it. I haven't seen a good NP, PA, MD, or DO resident/new grad who didn't use it. Even providers who have worked for years, still refer to this resource. For a quick medication dose look up, I use the free version of epocrates sometime. But a bulk of anything I need to look up comes from UpToDate

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Up to date, 5 minute clinical consult, and Dermnet.nz for all things skin.

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Uptodate is great.  For sure.  But keep in mind it is an editorial.  At some point you need to go to the primary sources to understand why you are doing what is recommended on uptodate.  Like for atrial fibrillation management.  Uptodate will tell you that rate control > rhythm control, and the HR range to shoot for is 70-110.  But you should read the RACE and AFFIRM trials, evaluate the design, methods, results, etc for yourself and change your practice accordingly.

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1 hour ago, Dodongo said:

Uptodate is great.  For sure.  But keep in mind it is an editorial.  At some point you need to go to the primary sources to understand why you are doing what is recommended on uptodate.  Like for atrial fibrillation management.  Uptodate will tell you that rate control > rhythm control, and the HR range to shoot for is 70-110.  But you should read the RACE and AFFIRM trials, evaluate the design, methods, results, etc for yourself and change your practice accordingly.

Thank you for ^^this. I was just going to say that one needs to use discretion and do their own thinking when it comes to info one reads. Up-to-date is popular and I use it as well, but it has its flaws. For one, some of the evidence they use sometimes lacks rigor or is of low quality. As a result, you can't always assume a recommendation based on opinion or "evidence " applies to every given situation. There are other sources that I've found that have proven superior to uptodate at times (i.e. dynamed).

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Uptodate is really good at admitting if the data is weak though. This isn't found in the summary and recommendations part all the time but their discussion is adequate for most things.

Plus they point you toward where they made their recommendation from.

 

The only times I would say UTD+ what they reference would not be enough would be highly specialized practices that I doubt any of us are actually working in.

I'll let the sub sub sub specialists determine hairsplitting changes  beyond what UTD and NJEM has to say on most things

 

Edited by Spadeforce

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I can speak to UpToDate as a nephrology APRN - sometimes its not correct with regards to the latest research and/or KDIGO guidelines.

That said, most of the time, its fine. When I have a question, I go back to the nephrologist.

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