I'm aware that many people roll their eyes at another "year in review" blog post but it's been some time since my last post here and I think it is a good way to end the year.
2011 was an important year for me professionally as I completed my DNP back in May. It was a grueling 3 years (that I mostly chronicled here on this blog) and in my mind was the right choice for me at this point in my life. I approach clinical problems and scenarios through an alternative perspective and I have really embraced this philosophy. I hope to apply some of this new wisdom to the health care system and patients alike.
Because I'm a glutton for punishment, following the completion of the DNP, in the Fall, I enrolled full-time in one of the University Based Training programs that was part of the American Recovery and Reinvestment Act's HITECH Act. Technology has always been my passion and I am so interested in the integration of information technology and health - it is really the future of health care. Thus far, I have completed 1 semester and have 1 more semester to go which is slated to start in January. This has been an enormous amount of work on top of a full-time job and family stuff but I am certain that this post-grad certificate along with the DNP is where I want to be professionally.
In August, I also starting blogging over at Online Nurse Practitioner Programs. I've been posting about 2 entries a week about all things NP-related. It has been a fun experience to blog professionally and I look forward to continuing to expand my professional social media activities (i.e. Linked In & Twitter - feel free to connect with me there too.)
In November, I ran for and won the Chair-elect position for the Nurse Practitioner Association of New York. This is a 3 year term that starts in January 2012 as Chair-elect, 2013 as Chair, and 2014 as Past-Chair. I am looking forward to serving the organization and hope to further strengthen membership and and reduce the practice barriers in NY so that NPs can care for patients consistent with our training and education.
I was recently notified that I won the American Academy of Nurse Practitioners 2012 State Award for Excellence in New York State. I am so surprised and honored to receive this distinction!
Whew! And that is on top of balancing a family including three children (7, 5 and 2 years old) and the full-time job in occupational health. I lost a very close aunt to lung cancer earlier this month and there is no other way to put it that cancer just sucks. All of this has been challenging and has caught up to me to make it overwhelming at times. I am actively trying to find balance in both my personal and professional lives. It will be something I work on in 2012!
So thats a look back at 2011 and I am looking forward to 2012. I wish all my readers a Happy, Healthy, and Prosperous New Year!
Saturday, December 31, 2011
Monday, November 28, 2011
Seeking NP Stories
I am posting this for a colleague who plans on writing a book about nurse practitioners.
Seeking nurse practitioners of all specialties to submit stories about the experience of being a nurse practitioner. The NP may live in any geographic area.
This may include stories about the role of NPs, patients, circumstances or the health care system.
Selected NPs will be confidentially interviewed and audiotaped if agree to be part of the project.
Please contact mga11@caa.columbia.edu
Seeking nurse practitioners of all specialties to submit stories about the experience of being a nurse practitioner. The NP may live in any geographic area.
This may include stories about the role of NPs, patients, circumstances or the health care system.
Selected NPs will be confidentially interviewed and audiotaped if agree to be part of the project.
Please contact mga11@caa.columbia.edu
Thursday, November 10, 2011
Nurse Practitioner Evidence
The latest nurse practitioner study conducted at Loyola found that "...the nurse practitioner reduced ED visits by improving the continuity of care and troubleshooting problems for patients."
These are the type of studies that need to be done. I am sick of the studies pitting nurse practitioners against physicians. The "us" versus "them" mentality is old, tired, and doesn't even belong in today's argument. The time has come to move past this and figure out a way to make the most out of available resources while ensuring that each profession practices to the extent of their education, training, and scope. Do we really need another study to show that NP practice is just as good or better than physicians or do NPs make more referrals or would NPs order more tests to arrive at a diagnosis? Please, this rhetoric is insulting to the entire US health care system.
In my opinion, nurse practitioners are not interchangeable with physician practice. We are different yet have many overlapping qualities. I have heard the argument that NPs practice medicine. Again, there are overlapping qualities but we are not analogous. How could we be when we are educated in varying models and practice settings for different lengths of time? We all deserve to be caring for the right patient at the right time and in the right setting. There are critical care NPs that do things that I cannot and I may be able to better care for a primary care patient in my setting.
As states realize that NPs can be part of the solution to the provider shortage and reduce practice barriers, I believe we will see increasing pressure concerning NP practice. NPs have a 40+ year history of providing culturally competent, evidence-based, cost-effective and high quality care. If someone wants to waste valuable resources researching this (again), then the turf battles will continue. However, my colleagues and I, as well as the many other stakeholders, would love to see more evidence proving how NPs increase the quality of care and reduce costs in this wasteful health care system of today.
These are the type of studies that need to be done. I am sick of the studies pitting nurse practitioners against physicians. The "us" versus "them" mentality is old, tired, and doesn't even belong in today's argument. The time has come to move past this and figure out a way to make the most out of available resources while ensuring that each profession practices to the extent of their education, training, and scope. Do we really need another study to show that NP practice is just as good or better than physicians or do NPs make more referrals or would NPs order more tests to arrive at a diagnosis? Please, this rhetoric is insulting to the entire US health care system.
In my opinion, nurse practitioners are not interchangeable with physician practice. We are different yet have many overlapping qualities. I have heard the argument that NPs practice medicine. Again, there are overlapping qualities but we are not analogous. How could we be when we are educated in varying models and practice settings for different lengths of time? We all deserve to be caring for the right patient at the right time and in the right setting. There are critical care NPs that do things that I cannot and I may be able to better care for a primary care patient in my setting.
As states realize that NPs can be part of the solution to the provider shortage and reduce practice barriers, I believe we will see increasing pressure concerning NP practice. NPs have a 40+ year history of providing culturally competent, evidence-based, cost-effective and high quality care. If someone wants to waste valuable resources researching this (again), then the turf battles will continue. However, my colleagues and I, as well as the many other stakeholders, would love to see more evidence proving how NPs increase the quality of care and reduce costs in this wasteful health care system of today.
Monday, November 7, 2011
Guest Post: Keeping Your Brain Fit After 65: 5 Important Memory-Boosting Ingredients Found in Common Foods
Eat your fish, it’s good for your brain.” This is what every mother said to get the kids to finish their meal. As we age, there are many physiologic mechanisms that occur making memory a thing of the past. While remembering something your wife said thirty years ago is still there, what the heck did you do with your car keys? Here are five tasty ways to encourage memory after age 65, or before.
1. Vitamin B12
Cyanocobalamin (B12) is an essential coenzyme required in many bodily activities. It is necessary to make the heme part of hemoglobin and it is also an integral part of nerve repair. A deficiency leads to pernicious anemia. Subclinical vitamin B12 deficiency can cause pain, electric shock feelings, sleep disturbance, depression, fatigue and memory loss.
Your body needs a chemical called intrinsic factor to absorb B12 in the gut. Production of B12 declines with age, so foods containing B12 are essential to provide optimal absorption. B12 is found in meat, fish and dairy. Because of the fat issue in red meat, and calories in milk, fish is a great source of B12. See, mom was right!
2. Phytofoods
Many studies have demonstrated that one of the biggest effects in post-menopausal women is a decline in memory. Many men experience a decrease in testosterone production called the male climacteric. Estrogen and testosterone are in the same metabolic loop: one can be converted into the other depending on sex genes. Foods containing phytoestrogens are beneficial to both men and women providing hormonal stimulation that increases visual special memory. Ever wonder why rabbits eat clover? It is very high in phytoestrogens. Foods high in these beneficial nutrients are: soy beans, oats, barley, lentils, yams, rice, apples, carrots, pomegranates, wheat germ, ginseng, bourbon, beer, and fennel.
3. Phenol and Phytoalixin
Phenol and phytoalixin’s are chemicals that certain plants release in response to stress or damage. In humans they have been found to do many positive things. One significant positive effect is a neuroprotective action. It has been shown to decrease the plague formation associated with Alzheimer’s disease and improve other degenerative neurological conditions. They also have anti-aging properties. Several studies have suggested marked improvement in memory in test subjects supplemented with these chemicals. They are found in the skins of red grapes, blueberries, and other fruits. Unfortunately, red wine does not contain a large amount of these protective substances.
4. Quercetin
Quercetin is a naturally occurring compound that is found in many plants. A flavonoid, it works directly on neurons and increases synaptic conduction resulting in faster and better connections in the brain. Common foods containing high levels of this substance are onions, fruits, vegetables, leaves, and grains. Onions have long been used in India as a folk remedy to treat memory loss.
5. Omega Three Fatty Acids
Omega 3 fatty acids have been touted as a treatment for high cholesterol, metabolic syndrome, and a variety of other age related processes. Omega 3 fatty acids have a significant effect on brain function, specifically memory and mood. Foods containing this are fatty fish like salmon, (Mom’s still right), the oils from nuts, olive oil, beans, and squash.
There are other ways to improve cognitive function like getting off the couch and using your mind. Practice may not make it perfect, but it helps. All the training and mental effort can’t help a brain that is missing essential chemicals required to provide memory. Give your brain the building blocks it needs and maybe you’ll find your keys more easily!
Author Bio:
John writes for Assisted Living Today, a leading source of information on a range of topics related to elderly living and retirement care and facilities, such as memory care.
1. Vitamin B12
Cyanocobalamin (B12) is an essential coenzyme required in many bodily activities. It is necessary to make the heme part of hemoglobin and it is also an integral part of nerve repair. A deficiency leads to pernicious anemia. Subclinical vitamin B12 deficiency can cause pain, electric shock feelings, sleep disturbance, depression, fatigue and memory loss.
Your body needs a chemical called intrinsic factor to absorb B12 in the gut. Production of B12 declines with age, so foods containing B12 are essential to provide optimal absorption. B12 is found in meat, fish and dairy. Because of the fat issue in red meat, and calories in milk, fish is a great source of B12. See, mom was right!
2. Phytofoods
Many studies have demonstrated that one of the biggest effects in post-menopausal women is a decline in memory. Many men experience a decrease in testosterone production called the male climacteric. Estrogen and testosterone are in the same metabolic loop: one can be converted into the other depending on sex genes. Foods containing phytoestrogens are beneficial to both men and women providing hormonal stimulation that increases visual special memory. Ever wonder why rabbits eat clover? It is very high in phytoestrogens. Foods high in these beneficial nutrients are: soy beans, oats, barley, lentils, yams, rice, apples, carrots, pomegranates, wheat germ, ginseng, bourbon, beer, and fennel.
3. Phenol and Phytoalixin
Phenol and phytoalixin’s are chemicals that certain plants release in response to stress or damage. In humans they have been found to do many positive things. One significant positive effect is a neuroprotective action. It has been shown to decrease the plague formation associated with Alzheimer’s disease and improve other degenerative neurological conditions. They also have anti-aging properties. Several studies have suggested marked improvement in memory in test subjects supplemented with these chemicals. They are found in the skins of red grapes, blueberries, and other fruits. Unfortunately, red wine does not contain a large amount of these protective substances.
4. Quercetin
Quercetin is a naturally occurring compound that is found in many plants. A flavonoid, it works directly on neurons and increases synaptic conduction resulting in faster and better connections in the brain. Common foods containing high levels of this substance are onions, fruits, vegetables, leaves, and grains. Onions have long been used in India as a folk remedy to treat memory loss.
5. Omega Three Fatty Acids
Omega 3 fatty acids have been touted as a treatment for high cholesterol, metabolic syndrome, and a variety of other age related processes. Omega 3 fatty acids have a significant effect on brain function, specifically memory and mood. Foods containing this are fatty fish like salmon, (Mom’s still right), the oils from nuts, olive oil, beans, and squash.
There are other ways to improve cognitive function like getting off the couch and using your mind. Practice may not make it perfect, but it helps. All the training and mental effort can’t help a brain that is missing essential chemicals required to provide memory. Give your brain the building blocks it needs and maybe you’ll find your keys more easily!
Author Bio:
John writes for Assisted Living Today, a leading source of information on a range of topics related to elderly living and retirement care and facilities, such as memory care.
Wednesday, October 26, 2011
Potpourri & an Election
I have certainly been keeping myself busy these days! First, I have been immensely busy at my clinical site. Hundreds of flu shots have been given in the last few weeks and I have been inundated with the change of season upper respiratory infections and allergies in what seems like everyone has (really, the care is largely supportive and conservative. I am a big fan of saline nasal irrigation!)
Second, school work continues in the Office of the National Coordinator for Health Information Technology post graduate certificate program as Clinician Leader that I am enrolled in. I am considered full-time and plan on finishing up in May 2012. The amount of work has been intense (an intensity that I thought I was done with following completion of the DNP this past May!) The course work isn't as demanding as the DNP, but there is just so much of it that is condensed into a relatively short time frame.
Second, school work continues in the Office of the National Coordinator for Health Information Technology post graduate certificate program as Clinician Leader that I am enrolled in. I am considered full-time and plan on finishing up in May 2012. The amount of work has been intense (an intensity that I thought I was done with following completion of the DNP this past May!) The course work isn't as demanding as the DNP, but there is just so much of it that is condensed into a relatively short time frame.
Third, I am running for Chair-Elect in the Nurse Practitioner Association of New York's (The NPA) election. Voting will begin next month and for the first time in many years, this is a contested election. It will be an interesting experience and am running against two other seasoned nurse practitioners for the position. (I am currently the Treasurer of the association). As any regular reader of my blog knows, I stand for transparency and accountability, with a sprinkle of common sense. My position statement is:
As your Treasurer, I’ve been responsible for guiding the Association through one of the most challenging economic times in our nation’s history. As a result, the Association enjoys financial stability to enhance member benefits and increase members.
In addition, our strong fiscal policies allows us to retain the best possible advertising and advocacy firms, as well as, professional staff, to ensure that our vision of barrier-free nurse practitioner practice in New York State is achieved. One of the greatest challenges we face are the often confusing and outdated laws that regulate nurse practitioner practice. The NP profession has and will continue to provide culturally competent, evidence based care that is of high-quality and cost-effectiveness.
Unfortunately, these regulations don’t accurately allow us to provide the care that we were educated and trained for. Therefore, it is essential that we have these laws updated to allow us to care for our patients of today and tomorrow.
If elected, I will work tirelessly to enhance communication and transparency within our association in part by taking advantage of new technologies. My goal is to empower members so that we are the ones shaping and defining our profession.
If there are any members of the NPA reading, I would appreciate your support in this election. (If you aren't a member and practice as an NP in New York, now would be a great time to join.
I will also be traveling to the NPA's Annual Conference this week and am looking forward to a great program.
Lastly, I've been regularly blogging (about 2 posts a week) at Online Nurse Practitioner Programs.com since August. Feel free to check that site out as well (if you haven't gotten enough of me already :)
Other than that, I am just trying to maintain balance between my professional life and personal one. My blog has always allowed me to reflect on professional issues, which I fully intend on continuing. It is quite therapeutic.
Wish me luck and I will be sure to post updates!
Tuesday, September 27, 2011
Instant Lab Results
I recently blogged about the prospect of patients getting access to their laboratory results before the ordering clinician signs off on it. This certainly is a patient-centric approach but is it a wise one?
I am mostly in favor of this however, many details still need to be worked out. In our forthcoming electronic health records world, this may be the tip of the iceberg related to patient-centricity and access to their record.
I'd love to hear your thoughts and concerns.
I am mostly in favor of this however, many details still need to be worked out. In our forthcoming electronic health records world, this may be the tip of the iceberg related to patient-centricity and access to their record.
I'd love to hear your thoughts and concerns.
Wednesday, September 14, 2011
Brief Update
Hello,
I just wanted to provide a brief update as to what I've been up to for the last few weeks. After completing my DNP this past May, I was actually feeling a bit melancholy thinking that my days of a "student" were officially over. Well, not so much! Since my passion is technology, I happened to be researching Health Information Technology (HIT) and found these University-based training programs set-up by the Office of the National Coordinator (ONC) under the HITECH Act. These programs train either health professionals on the IT side or IT professionals on the health side. Even better, there is grant that helps to pay for the majority of tuition fees!
I've always had a passion for technology yet, have been all self-taught with no formal training. The program that I applied to and was accepted offers a clinician leader track. It's been about 3 weeks and the hybrid program is intense! (I thought I was done writing papers, etc!) Thus far, it really is a wonderful program. I've met key HIT policy people and have gained great perspective into the push for all things related to electronic health records. I will be taking 18 credits over the course of the next 2 semesters (can anyone say glutton for punishment?!?)
I'm sure I will be focusing my next few posts here on HIT. There are many smart people in Washington that are working on these implementation initiatives (meaningful use, etc) and I am confident that we will see the successful transition from paper-based record keeping to sophisticated and intuitive electronic health records. This holds the potential of improving the quality of care by adding decision support logic while driving down costs by eliminating waste and duplication. Stay tuned.
Also be sure to check out this site (onlinenursepractitionerprograms.com/blog), where I am also blogging.
I just wanted to provide a brief update as to what I've been up to for the last few weeks. After completing my DNP this past May, I was actually feeling a bit melancholy thinking that my days of a "student" were officially over. Well, not so much! Since my passion is technology, I happened to be researching Health Information Technology (HIT) and found these University-based training programs set-up by the Office of the National Coordinator (ONC) under the HITECH Act. These programs train either health professionals on the IT side or IT professionals on the health side. Even better, there is grant that helps to pay for the majority of tuition fees!
I've always had a passion for technology yet, have been all self-taught with no formal training. The program that I applied to and was accepted offers a clinician leader track. It's been about 3 weeks and the hybrid program is intense! (I thought I was done writing papers, etc!) Thus far, it really is a wonderful program. I've met key HIT policy people and have gained great perspective into the push for all things related to electronic health records. I will be taking 18 credits over the course of the next 2 semesters (can anyone say glutton for punishment?!?)
I'm sure I will be focusing my next few posts here on HIT. There are many smart people in Washington that are working on these implementation initiatives (meaningful use, etc) and I am confident that we will see the successful transition from paper-based record keeping to sophisticated and intuitive electronic health records. This holds the potential of improving the quality of care by adding decision support logic while driving down costs by eliminating waste and duplication. Stay tuned.
Also be sure to check out this site (onlinenursepractitionerprograms.com/blog), where I am also blogging.
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