2014 Whirl Wind

Here it is 2015 and I am catching up on my events and thoughts from the past year.

     I started 2014 with a new job as a Nurse Practitioner in the Primary Care Department at the Veterans Administration Hospital in New Mexico.  What an amazing opportunity. To be a veteran and serve veterans is unique. Having insights and a shared experience and language is such a positive way to help make an impact on patients.  I have to admit I was probably a funny site: tall, pregnant, woman veteran (OIF & OEF) on a mission to improve the health of my fellow veterans. However, I jumped in and learned a lot.  Not only about the VA system as a medical provider, but also how to help my fellow veterans navigate the “system” to get great health care.

     In addition to starting a new job I completed my training in the Emerge program. Emerge is an organization that promotes diversity in politics by developing support for Democratic Women. It works by identifying, training and encouraging women to run for office, getting elected and seeking higher office. The training is a cohort-based seven-month training program. I met so many amazing, and talented women leaders. It was great to share the perspective of being a women, veteran and nurse practitioner with other leaders in our community.  Now that I am done with training I am developing a plan for what I need to do to run for office.   We need more nurses and Nurse Practitioners in leadership roles in our community and that includes political positions that influence and build our community.

     2014 was also the 25^th Anniversary for CLNkids(also known as Cuidando Los Ninos).  Our 25^th Anniversary Celebration was amazing. With the help from generous donors and Alpha Bravo Events  we were able to not only ensure that all tickets and proceeds went to CLNKids but we raised $16000. Even more exciting, that increased visibility in the community made our Christmas Fundraiser a huge success and we raised $58,000.  It has been a busy year. As Board President not only do I manage the executive committee, but I attend the finance committee (to maintain our budget and ensure fiscal responsibility), the advocacy committee, and anniversary planning committee.  I am not sure where I found the time, but I think the success was due to our event planner, amazing staff and our board members.  I love working with motivated, dedicated and engaging individuals. It makes everything easier.

     With all those activities I am not sure we could have added anything else in my life. However, life happens and now I can add being a mom to my list.  Our daughter was born in June and my life has been changed in so many ways. I changed everything to be more efficient with my time and be able to spend as much time as possible with her.  Mountain Man has also shown me his “dad” side. He really is an amazing man in so many ways.  It is often the little things I notice when I get home that just make me smile. The other morning after I fed baby girl and was headed off to work he said “I have noticed she likes to wear a sweater in the morning” right before dressing her . Or the other day when I came home to find him vacuuming the floor with baby sitting in the REI Baby Backpack on his shoulders laughing and giggling as he cleaned our home. I love being a mom and still being able to support my community. And now I get teach this to my daughter and hopefully show her the values I have through my own actions.  

2015 is the year of the mom-veteran-nurse practitioner for me. I hope everyone remembers that in everything you do you are always more than just a nurse or a mom or a friend. You are all of those things and more.

Policy and Politics for this Nurse Practitioner

I had an “ah-ha” moment today, here are my thoughts:

I served in the United States Army,  completing tours in Iraq and Afghanistan.

I currently serve my community in various ways, to include Cuidando Los Ninos (CLNKids.org) and American Women Veterans (http://americanwomenveterans.org).  Both are two organizations that I love on a soul level.

I think it is time to serve on another level, to have the positive impact on my community and the nation I am proud to be a citizen of.

That being said I have decided that for my birthday instead of spending money on material objects or things that won’t make me happy, I signed up to take a short 2 day course called “Ready to Run”.  I am not ready to put up signs declaring my candidacy just yet.  But, I have decided to ask for more mentorship from my friends and take an active role in my education of policy and politics.

I know I should outline my own political views but really I am still confused as to what I subscribe to exactly. I don’t think I belong to a specific party. I vote for issues and policies that help the community help themselves and grow. I don’t agree in handouts, but agree that those willing to put effort and work into life should be encouraged and helped.  My hope is that my friends understand and support me in this new journey. (P.S. we are all more than just anything, we are who we are).

Here is more information about the course I am taking: http://shri.unm.edu/readytorun.html

Research shows that women make government more transparent, inclusive and accessible, but too few women serve. In 2012, only 17% of US Congress was female, and women held only 27.7% of state legislative seats in New Mexico.

Ready to Run NM seeks to address the underrepresentation of women in public office in the state. A training program will be held in April 2013 over one-and –a-half days. Through an innovative curriculum that incorporates the political culture of the state, the program will present state and local campaign experts to highlight the specifics of running for public office. The program seeks to demystify the process of running for elected office, encourage more women to mount campaigns, and introduce them to elected and appointed leaders, campaign consultants, and party officials in the state to whom they can turn as they get ready to run.

Ready to Run™ program attendees walk away with...

“How to” instructions on running for office

Fundraising and media skills

Real-world advice and best practices from experts

Strategies for positioning yourself for public leadership

Inspiration to launch a campaign

A better understanding of party politics

Internet strategies for political campaigns

You can make a difference. Attend the Ready to Run New Mexico conference on April 12 and 13, 2013.

Please see details below.

Friday, April 12, 2013

2:00 PM to 4:00 PM - "Miss Representation, " a documentary by Jennifer Siebel Newsom that premiered at the 2011 Sundance Film Festival and aired on OWN: Oprah Winfrey Network, will be shown at the Student Union Building, Luminaria Room. The film explores how the media's misrepresentation of women has led to the under representation of women in positions of power and influence. The film is sponsored by Political Science Graduate Student Association (GSA).

5:00 PM - Registration opens at the MCM Elegante Hotel, Atrium Room

6:00 PM - Keynote Address and Welcome Dinner.

Former Congresswoman Heather Wilson will deliver the Keynote Address.

Saturday, April 13, 2013

Speakers include: State Senator Lisa Torraco; State Representative Jane Powdrell-Culbert; State Representative Georgene Louis; Mary Herrera, Former Secretary of State and many more.

Santa Ana A&B Conference Rooms, Student Union Building, UNM Main Campus

8:00 – 8:30 AM             Registration and Breakfast

8:30 - 9:45 AM             Morning Plenary:

Welcome: Dr. Christine Sierra, Director, Southwest Hispanic Research Institute & Professor of Political Science, UNM

9:45 - 10:00 AM           Break

10:00 – 11:30 AM         Breakout Session 1

Track 1 – (I’m ready) – Panel:

Launching Your Campaign

This session provides an overview of the key elements of a campaign; including assessing and establishing oneself as a candidate, developing a campaign plan, structuring a campaign organization, fundraising, Internet strategies and voter contact.

Track 2 – (I’m not ready yet) – Panel:

Introduction to New Mexico Politics and Public Life

This session, designed for those who are not ready to run, offers an overview of public life, leveraging community leadership for political leadership, types of offices to consider, and balancing competing priorities of a political career and family life.

11:30 – 11:45 PM          Break

11:45 – 2:15 PM           Luncheon Plenary

2:15 – 2:30 PM             Break

2:30 – 4:00 PM             Breakout Session 2

Track 1 – (I’m ready) – Panel:

Delivering Your Message: Platforms, Interviews and Public Relations

This session will provide a more in-depth look at how to clearly deliver your message and your political platform. You will learn both how to formulate your message and how to deliver it effectively to voters.

Track 2 – (I’m not ready yet) – Panel:

Navigating New Mexico Networks: Parties and Organizations

This session will highlight the power dynamics of party organizations, building relationships within parties and interest groups, and gaining party support. Here you will meet with party and interest group representatives and will be given a chance to network with political leaders in New Mexico.

4:15 – 5:30 PM           Closing Plenary: Strategies for Success

March is Allergy and Asthma Month

March is Allergy and Asthma Month

Allergies and Asthma

Here is a recent article I wrote for my new job. Enjoy

The Ides of March are rapidly approaching and with them the dreaded allergy season. Even saying the words make my eyes start to water and images of my sneezing in rapid succession come to mind. Allergies also referred to as seasonal allergies, such as Hay Fever and Allergic Rhinitis occur at certain times of the year. Most are caused by pollens from trees, grasses or weeds. At times mold spores can grow and cause additional problems for those who suffer from allergies. Common allergens in Albuquerque include: Arroyo willow, black willow, box elder and ash-leaf maple, annual ragweed, biennial wormwood, coyote brush and Bermuda grass to name a few. Pollen counts change daily. My go to spot to review the daily pollen count is www.pollenlibrary.com.

Most people breath in allergens and have no problem or minor symptoms but as many as 20% of people in all age groups have allergic rhinitis. Symptoms can range from nasal itching, discharge, sneezing, sore throat, hoarse voice, and itchy red eyes all of which are not conducive to having a great day.

The first thing everyone is cautioned about is to avoid their specific allergen. However, short of wrapping yourself in a bubble, it is difficult to go about your daily life and enjoy the great outdoors and avoid allergens. My suggestion is to do a little detective work. Try to identify what is your specific trigger. Is it the pollens (trees, grass, ragweed, tumbleweed) and insects in your local area (house dust mites, cockroaches, or ladybugs)? Are there animal allergens (skin, fur, feathers, saliva) or even molds in your home you were unaware of?

Your primary care provider will work with you to help identify triggers and can often suggest one or more medications.  These can include nasal glucocorticoid sprays, and antihistamines.  Your provider can also work with you to help find the best treatment, taking into account not only your allergy symptoms and severity, but also keeping in mind any other preexisting conditions you have that may exacerbate your symptoms such as asthma.

If symptoms are severe or persist, patients can be referred to an allergy specialist for further testing to identify the specific agent or agents causing the allergens. Allergy Shots can also be helpful for a certain group of patients. Allergy shots are injections that can make you less likely to have allergy symptoms. They are generally made to order, for each patient’s allergen triggers. They contain tiny amounts of elements that trigger and your allergy(s). Allergy shots are most effective for allergies to:

• Pollen from trees, weeds, and grasses
• Mold spores in the outside air
• Tiny insects found in dust also known as dust mites
• Tiny Flakes also known as dander from the hair, skin or fur from dogs or cats
• And stings from bees; honey , yellow jackets, hornets, wasps and in some cases even fire ants

It is important to know that Allergy Shots are NOT used to treat allergies to Latex, Medications or Food.

For many people Allergies and Asthma go hand in hand. Asthma is a disease that attacks the bronchial tubes. These tubes are responsible for carrying air in and out of the lungs.  Irritants and allergens can trigger these spaces to become inflamed, spasm and produce mucus.  These irritants can cause the airways to be narrowed and result in difficulty moving air in and out and subsequently breathing more difficult. Common symptoms of asthma include:

• Frequent cough, especially at night
• Shortness of breath
• Wheezing

• Chest tightness, pain, or pressure

While not everyone with asthma has the same symptoms, it is important for patients to know their “triggers” and keep them to a minimum if possible.

Keep in mind early signs of an Asthma Attack:

• Losing your breath easily
• Shortness of breath
• Feeling very tired or weak when exercising, in addition to wheezing, coughing, or shortness of breath
• Decreases or changes in peak expiratory flow; a measurement of how fast air comes out of the lungs when you exhale forcefully
• Signs of a cold or other upper respiratory infections, or allergies
• Frequent cough, especially at night
• Difficulty sleeping

Mild asthma episodes will usually respond to use of a rescue inhaler. More severe symptoms, or episodes that last longer require immediate help and you should be treated in the nearest urgent care or emergency department. 

I hope everyone goes outside, reads some Shakespeare and enjoys the day.

2013 is a Great Year

It’s 6:35 am, and after a long week I should be hidden deep under my comforter sleeping, but I am awake and happy so I thought I would catch my friends up.

Last year after graduating and completing the dreaded “Boards” I settled into what I thought would be a perfect job, working in a family practice clinic. I originally thought that was the environment I wanted to be in. That initially seemed comfortable to me. My goal was to have my own panel of patients and grow with a mentor. Unfortunately my ideas may not have been the goal of the clinic.

But, we are ultimately responsible for the doors of opportunity we open and close in our lives. My friend Beau turned in my CV/Resume and as if serendipitously, I was officially offered a new challenge. And as one door closed another amazing door opened.

This week was my first week in my new job, working in a wellness clinic and urgent care setting. It’s funny (in my mind) how I am drawn back into the urgent care setting, keeping in line with my Army Emergency Medicine roots. The office is filled with various personalities, all very driven in their own ways, eager to teach and grow. It’s funny how your personal challenges in life can change. I had previously felt somehow stuck in my previous job decision, and even though my commute was less than 5 min, it felt long and dreadful. I would leave work happy to have small opportunities to see patients, eyes sore from completing other people’s labs and responsibilities, ultimately feeling out of place.

This week, however, is completely different. My commute is longer, but I no longer dread driving to work. I have new challenges each day, I have read more on uptodate , journals, and prescribing guidelines, and had the ability to present a few challenging cases to my peers who are genuinely interested in teaching. Even our “Provider” meeting was a collaboration of presenting cases and reviewing x-ray films (We have old school films and I LOVE IT!).

Each night, I have come home tired, even to the point to falling asleep at 7 and 8 pm. That fatigue is great, and I feel like I am getting my groove back.(Insert Michelle doing her goofy, white girl, I’m happy and I don’t care who is looking "groove"). The best feeling of all is seeing my patients smile, feel comforted and sometimes even laugh. My last patient of the day said “I haven’t laughed in 2 months, thank you”.

2013 seems to bring other blessings as well. My friend Kellie submitted me for an award with the Albuquerque Junior League http://www.jlabq.org. I had the opportunity to attend one of their meetings and meet interesting and motivating women. That in and of itself is truly inspiring, however, I am grateful to have friends like Kellie who motivate me to be the person I am. Mountain Man and I are doing great and are planning for great things this year. My family is doing well. My friends are amazing. And now at 7:00am, I am going to tackle my to-do list from this week I have neglected. Here we go…

I passed my ANCC Board Exam

Well today has been an exciting day! I promised myself as soon as I finished I would write a blog for all of the other Family Nurse Practitioners (FNP) in the world who have finished school and are prepping for their board exam. 

What’s on the test?

Well, I can’t tell you questions, and even if I did it would give you false hope that you would learn that one question and get that correct one out of 175 questions. You are smarter than that you don’t need that. But ANCC does give you a generic list of subjects, and the test is a mix of every single thing listed.

How did you study?

I made a plan. I work as an Emergency Room nurse so working and studying is hard to do, but I tried to make a plan and stuck to it.  I Bought three study guides: 
1. The Fitzgerald CD review Course 2011
 2.  Nurse Practitioner Certification Examination and Practice Preparation, 3rd Edition By Margret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC 
3.  Adult and Family Nurse Practitioner Certification Examination: Review Questions and Strategies, 3rd Edition By Jill E. Winland-Brown, EdD, MSN, FNP.

1.       I listened to the review course CD’s after graduation when I had spear time: at the gym, while in the shower, on road trips, etc.

2.       I took my down time (ha ha ha) and did the free on-line tests while at work.

3.       I gave myself one full month and set a test date. I told my family, my friends and Mountain Man that I needed this time to myself to study and that I loved them for supporting me in advance.

4.       In that month (when not working) I took it one section at time. I listened to the Fitzgerald CD’s, referenced my ANCC Yellow/Black book (my friend gave me) and my Physical Exam/Bates book as needed to refresh the brain. Then I would do the practice questions for that subject/section from both books. First Fitzgerald’s book, she has questions and answers with long rationales and I thought of it as a further refresher. Then I would take one of the 100-120 question tests from the Winland-Brown book. Here is another suggestion: I googled a free bubble test worksheet and made copies so I didn’t have to look back and forth and could treat it like a test. I kept a spiral notebook and wrote out why I answered a question wrong, what I needed to know, etc.  For example if it was a prostate questions, I read the rational and wrote down the evidence based guidelines.  One section a day, then that night, I would review later once again. Only one section a day. Then repeat.

5.       The week before the test, I listened the CD’s daily. Wrote out information that I wasn’t remembering so well (Anemia it’s my Achilles heel, etc.) a dry erase pen on mirrors in my bathroom and in my guest room. Then I could review, even while brushing my teeth.

6.       Four days before I re-did the free questions from ANCC, the last two review tests in the Winland-Brown book, the questions at the back of ANCC’s black and yellow book and the questions you could purchase on line. (A little overboard yes). All the while I scanned the review spiral I made and the Fitzgerald workbook that accompanied the CD’s.

7.       The day before the exam, I reviewed my notes again. Then I took a break and got a facial and some spa time. I needed to relax. I also drove to the testing center to make sure I knew where it was. Then I went out to dinner with Mountain Man.

8.       The night before the exam I took a warm shower, used my lavender lotion, took a melatonin and went to sleep.

9.      The  Morning of the exam I ate a good breakfast, spoke to Mt Man about the random things I was having trouble with (Rubella, Rubeola, what happened, when, for who, and how many pennies?). He thought I was speaking a foreign language and that’s okay.

1.   Arrived early and took the test.

How was the test? 

Long, short, and basically a roller-coaster. Some questions I knew, so easy that I re-read them twice to make sure it wasn’t a joke. Others I was absolutely in the middle of the road. I marked the ones I spent longer than a minute on and decided to revisit them. There were times I felt over prepared, other times felt like I should have covered more of that theory stuff. The therapeutic communication and NP role questions easy, the Veracity, Transference, counter transference were a little more difficult.

I took a break at about hour and half, went to the bathroom stretched and then went back in. I went over all the questions I marked. Some I changed, most I didn’t. Then I sat back took a breath and pushed end.

And I passed. 

 Fitzgerald has a free power point on her website about advocacy, legal and ethical issues (and the info is also in her CD’s) valuable information. Don’t skip over that.

Some things to mention:

 I had a few sleepless nights and I read about people not passing. At one point I almost bought another study guide. To be honest, don’t do it, you don’t need to. I also read one great blog and she said what I am saying YOU WILL PASS.  I felt as though there needed to be more positive blogs so that’s why I’m writing today. The study course I took from Fitzgerald was great, stick to that.  Don’t read negative things and make sure to take care of yourself.  Spend time each day to review a section and review what you don’t know. You are smart. You finished your  FNP, took tests, wrote papers, even did hours upon hours off free work (Clinicals right?) and now you take one test. Prepare before hand, and tell you friends and family you’re a hermit till this hurdle is over and they will understand.

By the way: I PASSED and SO WILL YOU!