Oh my God, does newFNP ever love the holidays. Know why?
Tuesday, December 22, 2009
Happy Holidays 2009
Posted by newFNP at 8:38 PM 6 comments
Saturday, December 05, 2009
Always have and always will
NewFNP has the raddest grandparents -- all of them.
Posted by newFNP at 5:58 PM 9 comments
Labels: newFNP personal story
Tuesday, December 01, 2009
Pole Position
NewFNP really enjoys IUD placements. She finds procedures fun - a little break from the assessment of DP pulses and the futile attempts to palpate hepatosplenomegaly in her generally overweight patient population.
Posted by newFNP at 7:59 PM 3 comments
Labels: IUD, lady business
Saturday, November 21, 2009
Two things
One. NewFNP is fucking stoked not to have a mammogram again until age fifty. Not so nuanced a comment, but personal indeed.
Posted by newFNP at 5:37 PM 3 comments
Saturday, November 14, 2009
Choice
NewFNP doesn't need to be convinced of anyone's reasons for seeking abortion - she has been pro-choice for as long as she knew that the issue existed.
Posted by newFNP at 8:24 AM 9 comments
Labels: in a family way, politics
Tuesday, October 27, 2009
Saved yet again
Last week, newFNP had had it. She never wanted to return to clinic again. She had one especially bad encounter with a patient that left both parties feeling upset and involved newFNP telling the patient, "Pregnancy is not a disability - you do not need to quit work yet" in a not-so-nice tone and the patient telling newFNP, "You don't understand -- your job is easy." To which, of course, newFNP had an internal fit of apoplexy. It is a damn good thing that newFNP does not know how to say, "You have got to be fucking kidding me" in Spanish.
Posted by newFNP at 10:13 PM 8 comments
Labels: Boobs, encouragement
Thursday, October 15, 2009
One week follow up
Followers of newFNP may recall that last week she sent a gentleman to the emergency room with a temp of 102.3 and purulent nasal discharge. The day she sent him, he has come to clinic on his bike. When El Conejo was a no-show, newFNP told him that she would get him a cab and that he could lock up his bike at the clinic.
Posted by newFNP at 6:39 PM 2 comments
Wednesday, October 14, 2009
NHSC ya later!
It's official, bitches!
Posted by newFNP at 10:31 PM 9 comments
Friday, October 09, 2009
Sunken treasure
There are a few things which, if found in her bathtub, newFNP would wrap in a cloth napkin and tuck away in her lingerie drawer for safe keeping. These include a Harry Winston 3-carat flawless diamond, a bar of gold bouillon and a love letter from George Clooney begging for a second date.
Posted by newFNP at 4:48 PM 1 comments
Labels: George Clooney, IUD
Thursday, October 08, 2009
You're either in... or you're out!
NewFNP does not love to start her day with a veterinary emergency. Three hundred dollars later, her dog is on the mend and stoned on muscle relaxants. NewFNP needs a more affordable vet.
Posted by newFNP at 7:56 PM 2 comments
Labels: Fashion, holy shit, Olfactory hell
Tuesday, September 22, 2009
No. Just no.
Fucking pancreatic cancer. It is a goddamn awful diagnosis and an exceedingly difficult one to make until it's too late.
Posted by newFNP at 8:14 PM 5 comments
Labels: difficult situations, holy shit
Thursday, September 17, 2009
Reform
Would it surprise anyone if newFNP were to say that she is a supporter of a public option for health care coverage? Because she is.
Posted by newFNP at 7:29 PM 13 comments
Labels: politics
Wednesday, September 16, 2009
Pura vida
NewFNP has been home from Costa Rica less than forty-eight hours and she already wants to go back.
Posted by newFNP at 8:38 PM 1 comments
Monday, September 07, 2009
Lost in translation
Misspelling is common is newFNP's clinic. Chlamydia is tough to spell. Gonorrhea is no picnic either. And don't even get newFNP started on Kwashiorkor or borborygmi.
Posted by newFNP at 10:48 PM 5 comments
Labels: language barrier
Friday, September 04, 2009
Dementia praecox et Cocoa Brown
Would it come as a surprise to anyone if newFNP disclosed that Cocoa Brown had serious mental illness? It pains newFNP to see her suffer.
Posted by newFNP at 8:50 PM 3 comments
Labels: Cocoa Brown, mental health
Tuesday, September 01, 2009
Guiding Light
In newFNP's dreams, her clinic would utilize the in-speculum pap light. What a world of difference those lights make.
Posted by newFNP at 10:12 PM 8 comments
Labels: ghetto equipment, vag exams
Saturday, August 29, 2009
A very happy 4th anniversary
Today is the 4th anniversay of newFNP. She is hardly new anymore, is she?
Posted by newFNP at 8:52 AM 4 comments
Labels: anniversary post
Thursday, August 20, 2009
Milk it does...
Several weeks ago, newFNP stepped in to do a well child exam on an 18-month old well known to her. NewFNP takes care of her grandma (scleroderma), her grandpa (missing frontal skull bone after 2 infected craniostomies following a truck tire exploding and striking him in the head) and her mother (21-year old with uncontrolled hypertension on 5 daily medications including clonidine with a history of methamphetamine use, now abstinent).
Posted by newFNP at 10:03 PM 4 comments
Labels: unhealthy habits
Wednesday, August 05, 2009
Broken heart
NewFNP was awaiting the EKG results for her 20-year old methamphetamine treatment seeking patient when her awesome lab supervisor came out and handed her this:
Posted by newFNP at 10:25 AM 4 comments
Labels: holy shit, unhealthy habits
Wednesday, July 29, 2009
When you're sliding into first...
There are often times when the chief complaint truly misses the nuance of what the real concern holds in store.
Posted by newFNP at 10:12 AM 4 comments
Labels: poopies
Saturday, July 11, 2009
Fat
NewFNP is back from the most restful time she ever had in the state where she attended graduate school. Her school years there were full of studying and bad weather and really bad weather, whereas her Independence Day long weekend was full of tranquility, mild weather and relaxation with grad school pals.
Posted by newFNP at 4:36 PM 6 comments
Labels: in a family way, obesity, unhealthy habits
Friday, June 26, 2009
OB, oh boy!
It pleases newFNP that she continues to experience new challenges in clinic. Otherwise, the work gets a little too rote. Thankfully, newFNP's prenatal practice has been supplying her with a couple of not taught in school-style scenarios.
Posted by newFNP at 8:52 PM 0 comments
Labels: in a family way
Saturday, June 20, 2009
Girl, you'll be a woman (far too) soon
NewFNP is just going to put her bias right out there: if not a single teenager ever got pregnant again, newFNP would be just fine with that. Sure, having a baby when one is in the 10th grade is not the end of the world. It doesn't absolutely mean that one will never, say, graduate from high school or attend college.
Posted by newFNP at 4:32 PM 4 comments
Labels: difficult situations, in a family way, teen
Friday, June 12, 2009
Out of the rut, follow the gut (instinct, that is)
NewFNP has been caught in the hum-drum of sameness at clinic. Paps, prenatals, diabetics, URIs. These are the norm of clinical practice, but the routine gets a little drab. Don't get newFNP wrong - she doesn't want to work in a emergency room, but she does like a little change-up here and there.
Posted by newFNP at 10:19 PM 0 comments
Friday, May 29, 2009
Dress code violation
The inappropriate t-shirt trend has followed newFNP to the research clinic. The reach of the inappropriate t-shirt is, apparently, far and wide.
Posted by newFNP at 9:25 PM 14 comments
Labels: Other bitches just front
Saturday, May 23, 2009
Action!
What's up, nurses? We're fucking famous, that's what. Or maybe nursing leaders are in cahoots with the entertainment industry to make nursing appear to be a more attractive profession in the face of a horrible nursing shortage.
Posted by newFNP at 8:22 PM 3 comments
Wednesday, May 13, 2009
You down with PCP (yeah, you know me)
It cannot be stressed enough - the 30th patient of the day must not - repeat not - be difficult. That patient could be clinically complicated but personally reasonable or that patient could have a "gimme" diagnosis. NewFNP's favorite is UTI, but she could go for an otitis media or a fungal derm as well.
NewFNP isn't sure how to triage for this when scheduling appointments, but if she could develop an algorithm for optimal patient scheduling that ruled out end of day challenges, she could retire and buy an S4 and some Tory Burch tunics.
As newFNP perused patient #30's chart before entering the room at 4:40 to begin said patient's complete physical, she noted that another provider had charted "PCP abuse."
PCP? NewFNP glanced at her watch. She had not, in fact, used her flux capacitor and time travelled back to 1983. It was firmly 2009. She imagined that the demand for PCP would be minimal and that this patient's dealer might have a 2-for-1 special or a sign that screamed, "PCP - no waiting!!" whereas the lines for meth and crack would loop around the block. Of course, truly, newFNP has no frigging idea about PCP procurement. And even more significantly, she has no idea about PCP addiction treatment.
So newFNP goes about the social and medical histories which, as one might imagine, were both colorful and sad, and got around to asking about the PCP. She had been smoking PCP on and off for over 20 years.
"When was the last time you used PCP?" newFNP asked?
"Well, it stays in your system for a long time," #30 replied.
Hmmmm. It's an answer, yes, but it's an answer to an entirely different question.
"Oh, OK," newFNP responded. "So about how long ago was the last time you used PCP?"
"I want to stop," #30 replied. "It's hard to be a mom."
NewFNP imagines that it is hard to be a mom and that anyone would want to stop PCP use. Still, that nagging little question was stuck in newFNP's craw. NewFNP acknowledged her patient's desire to stop and assured her that she would receive a referral to behavioral health/addiction medicine treatment. But she had to ask.
"I'm sorry but I'm still unclear as to the last time you used PCP," newFNP gently prodded.
"I told you already!" #30 exclaimed.
"I don't think you did," newFNP stated. "You told me that you wanted to stop and that PCP stays in your system for quite some time. But I don't know how long ago you used."
"A month ago," she stated, as easy as 1-2-3.
The thing about PCP is that its lore is full of horror stories - people thinking they can fly while intoxicated, people exhibiting superhuman strength, people having delusions and behaving violently. And it's an hallucinogen, a class of drugs for which there is a paucity of documented treatment modalities.
So, after a month of not using in the face of all the same life stressors as are always there, how does someone maintain abstinence?
NewFNP gave her a counseling referral and some encouragement, but that's not really enough. Unfortunately, it's all many primary care providers have to give. Mental health and addiction treatments are expensive and not adequately covered under insurance plans and certainly not under this woman's public insurance plan.
Maybe newFNP should refer people to Intervention - let Jeff or Candy give it a whirl.
Posted by newFNP at 12:58 PM 4 comments
Labels: unhealthy habits
Monday, May 04, 2009
Rack 'em up
NewFNP is back from her conference and - you know - nothing says 'welcome home' like a diagnostic mammogram! As she prepared for her appointment and dutifully neglected to deoderize and moisturize, she reminded herself not to worry until there was something to worry about. She arrived at her fancy-pants medical center, registered, donned the wristband and was called back to get changed.
Posted by newFNP at 8:14 PM 3 comments
Labels: Boobs, newFNP personal story
Saturday, May 02, 2009
Taking it (the Big) Easy
The last time newFNP was in New Orleans, she was 22, on a meandering cross country road trip which had such highlights as the Carlsbad Caverns, Graceland and a variety of Shoney's restaurants, and was bunking in a bright pink hotel called The Frenchmen.
Posted by newFNP at 3:02 PM 2 comments
Labels: continuing edu-vacation, unhealthy habits
Monday, April 13, 2009
Not so lovely lady lumps
It's been a long time since newFNP has been on the business end of a cytobrush. A year, in fact. But today was the day for newFNP to go from provider to patient and shimmy down the table into the stirrups for her annual exam.
Posted by newFNP at 9:56 PM 5 comments
Labels: Boobs, newFNP personal story, vag exams
Saturday, April 11, 2009
The world is your oyster
When newFNP decided to become an NP, it was really because she wanted to take care of patients in a community health setting.
Posted by newFNP at 3:45 PM 3 comments
Labels: NP job options
Monday, April 06, 2009
Fashion disaster
NewFNP long ago gave up her white coat. Too stuffy. Too many cheaply sewn buttons falling off and too little desire to mend. Too much unflattering hip-spread look. Plus, it spent quite a while in the cargo area cum unwanted goods graveyard of her car and newFNP kind of just forgot about it. She now just rocks whatever outfit she's rocking that day and, for the most part, it's all good.
Posted by newFNP at 9:23 PM 3 comments
Tuesday, March 24, 2009
A sweet rack
Dude.
Posted by newFNP at 6:51 PM 5 comments
Labels: Boobs, office staff rant
Wednesday, March 11, 2009
Bring it.
There are times in everyone's role transition in which they wonder if they are, in fact, cut out for the career they chose.
Posted by newFNP at 9:15 PM 7 comments
Labels: encouragement, Olfactory hell
Sunday, March 08, 2009
Money honey
NewFNP has read article after article lamenting the primary care physician shortage. Often times, this is attributed to the high cost of medical school education. It's true - med school is expensive. It's true - physicians can make more money in specialty practice.
Posted by newFNP at 3:44 PM 12 comments
Labels: debt, encouragement
Saturday, March 07, 2009
Hard times
NewFNP noted recently that the economy is really hurting her patients.
Posted by newFNP at 8:22 AM 1 comments
Labels: poverty