Thursday, June 30, 2011

Pelvic Exam Queen


Once upon a time about 15 years ago I got my first pelvic exam. It was a horrifying day, not because I had a horrible doctor (Dr. Blair is awesome) but because there was a huge metal-looking duck bill expanding inside of my vagina.  The image has stayed with me over the years. Now, I, Nurse Nikki, the FNP student am performing about 15 pelvic exams a day with those same metal duck bills.  During my first attempt I'm pretty sure I hesitated about 3 times before I actually inserted the speculum.  My ultimate goal is to minimize discomfort and any traumatic experiences to what is already, for first-timers at least, a mentally exhausting but necessary event.

Everyday I strive to improve my technique and decrease discomfort. I think the key to a successful pelvic exam is all in the patient's position. (My preceptor at Planned Parenthood is an awesome teacher) Instead of positioning the stirrups in an awkward outward position, I place them slightly parallel and ask the patient to then point her knees outward. Her legs resemble a frog's legs (for you visual folks). With her bottom on the very edge of the table and knees outward, this creates optimal viewing. I refrain from a whole lot of touching just because it's not totally necessary. A simple and light touch to the inner thigh alerts the patient I am about to begin. A comforting reminder to relax also helps. Sometimes a little pressure to the introitus is necessary to initiate relaxation.

Needless to say, I am by no means striving to become a women's health nurse practitioner. I commend them for their ability to simply focus on the female genitals for entire work days. I love primary care and its always in the back of mind.  I always manage to add a few questions about cholesterol, glucose and weight management into each visit.

So I have about 10 more days left of performing about 10+ pelvic exams a day. I'm pretty sure that makes me the Queen of Pelvic of Exams (in the student category of course).

Thursday, June 23, 2011

Blog Launch Weekend: AANP Conference 2011 Las Vegas!!

My first AANP national conference! Once my plane touched down in Las Vegas, I was inspired to channel my energy into an anedoctal and hopefully inspiring blog.  Follow along...

I got off the plane with a nervous giddiness. I wanted to see it. 'See what?", my husband wondered as I dragged him along. "Nevermind, give me the camera, no, better yet I'm faster with my camera phone". "What are we trying to see", he shouted. "I want to see the sign, the sign that says Las Vegas welcomes the The National AANP Conference". We hurried to baggage claim. There was a sign for a Rihanna concert, some hot-looking Chippendale dancers, a human Mufasa, but no AANP. No mention of us anywhere. Maybe Las Vegas put the sign outside. We proceeded to the shuttle line. A quick sweep of the area still revealed no sign.

I didn't let a little sign, spoil the occasion. I was in Las Vegas for bigger reasons.
Project: Save Lives
Operation: Educate My Patients
Mission: Empower Myself

This minor case of disappointment made me realize folks are still a little greeen about nurse practitioners. Its a little frustrating pursuing a career that I have to teach people about before they allow me to touch them.  I hope to use this blog to vent my frustrations, jubilations and realizations as a 3rd year NP student and later as a new NP. Other nurse practitioners: new, old and students can use it as a platform to voice their questions and comments as well.

Small Disclaimer: Don't expect APA format because it ain't happenin'!