Real World NP

It’s not unusual to be taken by surprise when you see microscopic hematuria on urine dip results. The patients who end up with this as part of their presentation are often asymptomatic, and may even be giving you a urine sample for another reason – which can make chasing down the cause even more of a mystery.   If you don’t know where to start when it comes to determining the cause of microsc...

Getting comfortable talking with patients or other healthcare professionals about disabilities can be challenging. It’s not something that is typically covered in school, and if you don’t have personal experience with the subject, you may find yourself floundering trying to find the right thing to say – or to avoid saying the wrong thing. And when you don’t feel comfortable, how can you expect you...

Awkward conversations are common in healthcare settings. Learning how to actually have these conversations (or start these conversations, or navigate these conversations)…that’s much more rare. Discussing sexual health doesn’t have to be challenging for patients or providers; with some preparation and some practice, it can become as second nature as any other discussion you have in the exam room....

You know that moment in the job interview when they ask if you have any questions? Have you ever been totally stumped? Not fun. Even worse is when you get home afterward and think of all the questions that you wish you asked.   If you are on the job hunt, or about to be, we have the questions to ask that will give you lots of information about the job and the workplace, and really help you to...

You knew some things would be different when you decided to become a Nurse Practitioner. You would need more education; you’d have a whole host of new job-related responsibilities; you would probably even have different work hours. But did you expect the job search process would also be drastically different as an NP? This week, we’ll talk about some of the differences between RN and NP job search...

In this Livestream, I share about our newest course Managing Diabetes, Hypertension & CKD over at https://www.realworldnp.com/courses . After lab interpretation, the three main topics that new NPs struggle with managing are DM, HTN & CKD-- so I decided to review the 100+ page guidelines cover to cover, do a deep dive on all the meds, cold-call specialists with my questions and report back...

How much did you learn about urology in school? If your answer was “not a whole lot,” welcome. Most Nurse Practitioner programs do not cover urology concerns in great depth, which can contribute to a real lack of clarity once you start practicing. You may double or triple your knowledge of common urology concerns today.     This week, we talk with Dr. Joseph Acquaye , who answers al...

Ever find yourself at work until all hours finishing your charting – or, even worse, taking charting home with you? Wondering how you might possibly get a handle on all of this stuff before you drown? You are most definitely not alone; time management challenges are super common (especially in primary care) for new grads, seasoned NPs, and almost everyone in a patient-facing position.   This...

Why can’t diabetes management be like we learned in school? That was complicated enough. Now you’re on your own, and there are so many questions with your patients to manage diabetes. Symptoms that don’t necessarily follow a straight line. All of the elements of managing diabetes that are beyond your control – patient’s motivation, cost of medications, how realistic a plan may be, how long until t...

Heart failure is, without a doubt, one of the more complex topics that you will encounter in primary care. Two types, four stages, four classes, evolving guidelines for treatment, and a host of medications – it’s a lot to wrap your head around. Especially in a 15-minute visit. Let’s talk about the core concepts of heart failure and increase your confidence. We’ll cover: ✅ The two types of heart f...

For patients and providers, few things are more frustrating than recurrent UTIs. This week, let’s talk about recurrent UTIs and how to get real results for your patients. Gender - and how to approach all patients in an inclusive way The difference between recurrent and relapsing UTI Evidence-based versus anecdotal risk factors Labs to order, what to look for (and how to look) Strategies for manage...

You have a patient who has been coughing for weeks, maybe even a couple of months. You’ve already ruled out COVID; where do you turn next? This week, let’s talk about chronic cough – what it is, how it differs from acute cough, when to refer the patient, and more: ✅ Common causes – things like GERD, asthma, allergies ✅ The special history questions to ask and how they will help with your differe...

What could be causing your patient’s lower limb numbness? And more importantly – how do you figure it out? This week, we’ll talk about some strategies to help narrow down the cause of your patient’s symptoms, share some clinical pearls, some assessment techniques that can point you in the right direction (FAST), and more: ✅ The most essential history questions to ask ✅ Special questions just for...

With the most recent global Monkeypox outbreak in May of this year, there’s been a lot of confusion among patients and providers about treatment options and vaccination. With about 7,000 cases in the United States as of this recording, luckily the treatment options are starting to become more available. As I mentioned in the first episode of this series, thus far the treatments and vaccines have b...

Monkeypox has been confusing and scary for a number of patients, especially on the heels of the Covid pandemic that we’re still facing. Even though we usually make videos for primary care providers, we decided to make this episode, especially for patients, to help clear up some confusion for them, as well as show clinicians an example of how we have these conversations with our patients. In this e...

**ERROR UPDATE** I mistakenly said that cotton swabs can be used but it's ONLY synthetic swabs for monkeypox testing!! Link for testing instructions here . Monkeypox has been confusing and scary for patients and providers alike, especially on the heels of the Covid pandemic that we’re still facing. The WHO named it a public health emergency and global outbreak, as has the CDC, but that doesn’t nec...

Paps. How can such a common primary care intervention cause so much confusion? How often to screen, how to understand any findings that are not black and white, how to advise your patient about next steps – you would not be the first NP to feel overwhelmed with abnormal pap results in your inbox. This week, we’ll take some of the mystery out of this challenging clinical topic, and help you underst...

Whether you are a brand-new NP or you have been practicing for a while, the AANP has likely done something that has made your job easier.  But what does the AANP actually do and how does it work? In this special one-on-one interview with Stephen Ferrara, President-elect of the AANP, we got the opportunity to ask him questions from the Real World NP community. We talked about: ✅ What AANP is...

Depression in the primary care setting – super common. With a shortage of mental health providers and increasing numbers of patients with symptoms, depression is becoming a leading primary care health concern. If you feel unsure or unprepared for these patient encounters, you are in the right place. This week, we’re taking some of the mystery out of working with patients with depression in the pri...

By the time the patient with insomnia makes it to primary care, they have probably been struggling with sleep for a while, and have probably tried some things on their own – without luck. And now they’re hoping YOU can fix it, preferably…tonight? Insomnia is a murky clinical topic; it’s not always as simple as not getting enough sleep. If you aren’t sure where to start with the patient with insomn...

Let’s be real: the first few years of practice as an NP can be TOUGH. Not only do you have this vast amount of new clinical knowledge to put into practice, you’re also learning the ins and outs of how a clinic runs (for better or worse), and adjusting to being the place where the buck stops. Is it really surprising that you are wondering if it gets better? It’s a kind of taboo topic, even though i...

Labs interpretation for new nurse practitioners can be confusing, and most new grads don't feel well-prepared by what they learned in NP school. In this podcast episode, I break it down with a SUPER interesting case study from my first year as an NP, and make the approach super simple with 3 steps, including the top do-not-miss diagnoses. Join us for the Lab Interpretation Crash Course for Nurse P...

Managing anxiety in primary care is super common, but especially now during the pandemic quarantine. In this podcast, you'll learn: ✅ When it's anxiety... and when it's not ✅ How to assess symptoms, history and the best tools to make it faster and easier ✅ The step-by-step to manage anxiety, and what to do if it's not working. There's SO much I could say about anxiety and mental health, let me...

Your friend, your aunt, your patient in your primary care office - everyone seems to be talking about migraines. But is it a headache or is it a migraine? How do you know the difference? As a new grad, it’s not unusual to feel like you have been thrown into the deep end when patients present with a migraine or a headache. It’s not a super black and white topic, and patients sometimes have a hard t...

Patients who come into primary care for a headache are often worried that it’s something very serious - and it’s your job to know whether it is or not. Many headaches are nothing overly serious, but as a new grad, it can be hard to know just how concerned to be and what to do with your concern.   Let’s build your confidence and demystify some of the grey areas of headaches. In this video, we’...