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Happy 2019! Semester wrap up, personal and career goals.

January 9, 2019

Hi friends!

 

I hope you all had a wonderful holiday and Happy New Year! I find that I am apologizing for the lack of consistent posts...and yes, one of my goals for 2019 is to be more consistent with my blog posts! 

 

HIGHLIGHTS OF FALL SEMESTER 2018 --> 

 

DIAGNOSIS AND MANAGEMENT, FNP clinical rotation, FNP Seminar 

  • Finally taking the Diagnosis and Management course! This is one of three semesters taking Diagnosis and Management and I am glad we are finally taking the class we have all been waiting for. Diagnosis and Management was a LOT to handle this past semester, but also incredibly crucial to my education as a FNP. We studied various topics -- upper and lower respiratory, hypertension, endocrine, women's health, gastrointestinal, dermatology, etc. etc. We learned how to create differential diagnoses, diagnose, and manage conditions and diseases. Cheers to more diagnosis and management in the next two semesters and drowning in thousands of pages of notes! 

  • FNP Clinical -- I was placed at two different sites this past semester, one in pediatrics at a community health clinic deep into Brooklyn and another primary care site at the same FQHC (federally qualified health center) in the Bronx. It was pretty bittersweet saying goodbye to the Bronx site since I had been there for the past year and was getting to know the patients a lot more since I saw them every few months for follow ups. I was also starting to put together more management pieces as I saw patients since I was taking Diagnosis & Management. 

  • FNP Seminar -- Throughout the semester, we had to write case narratives based on patients we had seen in clinical and present them to our classmates during seminar. We would present our patient, their chief complaint, history of present illness, past medical history, impression with differential diagnosis, plan of care, and any recommendations or follow ups/referrals as needed.  

 

WOMEN'S HEALTH

  • Well Woman Gynecology -- I took this course as a part of my Women's Health Sub-specialty and it was one of the BEST classes I have taken so far here at Columbia in my NP curriculum. I think it should actually be required across all specialities as a part of the core curriculum! 

  • We had lectures on the menstrual cycle, contraception, cervical cytology (including how to interpret and manage results), abnormal uterine bleeding, vaginal infections and STIs, breast health, transgender health, menopause and more. 

 

  • We also had the pleasure of doing some hands on learning in our simulation lab -- 

    • Contraception (birth control) -- we had standardized patients come in and we each took turns discussing contraception options with them and aided in choosing a method. It was really great having this opportunity to anticipate questions and to practice using language that makes sense to patients. We also practiced injections for depo provera (hormonal birth control injection).

    • IUD (intrauterine device) -- we practiced inserting IUDs into uterus models! 

    • Breast health -- we practiced clinical breast exams with a standardized patient (who was wearing a model chest with a lump in it), and answered the patients questions regarding screening, when to screen, how often, which guideline is right for them, risks for breast cancer, etc. 

    • Nexplanon (birth control implant) -- this was a super neat experience with the makers of Nexplanon, Merck. Merck representatives came in to train us in inserting the Nexplanon and removing it. A few weeks later, we received official certificates signifying that we had been trained to insert and remove the device. For those wondering, the Nexplanon is a small plastic device that releases a hormone to prevent pregnancy. It is placed right underneath the skin in a patient's inner arm and lasts up to 3 years. 

    • Punch biopsy -- we learned about vulvar conditions which would warrant a biopsy. We practiced doing punch biopsies on simulated pads of skin. 

  • If anyone else is interested in learning more about my love for women's health and has any questions regarding contraception, leave me a comment below! 

 

EXTRA-CURRICULAR 

  • IPE SAB --> As one of the nursing representatives on the Columbia University Medical Center's Interprofessional Education Student Advisory Board (CUMC IPE SAB).. (yes long name!), the School of Nursing hosted an event with standardized patients. With the help of my co-representatives for the school of nursing, the Director of our simulation lab ,and simulation lab assistants, we created teams of 4 from various schools at CUMC (medical, dental, OT, PT, public health, social work, and nursing). Each team would go into the standardized patient's room and go about history taking and a general plan of care for the patient. The case we chose was of a middle-aged "Terry" who had fallen and broken their arm. Terry has a list of co-morbidities (hypertension, glaucoma, diabetes, mental health, denture problems, etc). It was great seeing students interact with one another and understand the scope of practice and medical focus from each profession's point of view. 

     

     

  • Work as a PACU Nurse at a Fertility Clinic --> Yes, I'm still working per diem as a nurse at a fertility clinic in the city. I go in to work anywhere from 1-3 times a week. I have some wonderful co-workers and am really grateful for this job. Super nice to make some side money while being a full time student. Living in NYC is not cheap, people! And wanting to take advantage of everything NYC has to offer before I pack my bags and move back to California has me crunching numbers. 

2019 GOALS --> 

 

PERSONAL 

  • Be more consistent with blog posts! I would ideally like to at least have a new blog post every 2 weeks. If anyone has any topics you'd like me to touch upon, comment below! 

  • Exercise more regularly -- can be something as simple as being on the elliptical for 30 minutes. I do want to get back into running. I ran that half marathon in November and have slacked off tremendously. 

  • Update my parents more. Whether they're quick phone calls, or emails highlighting my week/month. I want to keep them in the loop. 

  • Use my planner all the way through 2019! I am usually so good about my planner during the first half of the year.. and then start to use it less and less starting Sept/Oct. Can't let these beautiful stickers go unused! 

 

SCHOOL/CAREER 

  • Try my best always and don't compare myself to others. Easier said than done am I right? I need to focus on me. I need to do my very best and know that I am my OWN unique person. I have my own things that I am passionate and involved in, and I need to remind myself that every once in a while. 

  • PASS THE FNP BOARD CERTIFICATION EXAM!! YEP! I'll be taking it later this year, my friends! Wish me luck!!! 

  • JUMPSTART MY CAREER WITH A COOL FAMILY NP JOB! Okay, the job doesn't have to be cool, but it does have to at least be a good starter job, one that hopefully isn't too specialized since I do love primary care, one that is in CALIFORNIA (?!?! fingers crossed), one that pays at least decently well (i need to pay back loans, man), one that makes me feel like I'm making a difference.

 

I hope you are all having a great start to your 2019. I hope you all accomplish your goals, no matter how big or small! Reflect on your 2018, learn and grow from your past, look forward to making changes in 2019. Stay true to yourself and never stop learning. Talk to you all soon!

 

 

 

Sincerely,

 

Meagan

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