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Welcome to the ADVANCE for NPs & PAs blogs, part of the Healthcare POV: Blog and Forum Community from ADVANCE. Our blogs offer posts covering timely questions, advice and opinions about nurse practitioners and physician assistants, including career issues, education information, and help for new and student NPs and PAs. A list of our most active posts keeps you abreast of the latest discussions. We tag posts by topic so you can easily find posts that interest you. You can also edit your profile to make it uniquely your own to interact with your colleagues on the blogs. We look forward to hearing your voice.
July 23, 2014 8:38 AM by Keischa Cash of DNP Answers

Getting my DNP was challenging, but, unfortunately, my employer was not as supportive as I had hoped of my hard-earned achievement. When I received my doctorate I intended to introduce myself as Dr. Cash to patients and wanted staff to address me as such, as well. I found out this would be harder than I thought.

The organization I work for is highly physician-centered. Yes, they still reference NPs and PAs ...

July 22, 2014 10:21 AM by Mina Grasso of Aesthetics Practice Today

Acne scars may present in a variety of ways. The technical names are boxcar acne scars, ice pick acne scars, rolling acne scars, hypertrophic and keloid scars. Patients ...

July 21, 2014 3:02 PM by Caroline Pilgrim of First Year PA

Primary care is so imperfect. Each day I could probably find as many things to complain about as complaints my patients come in with, and I am beginning to see why burnout can occur. That is, if you don't have the right perspective. As I forge ahead on this year-one journey, I am creating tenets to avoid burnout. I'm honestly not a huge believer in self-help or magical powers of positive thinking, but we all ...

July 16, 2014 11:01 AM by Renee Dahring of Career Coach

Dear Career Coach:  I am a new grad NP with celiac disease and I am unable to eat at restaurants due to potential cross-contamination that inevitably leaves me ill for a week. What suggestions do you have to handle not being able to eat at a restaurant, without coming across like a "major diva" as you mentioned?

Dear Reader:  The structured office interview is how the employer ...

July 16, 2014 10:46 AM by Deanna McCarthy of DNP Answers

After waking up from my nap, (yeah, I know, a nap!) I started thinking about going back to school next month. I have been spoiled this summer - even though I am working, I feel like I am on vacation. This summer followed the most difficult semester that I have ever been through. This past semester I took Pharmacology and Physical Assessment with a clinical component. Do I really want to go back to getting up at 5 ...

July 16, 2014 10:39 AM by Debra Shelby of Dermatology Practice Today

In our programs, we learned about antibiotic abuse and "super bugs." Years of prescribing these antibiotics have come to a point where treating skin infections have become very difficult. The incidence with MRSA has increased and years of treating this infection has made it resistant to ...

July 15, 2014 3:46 PM by Mina Grasso of Aesthetics Practice Today

With the increasing popularity of tissue fillers, patients are looking more youthful in the mid and lower face. When looking at patients with volume augmentation of the mid and lower face, there can be a disruption in the frame of the face where the temporal fossa are hollow and overlooked. The temporal fossa is located just above the cheekbones behind the lateral orbital rim.   

As we age, the temporal ...

July 14, 2014 9:35 AM by Katrin Moskowitz of First Year NP

The last few months have been a balancing act, but one that I am enjoying. In the last two months I have been back in my Emergency Room working as a provider. I have been very fortunate that the staff that I previously worked with as a nurse have accepted me in my new role and continue to work with me in an efficient and professional manner. I was approached by a hospitalist and ...

July 10, 2014 12:24 PM by Amy Gouley of Dermatology Practice Today

This is a photo of a 56 year old male who arrived to our office for a total body skin exam.

Patient was born and raised in Washington with a negative history of skin cancer, both himself and family.
Patient enjoys sailing and boating and has spent numerous years outdoors.
The patient ...

July 9, 2014 10:54 AM by Deonne Benedict of DNP Answers

Although a 10th grade history teacher sparked my interest in history through asking provocative questions, that interest remained dormant for many years. Other than occasionally surfing the History Channel, I didn't know what a history enthusiast was. That all changed when I married my husband. My husband arrived with many book shelves full of history literature, many of them primary sources, ...

July 9, 2014 8:36 AM by Julie Schreiner of DNP Answers

Dr. Ruth, Dr. Phil, your dentist, your therapist, your veterinarian, your attorney, your pharmacist, your professor, and yes, your nurse practitioner are all potentially doctors of something... but why has the American Medical Association and the American Osteopathic Association stated that only MDs and DOs can identify themselves as doctors without explanation? A multitude of professions exist that call themselves ...

July 8, 2014 11:01 AM by Rachel Matson of NP & PA Student Blog

Currently, as I try to write this blog post, I have a Chihuahua under my feet and a 7-year-old leaning against my arm. One term into my journey to become a nurse practitioner and I've already had moments thinking, What ...

July 3, 2014 10:07 AM by Debra Shelby of Dermatology Practice Today

I graduate FNP school next year and I am interested in Dermatology.  I do not have any experience in this area.  Who would be a good contact to learn how to get into the field?

I get this question submitted to the NADNP website many times. It is a difficult question because dermatology is so difficult to find an opportunity. The best thing to do while you are in school is to contact dermatology ...

July 2, 2014 11:10 AM by Walton Reddish of DNP Answers

In May 2012, I entered an online Doctor of Nursing Practice (DNP) program. I had chosen to pursue the DNP because I viewed myself as a clinician and I had no interest in becoming a white coat researcher. After a great deal of investigation, I chose the school that most closely conformed to my tightly controlled schedule. I could go online and complete assignments at any time that I chose and there were no obligatory ...

July 2, 2014 8:26 AM by Renee Dahring of Career Coach

If you are about to look for your first job or you are just thinking about making a change, I have a couple pointers for you:

  1. Job searching requires a plan. Before you send out your first resume or application, you should have an idea of what it is you really want in a job. Sit down and make a list of YOUR job requirements. If there is one thing that employers dislike it is non-serious candidates. ...

July 1, 2014 3:02 PM by Johanna Golston of NP & PA Student Blog

After becoming a nurse practitioner and then deciding to obtain my doctor of nursing practice, I have been asked this question many times by patients, friends, family members, and even strangers. My short answer, which truly sums it up, is, "because I like the nursing aspect."

But what is the 'nursing aspect'?  In 1860, Florence Nightingale defined nursing as "the act of utilizing the environment of the ...

July 1, 2014 10:55 AM by Mina Grasso of Aesthetics Practice Today

Over time with genetic influences and facial expression, we see changes in the appearance lower face and neck. Complaints include worsening of a crease on the chin under the lower lip, dimpling of the chin, a sad or angry appearance of the corners of the lips, jowls worsening and loss of definition of the jaw and neckline. It is common to hear patients complain that they are starting to look like their mother or father. ...

June 30, 2014 12:03 PM by Katrin Moskowitz of First Year NP

I recently had the opportunity to return to Hyden, Kentucky for their Diversity Impact weekend. This is the second time I have had the privilege to attend and was even more excited to be there as an ...

June 26, 2014 2:15 PM by Amy Gouley of Dermatology Practice Today

66 year old Male presented for a "skin tag" on his left posterior leg for 2-3 weeks. Patient denies pain but does report some tenderness when it brushes the sheets of his bed.
Upon examination was these photos:


June 25, 2014 3:34 PM by Keischa Cash of DNP Answers

The most recent 2014 legislative session was one of excitement and of woes. We saw states like Connecticut, New York and Minnesota get full practice authority legislation signed into law. With the exception of Nebraska's law that was passed unanimously then vetoed by the governor, the 2014 session saw a lot of progress made toward achieving more autonomy for our nation's NPs. I for one was happy to see that Florida (where ...

June 25, 2014 9:23 AM by Deanna McCarthy of DNP Answers

As you may have noticed from my bio, I am a DNP student. I already have my master's as a clinical nurse specialist in critical care, but I am working toward the DNP degree and the right to sit for the CRNP exam. My goal is to become a family nurse practitioner, which is a long way from the patients I used to take care of in the cardiothoracic SICU. I remember when I first started my job as a Heart Transplant Coordinator ...

June 24, 2014 2:34 PM by Mina Grasso of Aesthetics Practice Today

Various nutrients and antioxidants have been identified to benefit overall health. These nutrients and antioxidants are also essential for maintaining youthful skin vitality. Eating foods rich in antioxidants and supplementing with these nutrients can help protect against free radicals. Free radicals can potentially damage DNA and can lead to cancer. Topical application of these nutrients and antioxidants to the skin ...

June 23, 2014 9:21 AM by Caroline Pilgrim of First Year PA

What I ask people who are considering PA school or trying to pick a specialty in medicine is that they decide what they like best about people. Do you like it best when people are passed out on the operating table, nonverbal? Do you like people when they're panicked and have chest pain? Do you like people when they are in their last days of life? Do you like people when they're less than 5 pounds and premature? Deciding ...

June 19, 2014 11:18 AM by Debra Shelby of Dermatology Practice Today

Here is another question sent to me on the NADNP website @ www.NADNP.net

"I am an ARNP with FNP-C certification and 10 years experience in dermatology. Recently, a new office manager was hired and has changed the billing for midlevel providers to direct billing with insurance carriers. Prior to this we all billed under the supervising MD who was onsite. BCBS of MA is denying some of the procedure codes ...



The ADVANCE for NPs & PAs blog offers analysis of and links to NP and PA professional issues and current healthcare events.

Share the trials and triumphs on the journey from rookie new graduate to experienced PA.

By reflecting on her own experiences as a PA student, Jenna hopes to reach others interested in the day-to-day life of a PA student.

Share the trials and triumphs of the journey to becoming an experienced NP.

If you're looking for your dream job or just want to know what's out there for NPs today, start here with the expert advice of nurse practitioners who specialize in placing NPs in good jobs.

This blog will highlight the latest technical tools that can be used in clinical medicine as well as tools for teaching clinical medicine in an academic setting.

DNPs and DNP students will share their experience with the doctor of nursing practice.

Read about new technologies that affect you in daily practice.

What are the latest trends in aesthetics? Our bloggers share their insight and experiences in this growing specialty.

Interested in dermatology or challenged by skin presentations in your practice setting? Dermatology Practice Today examines issues in skin care and skin disease.

NP and PA students have a clear voice here. Find out what your student colleagues are experiencing in their programs. Feel free to post comments and questions to add to the discussions.

This new NP will share the ups and downs of her first year in practice.

Share the excitement and nerves of the first year on the job with this new physician assistant.

The Politics of Healthcare covers the latest developments in healthcare policy and legislation.