Over the past month I have had some very challenging patients. I will often question, why and how did someone end up here at the correctional facility? I believe it is better I do not know. Actually, it is none of my business; it keeps the care unbiased and pure and it does not impact how I treat them. If one of the inmates upsets the ...

There was a disturbing incident that occurred a few weeks ago. I also look at this experience as an eye-opener for me. I have long come to this realization, but it was never more evident than when the incident happened. First, let me start off by stating, prior to my opportunity to work in corrections, I was judgmental and biased and I ...

My contact with pain patients was extensive during my residency in Aurora, North Carolina, a coastal town of about 400, with a patient population compromising of retirees, commercial fisherman and above-ground miners from a phosphate mine. I knew from that experience that even if I never found a job as an NP, I would not choose to do pain ...

I don't know how many of my fellow NPs and PAs have seen and or heard about HBO's four-part documentary on obesity in America, The Weight of the Nation, but I can't recommend it enough: it is an awesome and totally relevant examination of health in the States. So many of the individuals profiled in this series were reminiscent of ...

Costs for healthcare are rising. There is not a revelation in this statement, but as providers, we have to be mindful of the dollars we use because it affects raises. My former mentor would drive that home for me. When I would order a test, she would ask, ''Will that test change your treatment plan?'' And if I responded with ''no'' then she ...

There are six different physicians in my practice and thus, six different philosophical approaches to disease treatment and management. As a new NP, this can be somewhat frustrating. Some days I wish medicine and nursing were a bit more algorithmic. But alas, it ain't like baking a cake, so here's to finding the silver lining. Six ...

Recently our group was consulted in the care of a patient newly diagnosed with HIV. This patient presented to the hospital via the ED with altered mental status. A lumbar puncture was performed and the cerebrospinal fluid was sent off to the microlab for cultures. About 48 hours later, it was positive for Cryptococcus. An HIV test ...

Two weeks in and I absolutely adore my job in infectious disease (ID). I feel so fortunate and truly hope that my cohort find comparable satisfaction in their employment. Admittedly, I despise waking up early (this nurse remains accustomed to an 11-11 shift) but aside from that one inescapable detail, I am besotted. This job affords me both ...

On Monday, October 17, 2011, I started my NP job at the Martin-Tyrrell-Washington District Health Department. Over the 5 days of my first week on the job, I rotated to all three HDs in the district and attended the October 17th grand opening of Martin County HD’s grant-funded satellite clinic in Oak City, North Carolina. I will be the sole primary ...

In watching the practice of prescribing psychotropic medications I am very hesitant about my own prescriptive practices and keenly observant of other practitioners. I am acutely sensitive to the issue. It seems like every other patient I see, irrespective of the setting, is prescribed SSRIs and benzodiazepines, and almost none of them are also ...