Feel like you don’t know what you’re doing? Good.
“I feel like I suck, and I don’t know what I’m doing.”
Matthew Hall, CRNP
Lower Back Pain: Pearls, Pitfalls, and Practical Tips
Whether you are working in primary care, urgent care, or the emergency department, chances are you see a patient complaining of lower back pain during every shift. It’s one of the most common reasons patients seek care, but also a chief complaint that leads to over-testing, over-treating, and is one of the driving factors behind the opioid epidemic.
What NP Education is Getting Right
January was for reflection and honesty about the current state of Nurse Practitioner education; a plea to steer the ship in a different direction. Now, let's talk about what NP education is getting right. From community medicine collaborations with EMS to post-graduate fellowships, clinicians and institutions across the country are working to move our profession forward and better serve patients in an increasingly complex healthcare system.
IV Lidocaine for Renal Colic
Early in my career, I encountered a patient with severe renal colic who also had a history of opioid use disorder, now with several years of sobriety. Our initial treatment options with the usual non-narcotic medications and IV fluids had offered some initial relief, but his pain had returned with a vengeance. His battle with opioids had been hard fought, and he was adamant that he would only resort to opioids if we had exhausted every...
Thrombolytics for the Coding Patient
Managing a cardiac arrest is the paramount skill of an emergency medicine physician. The process is a furious loop of assessments, actions, and decisions. Choices are often made with minimal information to fall back on, and delays of mere seconds can define the outcome. When running the rapid mental checklist of Hs and Ts, the decision to give or withhold thrombolytics is one that is often made amidst a fog of uncertainty. And while the...
2026: A Time for Reflection, and Resolutions
Nurse practitioners are a vital part of our healthcare system. We are compassionate and capable clinicians who help to improve access to care in almost every setting and specialty. Behind the essential role we play lies a growing reality that is raising concern in the healthcare community: the path to becoming an NP in the United States lacks consistent standards, especially compared to the highly standardized, regulated training at the...
Ultrasound in Resuscitation: What Every EM Clinician Should Know
Bedside ultrasound has become a common tool in many EDs. Potentially one of the most important uses of ultrasound is during resuscitation. When a patient is crashing and every moment counts, having the ability to quickly assess the clinical situation and make critical decisions is paramount.
Asymptomatic Hypertension ACEP Clinical Guidelines Updates
“My dermatologist sent me to the ER for my blood pressure, and they told me I’m going to have a stroke.”
The Subtle Art of Eating Lunch
We are all guilty of it, and for most of us, it probably happened during our last shift. A protein bar while answering emails, a quick donut from the nurses' lounge in between patients. Eating your salad from the cafeteria while catching up on notes during lunch. The first sip of your breakfast meal replacement (aka energy drink/coffee).
Managing Opioid Overdose: A Practical Guide for Clinicians
Opioid overdoses have become an unavoidable part of our daily shifts in the ED. It is a tragic commonality that transcends social and economic lines. It would be a safe bet that if you are reading this, you likely have a friend, family member, or colleague whose life has been disrupted by opioid abuse.
Happy Nurse Practitioner Week!
Origin Story
The nurse practitioner (NP) profession can trace its roots back to a pediatric clinic in Colorado. In 1965, the first NP program was founded by Dr. Loretta Ford, a public health nurse, and Dr. Henry Silver, a pediatrician. This was in response to an expansion of Medicare and Medicaid that left many at-risk populations without adequate access to primary care, particularly in the pediatric population. Two years later, Boston...
Snake Bites and Antivenom: Tales from the Pit and What You Need to Know
I grew up on a military base near a small border town in New Mexico. As a child of the 90s, the ideas of what were considered reasonable and safe childhood activities differed greatly from today's standards. A shining example of this was at Moore's Trading Post, a local pawn shop and military surplus store just a few miles from the city limits. They were most famous for their rattlesnake pit near the entrance to the shop.