Independence Day Top 10 for NPs

I’ve been seeing a lot of top 10 lists on this Fourth of July from multiple social media sites.  So, I decided to make a top 10 list for my nurse practitioner colleagues. As you know, primarycareknowledge.com is the free website dedicated to the learning needs of primary care providers. So, I’m gearing this towards my novice nurse practitioner colleagues.  I hope you enjoy reading this.

10) Never forget your nursing roots. Each one of us practiced nursing before we practiced medicine.  While our physician colleagues practice the science of medicine, nurse practitioners practice the science of people. Always keep your care holistic.

9) Never stop listening. Some of the most important information you’ll get from a patient occurs while your hand is on the door knob. Never shut yourself out from the patient and remember that the visit never really ends. We care for our patients along an open continuum.  We care for our patients along a whole lifespan (or until they change practices…just sayin’).

8) Never forget that YOU are a person too. You have needs. You have family.  Never let your career impede your marriages, your family, your friends, or that joy you get from watching your favorite show.

7) Never stop learning.  Healthcare is an industry that changes and advances at the speed of sound. Attend conferences, learn from your colleagues, take the time to talk to pharmaceutical reps, and read those free journals you find in your mailbox. The more you know, the better you will be able to treat your patients.

6) Always be willing to teach.  Preceptors are the most important tool in shaping the future nurse practitioner.  When you were a novice, you hoped that those more senior to you would show you the ropes. When you get to that point, you need to remember that someone took the time and effort to teach you too. Being “too busy” is a cop out.

5) Be yourself.  You don’t have to follow a script or pretend you’re someone you’re not. Use the personality that has warmed you up to your friends and family to gain the trust of your patients.  Sure, not everyone will like you for this but those who do will be loyal to you. You don’t have to be a stuffed shirt.

4) Don’t work through your lunch.  At least, don’t make it a habit.  You need time to unwind and you need time to relax. If you find yourself working through your lunch, speak to whomever makes the decisions in your practice to give you more administrative time. Hey, I admit, I probably work through a lot of my lunches but do as I say not as I do.

3) As one of my mentors told me “Look, look, and look again.” When something doesn’t make sense, its for a reason.  When something doesn’t fit, there’s an answer for that. Even those patients who we see as hypochondriacs have reasons for feeling the way they do. Take the time to take a second look at those cases that don’t fit the bell curve.

2) Don’t be afraid to have “the talk.”  Death and dying are commonalities in primary care yet many of us don’t like to tell patients they’re dying.  Its the age old question of quality of life vs quantity of life. Hospice and “care and comfort” are viable options for terminally ill patients and a great “treatment” for patients who are suffering with terminal illness.  Those patients who are suffering fighting that impossible fight sometimes just need to be told that its ok to give up.

and finally,

1) Never stop fighting for autonomous practice.  Nurse practitioners deliver quality, cost effective care.  Research has always shown that our care is just as good as that of our physician colleagues. Get out there, take part in the struggle, talk to your congressional reps, and never stop fighting for that ultimate right. You don’t have time? You don’t want to practice autonomously?  Remember, when we’re long retired and gone, those who come after us will want what we fought for. Let’s make their struggle easier. Let’s leave them with our legacy: quality, cost-effective, and autonomous practice across the board without restrictions for all nurse practitioners.

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