Nurse Practitioner

Nurse Practitioner

Code Bell

Boston, MA

Female, 34

I have been in the nursing field for 12 years. I have worked as a RN in an adult medical-surgical unit, Neonatal Intensive Care Unit (NICU), and Pediatric Cardiac Intensive Care Unit (CICU). I went back to school to obtain my masters and now work as a nurse practitioner in a Pediatric CICU. These kids are sick. The issues can be straightforward or extremely complex. No patient is the same and no day is routine. I am lucky- I love my job (most of the time).

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Last Answer on February 22, 2015

Best Rated

What's the condition where grown-ups just drop dead at a young age because of a "hole in their heart", and is that something that you can screen in babies?

Asked by diamenteCS about 7 years ago

You usually don't drop dead from a hole in your heart but I wonder if you are referring to the hole called a patent foramen ovale (PFO)? It is the type of hole that Tedy Bruschi (patriots football player) had in his heart that lead him to have a stroke..... 20% of all people have this type of hole in the heart. It is a hole that is part of fetal circulation (in utero). In 80%of cases it closes and in 20% of cases it does not. Most people have no idea that they have an open PFO because there is no clinical significance UNLESS you have a clot that passes through the hole and goes to the brain therefore causing a stroke. Yes- you can screen for this as babies but there really isn't anything to be done for it and you would be hard pressed to find a clinician to close the hole for you- because the act of closing it would be more risky then actually having the hole. However- if you have had a stroke, etc then yes- a physician would close the hole. With kids just dropping down playing sports, etc- it is usually related to a rhythm disturbance not necessarily a hole in the heart. I hope that this answers this question...

Nursing seems like the most challenging field in medicine because you're expected to be clinical and caring. How do you balance that, and how to you keep from burning out?

Asked by NED about 7 years ago

In general where I work - most practitioners (MDs, NPs, RNs,etc) are both. It is a difficult balancing act but you can always be caring regardless of the circumstances. The best clinicians provide great care and have great relationships with the families. It is about being truthful and EVERYTHING is how you say it- never what you say. You can give the most devastating news in a careful/caring manner and the information is delivered and the family knows you care. The balance is only difficult when the caring outweighs the clinical- ie becoming TOO close to a family. It is impossible to make good clinical decisions if you are clouded by a personal relationship. Burning out is common. I protect myself by keeping patients/families at arms length- it is difficult but important.

If you think a doctor's recommended course of action for a patient is wrong, do you speak up about it? Or is second-guessing a doc by a non-doc something you just don't do?

Asked by J-town about 7 years ago

I would absolutely speak up. Communication is key in healthcare as in any profession. We look at the healthcare team as a sum of its parts with no person having more significance than the others. Everyone brings a different perspective and their voice is important. We are required to take classes in communication so that important information doesn't get overlooked because someone is afraid to speak up. The classes involve role play, etc and it has helped those that are less confidant or newer staff speak up to interject when they should.

How do the responsibilities of a nurse practitioner differ from those of an RN?

Asked by Misty_44 about 7 years ago

A nurse practitioner is considered a mid-level practitioner or physician extendor. You can think of a nurse practitioner as a hybrid between a RN and a physician. A nurse practitioner can diagnose an illness, order tests/laboratories, and prescribe medications. In some states a nurse practitioner can practice independent of a physician and in others a nurse practitioner needs to work collaboratively with a physician. In my unit my role is most similar to that of a fellow (a physician in training). I have my own patients that I am in charge of for the day- I examine the patients, order appropriate tests, and make a plan of care. I present all the data on morning rounds to the attending that modifies the plan as they see fit. A registered nurse provides direct patient care. They are truly the workhorses of the hospital. They carry out the plan of care and obtain the tests ordered by the nurse practitioner, physician, or physician assistant.

What % of babies delivered in your hospital have to be treated in the NICU?

Asked by stella about 7 years ago

I no longer work in the NICU but when I did we attended all of the high risk deliveries (those with known prenatal diagnoses that require immediate care, any with perinatal complications, preterm deliveries, multiplies and all cesarean sections). Even though we attended all of those deliveries not all of those infants were admitted to the NICU. I would have no idea what the percentage would be but it is very low.

Could a nurse practitioner pretty much do the job of a primary care physician?

Asked by Jaxon about 7 years ago

Yes and no. Nurse Practitioners are GREAT but they do not have the breadth of knowledge that a physician has. So for everyday illness and common things- great but for something more serious- a physician has the more in-depth training to go on.

As gender roles continue to evolve, are you seeing a rise in the number of MALE nurses?

Asked by Sky Hy about 7 years ago

Male nurses are on the rise especially in higher acuity care (Intensive care units). It is still predominantly female but there is a rise in male nurses. AND contrary to popular belief- they are not all gay. Alot are military or second career.

What's the CICU? What conditions do the kids have?

Asked by 718killa about 7 years ago

The CICU is a cardiac intensive care unit. We treat kids that were born with cardiac disease. Not the kind of disease that adults acquire from eating too much Burger King but the kind that you are born with (congenital). Most specifically - missing parts of your heart, things in the wrong place, holes, etc. The majority of the conditions require surgical correction to live.

Have you ever had to break the news to parents that their baby died?

Asked by levi.schwartz about 7 years ago

NPs can not pronounce a person dead- that is purely a physician thing. I have been involved in numerous code situations and redirection of care (removal of mechanical/chemical life support) that have ultimately ended in a patient dying. Even though there are many healthcare providers involved- the physician is the one that always updates the parents.

Do you ever get emotionally attached to your patients?

Asked by jasmine about 7 years ago

Yes. Since I work in a place where kids have heart disease that may require many interventions over a course of years and because I have worked in the same place for 10 years- I have had many opportunies to bond with patients and familes. I have taken care of many patients since the day that they were born and continue to care for them as they grow. It is wonderful to see how the kids thrive after surgery! Many times the parents bring them to the hospital so that we can see them when they are feeling well after they are healed!

Do a lot of nurses experience back pain or anything similar from being on their feet all day? Do they wear any special kinds of shoes or braces to combat this?

Asked by melissa mccoy about 7 years ago

Back pain is pretty common - mostly with caring for aduts because of all of the manual labor. Foot pain is pretty common from being on your feet all day long. I think that the favorite shoes to wear are Dansko brand shoes. I love them. They give the best support.

Are the moms and babies in your NICU typically lower-income families? Do you think that lower income mothers tend to be less vigilant about proper prenatal care?

Asked by teressa about 7 years ago

It has been years since I have been in the NICU- I can ask some of my NICU colleagues to get a better response BUT my gut feeling is that there isn't much of a relationship between being admitted to the NICU and being lower income. AND I don't think that lower income mothers are less vigilant about prenatal care. Many of the reasons of being admitted to the NICU have nothing to do with being lower- income or being less vigilant with prenatal care. For example: - have a fever as a newborn will buy you an admission to the NICU (requires septic workup) - having a congenital defect (cardiac, pulmonary, etc)- has no bearing on prenatal care- they are just a fluke. - multiples (usually born early and require some extra help with feeding and possibly respiratory- the lungs are one of the last things to mature in utero)

What made you decide to switch from adult care to neonatal and pediatric units?

Asked by ~ KJ ~ about 7 years ago

I worked with adults for one year as an RN in an infectious disease unit. In that year- I learned alot about adult behavior in the hospital. Some adults are IMPOSSIBLE to deal with. They can be rude, everything is a bargain, and it is back breaking labor. I think that everyone has a niche- and working with adults was just not for me.

For an ER nurse (ie in NYC) what are the hours legally allowed to be worked in one shift, and what actually occurs? And what is the chain of command for an ER Nurse?

Asked by Rissa over 4 years ago

I am not sure of the rules of nursing practice in New York. In Boston - I think the longest shift one is allowed is 16 hours. At least that is what my experience as been.

This is the chain of command I have always followed:1st Charge Nurse2nd Nurse Manager3rd Nursing Director

How is a nurse practitioner different from a PA? Can you both write prescriptions? How is the schooling differrent?

Asked by DL almost 7 years ago

 

Any recommendations on what to study for in this particular field?

Asked by Josh over 2 years ago

 

what made you choose this career?

Asked by de'asia liles about 3 years ago

 

My gf and I had unprotected sex on March 8. She took an ECP within 2 hours. Ovulation March 12-14 but had spotting from the take action pill from March 12-16. Her period was set for March 28. Took a test March 29 (negative) - could she be preg?

Asked by Rob 7 months ago

 

How do you like your carrier so far?

Asked by sue over 1 year ago

 

What was the most gory patient injury or ailment you ever saw? Are you horrified by this kind of stuff, or at this point, is it just "another day at the office?"

Asked by levi.schwartz about 7 years ago

 

I am on the Depo Provera shot and I just recently took a drug test at my job. Benzo was located in my system. Could it be from my Depo. Because I’m a single mother of two and I’m not on any medication or anything else.

Asked by Brittany over 1 year ago

 

Can I interview you for my college class?

Asked by Leslie Sotelo over 1 year ago

 

Hey I’m currently on the Depo Provera shot and I recently took a feud test at my job and tested positive for benzo. Is there a possibility that the benzo comes from my birth control. I’m not on any type of medication or anything else.

Asked by Brittany over 1 year ago

 

I have a stubborn case of and itchy dots on my legs and bottom the Nurse practitioner prescribed me a steroid cream (triamcinolone acetonide cream .5%) I am concerned about using this as I have heard of problems with males using steriods.

Asked by Larry over 2 years ago

 

I am a psychology student interested in mental health and I recently stumbled across the job title "psychiatric nurse practitioner". The problem is, I already have an associates degree in psych. Do I have to start over to get my bachelors in nursing?

Asked by Nadia 6 months ago

 

Have you ever worked with a doctor or doctors who, no matter how fancy their diplomas, you felt were just flat-out dumb?

Asked by Steve, M.D. about 7 years ago

 

since I take 300mg of Seroquel nightly, is it possible that I was misdiagnosed with mild sleep apnea?

Asked by shelia1257@yahoo.com about 3 years ago

 

I am currently taking phentermine. I have anxiety real bad so I was looking into a supplement called Ashwagandha premium stress response. Is it safe to mix the two together?

Asked by Makynlie almost 2 years ago

 

I had sex on Jan. 11 , every since then I’ve been having excessive vaginal discharge done clear and watery others white and creamy. What does this mean?

Asked by Alina over 1 year ago

 

What are some advantages and disadvantages of being a Nurse Practitioner?

Asked by Zee over 3 years ago

 

Yes is it normal to get an erection and ejaculate during prostate exam

Asked by Brandon almost 3 years ago

 

What pathway (schooling wise) did you take to become a CNP?

Asked by Tara Kamal over 1 year ago

 

What pathway (schooling wise) did you take to become a CNP?

Asked by Tara Kamal over 1 year ago

 

What's the longest shift you ever had to work? Does the time just fly by given how busy nurses are?

Asked by ay caramba about 7 years ago

 

What made you decide to become a nurse practitioner? What does the usual day consist of? Where do you work now? Do you like being a NP?

Asked by erin over 3 years ago

 

How do you feel about using a Coughy Cup (i.e., looks like coffee cup with 7 ply dual filtration) to mitigate germs and viruses in "close quarter areas" where people are expected to sit for long periods of time?

Asked by Freewash over 4 years ago