clinical tips

I will update this regularly for anything I've learned from school, textbooks, &... life!:

- Chronic lithium ingestion can lead to nephrotic diabetes insipidus which is the most common form of renal injury in lithium patients. NP management: ask psychiatrist to lower dose. If therapeutic effects for psych and psychiatrist doesn't want to lower dose => start on demopressein to treat DI. http://www.uptodate.com/contents/treatment-of-nephrogenic-diabetes-insipidus

- When adjusting dosage for lithium => see pt every 8 days ideally or 2 weeks (easier for pt to remember 2 weeks) initially. Not for the rest of the time.

- If pt is menopausal => ask about sexual difficulties due to dry vagina

- Over 65 y/o => pneumoccoccal vaccine. Usu. missed unless pt has been in the hospital.

- always promote diet & exercise in ALL patients

- try NOT to use the affected arm of the pt w/ total mastectomy for invasive procedures due to risks for lymphedema See: http://www.hopkinsmedicine.org/healthlibrary/conditions/breast_health/lymphedema_following_a_mastectomy_85,P00148/

Study tips

In the spirit of providing concrete (and hopefully helpful!) advice: Here are some ideas to to be as efficient as possible to process, digest, and retain the deluge of information medical school offers: (or any vocational school for that matter):

ORGANIZATION:
Divide & Conquer.  Categorize your study content into the following buckets:

• Can I learn this right now in under 5-10 minutes?
• Can I delegate this? (see teamwork below)
• Can I put this off until later?

After a full day of classes and workshops, many medical students find their study load to be dauntingly heavy, intimidating and disorganized.  The content to learn is often significantly more voluminous and complicated than that of college and many students find themselves in uncharted territory trying to expand their mental bandwidth.   

Take an hour after classes to systematically divide your study load into these categories.  Once completed, take a breath and then conquer the first bucket:  

Can I learn this right now in under 5-10 minutes? 

Because these are low-hanging fruits, you will find that studying is manageable.  Learning items in this category should be at a quicker pace and in a short 1-2 hours, you'll have accomplished a significant amount.  Day by day, the baggy study load becomes organized and manageable which is KEY to efficiency.  This approach also provides much needed motivation to tackle the more complicated and dense materials.         

Teamwork.  

No one makes it alone.  Find your  team.  Your study group should be small enough where you must be a  participating active member and not a passive silent participant.  You  have to trust your team: trust them enough to be comfortably wrong.  

When organizing your study load, consider which elements can be potentially delegated to the study group (particularly if you lack interest or strength in an area and one of your team members has a particular passion for that subject).  Why burn hours and mental anguish trying to understand renal pathophysiology when a friend can break it down for you in easy to understand principles and concepts?  Likewise, things may be delegated to you at which point you'll find yourself teaching: an invaluable way to reinforce learning.  An efficient and trusted team will shave off much waste and add significant value to your study time.  (My team was a  group of 4 trusted stalwarts: more than 10 years later we continue to  remain close in friendship).

Can I put this off until later?  

This is such an important element to organizing your material.  Prioritizing the timeliness of your curriculum is a necessary tool to achieving sustainability in an increasingly additive workload.  You minimize the waste of learning something that could have been put off at the cost of learning something you should have focused on due to an upcoming exam, rotation or workshop.  Simply by taking the time to categorize when something should be learned will help you stay focused, in-the-moment, and never behind. 


BEHAVIORAL MODIFICATIONS:
Most people believe your mind is your mind and there's little one can do to importantly augment how quickly you process information.  But here are some thoughts than can make incrementally small differences to give you an edge:

• Sleep.  All nighters to cram has diminishing returns.  Lack of sleep and fatigue has been compared to a blood alcohol level of at least 0.1% in one Australian study.  Your performance (exam, verbatim recall, etc) and your coordination (procedures, surgery) will be significantly better after a restful sleep.  
• Caffeine.  This is a drug.  Overuse predictably lends oneself to dependence.  The absence of this drug will predictably lead to a state of withdrawal and detract from performance and mental efficiency (headaches, moodiness, etc).  PEARL:  Use sparingly in key moments, caffeine will predictably AUGMENT mental efficiency.  A group of us in medical school never drank coffee on a regular basis.  We leveraged it by drinking it strategically right before an exam.  Our bodies never got accustomed to it and much like an intermittent drug, we felt the augmented mental alacrity when taking it sparingly (n.b. we never experimented with nor recommend "stay awake drugs" such as Provigil).    
• Stop multitasking.  We live in an era where smartphones and tablets are constantly at our fingertips.  Distractibility, attention-deficiency and hyper-activity are real phenomenons that children, young adults and professionals struggle with in this information-accessible culture.  It is an addiction and the metaphorical quick-sand of efficient learning and productivity.  Set predetermined times of studying and breaks to minimize these hazardous distractions. 

These tips aren't meant for everyone.  Learning styles are highly individualized - from toddlers  to medical students.  Visual, audio, oral, organized or procrastinator,  repetition or photographic...the key is to gain insight into your  personal styles and strengths (reference: Gardner's theory of multiple intelligences & Carl Jung's learning style dimensions).  Having achieved entrance to medical school, chances are you are well aware  of what works for you and what doesn't.  Don't re-invent!  Rather,  build on what has already made you successful thus far. 

I hope some of this is helpful.  Now stop procrastinating and get back to studying!

Source: https://www.quora.com/How-do-top-medical-students-study?share=1#!n=12

Tips for studying NP while working

Tips for studying in Nurse Practitioner school while working

• Invest in a good planner.  Tho google calendar can be helpful and you can sync it with your smart phone too. Whichever way you use, just make sure it works for you. I like to have a planner that spans the entire academic year from July 2015 to June 2016 for ex. 
• Simplify your lifestyle. I've reduced to work out only on the weekend and spend time after work at a local coffee shop or a library if you can find one to study. If you don't wear scrubs at work, make sure you simplify your work clothes. Since I don't wear scrubs at my current work, I've invested in nice professional dresses so I don't have to pair pants with shirts too often. I also wear wedges instead of heels for easy mobility. 
• Learn from your classmates. Your classmates will be helpful to give you insights. Also, it'd be good to study with them. You can always learn from anyone. Utilize any resources you have.
• Limit time on social networking time.  You'll be easily carried away. Prioritize your study
• Part-time. You may need to do part-time work or part-time schooling. It'll be impossible to work full time and study full-time due to school schedule.
• Enroll in next quarter/semester classes early. That way you can get your choices and don't have to worry about the class running out of space for you and you'll end up with a less favorable schedule.
• Ask your instructor. If you can't get the class you'd like to be in, make sure you contact and be nice to your instructor to ask if you can be in their class.
• Expect to work hard & smart. You won't be able to know everything in depth. Focus on breadth. If you can pick on a smart friend's brain, do it! 
• Read sth medical everyday. You will forget. So, try to learn. 
• Listen. I record lectures and listen to them on my commute to work. I get info. in and out that way.
• Timewasters. Learn to recognize tasks or ppl or thoughts that are time wasters. You'll be in school for a small amount of your life. School is the foundation for your career. So try to get the best out of it. 
• Enlist help. If anyone is kind enough to help you, thank them and allow them. If you need to pay to get things done, do it! Don't pay too much tho.  

~me 

Tips for buying textbooks

Tips for buying textbooks:

.  Contact the instructors for the next quarter a month or a few weeks before the next quarter starts to ask for the books they want us to use. Then, go online and buy them. It's usually cheaper when you buy them earlier. If you wait until quarter starts, the books become expensive since demand is high and supplies become scarce.

.  Buy books and write in pencil how much you bought them for on the first page in a light leaving no marks kind of way. That way you remember how much you bought them for and then you can sell them back.

. Check with your instructor if you can use older edition. Some texts don't change that much other than rearranging chapters or adding a few extraneous chapters. 

. After your NP school, you can just sell all of your books. Be patient. You can buy them again when new editions arise. By that time, it's going to be much cheaper! 

~me