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Starting my NP career in the bush
informing and directing successful role development and sustainability. http://dx.doi.org/10.1016/j.nurpra.2017.05.047 Starting my NP career in the bush Mr Robert Amm1 1 Wachs Wheatbelt Abstract: Title: From RN to NP in rural health Objective: 1. Explore my journey as a rural RN, into a rural Emergency Department [ED] Nurse Practitioner [NP], employed to work in a GP led health service. This will be achieved through: My personal reflection Challenges faced The positive impact of the NP position on staff and the community Goals moving forward 2. To inspire others in pursuing the NP career, and add to the discussion of promoting the NP role in healthcare services (N Jennings, Gardner, O’Reilly, & Mitra, 2015; Robins, Jamieson, Carroll, & Boreham-Downey, 2015) Method: Personal opinion and reflection, with supported evidence (Bryson, 2016). Approval to use information and data from Western Australia Country Health Service [WACHS] obtained for this presentation (Mills, Lindsay, & Gardner, 2011; WACHS, 2010, 2015) 15 minute presentation Discussion: Challenges working in rural setting, in GP led hospital. The rural ENP is not confined to Fast Track presentations (Natasha Jennings, 2013). Impact of having an ED specific practitioner in a rural hospital. Conclusion: 1. The transition from RN to NP is a challenge. 2. The ED NP role is a vital role for rural and remote EDs. 3. The ED NP is the vital link and support between rural and remote, GP clinics, and tertiary ED sites. http://dx.doi.org/10.1016/j.nurpra.2017.05.048 Management of severe phantom limb pain through a supported prescribing guideline Ms Kim Choate1 1 St Vincent’s Hospital Melbourne Abstract: Management of severe phantom limb pain through a supported prescribing guideline Choate, Kim www.npjournal.org
Department of Anaesthesia and Acute Pain Medicine St Vincent’s Hospital Melbourne Aim: This case study explores the pain management nurse practitioner candidate’s (PMNPC) use of a ‘supported prescribing guideline’ in the management of a woman with severe phantom limb pain. Background: The ‘supported prescribing guideline’, developed at St Vincent’s Hospital Melbourne enables the candidate to deepen and extend their knowledge and skills by ‘working into the role’ of an endorsed nurse practitioner and increasing prescribing confidence. The objective of the guideline is to ensure the PMNPC when endorsed, is able to prescribe medications in a confident, safe, and appropriate manner, according to legislative requirements (Dunn et al, 2010). Case Study: Up to eighty percent of patients experience some degree of phantom limb pain (PLP) after amputation (Subedi and Grossberg, 2011). For some, the pain can be manageable as the pain episodes are mild and short lasting. In contrast, severe neuropathic pain typically does not respond to many of the common analgesics and requires specific therapeutic approaches (Schug et al, 2016). Discussion: Sarah, a 31 year old woman underwent a hemipelvectomy for an osteosarcoma. Epidural removal on Day four precipitated intense PLP. She described “burning pins and needles” from the absent knee to the foot, with feelings of distortion in the leg. Although the stump pain improved, the PLP worsened eventually impacting on mood and recovery. The PMNPC, through a supported prescribing guideline, initiated numerous pharmacological interventions including: ketamine, lignocaine, calcitonin, antidepressants and opioids. Relief was eventually attained through a second epidural that was inserted 10 days after the operation. Non-pharmacological strategies included: distraction techniques, music therapy and counselling. Conclusion: This case study illustrates the PMNPC coordinating a multidisciplinary approach to pain management. Medical mentoring through discussion of the individualised treatment plan and supported prescribing enhances and broadens the knowledge and experiences of the candidate. Additionally, the PMNPC is able to initiate non-pharmacological approaches to aid patient care such as counselling and physiotherapy interventions. http://dx.doi.org/10.1016/j.nurpra.2017.05.049 A snapshot of the emergency department nurse practitioner’s day Mrs Welma Van Schalkwyk1, Ms Helena Halton1,2, Mr Jamie Bawden1, Mrs Lynne Willis1, Mrs Lisa Gray1, Mr Matt Rosington1, Dr Linda Coventry1,2 1 Sir Charles Gairdner Hospital, 2Edith Cowen University The Journal for Nurse Practitioners - JNP
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Department of Anaesthesia and Acute Pain Medicine St Vincent’s Hospital Melbourne Aim: This case study explores the pain management nurse practitioner candidate’s (PMNPC) use of a ‘supported prescribing guideline’ in the management of a woman with severe phantom limb pain. Background: The ‘supported prescribing guideline’, developed at St Vincent’s Hospital Melbourne enables the candidate to deepen and extend their knowledge and skills by ‘working into the role’ of an endorsed nurse practitioner and increasing prescribing confidence. The objective of the guideline is to ensure the PMNPC when endorsed, is able to prescribe medications in a confident, safe, and appropriate manner, according to legislative requirements (Dunn et al, 2010). Case Study: Up to eighty percent of patients experience some degree of phantom limb pain (PLP) after amputation (Subedi and Grossberg, 2011). For some, the pain can be manageable as the pain episodes are mild and short lasting. In contrast, severe neuropathic pain typically does not respond to many of the common analgesics and requires specific therapeutic approaches (Schug et al, 2016). Discussion: Sarah, a 31 year old woman underwent a hemipelvectomy for an osteosarcoma. Epidural removal on Day four precipitated intense PLP. She described “burning pins and needles” from the absent knee to the foot, with feelings of distortion in the leg. Although the stump pain improved, the PLP worsened eventually impacting on mood and recovery. The PMNPC, through a supported prescribing guideline, initiated numerous pharmacological interventions including: ketamine, lignocaine, calcitonin, antidepressants and opioids. Relief was eventually attained through a second epidural that was inserted 10 days after the operation. Non-pharmacological strategies included: distraction techniques, music therapy and counselling. Conclusion: This case study illustrates the PMNPC coordinating a multidisciplinary approach to pain management. Medical mentoring through discussion of the individualised treatment plan and supported prescribing enhances and broadens the knowledge and experiences of the candidate. Additionally, the PMNPC is able to initiate non-pharmacological approaches to aid patient care such as counselling and physiotherapy interventions. http://dx.doi.org/10.1016/j.nurpra.2017.05.049 A snapshot of the emergency department nurse practitioner’s day Mrs Welma Van Schalkwyk1, Ms Helena Halton1,2, Mr Jamie Bawden1, Mrs Lynne Willis1, Mrs Lisa Gray1, Mr Matt Rosington1, Dr Linda Coventry1,2 1 Sir Charles Gairdner Hospital, 2Edith Cowen University The Journal for Nurse Practitioners - JNP
e337