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Real World NP — Business
Real World NP

Hi, I’m Liz Rohr: family nurse practitioner, wife, parent, and founder of Real World NP, a continuing education company for new nurse practitioners in primary care.

I’m on a mission to equip and guide new nurse practitioners so they can feel confident and capable through comprehensive, concise, and hyper-relevant educational resources, without the fluff. We’re also here to provide an approachable, supportive community in order to bring about a new generation of healthcare providers who know that they can make an impact & inevitably disrupt the healthcare industry.

Each week you’ll hear a mix of clinical pearls and practice tips, guest interviews with specialists and allied health professionals, and guidance on navigating the role transition from RN to NP. Make sure you subscribe and leave a review so you won’t miss an episode. Plus, you’ll find links to all the episodes, plus extra goodies over at realworldnp.com/podcast.

Hosted on Acast. See acast.com/privacy for more information.

Copyright: © Liz Rohr

Latest Episodes:

Weight Management Part 2- Medication Management Mar 24, 2022

Show notes

Prescribing weight loss medications in primary care is SUCH a common challenge for new nurse practitioners. It feels like there are so many options and things to keep track of.

This week’s episode is a follow up from the last episode about weight management counseling-- all about weight loss medications in primary care.

This week I cover:

✅ Which patients are candidates for weight loss medication

✅ The three main types of medications, side effects to watch out for

✅ Goal setting and what to expect with patients

✅ Monitoring of patients and how often to have them come back to clinic

PS. I said most of the studies are heterogeneous but I meant to say that the studies are too homogeneous-- they’re not reflective of the diverse communities of patients we serve.

Read the blog post here.

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Weight Management Part 1- Lifestyle Intervention and Counseling Mar 22, 2022

Show notes

Weight management counseling in primary care is such an important skill, and it’s truly the foundation that patients need before we can start addressing weight loss medications.

In this week’s episode, I’m covering my approach to weight management counseling in primary care, that will hopefully help you feel more confident in your visits.

I cover:

✅ How to talk to patients, including actual easy scripted phrases to use so you get the information you need and they feel supported

✅ Special considerations with using the BMI calculator (who knew??)

✅ One key to actually move the needle forward in weight management conversations

✅ The hidden beliefs we need to address with patients that will set them up for success

✅ The mindset shift that will help you and your patients set realistic expectations and plans of care so they reach their goals

Read the blog post here.

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Pelvic Floor Dysfunction for New Nurse Practitioners Mar 17, 2022

Show notes

I’m SO excited to share this interview with you. I’m interviewing two pelvic floor therapists -- a family nurse practitioner who has gotten additional training, and a physical therapist with a specialty in pelvic floor therapy.

This is SO IMPORTANT. It seems like a hidden corner of medicine that we don’t learn about in school, or maybe it’s touched on when it comes to dyspareunia or urinary incontinence, but it’s so much more than that and we have the power to be so helpful for patients.

In this episode we cover so, so many gems, including:

✔What is pelvic floor therapy?

✔What is pelvic floor dysfunction?

✔When would someone need that?

✔What do you wish primary care providers knew?

✔What resources do you recommend to learn more or to get patients access?

✔Why should we not give exercise handouts?

Here are Melissa and Kathy's website and YouTube channel:

http://www.instituteforpelvichealth.com

https://www.youtube.com/channel/UCVH9Cd-W5YPHoz4cFGZQ3Xw

Read the blog post here.

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Interview with a Physical Therapist Mar 15, 2022

Show notes

Interdisciplinary collaboration is SO important in primary care. It’s a tragedy when we’re each rockstars in our own bubble of a profession, but aren’t collaborating or communicating enough to fully understand what each profession actually does.

I’m absolutely obsessed with physical therapy, and it’s a HUGE key to success for patients with musculoskeletal complaints in primary care-- but I didn’t really see how it worked on the other side until I was a patient myself.

In this week’s episode, I’m interviewing Stephanie who’s been a physical therapist for 10 years, and we’re answering questions from the email list about physical therapy. We cover:

✅ What physical therapy is and how they can help patients

✅ Who’s a good candidate (or not) and what patients should go that aren’t being referred

✅ The role of imaging before sending to physical therapy

✅ How to manage cost/time/insurance concerns patients have

✅ What we can do in primary care to counsel patients and prepare them to set them up for success with a physical therapist so they can finally feel better

Read the blog post here.

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How to Delegate Effectively as a Nurse Practitioner Mar 10, 2022

Show notes

When we’re nurse practitioner students, we’re so focused on the clinical aspects of our jobs that most of the time when we graduate, we’ve caught by surprise.

There’s an entirely new role we need to step into as well: delegating, supervising and managing staff members.

It’s especially tricky when you’re supervising someone, but you’re not technically their boss-- like medical assistants and nurses.

And it’s also difficult because as nurses, we’re so used to working as a team, pitching in, and it feels like we should just “do it ourselves” when it comes to delegating.

In this week’s episode, I’m interviewing executive and leadership coach Jackie Kindall with the questions from the audience about delegation and managing team members as a new nurse practitioner.

We cover:

✅ Why it’s actually a not helpful for us to “do it ourselves” and how delegation is actually helpful and important to do

✅ The common pitfalls new nurse practitioners and leaders experience when it comes to delegation and supervision

✅ How to effectively delegate and troubleshoot when things are not going well

Read the blog post here.

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How to Navigate Scheduling Issues for Nurse Practitioners Mar 08, 2022

Show notes

When I became a new nurse practitioner, I was so focused on learning the clinical pieces that it never occurred to me to learn more about the business of primary care.

Once I was on the job, I realized how crucial it is to understand those pieces and how I fit as a clinician in the primary care office ecosystem.

This is particularly relevant when it comes to scheduling patients. It seems like a minor thing, but it causes a lot of nurse practitioners painful headaches, and can be tricky to both understand the problems and navigate out of them unless you understand the full picture of how it fits into the day-to-day running of the practice.

In this week’s episode, I’m building off of last week’s video where I talked about the business foundations of primary care. I cover:

✅ The foundational pieces to understand when it comes to scheduling patients

✅ The way that it can look ideally, and the less-than-ideal “real world” way it can look

✅ Examples of issues new nurse practitioners face, and ways to navigate out of them

Read the blog post here.

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How Primary Care Offices Work for New Nurse Practitioners Mar 03, 2022

Show notes

As nurse practitioners, we primarily learn the clinical aspects of practice. For good reason-- we’re taking care of real patients’ lives. But there’s a whole lot more to learn on the job, from delegation and leadership, to navigating day-to-day challenges in the ecosystem of a clinic.

I was SO focused on learning the clinical parts as a new NP, that I was caught by surprise at my first job. I didn’t realize how primary care offices work-- the business of running a clinic -- and the role I now played.

Understanding how primary care offices work from a business perspective can help you in SO many aspects of your job as a nurse practitioner-- from asking the right questions during a clinic interview, to negotiating salary, to making improvements in clinic workflow or requesting more support.

In this week’s episode, I’m covering the foundations of how primary care clinics work from a business perspective, your role, and it will serve for the basis of a few upcoming videos where I address the “ideal world” and the “real world” of primary care offices, and how to navigate the common issues that come up.

Read the blog post here.

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Interview with a Women's Health Nurse Practitioner Mar 01, 2022

Show notes

One of the struggles for new nurse practitioners in primary care is managing women’s health topics, and knowing if and when to refer to an OBGYN specialist. We want to do things the right way and use resources we can trust.

In this week’s episode, I’m interviewing Monica Carter, who is a family nurse practitioner who has practiced in the women’s health setting for the last 13 years. She dropped SO many pearls and pitfalls of practice, and is truly a gem of a human. We answered questions from the community for a women’s health provider, including:

Tips for finding cervixes on pap smears, when to do a pap post-hysterecomy, and how to assess the variable appearances of cervixes on exam
Tips and resources for managing menopausal symptoms, abnormal pap results, choosing contraceptives (such great insights!) and medications in pregnancy
Getting into GYN as a family nurse practitioner
When to refer to maternal fetal medicine
Initial workup for infertility and pearls of practice

Check out the resources she mentioned inside the video here:

Menopausal symptoms

ACOG green journal (need an ACOG membership or you can purchase)

https://journals.lww.com/greenjournal/Abstract/2014/01000/Practice_Bulletin_No__141__Management_of.37.aspx

Menopro

https://www.contemporaryobgyn.net/view/nams-launches-free-mobile-menopause-app

Choosing birth control & best resources - Contraceptive technologies - book and conference

http://www.contraceptivetechnology.org/

ASCCP app

https://www.asccp.org/mobile-app

Reprotox app

https://reprotox.org/

Read the blog post here.

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Time Management for Nurse Practitioners: Inbox Feb 24, 2022

Show notes

There’s SO much to manage as a new nurse practitioner, on top of developing your clinical knowledge, making a thousand decisions a day and becoming a leader in the healthcare space. The better your time management, the more time to get your work done and ACTUALLY rest at the end of the day.

In this episode, I’m covering the rest of what we do in a day in the life as nurse practitioners-- inbox management and the time management strategies to make it all easier.

I go over:

✅ The types of documents and tasks we need to manage when we’re not seeing patients

✅How to prioritize them, and how to use your EHR to support YOU

✅What to look for, what to ask for, and how to bring suggestions to your team if it’s not going well

As always, if you want help with your lab interpretation, join us inside the Lab Crash Course! It comes with 8.7 hours of continuing education, it’s self-paced and you get lifetime access. Learn more: https://www.realworldnp.com/labs

Read the blog post here.

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HSV Diagnosis for Nurse Practitioners Feb 22, 2022

Show notes

So often in primary care, patients come in asking for testing for herpes, whether they have symptoms or not. Sometimes it’s because they “want to be tested for everything,” or are concerned about an exposure from a partner. As a new nurse practitioner, I wasn’t always confident about the best approach.

In this week’s episode, I’m covering:

✅ When to consider HSV, and the unlikely ways it can present

✅ What the difference between primary, non-primary initial and recurrent infections are, and what it means for the patient

✅ The top differential diagnoses to consider

✅ How to test for HSV, what the gold standard tests are and what NOT to use

Read the blog post here.

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