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Reflecting On My First Month As A Neurosurgery Nurse Practitioner

Holy guacamole! It has now been a little over one month since I've started working as a neurosurgery nurse practitioner fellow, and it's crazy to see how much I have grown in just this one month. Despite seeing patients who come in for the same condition, each and every patient is a unique learning experience because each may present differently and/or have other individual care needs to be considered.

Me and the other fellows celebrating the completion of the 1st month of the fellowship program

I've officially moved out of taking care of (mainly) adult patients in the cranial clinic and inpatient setting, and will now be utilizing my pediatrics skills to take care of kids in the neurosurgery specialty. Unlike adults, where the clinic is split between the cranial side and the spine side, the clinic is run altogether for the kids and there are developmental milestones to consider. A good thing though (as my mentor reminds me) is that kids are typically not as sick as adults.

I will admit. Learning all the new neurosurgery terminology and being able to speak the lingo was difficult at the beginning. And even now, I'm still learning! What has been helpful for me thus far is reading about at least one condition per day. It doesn't stick on the first try all the time, but the repetition and seeing patients with these conditions have been very helpful.

Another thing that has been helpful for the outpatient clinic workflow is reviewing the patient's charts the night before. I don't get paid to do this, but doing so allows me to look up conditions, read up about the patient, and make any notes I need to (via the electronic medical record's (EMR) sticky note function) prior to the clinic day. It can be time consuming and is extra work, but I think it has been helpful for my learning and just to keep the clinic day flowing smoothly.

Conditions I've learned about so far:

  • Glioblastoma Multiforme (aka GBM)
  • Pituitary Tumors
  • Holoprosencephaly
  • Brain Aneurysm
  • Chiari Malformation
  • Plagiocephaly
  • Craniosynestosis
  • Pineal gland cyst
  • Meningioma
  • Syringohydromyelia
  • Syrinx
  • Hydromyelia
  • Normal Pressure Hydrocephalus
  • Elevated Pressure Hydrocephalus
  • Pseudotumor Cerebri (aka Idiopathic Intracranial Hypertension (IIH))
  • Astrocytoma
  • Meningocele
  • Myelomeningocele

Medications I've learned about/reviewed so far:

  • Fioricet
  • Oxycodone
  • Avastin
  • Gliadel Waffles
  • Temodar
  • Salt Tablets
  • Decadron
  • Hycet

Skills I've learned to do/reviewed so far:

  • Suturing - Simple interrupted, Figure 8, Running
  • Shunts adjustments - Certas, Codman, Strata

My time has been pretty busy juggling the work days, meetings I need to attend as part of the fellowship (there are about 4 different ones), and working on my research project. Of course, there are other things like just being an adult, hanging out with friends, spending time with my husband, and making time for myself. Although I was originally hoping to do a weekly reflection post, I think I'm going to be doing more of a "monthly roundup" reflection (inspired by Trader Joe's monthly Fearless Flyer).

See you all in about a month when I'm finished with the pediatric neurosurgery block!

Nicole G.

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