AANP Conference

I went to the American Academy of Nurse Practitioners conference in June this year for my first time. It was a neat experience and great to be around so many NPs. The one thing I noticed though, was just how many NPs worked in primary care. I knew from reading, many NPs go into in primary care settings, but I suppose not working in primary care myself I never really see it first hand. In grad school I pretty much spent all my time with the Acute Care specialty folks and never really knew what Family or Adult were up to. And since I've always worked in a hospital, I still spend all my time with other ACNPs. Many AANP meetings were on primary care topics, many folks I met were in a primary-care specialty, and I was feeling a little left out being in Acute Care. It got me wondering just what were the specialty demographics at the conference. Well, I don't know about the conference directly, but I learned that the AANP membership consists of 62% Family NPs, 22.5% Adult NPs. ACNPs were only 6.5%. No wonder I felt out of place. I was particularly excited when there was an acute care topic and I could bond with others that worked in the hospital setting.

But overall, being at the conference was a great feeling, because in the end we are all NPs. There are times at your hospital job you feel out numbered and aren't sure where your big support group is. In some cases, you may be the only NP on your team, or even in the hospital. That was the case in my previous job. But I never felt like that when I worked as an RN. Then I had a bunch of other nurses around me, and a whole chain of nursing command that I knew was there to go to if needed. Don't get me wrong. I absolutely love the surgeons I work with, and feel truly part of the team. But I'm not a surgeon, nor do I care to be one. There are a couple of other NPs I work with, so I am not literally the only NP around. That helps. But when I went to the conference, the best thing was we were all NPs! That alone made us connected. And then to top it off, it was also the largest NP gathering to date. Now that's neat!

What's the difference

I am often asked when I say I work as a nurse practitioner, "What's a nurse practitioner?" I'll also get, "Oh, is that like an LVN?" or "Oh, my friend's a nurse and...". I have learned that many people don't know what an NP is. So how is my job different than an RN? Well, I am an RN too, but I no longer work at the bedside. The easiest way to describe the difference is to say how my job changed from when I worked as a nurse to what I do now. As a nurse, I carried out all the orders the physician, nurse practitioner, or physician assistant wrote. (As a point of reference, I worked in the ER). I did functions such as placing IVs, drawing blood, placing Foley catheters, placing NGTs, performing EKGs. Those were fun things, but there were a lot of not-so-fun things. For me, that was namely cleaning up after bowel movements. Now, I was in the ER, so fortunately that wasn't nearly as often as nurses who work the floors/ICUs have to deal with. But for me, the bigger downside was not having more control over the patient's management. It was one thing to have to "anticipate the doctor's needs" but it's another to actually make those orders.

Now as nurse practitioner, I manage my patient's care. I write orders for tests or labs they need, interpret the results, write prescriptions for meds they need both inpatient and at discharge, discharge patients from the hospital, work with the interdisciplinary team to prepare for discharge (like needing a wheelchair or placing in nursing facility). Some other functions include pulling chest tubes, downsizing or discontinuing trachs, and doing VAC changes. During grad school I learned how to place chest tubes and central lines, but the job I took doesn't have the NPs do this- in part because I work at a teaching hospital where all the residents are dying to do them and need to learn as part of their residency. What procedures you do will vary according to the job, and according to your state's reguations.

For me, moving from the bedside to have more autonomy was the right choice. I know many nurses though that have no desire to have authority to manage the patient's care. And this is certainly not because they are not capable of the work. But realistically with the autonomy comes more responsibility that some nurses just don't want. Not to mention the sacrafices of going back to school after you already have a great job, and potentially worse work hours than you had. Some NPs take call- I fortunately don't. All-in-all, I think going back to become an NP was a great decision and I would support anyone considering the idea of working as an advanced practice nurse!

Trauma by region

I was reminded yesterday, as I cared for a patient hit by a surfboard, that you don't see this kind of trauma everywhere. Beach trauma is only relevant to certain regions. Although obvious, I guess most of us don't really think about the regional trauma you'll get when picking a trauma job. Going into trauma I expected car crashes, gunshots, assaults (which of course I do see plenty of), but living on the coast brings an additional group that I realize not every trauma center will see. On the other hand, my friend's sister works in trauma in a rural region, and sees things I never would: animal attacks, snowmobile crashes, and even falls in wells. Other locations can see farming accidents and bull riding accidents and south sees border-related trauma (often injuries from jumping the border). I love working in trauma and personally I think the beach-related injuries are an interesting change. But I think it is interesting that a group of people all trained and ready to go out into the trauma world may end up really seeing some different cases depending on where they decided to work. I did all my training in ER/Trauma at a school not near a beach so getting a surfing accident was new when I moved. But does that matter? No. Ultimately trauma is trauma, and really regardless of mechanism, you approach it in the same fashion and with the same protocols. But for those of you new to trauma, or considering entering trauma, this may be an aspect you haven't really thought about- just as I hadn't. Realistically, I think just about any trauma center you go to will have motor vehicle crashes (and motorcycles) and falls, and sadly I bet assaults. But there will also be traumas that are unique to your location, which may actually be the ones that you find extraordinary and make you truly connected to your community.

Welcome to Nurse Central!

Hello blogger community and readers!

Welcome to Nurse Central, a place to discuss all things nurse-related. Nursing is a great career path and I'm here to support any potential newcomers to the profession, as well as connect with fellow nurses of all levels, specialties, and locations. Health care professionals, and nurses in particular, are a unique group of people that are bonded together by experiences very few other professions are exposed to. We have to see, do, and deal with things on daily basis that bond us together in a special way. And sometimes you want to talk about these experiences with others that can understand where you are coming from, but perhaps don't want to share it will all of your co-workers.

I am a Nurse Practitioner and have already created an informational website for NPs (http://www.worldofnursepractitioners.com/). But that site is primary only devoted to nurse practitioners and so far doesn't offer the opportunity for anecdotal discussions. I believe informal discussions or narratives of the job are sometimes just as important as the formal academic information. For those considering entering nursing, it just may be this information that gives you the the full insight into the career to make a decision. And Nurse Central is for all nurses, or soon-to-be nurses, or even those just curious about nursing.

I will share my thoughts, experiences, advice or tips, and I look forward to reading any comments or questions as we go along. Welcome!