Monday, August 29, 2005


Lesson One:

Public programs require certain kinds of documentation that are not taught in school. They do not follow SOAP format. They defy logic. They are copious. They took up a lot of newFNP's time today.

NewFNP has to confess that she unloaded so many compaints to a fellow new FNP tonight that she have little left to share. A synopsis: 5 patients, all Spanish speaking and one requiring a corneal transplant as far as newFNP can tell. With 5 patients, who can really complain?

Oh wait, newFNP can. It's because it appears that in two weeks time, newFNP will be seeing around 20 patients a day. Hmm? Cuantos? Come again? That's right. Twenty. Other new NPs may have a more luxurious practice environment in which they see far fewer patients until they feel more comfortable. NewFNP appears to be learning in the "trial by fire" school of practice, whereas other new NPs are in a more nurturing, womb-like setting. It's hard to know which is better. Is it better to get your ass handed to you and land on your feet than it is to be eased into it? NewFNP doesn't know. She guesses that we will all learn, regardless of the practice philosophy.

An aside: to those interested in the national debate regarding universal coverage versus health savings accounts, there is an intersting article in the New Yorker this week. Malcolm Gladwell examines the concept of moral hazard and how it plays into the Bush plan for health care. He looks at its underlying theory and offers some arguments against it. It's worth checking out if you aren't super interested in getting an MPH but would like to have some insight into our national health care fiasco, er -- debate.

On tomorrow's agenda: pediatric well visits. Ah, the sweet, sweet world of squirming babies, defying newFNP's attempts to visualize their pearly TMs. She can't wait. They are sweet, those babies, but why do they hate to show their TMs?

Things newFNP learned today:
1) Seb derm - on an infant, you can use baby shampoo. Leave it on for a couple of minutes and then give it a massaging scrub that you would tip $10 for in a Soho salon. Tenacious seb derm in an infant? Give it a little 1% hydrocortisone for a week. Don't go crazy though! We all know the pitfalls of the topical steroid on fresh baby skin.
2) NewFNP hearts ePocrates. Shameless, she knows, and they don't even pay her. But bless them.
3) Bring snacks. That is no joke.


NewFNP said...

I realize that you have now been an FNP for some time now, but thank you for having this blog. Your first few days as an FNP sound like mine! I just started out last week and am already seeing 10 patients, mostly spanish speaking. I want to scream, cry, quit, laugh and feel as though I am completely unprepared, but yes, tossed into the fire versus nurturing womb environment, hits very close to home. I guess I'll keep chugging along and see how it goes.

Anonymous said...

Holy crap this FNP just graduated, possibly from the same school as new FNP, and is studying for boards and starting a job shortly. This blog is precious.