The Nurse Practitioner Mentor Blog 

Starting insulin makes a lot of us nervous. It did for me too. The good news is that basal insulin is the simplest place to start, and a clear workflow takes most of the fear out of it. Insulin is individualized, but here's how I start it safely and confidently.

When I consider insulin

Start insulin...

You've decided a patient is a good candidate to come off warfarin and onto a DOAC. The tricky part is the handoff, keeping them anticoagulated the whole way through without overshooting into a bleed. Here's how to do it cleanly.

If you want the warfarin side first, start with warfarin basics and dos...

You inherit a patient who's already on warfarin, and now you're the one managing the INR. Some of these patients have a coumadin clinic, but plenty rely on their PCP. Here's a clinic-friendly guide you can use today.

DOACs like apixaban and rivaroxaban are often easier to manage, but warfarin isn't ...

Not every patient can take estrogen, and not every patient wants a daily pill. When the combined pill is off the table, you still have a full menu to offer. Here's a fast, clinic-friendly run through the non-COC options: who each one fits, how to use it, and the counseling that keeps people on it.

I...

Contraception counseling is one of the most common visits you'll have in primary care. For a lot of women, the combined pill is the option they already know and want. The work isn't knowing the pill exists. It's knowing who can safely use it and who can't.

Here's how I think through it, grounded in ...

A patient tells you their heart's been racing or skipping. Most of the time it's benign, but a few of these are the ones you can't miss. Here's the approach I use in clinic to sort them out fast.

Step 1: Are they symptomatic at the visit?

If they're symptomatic in the office:

• Get an EKG right away
...

A patient's lipid panel comes back, the LDL is elevated, and you have about ten minutes to decide whether this needs a statin, a recheck, or just lifestyle counseling. Here's how to make that call quickly and document it cleanly.

Dyslipidemia vs. hyperlipidemia: the terms

• Dyslipidemia is the broad
...

Hi, I'm Allison Sowders, FNP-C, the family nurse practitioner behind Nurse Practitioner Mentor. If you are a new NP in primary care and you feel overwhelmed, second-guessing your decisions, and wishing someone would just show you how to think through a visit, this is for you.

Why I built this

NP sch...

How to stay on time with 15-minute visits

Fifteen minutes per patient sounds impossible. It includes check-in, rooming, you actually seeing the patient, and everything else: testing, referrals, prescribing. The reason some NPs still finish on time is not that they work faster. It is that they run th...

You ordered the screening mammogram. The patient actually completed it, which is a win on its own. Now the result comes back abnormal, and you have to decide what happens next.

Here's a practical workflow you can use in primary care so you're not guessing.

Step 1: Order the right test

Start with th...