Pediatric Providers Refusing to Treat Unvaccinated Children?

One observation I have made throughout my career is that parents approach raising children very differently.  To some mothers, their 5 year old son's leg laceration is a cosmetic surgery emergency, others see their child's first cut as one of many future battle scars.  Varied approaches to parenting extend to vaccine beliefs as well with many modern parents electing not to vaccinate.  Concerned pediatricians have taken note and many are now refusing to treat unvaccinated children.

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Nurse Practitioner Scope of Practice: Texas

Ahh, the Lone Star State, famous for it's spirit of pride and freedom, the Alamo and the invention of Dr Pepper.  Among the lesser known facts about Texas is that it is home to nearly 10,000 nurse practitioners.  Does Texas' independent attitude extend to state laws governing NP's?

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Obamacare Update: 'It's All Going to Get Down to Nurse Practitioners'

Yesterday, my father-in-law sent me an e-mail titled 'It's All Going to Get Down to Having Nurses and Nurse Practitioners Do More!'.  After reading the Wall Street Journal article attached to his message, I think he's right.  More importantly, both medical and non-medical academic communities are taking note of nurse practitioner's potential.  

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Book Review: Eat to Live

Daily exposure to illness and chronic disease through my work makes me terrified of developing serious medical problems.  You might think that as a nurse practitioner I would have faith in modern medications to adjust my blood pressure should it spike in the future or lower my blood glucose in the case that I develop diabetes.  I do not.  Rather, I take every patient I meet suffering from these problems as a warning sign...prevention is key.

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The NP Profession: Image vs. Reality

My social life takes a blow from pulling frequent night shifts, but really it is my favorite time to work.  The emergency department is (usually) a bit slower and a spirit of camaraderie and teamwork is present that simply does not exist during the day.  The wee morning hours lead to laughs and jokes that don't occur among well-rested employees or when administrators are roaming the halls.  Night shifters are happier, lighthearted and the designated night nurses are really good at their jobs. 

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Do You Need to Work as an RN Before Becoming a Nurse Practitioner?

One of the obvious prerequisites to becoming a nurse practitioner is acquiring an RN degree and license.  You can't after all become a nurse practitioner without first being a nurse.  The RN and NP role are however very different and many prospective nurse practitioner's don't want to work as nurses.  Do you have to work as a nurse before attending a nurse practitioner program or working as a nurse?

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Patients Googling Symptoms- Does This Mean They Don't Trust Providers?

My patients usually present with an idea of what medical issue they might be experiencing.  How?  They have consulted Dr. Google...and therefore concluded they are suffering from some sort of cancer or rare plague.  The insect bite on their big toe from two days ago has become red and swollen.  Forget the more likely allergic reaction or mild case of cellulitis, this is the dreaded necrotizing fasciitis.  Do patients consult Google out of curiosity, or is it because they no longer trust medical providers?

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Are B12 Injections Effective for Treating Fatigue?

The pinkish-red liquid known as cyanocobalamin, or B12, has achieved legendary status among our patients.  It seems there is nothing a B12 injection can't fix.  Fatigued?  Forget sleep, stop by your primary care provider's clinic for a quick B12 upper.  Although this medication is rumored to solve a wealth of common health problems, primarily fatigue, is it actually effective?

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Wise Consumer Health Month: 4 Ways to Save Your Patients Money

Consistent with true American fashion, I am an expert consumer.  This morning I woke up, rubbed my eyes, stumbled into the kitchen to brew a cup of coffee and promptly flipped open my laptop and began browsing my favorite home decorating websites in search of the perfect coffee table.  Not even 7am and I am already contemplating a hundreds of dollars purchase.  An annual expense more costly than my dream coffee table for most Americans is medical care.

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Case Study of the Week: Pseudotumor Cerebri

Don't you hate those diagnoses you cannot make with a simple physical exam or routine lab work, the diagnoses that are potentially serious but often disguise themselves as more benign conditions?  Pseudotumor cerebri is one of these tricky medical conditions- often initially misdiagnosed as a migraine headache but essential to treat properly.  To learn more about this interesting condition and hone our diagnostic skills, I have chosen pseudotumor cerebri for this week's case study.

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Nurse Practitioner Scope of Practice: California

Californians have the luxury of sunny weather, year-round glowing tans and probable movie star sightings.  In keeping with their good fortune, let's kick off this state-by-state scope of practice series by reviewing rules and regulations governing the more than 17,000 NP's practicing in the The Golden State. 

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Medical Week in Review 2-15-2013

TGIF!  It has certainly been an interesting week in the ER.  It seems nothing makes people prone to public intoxication quite like Valentine's Day.  I have heard enough stories of unrequited love, relationship triangles and break-up's for this year.  I think next year I might request Valentine's Day off work.  Looking for some entertainment to make the work day pass by more quickly?  Check out these interesting medical tidbits.

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