Men are more likely to put off routine health care appointments for screenings which often leads to a less healthy lifestyle. Men are also more likely to delay seeing a health care provider for symptoms of a health problem that could lead to conditions affecting men such as heart disease, prostate, testicular, and colon cancer along with osteoporosis and nutrition issues.
With the glaring issues of Men’s health, Mr. Graham has recently started his clinic that focuses on primary care and men’s health. NP-VIP Concierge Medical clinic provides comprehensive health care in your home, over your phone or home computer with the use of a HIPAA-approved telemedicine app. Telemedicine is the use of telecommunication and information technology to provide clinical health care from a distance. It has been used to overcome distance barriers and to improve access to medical services that would often not be consistently available in distant rural communities or busy lifestyles.
Mr. Graham started his medical career of as a medical assistant 26 years ago when he joined the United States Army and served a total of 22 years of active duty service. During his tenure in the Army, he became a Registered Nurse, graduating from Alcorn State University in 2006 with his BSN and Walden University in 2015 with an MSN as a Nurse Practitioner and is currently pursuing his DNP. Mr. Graham is also a Duke-Johnson & Johnson Nurse Leadership Fellow at Duke University. As an Advanced Practice Nurse, Mr. Graham has worked in areas such as Primary Care, Urgent Care, and Critical Care. With the variety of experience, Mr. Graham has focused on Primary Care with a focus on Men’s health. Research has shown that men, their health has for the most, has taken a back seat to women’s health. Mr. Graham’s focus is on prevention and early detection.
LGBTQIA? Sounds a bit like alphabet soup right? The acronym LGBT has evolved over the past several years to include other populations but the individual needs of each population within this acronym vary and are not “one-size-fits-all. “ These gender and sexual minorities still encounter issues concerning sexuality, identity, gender and freedom of expression with their healthcare providers. It is a well-documented fact that the majority of healthcare providers today have not been properly educated on how to care for this population therefore, the specific needs pertaining to each individual group represented in this acronym go largely ignored.
The truth is more and more persons are identifying as something other than what is considered gender binary-the classification of two fixed genders: male or female, masculine or feminine. Persons who identify as non-gender binary may present to your office as lesbian, gay, bisexual, transgender, intersex, queer or questioning, asexual or ally. As providers of healthcare, we already know how to take care of the human body in whatever manner is necessary to optimize patients’ health however; it is equally important to be able to speak their language. Understanding some common terminology will relay the message to your patients that you are providing inclusive and affirming care. Below are some of the most common and acceptable terms that are used by the LGBTQIA community.
Lesbian: A woman who is attracted to other women romantically, physically and psychologically.
Gay: A sexual attraction towards people of the same gender.
Bisexual: A person who is attracted both physically and romantically towards people regardless of their gender.
Transgender: A person whose identity and/or gender expression differs from the sex they were assigned at birth. A transgender person may choose to transition with the help of hormones, surgery, and name change to the gender to which they best identify. The term “tranny” is considered derogatory and should never be used.
Queer: Traditionally, the term “queer” has been as a type of gender slur but in the correct context, people who identify as queer are those whose gender, gender expression and/or sexuality do not conform to the societal norm. It is an umbrella term for someone who does not identify as cis-gender or heterosexual.
Questioning: This term describes a person who is exploring their gender, gender expression and sexual orientation.
Intersex: An individual who has been born with ambiguous genitalia or a combination of both male and female chromosomes and genitalia.
Asexual: The absence of sexual attraction or desire for any type of a partnered relationship.
Ally: An advocate or someone who supports the LGBTQIA community.
Cisgender: A person whose gender identity aligns with their biological sex.
Cross-dressers: Individuals who wear clothing of the opposite sex for erotic arousal, emotional or psychological reasons. This is a form of gender expression. The term “transvestite” is no longer used and is considered a derogatory term.
FTM: (Female-to-male): A biological female who identifies as male. This is also referred to as a transgender male.
Gender fluid: A person whose gender expression and identity that crosses between the typical male and female outside of the societal norm.
Gender Queer: A person whose gender identity and gender expression may be a combination of either male and female genders or neither.
MTF (Male-to-female): A biological male who identifies as female. This is also referred to as a transgender female.
While there are a great deal of other populations and terms, this short list will provide you with a little bit of insight as to the differences among individuals who identify as such. Keeping an open mind as well as acknowledging if you mis-gender someone will go a long way in establishing a healthy patient/provider relationship built on mutual respect and trust. After all, this community of people is just that-people and they deserve the same treatment given to everyone else.
Vanessa Pomarico-Denino, Ed.D, FNP-BC, FAANP
Northeast Medical Group, Hamden, CT: APRN, Lead trainer for transgender education
Fitzgerald Health Education Associations (FHEA), North Andover, MA: Senior consultant
Southern Connecticut State University, Adjunct faculty
Long before I had the inkling to become a nurse entrepreneur myself, I was helping other nurses cultivate their entrepreneurial ideas. I was good at coming up with business ideas for others who wanted to start a business using their nursing education. For as long as I can remember colleagues always seemed to ask me about doing something outside of the bedside.
After awhile, I decided to write a book about being a nurse entrepreneur without actually being an entrepreneur. In 2013, I published my first book, So You’re a Nurse and Want to Start Your Own Business? The Complete Guide for nurses who wanted to move from the bedside. My business, ReNursing Edu (Formally known as ReNursing Career Consulting), was modeled after this book. Unbeknownst to me, my book was just the beginning.
Not long after publishing my book, I was contacted by an editor for Minority Nurse magazine to write blog posts and articles for their magazine. I was thrilled! I wrote regularly for Minority Nurse about nursing topics I had experience in—starting a business and being a nurse practitioner.
Fast-forward to today and I am the published author of more than 20 titles that mostly focus on business and nurse practitioner education. My focus is on nurse practitioners because while in school I noticed a gap in our education that left us at a disadvantage after graduating. This gap encompasses not only clinical education, but also business education and personal finance when dealing with the cost of going to school and the aftermath of student loan debt.
My books have branched out into other educational products for nurse practitioners that will assist them in clinical practice. My most recent product is the NP H&P ™ clinical journal that helps students log their clinical encounters while in school for easy access when it comes time to enter them in their schools clinical tracking system. The journal also contains prompts on what to ask when taking a patient history so as not to forget the important points.
Other products in the ReNursing Edu line include NP Clinical Cheatsheets™ that provide a quick reference guide for everyday clinical practice. The cheatsheets have a lot of information in a single page such as charting tips, common measurements, fracture types and more. They are available in both laminated and digital versions depending on preference. A second cheatsheet will be coming out later this year that focuses on issues seen more in an urgent or emergent type setting.
When I wrote my first book I never imagined where it would take me, especially since I didn’t plan on writing another. Since starting ReNursing Edu, I’ve come to realize that as an entrepreneur your business may not look like you imagined it would be when you first started. It’s important to go with the flow and change direction if your business ends up taking you elsewhere.
Nachole Johnson, MSN, FNP-BC
https://www.renursing.com
For more information on ReNursing Edu or ReNursing Edu products please visit www.renursingedu.com
Many NPs who want to start a business are looking for a niche. While I started a primary care practice for women in 1985, I was ready for a change. I was looking for a niche that could provide me with a part time practice that would allow me flexibility, low stress and a healthy income. I wanted to be free of the ever increasing, administrative burdens of managing a traditional fee for service practice. Those tasks that were taking me away from face to face delivery of patient care that was so important to me.
In my waiting room I had a digital picture frame with photos from my trips. Patients would see it and ask me for advice about their upcoming trips. What shots do I need? How can I prevent traveler’s diarrhea? Should I take malaria pills? It occurred to me that there was a need for this type of service in my community and it could be a practice I could do part time.
In 2008 I opened Travel Health of New Hampshire, PLLC (www.travelhealthnh.com). I operated it on a limited basis side by side to my primary care practice until 2015 when I retired from primary care and now I operate the travel clinic part time.
Why do I think travel health is perfect practice model for an NP owned business?
1. Low cost to start – you can easily open a travel clinic for less than $15,000.
2. Perfect model for a cash only practice since most insurances wont cover travel health anyways.
3. Low overhead- you don’t need a lot of space or fancy equipment.
4. Low need for staff- I actually don’t have any. A full -time travel clinic could run with an NP and one staff person.
5. It’s easy to learn what you need to gain expertise in travel health online. Great for new grads. (www.BeaconCEU.com “The Comprehensive Course in Travel Health”.
6. You don’t need sophisticated business skills to run it successfully.
7. There is an online program that teaches you step by step how to start and run a travel clinic (www.BeaconCEU.com “Owning, Opening, & Operating a Travel Clinic”).
8. Great add on – you can add travel health as another revenue stream to an existing practice.
9. Flexibility – see patients when you want, no call, and you can do this part time while you work for someone else. Ideal for someone who wants time with their family or as a semi-retirement business.
10. And it’s fun! Patients are happy to come see you. You can spend 45 minutes to an hour with your patients and really get to know them.
Travel health is an exciting field in health care that is a perfect practice for an NP owned business. What are you waiting for?
For more information contact Nancy Dirubbo, DNP, FNP, FAANP, Certificate in Travel Health at ndirubbo@BeaconCEU.com
Medical house call practices by nurse practitioners are beginning to gain a lot of attention, as more nurse practitioners are making house calls to provide medical aid to patients who cannot visit a health facility. A Housecall practice by nurse practitioners enables advanced practice nurses to build a private practice with less overhead, and ultimately, earn more revenue. It also offers some flexibility in work schedule, as well as some degree of freedom. If you are a advanced practice registered nurse (APRN), you too can start a house call practice today.
Key Steps for Starting a House Call Practice
Starting a house call practice can be a tumultuous process for many nurse practitioners, as most are confused about where and how to start. However, like many small businesses, a nursing house call practice also requires certain steps and processes you have to take to make it a success. To help you build a successful house call practice, highlighted below are some crucial things you need to do.
· Get Your Credentials
The first thing you need to do before setting up your practice is go through the credentialing process. This is required, especially, if you will be accepting payments from patients with government or private insurance. You will be asked by insurers about your medical background, as well as all the necessary licenses and permits. The entire process can take several months, so you might want to start early, to get it over and done with, as soon as possible.
· Get Licensed
Next, you need to follow some important regulations set up by your state and the federal government. You will need to get licensed by the APRN licensing department in your state. Depending on the state where you hope to have your practice set up, you might want to visit the Board of Nursing for your state to get the requirements. There may be other requirements you might have to provide, including DEA registration if you will be administering medication to your patients. You might also need to provide a national provider identifier number (NPI). If you do not have one, you can apply on the National Plan and Provider Enumeration System website.
· Establish a Legal Structure
Your house call practice will also need a legal business structure, which will help determine how you will be paying your taxes, as well as the extent to which you will be liable for losses, debts, and lawsuits. Thus, you might want to hire an attorney that will help you make the right legal decisions. Your attorney will oversee the entire legal aspect of your practice, by drafting legal documents like articles of incorporation/organization, partnership agreements, etc.
· Fund Your Practice
You may also require a small business loan or some other form of capital, to fund your house call practice. You will need to consider the cost of equipment, an accountant, attorney and other costs. Other expenses to add to your start-up cost, include the cost of medical records software, computers, medical supplies like gloves, bandages, syringes, etc. To get funding for your practice, you will need to find the right lender for you, as well as make sure that you have all the requirements they need.
These are just some key steps you need to take when planning to start a house call practice. for more in-depth information on how to start a house call practice as a nurse practitioner, You should Order Housecalls 101. And, if you would like to learn, first hand, the essential skills, and tools needed to run a successful house call practice, Book the House Call Course by Dr. Lawson today!
The power of Nursing Leadership: Difference between a leader and a boss The buzz word these days seems to be “I am a BOSS” as well as other catchy phrases as it relates to being in charge, autonomous, independent and the like thereof. I wanted to delve a bit deeper into the word Boss and how it does not make you a leader. As I was researching the word boss and leader, I came across these definitions from the Merriam-Webster dictionary. Boss- a person who exercises control or authority union bosses a mafia boss; specifically: one who directs or supervises workers. Leader- a person who leads: such as a guide and/or conductor. A person who directs a military force or unit leaders of the army. A person who has commanding authority or influence.
What stood out as a difference were the words influence, lead, guide to describe leader while a boss used words like control, authority, direct and supervise. I have 22 years of leadership experience of being a leader in the Army. The Army has afforded me the opportunity as a very junior Soldier to be placed in leadership positions above my grade level. Years later becoming a nurse, I’ve gained experience to be a nursing leader through developing both my bedside and administrative skills. I have been stationed in remote areas of the world where I was the only public health nurse and had the privilege to serve as the Garrison health consultant and be instrumental as a site surveyor in the grand opening of the child development center in Daegu, Korea. The military has taught me about peer leadership and how to successfully earn respect based on character and not just position. The military has helped me to strive to be a compassionate, hardworking and strong nurse whether it’s in the Medical surgical department, pediatric unit or disaster preparedness for family and servicemembers who staged in South Korea from the Japan Tsunami of 2011. Leadership is not defined by title, rank, degree or stature. It is born and bred and exists within. It is a desire. It is advocating and taking care of others. It’s acknowledging weakness as well as strength. It is the empowered, empowering others to be leaders. I’ve been fortunate to attend leadership courses that helped hone and define my leadership skills. Leadership has taught me that one should never compromise their moral compass to get to the top but should always carry themselves with honesty and integrity. The late Dwight.D.Eisenhower, 34th President of United States, once said, “The supreme quality of leadership is unquestionably integrity.
When discussing Nursing Leadership, it is safe to say that it is the driving force in advocating and delivering the quality of care and the patient care outcome that is essential in today’s complex healthcare system. It is my belief that from the moment you become a nurse, you become a leader. From the bedside, to the administrative role, you are a leader. As nurses, we have to take on the role of a leader, be that change agent who will leave a legacy that influences not only our healthcare system, but the next generation of nurses. The profession of nursing must find a way to afford opportunities to the most exceptional individuals, even if their journey of success was not like their own. This is an act of selfless service, to be able to embrace the entire young professional nurse in an effort to produce the greatest outcome.
I want to share with you six leadership nuggets that have guided my everyday actions and have influenced my approach to nursing:
1. Always display integrity and allow no one, no organization to get in the way of that.
2. Loyalty to yourself, your organization, colleagues and those entrusted in your care.
3. Compassion- Its ok to be firm, fair and assertive but do not lose sight of extending compassion.
4. Professionalism- Nursing is a profession, act accordingly.
5. Always put yourself in position to learn new things-Continued education is key to future success.
6. Never forget your Why.
Dr. Estacy Porter NP
Dr. Estacy Porter is a wife, mother of 4 kids and a retired Army Nurse Captain of over 22 years with her last job as Chief of Preventive Medicine Department. She is a Board Certified Advance Public Health Nurse and licensed Nurse Practitioner in Community Health. Dr. Porter is the founder and CEO of Jewel in His Eyes, a Holistic Health Empowerment program for girls and women to live and be the healthiest version of themselves as well as founder of Garifuna Nurses United, is a membership-based organization with a mission to gather Garifuna Nurses from across the diaspora together to foster a positive environment of growth, professional development and address health disparities amongst the Garifuna people. Her Doctoral Project focused on developing an executive level leadership and mentorship toolkit for Army Public Health Nurses.
