Showing posts relating to: The Rounds: Clinical Considerations

Can Nurse Practitioners Text Patient Care Orders?

Have you ever texted about a patient? In the emergency department where I work, texting can be an easy way to consult with a specialist or send an image of a patient's X-ray, lab results or even chief complaint. But, is this legal? What are the implications of texting about patient care?

Continue reading

Which States Allow Nurse Practitioners to Prescribe Suboxone?

Nurse practitioners are newly allowed to prescribe buprenorphine (Suboxone) as part of the Comprehensive Addiction and Recovery Act signed into law by former President Obama. While the Act augments nurse practitioners' scope of practice from a federal standpoint, some states are more limiting in the freedoms they allow NPs. In which states can nurse practitioners actually prescribe Suboxone?

Continue reading

Which Flu Patients Need Antiviral Meds?

I didn't originally intend on making it viral syndrome week here on MidlevelU, but given the season it seemed appropriate. After my shift the other day in the emergency department, I felt the need for an influenza brush-up. So, I'm passing on the relevant and lesser known tidbits to other nurse practitioners who could also use a refresher. Yesterday, we looked at influenza testing and its accuracy (see 5 Lesser Known Facts to Help Make a Flu Diagnosis). Today, we'll take the next step in the patient care process and look at treatment. 

Continue reading

5 Lesser-Known Facts to Help Make a Flu Diagnosis

How accurate is the flu swab? Can I just use clinical intuition? And more...

I'm still crossing my fingers that the last shift I worked in the ER won't leave me sick with the flu. It seems like every other patient I saw tested positive for influenza A. As nurse practitioners this time of year, in many settings we're bombarded by sick patients. While we can't do much for viral syndromes in most cases, there are some general guidelines we must abide by and helpful information to know that impacts diagnosis. 

Continue reading

What NPs Need to Know About Treating RSV

Cold and flu season if definitely here! In addition to the seasonal flu, respiratory syncytial virus (commonly referred to as RSV) is another prevalent and highly contagious virus that can affect patients of all ages through the fall and spring months. Nurse practitioners can expect to see these patients in their practices this season. In most older children and adults who are generally healthy, RSV causes mild, cold-like symptoms which typically resolve on their own within a few weeks. But for some patients, RSV can be serious and in some cases, life threatening.

Continue reading

Our Top Clinical Resource Picks for the Year

Have you started your countdown yet? Whether you're vigilantly watching the seconds tick by, or sleeping through the New Years transition, the beginning of this season is not only a time to look forward but also one to look back. When it comes to my work as a nurse practitioner, there's nothing I appreciate more than a good resource. So, in the spirit of the New Year, here's a look back at our top picks for clinical resources in 2017. Which were your favorites?

Continue reading

Can Nurse Practitioners Perform Endoscopy and Colonoscopy?

I recently received a nurse practitioner scope of practice question from a surgical center practice manager. She wanted to know if nurse practitioners and physician assistants can perform endoscopy and colonoscopy. Is this in your scope of practice as an NP or PA?

Continue reading

How Can NPs Learn LARC Insertion?

As a nurse practitioner, training to provide more services and procedures gives your career a major boost. Not only do these abilities serve your patients well, they also make you a more marketable provider and provide value in the workplace. In my own nurse practitioner career, I have enjoyed furthering my clinical and procedural skills as this also keeps me relevant, challenged and up to date with the latest in evidence-based practice. 

Continue reading

What are PECARN Rules? Hint: They Don't Involve Nuts

Deciding when to order a CT scan in the case of a head injury can be a frustrating process. Yes, the likelihood of a serious finding is often low, but do you really want to be wrong when it comes to a head injury? Absolutely not- the stakes are too high. In kids, the CT decision becomes an even riskier process. Ordering a CT scan unnecessarily increases risk of radiation-related malignancy later in life. Enter the PECARN rules. 

Continue reading

Clinical Pearls for Otic Foreign Body Removal

When I began working in the emergency department, I was surprised the first time I encountered a patient presenting with a case of insect-in-the-ear. Really? It just crawled in there?! Then, the scenario played itself out over and over again. Whether it's an exploring insect, a bead, or a pea that makes its way into a patient's ear canal, as a nurse practitioner you may find yourself removing otic foreign bodies from time to time. While the procedure is usually quite simple, if done improperly serious complications can result. 

Continue reading

4 Written Resources for Lab Interpretation

Our last post talked apps for lab interpretation. While apps are convenient and take up only virtual storage space, we totally side with nurse practitioners who prefer more tangible clinical resources. If you're a book-loving NP, there are a number of helpful references out there to guide you in ordering and interpreting lab studies. Which pack the most punch in the clinical setting?

Continue reading

The Rules for Delivering Bad News to Patients

I've talked to some colleagues recently who've been a little down about their roles as nurse practitioners. Working in family practice, they have found themselves in the position of delivering bad or upsetting news to their patients. Cancer diagnoses were fortunately made rather than missed, but letting a patient know they've got a serious, life-altering illness or condition is tough, not to mention, this is not something most of us as NPs learn to do in school. 

Continue reading

Pages