Monday, March 31, 2008

Invisibility

An article about the lack of physicians in rural upstate New York appears on the Albany Times Union website here, "An unhealthy situation for patients." Sadly, the utilization of nurse practitioners is not mentioned anywhere throughout the article.

Don't get me wrong, yes we need more physicians in rural areas. Though, how innovative would it be to effectively use a resource that already exists, is willing and more than capable of alleviating the health care burden, than nurse practitioners. Lawmakers need to recognize this and support barrier-free nurse practitioner practice along with the offering of similar services as those focused on physicians.

I hate to oversimplify things but according to my crude research: There are 19 physicians licensed in Schoharie county in upstate New York according to statistics from the State Education Department. There are 18 nurse practitioners licensed in the same county. If nurse practitioners were better utilized, the citizens of Schoharie county can essentially have their providers double without any additional resources. Seems like a no-brainer to me.

Sunday, March 30, 2008

Gender Differences Seeking Health Care

Dr. Steven Lamm, author of the book, The Hardness Factor, writes a column on the Today portion of msnbc.com about the different attitudes between men and women seeking health care. Dr. Lamm writes, "After three decades of treating both sexes, I have concluded that many men simply don’t think to put doctor visits on their “to do” lists. They look upon going to a physician as some undesirable form of pampering, no matter how sick they are. In general, men are not all that good at taking care of their health, probably because they have not grown up with periodic medical exams. "

There is no doubt that women seek health care earlier and more often then men. As a former college health provider, I would easily see 4 female patients to every 1 male patient. While Dr. Lamm attributes this difference to the "traditional masculine pattern," to which I largely agree, I have additional food for thought. Perhaps men aren't encouraged enough to bring up their concerns or when they do, they are minimized by their male providers. According to gender statistics from a 2006 AMA survey, there are roughly 665,000 male physicians to 256,000 female physicians. Could this "traditional masculine pattern" carryover to the provider side too?

I think the take home for providers is that we be more cognizant (other than the obvious) gender differences between men and women seeking care. The take home for patients, male or female, is that if your provider isn't adequately assessing your needs and concerns, don't be afraid to ask or seek another opinion.

Friday, March 28, 2008

Nurse Practitioner Study On Nasal Rinsing

Nurse Practitioner Jennifer Walsh recently conducted a preliminary study along with Dr. Wellington Tichenor on a bacteria found in tap water that may be linked to chronic sinusitis (a sinus infection generally considered to persist for 3 months or more). Their findings suggest a bacteria, atypical mycobacterium, found in tap water and not killed by chlorine, can be a contributing factor to chronic sinusitis when patients use tap water for nasal irrigation. Patients with sinus infections are often told to irrigate the nasal passages, and thus the sinuses, with a mixture of salt and tap water to assist in clearing secretions and congestion. Though more research is needed to further investigate this claim, perhaps we should suggest using a store-bought sterile preparation of saline in the interim.

You can view the short piece by WABC 7 here and the link to Dr. Tichenor's website here. Congratulations Nurse Practitioner Walsh on your research!

Nurse Practitioners Fill Key Roll

Here is a well written article from today's Tennessean about Nurse Practitioners filling key rolls in primary care. To no one's surprise, The Tennessee Medical Association opposes this and even wants to add more barriers to nurse practitioner practice and therefore block access to affordable, high-quality care. They even find a way to throw retail clinics in the mix.


My question is why do they feel a need to impose stricter limits on NP practice? Are there studies to show that NP-practice is unsafe or not as good as physician-practice? In fact, studies show the contrary. I like to think of myself as a person of proof. If you can show me other than anecdotal evidence, that NP practice needs limits rather than autonomy, I'd welcome the proof.


I also don't want this to be a nurse practitioner vs. physician rant. We are all members of the healthcare team and need each other to collaborate and critically think when caring for patients. I certainly can't do it all by myself nor do I really want to. In my experience, I've see physicians collaborate with one another, pharmacists, physical therapists and yes, even nurses. A lot of us have areas of special interests or expertise. Wouldn't it be better to collaborate with that individual on that particular topic rather than someone not versed in that area? That would seem to make sense to me!

Wednesday, March 26, 2008

Hello & Welcome

Welcome to my blog! I've pondered creating this for sometime now as I've searched the Web along with other blogs for current nurse practitioner-related content and have been unable to find much. This is my attempt to provide accurate and current information regarding Nurse Practitioner practice.

My main goal is to start a healthy dialogue among nurse practitioners, other healthcare professionals and patients alike. There are a lot of misconceptions, inaccuracies and feelings about what nurse practitioners can/can't and should/shouldn't do. I've come across dozens of blog posts that are just plain wrong and hedge on bashing the profession. I hope to clarify some of these misconceptions in the hopes of providing the best barrier-free care possible to patients alongside other members of the healthcare team.

For those of you unfamiliar with a Nurse Practitioner, lets start with a definition from the American College of Nurse Practitioners:

"Nurse practitioners (NPs) are registered nurses who are prepared, through advanced education and clinical training, to provide a wide range of preventive and acute health care services to individuals of all ages. NPs complete graduate-level education preparation that leads to a master’s degree. NPs take health histories and provide complete physical examinations; diagnose and treat many common acute and chronic problems; interpret laboratory results and X-rays; prescribe and manage medications and other therapies; provide health teaching and supportive counseling with an emphasis on prevention of illness and health maintenance; and refer patients to other health professionals as needed.

NPs are authorized to practice across the nation and have prescriptive privileges, of varying degrees, in 49 states. The most recent Health Resources and Services Administration Sample Survey report (2004) shows 141,209 Nurse Practitioners in the United States, an increase of more than 27 percent over 2000 data. The actual number of nurse practitioners in 2006 is estimated to be at least 145,000."

Thanks for reading, please write comments and check back often. I hope to post regularly.