Nurse Practitioner – in specialty care

A Nurse Practitioner (or NP) is a registered professional nurse with advanced education and training who evaluates and treats patients as an independent health care provider.  The first formal Nurse Practitioner program was developed at the University of Colorado in 1965, and the educational programs have continued to grow throughout the United States and abroad. There are currently over 140,000 licensed NP’s practicing in the US.

All NP’s have a basic degree (Bachelor’s degree in Nursing) and a Masters Degree, which prepares them with specialized knowledge in the evaluation and treatment of patients in a wide variety of clinical settings. Some NP’s have earned a Doctor of Nursing (ND) or Doctor of Nursing Practice (DNP) degree which requires additional education of approximately 4 years.

All Nurse Practitioners must have certification from a national board, such as the American Nurses Credentialing Center. The license to practice as a NP is granted from the individual’s State Board of Nursing in which the NP practices. Some Nurse Practitioners practice in primary care, while others specialize in areas such as pediatrics, gerontology, oncology, women’s health, orthopaedics, neurosurgery, neurology, cardiology, psychiatry, etc.

Nurse Practitioners practice in a variety of settings, including rural clinics, offices, acute care hospitals, emergency department, urgent care, nursing homes, rehab facilities, schools and academic facilities.

Some of the services that NP’s provide include:

• Evaluate and treat acute and chronic illnesses
• Ordering and interpreting diagnostic tests
• Evaluate and treat various specialty disorders
• Prescribe medications
• Prescribe treatments
• Health education and health counseling

Choose a Nurse Practitioner for your health care provider!

What is my responsibility as a patient?

Most individuals will need to seek medical evaluation and care at some point in life. This can be a very tense and frightening experience, especially if the individual is very ill. Interactions with health care providers can be intimidating. Whether you are healthy and just in for a yearly check-up, or you have an urgent medical problem, there are some ways that can help to reduce the stress and make the appointment more productive.  Your responsibility is to become an active participant in your health care. It is our pleasure to evaluate and care for you. This process helps us better meet your needs.

Here are some tips to help you interact with your provider and have a successful appointment:

• If you are a new patient to the practice, arrive to the office about 15-20 minutes before your scheduled appointment time to complete paperwork. Some offices will mail new patient forms ahead of time for you to complete at home- always ask if this is available.
• Always arrive on time to the appointment.  If you are running late, call as soon as possible to let the office know- you may need to reschedule.
• If you need to reschedule, please call the office as soon as you know. Do not just “no-show’ for your appointment- this wastes valuable time for another person who might need to be seen.
• Ask the receptionist if your health care provider is on schedule- Sometimes in a specialty practice (such as a surgical or specialty) the provider may be delayed in the operating room or hospital. If your provider is late, ask for a time-frame, and if you are unable to wait, reschedule your appointment.
• Bring your insurance card and a photo ID to the appointment. If you do not have these, the appointment may need to be rescheduled.
• Bring your co-pay. Most insurance policies require some amount of co-pay- if you are not sure, ask when you schedule the appointment.
• Bring a complete list of ALL of your current medications- including over the counter meds such as Tylenol, vitamins, supplements, etc. The provider will review your medications with you during the appointment.
• Bring a list of all of your medication allergies- it is vitally important for your provider to understand your previous reactions to any/all medications/latex or tape.
• If you have had scans (MRI, CT, x-rays) from a different facility, have that facility transfer the images to a CD and hand-carry them with you for your appointment. DO NOT rely on the imaging center to mail the images to the provider. In most cases, a radiology report is not sufficient- the provider must see the actual pictures on the CD.
• Be completely HONEST with your provider. If you smoke- tell him/her. If you drink alcohol or use drugs- be honest about the amount and type. Your provider cannot help you unless he/she understands all of your health issues.
• If you are receiving prescription medications- especially narcotics- from another provider, tell your provider at the time of your appointment. Some medications can interact and result in life-threatening problems- your provider needs to know exactly what/how much you are taking.
• Be aware that if you are given a prescription for a controlled substance (such as a narcotic), the prescription information will be entered into the Colorado Prescription Drug Monitoring Program (PDMP) database.
• ASK–Write down all of your questions ahead of time so you are sure all of your concerns are discussed.
• If you do not understand what your health care provider is telling you- speak up and ask for clarification.
• If you do not speak or understand English, bring someone with you who does. If you do not have someone to accompany you, ask for an interpreter when you schedule your appointment
• Bring a family member or close friend with you to the appointment to help remember what was discussed.
• HIPPA laws require that your health care provider have written permission from you to talk with ANYONE else about your health care. The providers are NOT allowed to speak to anyone (including a family member) without your written permission.
• Bring a pen and paper to write notes- especially if this is the first time you visit with a provider.
• If the provider orders a test, such as MRI, CT scan, colonoscopy, etc, make sure you ask the specific requirements of the test (such as food/water/medications prior to the test) and if you will need a driver
• Do not expect to leave with all of the answers- more often than not, the provider will need to order or review tests to make conclusions
• If you schedule a follow-up or return appointment, have the receptionist give you an appointment card with the date and time.
• If you call the provider’s office, make sure to leave a working phone number to receive a return call. If you are unavailable during specific times of the day, make sure the office is aware.

Sun Time

Just about everyone enjoys a bright sunny day, but did you know that the sun can cause damage that you can’t even see? Ultraviolet rays are energy that comes from the sun that can cause damage in many ways. Everyone’s skin ages at a different rate, but most people will begin to see age-related changes at around age 28. At that age, the epidermis (outermost layer of the skin) begins to thin and the normal renewal capacity of the dermis (next layer) becomes less elastic. The effects of the sun on aging skin can show up as brown spots, areas of redness, wrinkles, and thinner appearing skin. The sun is one of the main culprits for accelerating these age-related changes.

 

There are 2 types of ultraviolet rays that can cause damage:

1. UVA- these are the rays that are the longest, and most powerful, and can come through even on a cloudy day. UVA rays are about the same year-round, so there is always risk of over-exposure. Exposure to UVA rays reduces the amount of collagen (elastic portion) in the skin, and results in wrinkles, thinning of the skin layers, and dilation of the tiny surface blood vessels. The UVA rays cause the most damage, as they can penetrate auto glass, some clothing and even office/home windows. If you commute a long distance in your car, you might notice brown spots on your hands- that may be due to UVA exposure of your hands on the steering wheel. Tanning beds are especially dangerous, as they emit UVA rays and can increase the risk of skin cancers.
2. UVB- these are the rays that most commonly cause sunburn, age spots and freckles, as they penetrate the outer layer of the skin more easily.  Because UVB rays typically penetrate the outer skin layer, they are also more dangerous and are more often associated with the development of skin cancers. UVB rays are typically stronger in the summer, in higher elevations and in locations closest to the equator, however, they do not penetrate glass as easily as UVA rays.  Both UVA and UVB rays can accelerate the development of cataracts and eye damage.

High risk individuals

• Those who work out in the sun (construction/roofers/street workers/landscapers)
• Those who have fair or light colored skin
• Anyone with a family history of skin cancer
• Anyone with a family history of cataracts
• Anyone who lives in high elevations or near the equator
• Persons who take certain medications (always review the medication insert for precautions)
• Elderly individuals, infants and small children
• Persons with illnesses that suppress the immune system