Oh my God, does newFNP ever love the holidays. Know why?
Tuesday, December 22, 2009
Posted by newFNP at 8:38 PM
Saturday, December 05, 2009
NewFNP has the raddest grandparents -- all of them.
Tuesday, December 01, 2009
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.
Saturday, November 21, 2009
One. NewFNP is fucking stoked not to have a mammogram again until age fifty. Not so nuanced a comment, but personal indeed.
Saturday, November 14, 2009
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.
Tuesday, October 27, 2009
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.
Thursday, October 15, 2009
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.
Wednesday, October 14, 2009
It's official, bitches!
Posted by newFNP at 10:31 PM
Friday, October 09, 2009
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.
Thursday, October 08, 2009
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.
Tuesday, September 22, 2009
Fucking pancreatic cancer. It is a goddamn awful diagnosis and an exceedingly difficult one to make until it's too late.
Thursday, September 17, 2009
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.
Wednesday, September 16, 2009
Monday, September 07, 2009
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.
Friday, September 04, 2009
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.
Tuesday, September 01, 2009
In newFNP's dreams, her clinic would utilize the in-speculum pap light. What a world of difference those lights make.
Saturday, August 29, 2009
Today is the 4th anniversay of newFNP. She is hardly new anymore, is she?
Thursday, August 20, 2009
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).
Wednesday, August 05, 2009
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:
Wednesday, July 29, 2009
There are often times when the chief complaint truly misses the nuance of what the real concern holds in store.
Saturday, July 11, 2009
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.
Friday, June 26, 2009
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.
Saturday, June 20, 2009
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.
Friday, June 12, 2009
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
Friday, May 29, 2009
The inappropriate t-shirt trend has followed newFNP to the research clinic. The reach of the inappropriate t-shirt is, apparently, far and wide.
Saturday, May 23, 2009
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
Wednesday, May 13, 2009
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.
Monday, May 04, 2009
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.
Saturday, May 02, 2009
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.
Monday, April 13, 2009
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.
Saturday, April 11, 2009
When newFNP decided to become an NP, it was really because she wanted to take care of patients in a community health setting.
Monday, April 06, 2009
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.
Tuesday, March 24, 2009
Wednesday, March 11, 2009
There are times in everyone's role transition in which they wonder if they are, in fact, cut out for the career they chose.
Sunday, March 08, 2009
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.
Saturday, March 07, 2009
NewFNP noted recently that the economy is really hurting her patients.