I work two days a week in Primary Care in West Auckland. I see all the children that present to our low decile clinic. I go from birth to 18 years. A typical day is quite varied. Yesterday at work I saw kids with Hand Foot & Mouth disease, chicken pox, lots of skin infections, asthma, upper respiratory tract infections strep throat, urinary tract infections and several teenagers that were pregnant, one with positive gonorrhoea. So you can see that my scope is broad, varied and interesting. I just relocated to Auckland from Pukekohe where I ran a pediatric clinic within a large primary health clinic. I saw kids 11 years and younger and the clinic became very popular and busy. I saw lots of the same as above, with the exception of the sexual health issues.
I completed my Masters in Nursing in the United States at a young age—back in 1982! Before you were born. J At that time the Nurse Practitioner role was not well developed, and not included in the Masters preparation. After I finished my MSN, I taught pediatric nursing for many years, while still working a lot on the wards in paediatrics. In the 1990s, at the urging of a friend who was a pediatric intensivist, I returned to school to complete my FNP. I finished in 1998 and passed the National exam. I started working at a pediatric clinic with another NP and 2 pediatricians, and stayed there until I moved to NZ in 2005.
When I came to NZ, I worked first as a practice nurse as I had not done my portfolio for Nursing Council for recognition as a NP. I finally did that and became a NP in December 2008. Now I am a frequent panel member at Nursing Council for nurse practitioner applicants. That has been an interesting and rewarding activity. Luckily, I was asked to teach here at AUT last year, so I am getting a great mix of clinical and academic life.
For nurses that are interested in becoming a nurse practitioner, I suggest you don’t narrow your scope down too much. (ie eczema, or wounds) Keep a broader scope and in the meantime get as much experience in clinical as you can. Start thinking outside the box: as a NP you will be making diagnosis, and that requires a shift in thinking from what nurses usually do. Start thinking what the diagnosis might be, and discuss these with the doctors you work with. Do lots of practice with assessments. Learn all you can about disease processes and basic anatomy and physiology. Within my scope I have prescribing rights. I would really urge anyone wanting to be a NP to ask for prescribing rights, as if you don’t have them then you are not going to be able to practice autonomously. It is built into the masters curriculum, generally the nurse takes an advanced pharmacology course and then the last semester they take a prescribing practicum where they actually work with a prescribing mentor, GP or NP, and learn how to prescribe. This is something we look closely at when interviewing perspective NPs at Nursing Council. I have a panel tomorrow, and I have made a scenario to present to the candidate in order to ascertain that she will be a safe prescriber.
It is really fun being a nurse practitioner and there are so many opportunities for a NP.