Real World NP

When I became a new nurse practitioner, I was so focused on learning the clinical pieces that it never occurred to me to learn more about the business of primary care. Once I was on the job, I realized how crucial it is to understand those pieces and how I fit as a clinician in the primary care office ecosystem. This is particularly relevant when it comes to scheduling patients. It seems like a mi...

As nurse practitioners, we primarily learn the clinical aspects of practice. For good reason-- we’re taking care of real patients’ lives. But there’s a whole lot more to learn on the job, from delegation and leadership, to navigating day-to-day challenges in the ecosystem of a clinic. I was SO focused on learning the clinical parts as a new NP, that I was caught by surprise at my first job. I didn...

One of the struggles for new nurse practitioners in primary care is managing women’s health topics, and knowing if and when to refer to an OBGYN specialist. We want to do things the right way and use resources we can trust. In this week’s episode, I’m interviewing Monica Carter, who is a family nurse practitioner who has practiced in the women’s health setting for the last 13 years. She dropped SO...

There’s SO much to manage as a new nurse practitioner, on top of developing your clinical knowledge, making a thousand decisions a day and becoming a leader in the healthcare space. The better your time management, the more time to get your work done and ACTUALLY rest at the end of the day. In this episode, I’m covering the rest of what we do in a day in the life as nurse practitioners-- inbox man...

So often in primary care, patients come in asking for testing for herpes, whether they have symptoms or not. Sometimes it’s because they “want to be tested for everything,” or are concerned about an exposure from a partner. As a new nurse practitioner, I wasn’t always confident about the best approach. In this week’s episode, I’m covering: ✅ When to consider HSV, and the unlikely ways it can pres...

Billing and coding clinic office visits are probably not the first thing nurse practitioners think of when they graduate. It's probably more like: Phew! I’m so so so glad that's over. What comes next?!  How am I going to find a job? I’m not going to worry about that right now because... ...I'm finally done with NP school! 👩‍⚕️🦄💪 But unfortunately, the skill set of medical billing and...

Billing and coding your office visits for for your office visits can feel overwhelming, tedious and too-hard-to-learn. But, one under-charge here and there may not seem like much, but when you add them all up... In this week's episode, though, I'm breaking it down SUPER simply (with a cheat sheet!) Plug the data in and out pops the right E&M code to use. You'll learn: ✅ How to accurately bill...

I recently got the question from a new nurse practitioner, “what do you do when you want to give up as a nurse practitioner?” I’ve definitely been there before myself, and with the stress of this last year and a half, I know a lot of other new nurse practitioners and NP students are feeling that way, too. In this week’s episode, I’m covering what to do when you feel like this, including: The most...

Patients coming into primary care with a chief complaint of hair loss can be so stressful as a new nurse practitioner. First, let’s normalize this. It’s a broad differential and can be tricky to parse out. It can also feel really stressful and emotional for your patient presenting for care, which adds even more pressure. In this week’s episode, I’m covering how to approach hair loss in primary car...

So many new grads are most worried about building their clinical knowledge base-- for good reason! But it’s one thing to prepare for clinical topics-- researching algorithms, choosing the best practice based on the evidence-- but an entirely different experience trying to apply them to the “real world.” Through Real World NP, I have the awesome privilege to work with new grad nurse practitioners o...

This has been on my heart this week - between working 1 on 1 with mentees and seeing the landscape online of new grad nurse practitioners, I see this ALL the time. Feeling like you're the only one feeling this way. Feeling behind, not knowing enough, and then beating yourself up for it. If this sounds like you, take a listen-- sometimes just naming and acknowledging what's ACTUALLY going on makes...

How did your entire visit get eaten up by getting the HPI? What are you supposed to do in a visit with the complicated patients with 17 chronic conditions? I learned many time-management lessons the hard way in my first year of practice, and they're the same patterns I see in my NP students and new grads I've worked with. In this episode you'll learn time-saving tips to help before, during and aft...

Keeping your head on straight while juggling so many moving pieces in a typical day as a nurse practitioner is TOUGH. I heavily rely on structure and routines to make sure I keep it all straight — and I don't miss anything! In this episode, I go over my routines with new patients, annual physicals, follow-up visits and sick visits, so you can stay on track and make sure you've got all the info you...

I love caring for patients with chronic conditions now, but it wasn’t always the case. Like so many new grads, I struggled with caring for patients managing chronic conditions -- where to start, how to proceed, feeling like we weren’t making any progress towards “control” of those conditions (diabetes, chronic kidney disease, hypertension, etc). When I was a new nurse practitioner, I was incredibl...

Chronic care conditions are a big part of working in primary care, but they’re also complex, time-consuming, and stressful to treat, especially for new nurse practitioners.  So this week, we’re going to do a walkthrough of how you can conduct these visits, but in a way that that feels timely, organized, and safe! In this video, I touch on the 4 most important steps to take in each chronic car...

When I was a new grad, I thought I’d never master CKD. It was so stressful because, as you probably know very well, unmanaged CKD can lead to kidney failure.  But the more I’ve learned and practiced medicine, the easier it gets. And now? I’m obsessed with CKD — it’s one of my favorite clinical topics to explore these days.  So hopefully in this week’s video, I can share some shortcuts to...

In Part 2 of our Resistant Hypertension videos, I’m looking at hyperaldosteronism, or high aldosterone levels, as a cause for treatment-resistant hypertension — and an underrecognized one at that.  So what is high aldosterone? Where does it come from? When do you check for it? What causes it? If a patient has high aldosterone, what do you do next?  Let’s dig in! Note that assessing for t...

Both pharmacists and nurse practitioners play a critical role in medication management for patients.  But we don’t always understand what we can do for one another, which can lead to confusion, frustration, and missed opportunities. Finding ways to collaborate and build professional bridges, however, can improve outcomes for everyone.  In this week’s video, I talk with Miriam Ahmed, a ph...

Resistant hypertension is a common chief complaint in primary care clinics. But for new nurse practitioners, there’s a lot to sort through.  In this video, I walk through the thought processes and approaches to managing resistant hypertension in primary care.  ✅ How to talk about medication adherence with patients ✅ The role of ongoing blood pressure checks — both in clinic and at home...

Dizziness alone accounts for about 5% of all primary care office visits in the US.  5%! That's a huge number.  But as a chief complaint, dizziness is somewhat nebulous. The causes of dizziness can run the gamut from annoying-but-benign to yikes-let's-get-you-to-the-ER. So how do you sift through all the possibilities and uncover what’s really going on with your patient?  In Diagnost...

Back pain — it’s truly one of the most common issues you come across in primary care. That’s why you need to have your diagnostic approach to it down pat as a nurse practitioner.  And the sooner you get comfortable diagnosing back pain in primary care, the sooner you’ll feel confident helping your patients on their road to recovery.  In this week’s episode, we talk about why you should r...

It’s super common for new NPs — and experienced ones — to get anxious when encountering orthopedic complaints.  It’s a conundrum — on one hand, it seems like it should be simple. After all, you can feel all the musculoskeletal body structures right there.  But at the same time, there are so many (SO MANY!) nuances to each body part. And there’s a lot of ortho lingo to wrap your head arou...

Do you ever find yourself spending an ENTIRE 20-minute visit just getting a history? And even with all that time, do you still leave the room feeling like you didn't even get the info you needed? In this episode, I'm sharing my top tips for not only a FASTER history, but also a more accurate one — so you can take great care of your patients while saving time and, quite honestly, health care dollar...

Seeing "lower leg swelling" as the chief complaint for patients as a new nurse practitioner was incredibly stressful. What’s the best course of action? Should you give diuretics for symptom control? Is this something serious...or something totally ordinary? I had a super interesting case the other week and knew immediately that I had to share it with you — and it was one that I actually got a doub...

Urine microalbumin: you need to check it once a year for patients with diabetes. But interpreting the results — and knowing what to do with them! — can be tricky.  In this episode, you’ll learn: When to order urine microalbumin labs How to interpret the results and what to do with them How to treat abnormal levels 4 steps to elevated microalbumin management Read the blog post here. Need more...