WOMEN'S HEALTH #1

Last Friday I had officially started my big chunk of hours to be completed just before Christmas. I have to do a minimum of 24 hours a week to get them done. I have arranged for me to get into different areas such as family practice, cardiology, women’s health, and OB/Gyn. I have to complete a certain amount of hours in each area. I still have to find an urgent care to spend about 40 hours in. I will try to tackle that next week. Unfortunately, there are many physicians and NP’s who do not want students. But I do what I have to so I can graduate in January 2005. That was why I drove 140 miles round trip to get my pediatric hours in a few months ago. I have to take the hours when I get them.

Today I spent 8 hours at a clinic which deals mainly with women’s health issues. When I first began my women’s health portion of the program at the beginning of this year, I was unsure if I would like it or not. Afterall, it is not my favorite office appointment or exam, so why would I think it should be other women’s? As an NP, why would I want to do pelvics all day long? I have actually been surprised. I am actually considering getting into this area as an NP when I graduate. At least for a little while to gain some experience. I am finding it more enjoyable and challenging than I originally thought. After doing some soul searching, I think I figured out why. Nurse practitioner’s are known to do a lot of teaching in the clinical setting. That is what they do best. When it involves women’s issues, I believe there is a significant need to teach the community regarding birth control and preventative care. I guess I think I can make a difference. I remember when I was young(er) and naïve. We will see.

A good example was a 19-year-old woman who came in today for her yearly exam. Last year she was diagnosed with Trichomonas and treated. Today she complained of the same symptoms. She is currently involved in a long distance relationship where she sees her boyfriend once a month. She says she is monogamous. She realizes the only way she could have contracted Trichomonas was by him who had contracted it from somebody else. During the whole conversation she was shy and giggly. Her boyfriend being with another woman (or two…) did not seem to upset her. She does not use any type of birth control, even though she does not want to get pregnant. Her exam revealed she once again had Trichomonas and needed to be treated. A lot of education went into her visit. She was young minded and probably will end up pregnant or with another sexually transmitted disease in the near future. I tried to teach her about the risks of contracting a STD that could by a life long problem. She was lucky she had not yet contract genital herpes. Hopefully a quarter of what was said today will sink in to prevent her from getting any more infections.   

A 32-year-old woman comes in today with the complaints of a herpes outbreak. She has been with her boyfriend for one year and believes he has been monogamous. He was diagnosed with HPV not long ago. She got infected with genital herpes in a previous relationship. The exam revealed she had healing herpes lesions as well as a suspicious area on her cervix. The testing done will reveal if she was infected with HPV by her current boyfriend. There was also a lot of teaching regarding STD’s and preventative care. She took the situation a little more seriously than the patient above. HPV is a precursor to cervical cancer.

I will go back to the same office next week to get more experience with preventative care, contraception use, and teaching. I have a long way to go before I feel comfortable in this area of advanced practice nursing. It interests me and I want to do the best I can to teach and try to prevent problems that could have been prevented. I am looking forward to more challenges.