Wednesday, July 30, 2014

Attitude is 90%

The human body is amazing in how it works. As healthcare practitioners we can tell you the anatomy and physiology of how it works. But if you do not have the right attitude you will never reach your potential. Also I believe without the right attitude you will hinder your mental and physical health. 

Friday, July 25, 2014

Mayo Clinic and Rochester

Rochester's population is about 110,000 people and growing quickly.
The two largest employers are the Mayo Clinic with about 36,000 employees and IBM. A lot of downtown is made up of Mayo buildings and businesses that support Mayo or rely on the visitors Mayo brings to town.
Looks and feels like a bigger city than the population 

Tuesday, July 22, 2014

Mayo Clinic

Mayo Brothers 

Visiting Rochester and the Mayo Clinic, and it becomes obvious that the Mayo Clinic is a huge and almost immeasurable part of the community. I do mean this in a good way. In the same way Disney World transformed the Orlando area from a swamp in the 1970's to a vacation tourist destination today, the Mayo Clinic is transforming Rochester into a world class Medical Destination.

Friday, July 4, 2014

New Grad RN and NPs jobs. . Spread Your Wings

I have to take my own advice. For years I have worked with student nurses and the one question they ask more than anything else is not about patient care,  it is about jobs after graduation. My advice to new grad RN's has always been to be flexible, and go anywhere to get experience. As a new RN I moved 1500 miles to get my first job, and afterwards with that experience on my resume jobs came easy. True some people can't move because of family, but others won't move because they are afraid to leave the security of their community. The economy changed things and over the last 5-years it became tougher for new RNs to find work, and even more so in areas like San Francisco and Boston where nurse are paid extremely well. My advice is even more relevant now and I still tell student nurses to leave home and go spread their wings to get some experience. Besides traveling to another city for a job interview is exciting and it also shows them you are committed. Then after a year or two, when you think you know what you are doing, you can go ahead and apply to work closer to home. Moving away is what 99% of medical students have to do for their residency experience.

I do understand not wanting to move, I liked calling the SF bay area home for the last five years. After becoming board certified six months ago my plan was to continue working on-call as an RN, while started to apply for local NP jobs. However, most of the jobs near me were in pain clinics or one of those retail store clinics, and that was not for me. I want to keep learning and preferably in a teaching hospital or specialty setting. The current hospital I work at is not NP friendly (NPs know these places) and other jobs near me were being filled with those who had experience and connections. 

 It was time to spread my wings and apply only to places I wanted to work, and in specialties like orthopedics and sports medicine, because I like the musculoskeletal specialties. Getting hired as an NP is a long process of interviews and credentialing, but after all the paperwork I got the job I wanted, in the specialty I wanted. So NPs & RNs spread your wings and do not settle in your little corner of the world looking for a job you may not want. Beyond my expectation I now leave the bay area to start a new job at the Mayo Clinic. 

“Travel is fatal to prejudice, bigotry, and narrow-mindedness, and many of our people need it sorely on these accounts. Broad, wholesome, charitable views of men and things cannot be acquired by vegetating in one little corner of the earth all one's lifetime.” - Mark Twain

Tuesday, June 3, 2014

Life Has Many Paths

Mt. Diablo Trail

The path can be easy or challenging, but staying in your comfort zone often leads you nowhere.

Getting an NP job as a new grad was challenging. It felt like being a new grad RN again except with more intense panel interviews. Over the years working with student nurses I have told them they may need to move to get a job and experience. Well now it is my turn, and the hard part will be moving. I have lived in this place for 5-years and really like it, but the job and experience I want is too far away. The San Francisco bay area is a great place that pays well, and that means NPs and RNs with experience come from around the country to work here. Someday I will be that experienced NP taking away a job from a new grad. Not because it was planned, but because I was on that path. 

Sunday, May 18, 2014

Yeah Minnesota

 Courtesy of

 Right after Connecticut Minnesota voted and now makes 19 States and the District of Columbia that have become full practice states for NPs. 

Saturday, May 3, 2014

NP Independence expands again.

Eighteen States and the District of Columbia now allow NPs to practice independently. Connecticut being the most recent. As four decades of outcome research in primary care has shown, NPs provide safe, high-quality care. These are not straight out of school NPs practicing independently. Depending on the State it can only happen after gaining 2-4 years (approx 4200-8300 hours) of experience working in collaboration with a physician. Yes, there will be a few NPs able to become independent right away, but most will stay working in their current positions and with physicians.

The West seems to be more progressive in this matter, but the East will catch up. It's a tough fight with the National and State chapters of the AMA, a few think only doctors are qualified to diagnosis and treat patients. California tried to pass an NP bill last year, but the California Medical Association spent a lot of money and it failed. It usually takes a few tries to pass these types of things.

But what's happening in the South and not one State. I worked in Florida as an RN, and understand the good old boys club (FMA), with their large membership of retired and semi-retired doctors not wanting to give an inch to NP independence. But as for the rest of the south, this is the stroke belt and a recognized area of health problems, in addition to a shortage of primary care practitioners. NPs need to get together and organize because patients need you, but expect a smear campaign from your state medical association    

Friday, May 2, 2014

Time to Relax

Instead of stopping posts on this blog, it will now have to be my generic happy nurse practitioner blog.  This after finding it impossible to remain anonymous using Blogger which is a Google product. Because I also use and have accounts with other Google products like; Gmail, Picasa album, Google Docs, Google Drive, Google Maps, Android OS & apps, Google +, Chromecast, YouTube, Google Scholar and Google Music.  In addition, there is not much to complain about in life now that two big stresses have come to an end.