The Nurse Practitioner

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New and Noteworthy
A forum for discussion on recent news and developments in healthcare and the NP field.
Tuesday, August 16, 2016

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Michael Phelps may have made it trendy, but cupping has been around since 1550 B.C.1 First used by the Egyptians, this therapy practice uses both dry and wet cupping methods to create suction on the skin. The suction cups help with pain management, inflammation, blood flow to muscles, and overall wellbeing.1 It is no surprise why many of the Olympic athletes have taken to this Egyptian therapy by storm.

During the dry cupping therapy, a flammable substance (such as alcohol) is applied inside of the cup and set on fire. As the fire diminishes, the cup is lowered onto the skin, and the cooling air creates a vacuum. The blood vessels begin to expand as the skin rises and reddens from the vacuum's pressure. Some therapists create this vacuum with rubber pumps rather than fire.1

Wet cupping is quite similar but requires a second suction after the therapist makes slight cuts to draw out any blood. Proper creams and bandages are provided after the therapies to prevent infection. Any redness, bruising, or marks will dissipate after 10 days.1

Centuries later, this therapy continues to prove its relevance and efficacy, as more people are intrigued to try it and are satisfied with the results. Michael Phelps did win 6 Olympic medals (5 of them gold) after all. . .
 
REFERENCES
1.  WebMD. What is cupping therapy? www.webmd.com/balance/guide/cupping-therapy.​


Tuesday, August 9, 2016
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Whether or not NPs should be granted full-practice authority continues to be a controversial issue in healthcare. Despite the opposing views, one thing remains undebatable: there is a shortage of healthcare professionals. President Barack Obama and the Clintons have made it clear which side they are on.  

When President Obama first introduced the Affordable Care Act in 2010, the goal was to make care more accessible and affordable. This was put into place so that healthcare professionals who were doing “heroic work each and every day” did not have to fight against a system that worked primarily for insurance companies rather than for the American people.1 With the new healthcare plan, patients were able to be treated in a timely manner, and physicians’ responsibilities became more manageable.2 Such a change could only be achieved when NPs were able to treat patients, make diagnoses, and write prescriptions.

NPs need the ability to write prescriptions—now more than ever—considering the country’s opioid epidemic. In February, President Obama proposed a $1.1 billion fund to help end this epidemic. The proposal allowed NPs to prescribe buprenorphine to help treat opioid addiction but only in states where it was legal to do so.3 Those opposed to NP full practice worried that increasing the quantity of care would sacrifice its quality.

It has been 6 years since the Affordable Care Act was implemented, and opioid-related deaths continue to rise; however, NPs are still fighting for full-practice authority. President Obama is not the only one fighting for them. Former President Bill Clinton recently spoke at the DNC regarding NPs’ contributions to healthcare in the past and how they still play a vital role in our nation's access to care.4

Presidnet Clinton mentioned a rural health committee he asked his wife, Hillary, to chair in 1979 and how deploying trained NPs was the solution. "In 1979, just after I became governor, I asked Hillary to chair a rural health committee to help expand healthcare to isolated farm and mountain areas. They recommended to do that partly by deploying trained nurse practitioners in places with no doctors to provide primary care they were trained to provide. It was a big deal then, highly controversial and very important."4 -Bill Clinton

 
REFERENCES
1.  The White House: President Obama discusses health care at Childrens National Medical Center.  https://www.whitehouse.gov/video/President-Obama-Discusses-Health-Care-at-Childrens-National-Medical-Center.

2.  Los Angeles Daily News: Obamacare spotlights need for nurse practitioners, physician assistants.
http://www.dailynews.com/government-and-politics/20140307/obamacare-spotlights-need-for-nurse-practitioners-physician-assistants.

3.  American Associate of Nurse Practitioners: AANP applauds president Obama’s recognition of the vital role nurse practitioners play in addressing our nation’s opioid epidemic.  https://www.aanp.org/press-room/press-releases/166-press-room/2015-press-releases/1882-aanp-applauds-president-obama-s-recognition-of-the-vital-role-nurse-practitioners-play-in-addressing-our-nation-s-opioid-epidemic.

4.  Barton Associates: Former president Bill Clinton gives a shoutout to nurse practitioners. http://www.bartonassociates.com/2016/08/01/former-president-bill-clinton-gives-a-shoutout-to-nurse-practitioners/.


Thursday, August 4, 2016

 

The Zika virus is continuing to spread,and it is estimated that the number of cases could rise to 100,000 by the end of 2016.1 Just less than a month ago, the death of an elderly man was reported to be related to Zika.2 It is a virus we cannot ignore. As an NP, what can you do to help? Knowledge is power in the fight against this virus, and NPs—especially traveling nurses—need to know everything they can to educate the public.
 
In addition, NPs need to know how to help treat the virus. Travel nurses in the ICU need to be as up to date on this information as possible.3 Since some questions regarding Zika are left unanswered, it is important that NPs continue to read up on any possible advances in its treatment and/or prevention. ​
Currently, it is known that none of the cases in the U.S. have originated from a mosquito bite but rather through sexual contact. There are countries where it is imminent to practice extreme precaution by using house pesticides and skin-protectant spray. If traveling outside of the U.S., be aware of which countries have the highest risk of contracting the virus. This information can be found on the CDC’s Zika travel info​rmation page.3
 
If transmitted through sexual intercourse or a blood transfusion, the Zika virus will present with symptoms similar to that of a cold (sore or achiness, rash, low fever).1 NPs must require all patients who show these symptoms to be tested for the virus--especially if pregnant. Although little is known about the virus, it is confirmed that Zika can be transmitted in utero and can cause birth defects, such as microcephaly.
 
The CDC estimates that 80% of cases will go unreported due to insufficient testing.1 The healthcare professionals responsible for a patient’s care—NPs, critical care nurses, and traveling nurses—need to take extreme caution with all patients who exhibit symptoms, are sexually active, plan on becoming pregnant or already are, and provide the care they need.
 
 

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Watch this video​ to learn more about the virus’ origin and symptoms.4
 To stay up to date on news regarding Zika, please visit the CDC’s website.
 
REFERENCES:
 
1. American Mobile: Zika in spring 2016: The latest states for travel nurses. http://www.americanmobile.com/nursezone/travel-nursing/zika-in-spring-2016-the-latest-stats-for-travel-nurses.
 
2. CNN: Utah resident is first Zika-related death in continental U.S. http://www.cnn.com/2016/07/08/health/utah-zika-death.
 
3. Centers for Disease Control and Prevention: Zika travel information. http://wwwnc.cdc.gov/travel/page/zika-travel-information.
 

Wednesday, July 27, 2016

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NPs prioritize providing the best care for their patients. It is sometimes easy to forget that with every patient comes another responsibility—their family or loved ones. While optimizing patient treatment in a timely manner is an utmost priority, it is vital that nurses also recognize their role in communicating with families.  ​

NPs need to choose how information (such as a diagnosis) is presented, keeping discretion in mind, and having a complete understanding of the patient’s experiences, concerns, and any other pertinent issues.1 Honest, thought-out conversations will establish a patient relationship built on trust, which will ease the process of care and help guide interactions with the patient’s family. ​

The NP provides valuable information to the family to help choose important (sometimes life or death) treatment decisions. The NP also acts as a translator between caregivers and the physician. A study done on nurse-family relationships in the ICU found that universally, it is the nurse that develops the closest relationship with the patient and family.2

Balancing the patient’s best interests and what the family wants is difficult and sometimes ethically challenging. It is helpful to consult with other clinicians to form the best plan of action. New approaches and strategies in regards to decision making and communication must be implemented in the work environment. It is time to utilize this wonderful relationship that NPs have created by enhancing our communication skills.

REFERENCES
1.  National Center for Biotechnology Information: Communicating in Nursing. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990376.​

2. American Journal of Critical Care: Communicating and Connecting with Patients and their Families.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990376.​


Wednesday, July 20, 2016

In the nursing profession, time and care are dedicated to patients, but along the way, the NP's wellbeing can be forgotten. It is important to be the healthiest you can be—both mentally and physically—so that you are able to provide optimal care without sacrificing your own health. Eleanor Brownn once said that "you cannot serve from an empty vessel." 

Long hours, patient deaths, and stressful days eventually take their toll on NPs. Burnout, a term used to define complete exhaustion and lack of personal accomplishment, is also common in NPs. Although stress cannot be eliminated entirely, it can be lowered. Remember that self-care is not selfish—it is a necessity in order to be successful. Here are three simple ways to help lower stress and improve your mental and physical health.

  • Write: Whether it is in a notebook or on your iPhone, take time to write out how your day went or what has been bothering you. Sometimes, writing (or typing) out what is weighing on your mind can ease stress. It is ok to have a stressful day, but it is not ok to hold it in!
  • Exercise: With a busy schedule, this is easier said than done. However, any little bit of exercise can boost your mood with the release of endorphins. Exercise will also give you time to reflect. So go ahead, take an evening jog or a walk during your lunch break, or hike through a local park.
  • Take a break: Immerse yourself in something that gets your mind off of work. Listen to music, catch up with an old friend over a meal or the phone, or watch a movie. When you have time off, take it. Remember that it is healthy to have a life outside of work, as it allows you to be refreshed when you start a new week.​
  • Color: Coloring, whether freely or in a coloring book, has proven to be meditative and lower stress levels. Its repetitive nature eases the mind, and its connection to childhood creates feelings of happiness. Painting or creating any other form of art can help reduce stress as well.
A NP cannot carry out the appropriate treatment and care plans for patients when they are exhausted mentally or physically. It may not be practical to get 8 hours of sleep every night or exercise every day, but it is important to do at least one activity that benefits your body or mind. Find something that brings you joy or peace and works for you, whatever that may be. ​​

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Check out this website​ for a list of self-care activities. Click here for free, printable mandala coloring pages.

About the Author

Jamesetta (Jamie) A. Newland
Jamesetta (Jamie) A. Newland is a Clinical Associate Professor at New York University College of Nursing where she is the director of the Doctor of Nursing Practice (DNP) program. She is also a certified Family Nurse Practitioner in the NYU Nursing Faculty Practice. Her expertise on nurse practitioner education and practice has been sought nationally and internationally. She is the current editor-in-chief of The Nurse Practitioner: The American Journal of Primary Healthcare, the inaugural journal publication for nurse practitioners.