Faculty: Janet Davis, MSN, RN, GNP, CWOCN
Release Date: 07/01/2014
Can someone please tell me where to get information for prep books for crtification?
So I just joined the DNA recently and I'm fairly new at this. I have a tele and home health background and currently work in an outpatient dermatology practice. I wanted to ask my fellow nurses what kind of advatages as far as job offers, etc a nurse might get from having a dermatology certification? I have an associate's degree and all I see are job postings for derm NP. Any input, advice would be greatly appreciated. Liz
Am currently working as an NP in a dermatolgy practice. The transition during my first year as an NP has been tough - mentored initially by a provider that was seeing up to 50 patients a day and was not assisted nor given chance to become familiar with EMR used there, nor with how office worked, or how triages were managed. The assistance with EMR as well as with triages occurred after some missteps and I've since made improvements and continue to consistenly improve. That being said, it has been a hard year for me with a number of missteps. An unsupportive fellow provider adds misery to the mix and has created unfavorable perceptions about me (as well as a few other staff members).
I am stressed. I work mostly on my own and gaining access to other providers for questions is frequently done by calls or text, with a delay in response. The same occurs when I have access to a fellow provider. Recently triaged a preliminary path report. A final path report later came in, changing the diagnosis and hence, the treatment plan. In triaging the preliminary report, I did not see "preliminary." I slip up on occasion. So do others. I've also picked up on others errors (some serious) and while grateful to have noticed the error for the patient's sake, sought to correct it discretely and professionally.
I am learning and improving all the time and am making sense of it all, yet am unsure if it's me lacking the ability or if the environment is making it an overwhelming experience. I also am struggling with the negative perceptions the fellow provider has cast about as the spotlight seems to be focused on me when I slip up.
Anybody with similar experiences? Is this part of the role transition?
Hi, I just joined this organization today. Most of my career in nursing has been in the operating room (general surgery). Last March I made a major change and moved into dermatology, specializing in Mohs surgery. On slow days, I work in the dermatology out patient clinic. My question and concern is, does it make any difference in outcome where clean technique is used instead of sterile technique? I'm having a difficult time finding any research and documentation that says anything definitive. My gut feeling is that clean technique is fine. I've read that in some Mohs clinics non sterile boxed gloves are used instead of sterile gloves with no significant increase in infection rates. I realize that the skin is much more vascular and on the surface, both of which cut down on infection rates but if there are any studies or articles that could help clarify this point, I'd love to read them. Any assisstance would be appreciated.
Hello everyone reading,
I am a FNP also, who took a job in Primary Care, a practice owned by an ARNP! I can say that I love it, as NPs are surely forward thinking. I see client's in the office on Friday's who want their suspicious lesions looked at or who want a skin tag or bothersome Nevi removed. I use a dermatoscope and take pictures with the DL3 model with my iPhone 4s (Awaiting my iPhone 6 Plus to arrive). Deciphering skin lesions is a passion of mine! I am so thrilled that we are offering our client's the option of a one stop shop without having to refer client's out to dermatologists for a second co-pay and long wait times.Additionally, we may offer Botox soon, as I have been trained in that also. I precepted at a derm office and was leary of specializing in just skin as I enjoy treating my clients holistically. As an FNP and previous pediatric experience, rashes are not new to me...in fact 1/2 of the questions for the board seemed to be on skin complaints or dermatological diagnosis and treatment of such. It is very difficult to get into a derm office in Florida with the new Dermatology DNP program at USF, many dermatologists require more than an MSN/FNP. When I attended the 2014 National Association of Dermatology Nurse Practitioner Symposium (which is a great forum for furthering skills and knowledge), I spoke to several Family NPs from around the country who experienced similar difficulty in trying to transition into a dermatology practice. I hope to get some good pointers from the posts, as I my see patients in rehab centers also - where the facility has consulted an organization of NPs who have no further training (as wound care consults) who prescribe my patients the wrong pharmacological treatment in misdiagnosis. I am very frustrated with this, as no one in my office consulted them, and they are not limiting themselves to wound care (e.g., pressure ulcers). Any ideas? Trying not to step on toes, but, the LPNs should not be able to order the consults without the Primary Care Practitioner authorizing it, correct? The company has a dozen NPs with Protocols as FNPs or NPs doing gynecological and other exams and primary care type protocols without any other certifications listed. In Florida it is required NPs practice under the supervision of a physician. Their supervising physician is a primary care physician (Adult). Many of these so called "wound care" NPs are prescribing steroid creams for everything calling it Psychogenic pruritis (diabetic patient with an Hgb A1c of 10.4) when it was Folliculitis and candidal intertrigo- where topical corticosteroids made it worse. Had to d/c their script and write for econizole 1% topical with rash gone in 3 days. Yet, they billed for 2 visits in one month consulting on the patient, which no practitioner of the patient's ordered. How is the Medicare $$$'s going to last? Seems like greed, as well as bad politics/ethics going on! Would love to hear your thoughts ... everyone! Am I alone on this bad feeling... is it so bad out there...this kind of bad business is creeping up? I look forward to your advice!
In Shock, Diane