THE NERVEWRACKING NURSE PRACTITIONER

Weight Loss with HCG - How it Works

2009-11-23T06:52:00.001-05:00

5 "Time-Saving" References for Healthcare Providers and Business Owners

2009-05-04T13:07:00.004-04:00

You will DEFINITELY want to "bookmark" these if you have ever wondered about Grants, Demographics, Business Licenses, or Malpractice Laws and Nurse Practitioner Legislation by State!

These are a few resources I thought I would share with you to save you a LOT of time! This is especially great for Healthcare business owners, Nurses, Nurse Practitioners,....
but if you are ANY type of business owner or someone thinking of starting any type of business you will be happy to have this on-hand for later reference.

Summary of Medical Malpractice Law -Index of Malpractice Laws by State. Great Resource to have for Nurse Practitioners and healthcare providers when you have questions regarding laws, practice issues, and comparing differences from state to state.
The 2009 Pearson Report -The most recent annual report on Nurse Practitioner laws as published in AJNP. This is a detailed national state-by-state overview of legislation and healthcare issues affecting Nurse Practitioners. Everyone involved in delivering healthcare should be familiar with this report.
Demographic Resources for Conducting a Market Analysis-Anyone considering opening a business, or for those who are just curious about demographics or doing a research study, this is a comprehensive resource list with numerous choices to provide you with more than enough information. It contains census data, consumer trends in buying and marketing, survey results, and statistical data on income and housing with maps and reports. If you want to find out the age, income, marital status, social and economic status, race, or gender of any area in the nation then you will find it in this list of resources.
National Institute of Health's Guide to Grants and Contracts- If you are looking for a grant, government contract, or funding opportunity you will likely find it here! This is a very informative website that includes applications, deadlines, and FAQ's on obtaining a grant. Good one to bookmark in case you ever need it!
Business Licenses and Permits- Whether you are a healthcare provider, purchasing a franchise, or opening a neighborhood deli ..THIS is your starting place! You will definitely want to save this website just in case you ever need it! It will save you several hours and even days of searching for pieces of information! It is an interactive site allowing you to type in your State, County, and City. Once you enter this information it will pull up everything you need to start and operate a business in the designated area. It will walk you through naming a business, incorporating or choosing a legal entity, and even tell you what type of business licenses you will need along with the contact information to obtain it! MUCH better than searching for all of this one at a time.

I hope you find this useful. I certainly have! Please let me know if you have any similar resources to add to this list.

Jennifer Butler,FNP

15 "Must-Have" Resources for Healthcare Providers and Consumers

2009-04-25T12:54:00.012-04:00

Do you ever get tired of not knowing where to look to find clinical information you need?

Tired of trying to find your way through google searches and stacks of reference books??

There are so many clinical and medical resources available online for Nurse Practitioners, Physician Assistants, Physicians, Nurses, Patients,..it can be overwhelming. If you are like me, I love when friends and associates share a resource that I will ACTUALLY USE ! Especially one that I can also tell patients to use in a clinical setting to show them examples or pictures of a health problem.

This is a small list of some of the websites and resources I use commonly and have really found valuable in saving time. I know there are many I have left out, but again, I didn't want to overwhelm you with too many to search through.

If you are a healthcare provider or someone who enjoys looking up their own medical information, you will definitely find several resources here that you will find extremely helpful. Please leave any comments or suggestions if you have a source you use regularly for clinical information that you think should be added.

visualdxhealth.com This is one of my favorite sites, it has visual pictures and graphics for searching and viewing skin problems, diseases, and anatomy. You can search by location, disease, age..is a very useful and interactive tool that is great both for healthcare providers and patients. Visual diagnosis health is a FREE resource (and also have widgets you can put on your site, blog or desktop!).
icyou.com VERY COOL! healthcare videos on-demand, great for patients and healthcare providers. FIND any health-oriented video you seek from hundreds of certified medical and health professionals, as well as regular people dealing with the same issues you are.
eatright.org The American dietetic association.The ADA Nutrition Care Manual is a valuable resource providing disease-specific information and evaluation, printable client handouts, calculators that compute BMI/weight range, customization tools and much more.
healthlinks.net A Worldwide Useful Resource for Healthcare Consumers, Healthcare Providers, and Professionals PROVIDING LINKS to health Services and Products, Alternative Health, Education, Dental and Medical Resources, Hospitals, Employment, Healthcare Publications, Mental Health and Much More! This FREE resource site is to find LINKS for anything you may possibly need.. much easier than doing a web-engine search! It offers a FREE link source for your site and is also a wonderful place to advertise with very cheap ad rates and options. It optimizes ad placements on related sections of the site so OTHERS CAN LINK TO YOU easily or make YOUR search easier if YOU ARE LOOKING for any services or products. Their Directory includes a clinical resource library, forums for discussions, clinical trials, healthcare job placement links for NP's, PA's, RN's, MD's, and many other allied health professionals. Healthlinks offers links and resources also for business owners and entrepreneurs such as logo services, marketing, advertising, and branding for your specialty or business. Very useful to have as a bookmarked favorite! You will certainly find this helpful and time-saving as a resource if you navigate through the site..and its FREE to use!
uptodate.com UpToDate is an evidence based, peer reviewed medical information and clinical resource site. It is available via the Web, desktop computer, and also has an optional medical mobility software component for PDA and smartphones. It is valuable to help find answers quickly, increase clinical knowledge, and improve patient care. You can use it as a FREE resource, or pay a yearly fee to get more detailed medical information to use as a reference source on your PDA in a clinical practice setting. I love this software and am debating paying the fee for the more extensive database to use on my PDA. I am currently using epocrates, which is detailed below, and have been very pleased with epocrates medical mobility software. I would love feedback from you or anyone you know who has had experience with both epocrates and uptodate for PDA clinical practice use. I cannot provide a personal experience to compare the software as far as one versus the other,but hoping someone will provide their experiences to share. If I receive any feedback on this comparison I will post the information.
National Center for Complimentary and Alternative Medicine Provides Research-based information on various treatments and conditions. Compares recent studies on complimentary and alternative medicine (CAM) including acupuncture and herbs and relating it to clinical practice. You can use the site as a FREE source, or join for a membership for a yearly fee if you choose. So far I have not needed to join this site. You can find a lot of what you are searching for without paying a fee, but it depends on your specialty and interests. I find most of the medical information and research I need through another paid membership at consumerlab.com, detailed in the list below.
health.com You will love this one! I use this daily! Great information for patients and all healthcare providers. Offers you a search option within the site for any disease or problem and most recent topics. You will see a section where they list "the most emailed" , "the most popular",etc. You may find that it helps you to understand what the general public is searching for so you can be aware and have your answers ready for them! If you are involved in social networking sites such as facebook or twitter, you may also find many topics interesting enough to want to "share" the link with your friends or followers. I have found this to be a great marketing tool, as well as educational for both myself as a NP and healthcare consumers. It even has list of all the fad diets and an interactive comparison tool, individualized meal plans, quiz's, how to help back pain, fibromyalgia videos, links..full of useful resources and tools. This is a FREE resource. However, if they charged a membership fee...I would definitely pay it!
consumerlab.com Another favorite! If you have patients coming in with handfuls of vitamins and herbs..here is where you can find the REAL STORY, or the "quality vs.crap" products to know what to recommend safely to avoid getting your butt sued off!. You know that Vitamins, herbs, and other supplements are not regularly tested by any government organization. This reputable company is continuously evaluating nutritional supplements ,vitamins,and various drugs in a laboratory environment. FINALLY..a clinical resource to easily search by brand, ingredients, company, or even disease process!You can actually find out WHICH brand and product is ranked best, what methods are used to test the products, and what is REALLY in a product versus what the label claims. Consumerlab.com contains many articles, recent research findings, warnings and recalls. Some of the data is shocking! You have an option of joining FREE or can join for a small yearly fee to get more research data. I joined for around $30 for 1 year subscription, and has been worth every penny so far!
epocrates.com Cannot be beat!(I don't think anyway) I have loved this software since Day ONE! I started out with the FREE epocrates RX for my desktop and PDA, and have since upgraded several times. I found that having so much on my PDA in one program would save me and my patients so much time. I now have the essentials deluxe and love it because of the ICD AND CPT codes. The drug formulary search by insurance plan is the best resource I have found for pulling up a patient's specific insurance formulary and knowing what to prescribe, avoiding pharmacy callbacks, saving me time, and saving the patient a lot of money. You get a lot of happy patients when you save them money and show you care enough to be concerned about their ability to afford their medications and treatments. The add-ons available are mostly free and include mobile continuing medical education (CME), BMI, calculators and conversions for medications, IV rates, INR's; screening tools including ADA, DSM-IV, ATP III, CHD risk, lab values, clinical recommended guidelines, clinical updates, medical and peer-approved research, and even compensated clinical market research if you qualify. The newest application software add-on that i find amazing is "epocrates patient snapshot" which integrates with Google Health. The Healthcare Provider is able to monitor self-reported health information by a patient who enters their medical history on Google Health. The patient can enter current blood sugars, blood pressures, weights, or anything pertinent to their condition. I have not had experience with this yet, but if it works as stated it is a brilliant concept for both healthcare consumers and healthcare providers to promote communication and disease stability. Until recently, epocrates had many glitches with blackberry mobile devices. Now this has finally been corrected and blackberry mobile devices can be used just as easily as Windows or Palm devices. Prices range based on the various program software that you choose. Some are FREE including most of the add-ons. The upgraded subscription programs range from $60-$199 for 1 year, or $89-$299 for 2 years. You may want to try the FREE versions and add-ons first and get used to the programs. It takes a while to download and decide which version of medical mobility software you are going to stick with, and then get adjusted to it. You wouldn't want a couple of months worth of a paid subscription to be wasted during your "learning curve". Call the support desk prior to paying for anything and make sure your mobile device is compatible, and check for specials. I receive coupons and newsletter emails for savings codes quite often now and didn't realize this at the time. Hope this helps you if you are considering these programs.
American Medical News I recently found this a few weeks ago, and have used it more than I realized at the time. It is a NEWS source for anything medical related. You can find the latest breaking stories, follow-ups on older issues, government related medical information, healthcare trends for the USA, political discussions about healthcare problems and universal healthcare proposal updates. It includes headlines for comprehensive articles on recent clinical findings and stories, practice management guidelines and tips, medicare information and supplement plans, practice pearls, EMR, new updated vaccination guidelines, recent epidemics, and a section specific for the uninsured and professional liability insurance. You will find this a valuable resource if you keep up with recent medical news and healthcare issues. You may not use msnbc, reuters, or Time online as often if you are using any of these now. Amednews.com is a good source to find medical and health information quickly and easily all in one source without scrolling through numerous other topics to find what you are looking for. American Medical News is a FREE resource.
emedicine.com I have not used this site as much as the others, but it has a LOT of great information if you are looking for something you have been unable to find in other resources. For example, you can search by medical specialty and find how to perform a certain procedure. If you have a patient questioning you about details of a surgery, you can find detailed information on that particular surgery to review with the patient. You may find the joint injections interesting, which is listed under " clinical procedures" . It offers information on the newest technology and medical information, as well as current research findings and clinical resources for you and/or your patients. MEDSCAPE and medscapeCME are also in different sections of this site. It offers a very large database to choose from to obtain CME's, discussion forums, and a large resource directory for just about any medical topic you can imagine. You may use this website already or more often than I do. I prefer the other sites I have listed, just a personal preference though, as they are easier to navigate and quicker to find exactly what I am searching for. This is a wonderful resource, but may be a little too large and overwhelming for some. It is FREE, at least for the services I have used it for thus far. I would appreciate your opinions on this if you are a frequent user of medline, medscape, medscapeCME, or emedicine.
advanceweb.com I have enjoyed this and found it very useful. They have a FREE journal they will send you via regular mail, and/or online email, newsletters with great information and updates. This, when used as a Nurse Practitioner resource, provides practical clinical articles, current medical research, healthcare trends, modern technology in medicine, professional news and both private practice and career guidance for numerous specialties. Advanceweb stays current with healthcare changes and shares useful information. They provide help for a Nurse Practitioner to "stay current" with changing times. Currently, there is an article on the NP homepage which offers tips for social media specifically for nurse practitioners, as well as various columns and discussions on various topics relating to NP's. If you click the direct link from the bullet in the beginning of this paragraph in this section, it will lead you directly to the page on advanceweb for nurse practitioners. However, if you type in the url or go to the homepage for advanceweb.com, it also offers specific sections for any healthcare entity or provider such as therapists, CNA's, PA's, RN's,etc. The home page allows you to choose your specialty and the info you receive is based on what you choose. This is a great FREE resource for anyone involved in healthcare either as a provider or a consumer.
epill.com You probably will have someone in mind when you look at this site! I had several and wish I had found this earlier, or been the one who invented this! This is a resource for devices that remind you to take your medicine. It offers proven practical solutions for better patient compliance both for patients and peace of mind for caregivers. A few examples of these medicine reminders: pill dispenser, multi-alarm, pill timer, compliance statistics, vitamins, Rx, pills, elder-care, watches, pill organizer, Casio,.. the list goes on and on. You may want to download their catalog in pdf format for later use. I have had several caregivers who have loved these resources. They offer a money-back guarantee on the pill reminders too, so nothing to lose if the patient doesn't like what they order. You may not use it much, or may use it more than you realize. They offer discounts for ordering multiple items. If you have many patients interested, you could order these for them at a cheaper price to save them a few dollars, or either keep these in your office to resell as a 2nd income for yourself. Either way, it is good to know this exists.
preventdisease.com You may find the "health tools" section on this site a good reference source. It provides a lot of calculations in one place that patients ask about frequently such as BMI, BMR, Target Weight, Body Composition for kids vs.adults, and women vs. men. Also, this section provides blood pressure assessments, blood alcohol estimator, calories burned calculators, calorie and nutrient calculator, conception calculator, disease risk, exercise information, ideal body weight and mass, and even a musculoskeletal atlas. Patients really enjoy looking at this and seeing their scores. You may find yourself referring patients to the website much more than you use it yourself. It offers a membership, however I have never needed to join to get resources. I have been able to find plenty of information without going through the membership section. Patients can choose to join if they wish for more information. For healthcare providers, the membership is not that necessary.
drugdigest.com DrugDigest is a noncommercial, evidence-based, consumer health and drug information site dedicated to empowering consumers to make informed choices about drugs and treatment options. A drug library is included, along with several interactive tools for patients to keep a list of current medications, drug interaction checkers, safety tips, and drug comparisons. I have found this to be a very good resource, especially for elderly patients, to get information they need and keep up with their medications.

I hope you will find some of these clinical resources very useful whether you are a healthcare provider or a healthcare consumer. There are many more resources available, these are just a few of the ones I have found to be beneficial to me as a Nurse Practitioner and to my patients.

Anything that saves you time is a valuable resource, I hope you will also share any that you have found.

Check back often and I will try to provide you with more valuable information and resources. You may choose to subscribe to the RSS feed so you will be notified in the future when new posts are published. Please share this with others that may find it helpful.

Until next time... Jennifer Butler, FNP

Social Networking for Nurse Practitioners

2009-04-09T15:11:00.008-04:00

Do I need to worry about social networking as a Nurse Practitioner?
The Answer is YES!!!
Social media,social networking, online marketing for small business, SEO, keywords, blogs, websites, links, ... If you dont know these terms in today's business world you better get busy!

I wondered this myself, but i finally jumped onboard the social networking boat a few weeks ago and it is amazing all the places it has taken me! Now I "see the light" and as a Nurse Practitioner opening a private practice I have learned more from the resources I have discovered through social networking in a 2 week period than I have by other traditional methods over the past 6 months!
Its all about making connections!
The best part is...I have made friends, business associates, and through one or two resources it led me to many more. Now I have compiled a huge list of resources from anything to business to clinical issues, and have people to go to find out just about anything I want to know.

Through Facebook, twitter, and LinkedIn I was able to re-connect with old friends, schoolmates, and find so many more people from nurse practitioners and other healthcare professionals to bankers, authors, and even an actual honest car salesman who helped me via IM chat to fix my trunk that i couldnt get to open.
The point is, these few networking sites gave me a world of resources and led me to other sites in which i was able to talk with other nurses and nurse practitioners and offer them help with their issues and also get advice for myself. I feel like this has opened a new door full of possibilities, and is great knowing if I need help then I have all the resources i need to get it at my fingertips.
I am very involved with political issues surrounding healthcare, laws, and keeping up with the latest technology in medicine. I now have met others across the USA who have similar interests and am able to keep up with everything easier through reading their blogs or participating in the organizations that link us together.

One of the resources I found which linked me to many nurse and nurse practitioner groups and forums is
www.nursingschoolsearch.com/blog/2008/07/50-social-media-and-networking-sites-for-the-medically-minded/

Here is an example of one of the lists they provided of resources for nurses. They also have lists for nursing students and other lists of resources based on categories. But this was the one I liked and I joined almost all of them and was able to get some great connections,friends, and resources from both nurses and nurse practitioners.

NurseGroups.com: Get a free membership with this site for social networking, professional networking and blogging.
NurseLinkUp: As "The Nurse Social Network," this community features news stories and studies as well as a place for nurses to connect online.
Nurse Connect: This website includes nursing forums, blogs, news stories, job posts, information about nurse education and more.
International Council of Nurses: Connect with nurses around the world through this network, which has been around for over 100 years.
TravelNursingBlogs: Read blog posts or start your own blog on this site to share stories and learn about travel nursing.
Nurse’s Cafe: Nurse’s Cafe is a social networking site that’s still in beta form. Use the site to link up with other medical professionals in your area or specialty, or who share similar interests and hobbies.
Nurse.com: Here, nurses can connect over blogs, photos, forums, and job postings.
National Association of Hispanic Nurses: Learn about conferences, scholarships, awards and networking for hispanic nurses on this official site.
NursingDiscussions.com: Read articles, learn about education opportunities, check out nursing blogs and visit the forum on this site for nurses.
MyNurseBook: Nurses around the world interested in recruiting nurses and bettering public health policies network on this site.

Another resource i frequently use is www.npcentral.com, it provides a directory list of all nurses and nurse practitioners that add their name and practice information to the directory.

This is just a sample of the resources I have discovered over the past week. If anyone joines of these, find me on there and add me as a "friend" , would love to connect with people on the sites and join in on the discussions. As i have said before, we have a much more powerful voice when we work together and help each other. This has helped me, and i hope by me sharing it will also help you.

I would love to hear any comments or feedback from anyone on these resources. If you have any others you have found to be beneficial, please let me know . I am working on a resource list for nurses and nurse practitioners to use to help them both clinically and professionally that i will add to the site at some point.
I have found numerous blogs that i love to read and will be adding those also in blogroller, so keep watching and it will be on here soon and i will continue to add to it as i find more.

So get to working on your social networking, it is well worth spending the time to get started with it when you compare the time it saves you in the future in hunting for help or resources .

Feel free to use the green icon below each post which will expand into a "share this" option so you can send it to others that may find it useful or post to your online profiles. It is nice to have so many resources in one place. You can also subscribe to the RSS feed on here and it will send you information when i update the resources or add more things you may find helpful.

Let me know what u think!

What is a Nurse Practitioner anyway??

2009-03-27T14:28:00.013-04:00

"WHAT IS A NURSE PRACTITIONER?"

You know the saying.."If i had a dollar for every time...??" I honestly can say I would be on the Top 100 list for wealthy people if I DID get a dollar for every time someone asked me the definition of a nurse practitioner. The most common questions are... "When are you going to finish to be a doctor?", "Why didn't you just go on to be a doctor?","Are you a practicin' nurse?", and "Whats the difference between you and a doctor?". After I my last post, I found a short video that describes exactly WHAT a Nurse Practitioner is and can do. I was so happy to find this!

This is a short video of a National Medical Report that i found through my favorite Nurse Practitioner organization, Nurse Practitioner Business Owner , my "go-to" place to find almost everything a NP could possibly need. This video was produced by the American Academy of Nurse Practitioners which is a national certification agency. I found it very knowledgeable and accurate in answering all of the questions about NPs. I wanted to share it with everyone.

I highly recommend any other Nurse Practitioners to download this video and share it with others. For Nurse Practitioners with private practices, it would be a great video to show new patients while they wait to answer their questions about our role in health care.Some of the issues I discussed in my previous post are also discussed in the video, so I am glad to see others thinking the same way enough to provide a video on these topics.

I would appreciate any comments on the comments tab on the bottom of the page if this was a useful video for you, or any further questions I will be happy to answer your comments.

And if you are a NP who has not joined Nurse Practitioner Business Owner yet, I highly recommend it in saving you a lot of time and energy searching for information across the web on your own. You do not have to become a member to get valuable information, there is a member and non-members section. Both are excellent for resources of any kind.

Click on play to begin video...enjoy!

The Beginning of the Domino Cycle..Can YOU Answer the Question??

2009-03-24T05:22:00.004-04:00

CAN ANYONE ANSWER THIS QUESTION?... I can't.

Every day there are politicians in the news and giving interviews discussing the serious problems of this country's health care system. For myself, and many other health care providers,we have a big RED FLAG we are waving full of answers that is being ignored.

Nurse Practitioners have a purpose in the health care system. We offer a valuable service to fill a large niche' that is in high demand. If you plug these variables into any business plan it would be easy to see as a successful venture. If there is high demand for a service, and someone available to supply this service, then why is a potential "win-win" solution being ignored??
.... WHAT IS THE REAL PROBLEM??

In the 1960s, Nurse Practitioners(NPs) began providing primary health care due to a physician shortage. They filled in the gaps, giving people in all areas access to medical care. NPs are trained to provide quality health care independently and without supervision. Numerous studies have proven that the quality of patient care and satisfaction of care received by a NP meets or exceeds that of a physician.

Due to the current shortage of physicians, especially in rural areas, many people do not have access to health care and medical treatment. Also, some areas have a local physician yet he/she is not accepting new patients. It is not uncommon for people who do have an appointment with their physician to have to wait several hours to receive treatment. When they are finally able to be seen by their doctor, they are given a 5 minute consultation and exam, a prescription to "fix" their immediate illness, and are sent home. The doctor isn't able to do more, as there could be 40 more people in the waiting room that he/she is expected to see. So,...what happens? ...

..... THE DOMINO CYCLE BEGINS........

People only go to the doctor's office when they are sick...
There is more sickness and chronic disease due to lack of screening tests, check-ups, and teaching about wellness..
Increased inpatient and E.R. visits, costly for everyone...
Nurse Shortage in hospitals leads to poor patient-care and re-admissions...
Insurances are not paying hospitals enough to hire more nurses...
Patients pay higher insurance premiums,cannot afford medications.
Lack of care and medications leads back to more hospital admissions...
Family Practice physicians are overworked, and not getting adequate insurance payments..
. Patients without insurance cannot afford to pay doctor bills
Physician salaries are lower,many practices closing in rural areas...
Very few medical school students are choosing family practice due to low salaries. Vast majority are choosing specialties to avoid hassles..

So where does this lead? ???

The general population is sicker,......
receiving inadequate health care,.......
and cannot afford it if they try.

Doctors cannot afford to pay their increasing overhead costs while payments from insurance companies are rapidly decreasing. More patients are required to be seen per day to break even.Prices cannot be raised due to insurance contracts yet expenses rise due to malpractice, supplies, and taxes.

Health Insurances are going broke due to high hospital visit claims and paying for costly prescriptions for the their insured. Therefore, benefits are cut, payment to doctors and hospitals are less, services are limited, and premiums increase.

People avoid going to the doctor if they do have access because of cost resulting in more acute illnesses and less stability of chronic diseases.

DOMINOES, MORE DOMINOES..

WHAT WILL IT TAKE to get the politicians at both federal and state levels to realize this crisis?

WHAT WILL IT TAKE to get them to see that Nurse Practitioners are available and highly competent to fill this need?

NPs are educated professionals who focus on prevention, wellness, and treating the patient as a whole. Nurse Practitioners care for each individual, consider their support systems, environment, ethnicity, beliefs, and social-economic status.

There is NO "one size fits all" in health care.

Quality care equals individualized care, teaching, and LISTENING. PERIOD.

If Nurse Practitioners are to fill in the gaps where there is a lack of physicians available to provide adequate health care. ...

WHY DOES A NURSE PRACTITIONER HAVE TO HAVE A "COLLABORATING PHYSICIAN AGREEMENT" IN ORDER TO PRACTICE??

If there WERE ENOUGH physicians, then other health care providers would not be necessary.

So, as a Nurse Practitioner, what should we do to get this point across?

We cannot provide care that is needed, and wanted, without a physician. Yet there are no physicians in the areas that need this care... ?

ARE WE SUPPOSED TO GIVE UP AND LEAVE THE UNDER SERVED RURAL AREAS TOO?? Sadly, this is already starting to happen.

My "David vs. Goliath" battle... and purpose for this blog...
As a Family Nurse Practitioner in a small southern town, I am facing many of these political battles. I have worked in the same town for over over 15 years and have many patients I truly care about. The physician I was previously employed with has retired. My choices were to open my own private practice, or move out of town. I do not know another NP personally who has fought the battle of opening their own practice, ..and won.

I don't want to move. I want to see my same patients I have seen for many years, and they want to see me as well. Yet due to politics and power struggles, this concept is proving itself near-impossible due to state laws. I have been working on opening a family practice since November,...day in ....and day out. I have neglected my family, friends and have become almost obsessed with accomplishing this goal. It is not fair to them, or to me, or to my patients who don't understand how difficult this is and has been.

I tell myself...I cant let my patients down. I cant let my family down and make them move away. I cant let myself down and give up. But most days lately have been an emotional struggle in not knowing what to do next. I keep thinking "this too shall pass", and that someone has to be the one to fight, survive, and conquer this storm of power and political repression... so why shouldn't it be me? I have accomplished all the other goals in my life that i have been determined (aka: stubborn) enough to be able to achieve, so this shouldn't be any different. But,.. it is. I cant change the laws myself.

I am immersed in a "David vs Goliath" battle. There are a few other physicians in the surrounding counties, but most of them do not want to see a NP have a private practice. They know I am clinically competent, and have built a good professional reputation in the area. BUT...none of that will make the 2 letters that follow my name , NP, change into the politically correct acceptable 2 letters, MD. This is a reality I cannot control, fix, or change...no matter how hard I try.

The last few weeks I have actually considered throwing in the towel. It is putting such a strain on everyone around me, and i think it is causing me to be depressed and feel guilty for causing them such instability. I am craving stability and safety and tired of this constant nagging fear and worry. My outlook on this isn't what it was before. I am getting very discouraged, very broke, cranky, moody, emotional and just exhausted from the worry and stress over it. I have a job I work on a part-time, as needed basis that is flexible with days and times. .Yes, I could forget opening the practice and just work the other job. And at times I think i must be NUTS that i am choosing to open my own practice to deal with all the stress and headaches that come with owning any business, but especially health care because of insurances and billing codes,etc. But, this is what i do, it is who i am, it is what fulfills me in many ways.

I enjoy caring for people and going the extra mile to help them when nobody else will. It's like looking for the missing pieces to a jigsaw puzzle...when you find the pieces that fit, and can see someone get well, its priceless.

I will stop rambling. This is probably the longest blog in history of all blog posts. maybe i will get an award for that! ya think?? ha ha.

RELATED RESOURCE SHARING
I will Share my resources to others searching for related Info. It helps to find a person or a source to help with resources who has been down similar roads or who is considering it, or just anyone who wants some good resources in general.

If anyone has suggestions for good resource sites or software you have found useful in business, marketing, newsletters, templates,graphics, affiliates, or sources for newest updates on health info with RSS feeds, etc. I will begin a list of resources by category to be used by others to help them also. Is unnecessary doing weeks of research for something when you have a list others have tried already and can get honest feedback.

I will give you my experience on any websites or software on anything I have personally tried. I have invested a lot of time researching and downloading/saving/bookmarking,etc. Many I did NOT like and uninstalled them, others were mediocre, and a few have been great.

I have compiled a huge collection of resources for NPs, APRNs, PAs, RNs and many of the resources are for general business start-ups, and many of the sites i have found very useful in meeting other NPs, entrepreneurs, women entrepreneurs, article resources, information for marketing with emails and newsletters, and websites of course. Have discovered some cool free software and plug-ins, and know the laws inside out for NPs in this state, as well as some very good sites you can join for a very low price and get on discussion boards with people doing the same thing as you in business. Most of the q's I have had were answered the same day and by several NPs across the country including mastermind groups on topics, downloaded web casts from other professionals who have made it to their goals, ways to add procedures for profits, and some great ideas for side businesses if no one yet has discovered doing these in your area.

I believe that if people work together, and bind together as a group to help one another and pool resources, it would benefit everyone in making progress in many various ventures,goals, and projects.

SORRY FOR SUCH A LONG POST. Had to get this soapbox started...
... and open a can of worms too!
I will provide a few random resources in follow-up posts for NPs and consumers based on topics generated through any responses.

THANK YOU for taking the time to read my first post. I hope to help others both from my experiences and resources gathered by any followers of this blog.

Would love to hear some opinions or ideas on these or related topics. Also, any personal experiences with your family or yourself where you have been impacted with problems accessing health care and affording medical treatment. The cost of prescriptions not covered under your paid prescription plan, other out of pocket expenses , and high insurance premiums are forcing many people to give up other necessities such as food and heat. Has this happened to you?

Any answers to the questions IN RED???

Comments on the DOMINO CYCLE??

Until then-