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Graduated, passed boards, got a job… now what?

“Don’t Hurt Anyone”

My first job as a nurse practitioner was ideal. I knew all the physicians. I knew all the nurses. I knew all the administrators. Yet, I was scared beyond belief. First and for most I did not want to hurt my patients. Second, I wanted the staff that I worked with to accept me as a competent nurse practitioner. I remember clearly two conversations from those first few days; “John, don’t hurt anyone” and two, “John, one of the most important things is know what you don’t know”.

That first year was fast and furious. I was surrounded by the best ED physicians in the area. While I know many of them didn’t sign up to “teach” new providers, each of them embraced us in their own way and guided us to provide the highest quality of care. They shared their experiences and resources to challenge us daily. Each of them had different approaches. Some recommended daily podcast, others recommended written resources, and then of course our medical director encouraged us to select weekly topics and write a case study. All of them made me the provider I am today.

Below you will find some of the resources that we used to improve our knowledge and increase our confidence in the emergency department environment.

Medical Books:

Dubin, D. (2000). Rapid interpretation of EKG’s : An interactive course. (6th Edition). Fort Meyers: Cover.

Gomelia, L. & Haist, S. (2006). Clinician’s pocket reference. (11th Edition). New York: McGraw-Hill

Levine, B. (2018). Emergency medicine resident association: Antibiotic guide. (18th Edition). Irving: EMRA.org

Lewiss, R., Saul, T. & Shah, K. (2012). Essential emergency imaging. Philadelphia: Lippincott Williams & Wilkins

Silver, T. (2002). Joint and soft tissue injection: Injecting with confidence. (3rd Edition). Oxon, United Kingdom: Radcliffe

Medical Blogs:

Emergency Medicine Literature of Note
http://www.emlitofnote.com/

Academic Life in Emergency Medicine
https://www.aliem.com/

A list of emergency medicine blogs
https://blog.feedspot.com/emergency_medicine_blogs/

Online resources:

Online medical risk calculator (think Wells Criteria, Heart Score, NIH, CHAD, SIRs, PERC)
https://www.mdcalc.com/

Online pediatric dose calculator
http://www.emiphysicians.com/calculator1.html

Practice Provider Essentials:

Practice Provider Essentials has numerous member resources available for the new and seasoned professional. A few examples of resources provided on the membership portal include: suturing techniques, joint injections, radiology interpretation, joint reduction, and an image guideline to determine the correct CT or MRI study for common indications.

Accepting your first position in the emergency department may be one of the most exciting times of your life. The providers around you are a wealth of information. Seek out resources that are current and supported by the literature. Go to work prepared and remember to know what you don’t know.

John W Rothwell III, DNP, APRN, FNP-BC

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