The Precision Health Nurse Practitioner led clinic is a private primary care centre focused on timely prevention of chronic disease and improvement of overall health and wellness. The Precision Health Nurse Practitioner team provides healthy lifestyle support for mental health and wellness as well as people looking for help with diabetes, weight management, smoking cessation, prenatal education and Well Child exams, hypertension, cardiovascular disease and more. While both are dedicated to helping people live their healthiest life, the Precision Health Nurse Practitioner Clinic provides primary care support. Nurse Practitioners are registered nurses that have undertaken graduate education and training in advanced clinical practice. They provide a crucial role in assessment, screening, healthy lifestyle support, education and chronic disease management all with the goal of improving health outcomes and facilitating access to services.
The NP was highly regarded when working intermittently with United States Defence Force health professionals transiting through the area during the exercise. The global responsibility of health care provision to those in need, secondary to crises arising from international political unrest and instability, will continue to provide the Royal Australian Air Force with ample opportunity to provide health care in austere and complex environments. Patient education is at the center of prevention and wellness. It is expected that this implementation would realise cost savings when related to the NPs medical equivalent as well as productivity benefits derived from the role. As a health and wellness organization, we practice in accordance with the Health Information Act in order to protect the privacy of our participants. Some patients, she said, would want to see the actual device, to touch it. Hickey Nurse practionar prec also worked with the American Academy of Nursing on recommendations for how advanced practice Nurse practionar prec can contribute to precision medicine Williams et al. Wilma Alvarado-Little asked the panelists for any guidance they could share on how to have a conversation with an individual who is the first person in a family Sapphic olive have a genomics-based diagnosis. The final session of the workshop examined two aspects of conveying information to the public about precision medicine.
American uniform association. DISCUSSION
In some states, Nurse Practitioners can practice completely independently of physicians, treating patients and prescribing medications as a physician would. However, in other states, a written collaborative or supervisory agreement with a physician is Doggy style lolicon required for practice. In comparison to physicians who are required to complete a minimum of 7 years of post-baccalaureate training. Retrieved 1 June A new nurse practitioner may have between and 1, hours of clinical training, compared with a family physicianwho would have more than 15, hours of clinical training practionag the time of certification. In full practice states, NPs are able to assess patients, diagnose conditions, order diagnostic exams, and provide treatments under the authority of their regional state board of nursing. By Degree. All nurse practitioners must first be registered nurses, so a bachelor's degree, associate degree or other approved diploma is a requirement. To pracitonar for a college nursing program, students typically need to complete secondary school coursework in chemistry, biology, and algebra. Consumers of Nurse practionar prec services are demanding more convenient and accessible options to care. Being nurses, they gather information about a patient Nurse practionar prec only to include physical symptoms, but psychosocial and environmental information as well. All of the education must be obtained at an accredited Love mommy young school. To explore in detail how to join one of the growing Nurse practionar prec specializations, please check out the following pages:.
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- A nurse practitioner is an advanced practice nurse who has more clinical independence and authority than some other types of nurses such as registered nurses RN or licensed vocational nurses LVN.
- A nurse practitioner NP is an advanced practice registered nurse classified as a mid-level practitioner.
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NCBI Bookshelf. The final session of the workshop examined two aspects of conveying information to the public about precision medicine. Kathleen Hickey, a cardiac nurse practitioner and an associate professor of nursing at Columbia University Medical Center, discussed precision medicine from the perspective of the nursing profession, and Chris Gunter, the director of communication operations at the Children's Health Care of Atlanta's Marcus Autism Center, addressed precision medicine in social media.
Jennifer Dillaha, the medical director for immunizations and the medical advisor for health literacy and communication at the Arkansas Department of Health, and Carla Easter, the chief of the Education and Community Involvement Branch of the National Human Genome Research Institute NHGRI , then provided their reactions to the two presentations, and Catina O'Leary, the president and chief executive officer of Health Literacy Missouri, moderated an open discussion following the reactors' comments.
Kathleen Hickey has been a nurse practitioner in a cardiac clinic that sees patients and families with a variety of inherited cardia arrhythmias, and in that role she has had to communicate very clearly and concisely what those conditions mean to the affected individuals and their families.
She said that she had entered the field in an era prior to the sequencing of the human genome, yet even then she and her clinician colleagues knew that arrhythmias ran in families and that there were genes yet to be discovered that were playing a role in the sudden cardiac deaths they were seeing in these families.
At the same time, a new technology was developed—the implantable cardioverter—defibrillator ICD —that could save lives, and she recounted how she had to adapt to the literacy of the patients and families at risk when she spoke with them about this new technology. Some patients, she said, would want to see the actual device, to touch it. Others wanted to talk to a patient who already had one implanted to find out what it felt like to have the device inside the body and what a shock felt like.
Some of the younger female patients would want to speak to other young women who might be planning a pregnancy. Patients wanted to know if they could exercise and if the device would affect their lives. Then came the Human Genome Project and the discovery of many monogenic disorders that can cause arrhythmias and for which there are now genetic panels of tests to screen patients and identify those at risk for such conditions as long QT syndrome or Brugada syndrome.
Now, in this era of precision medicine, she not only had to communicate about the therapies that existed but also about genetic testing and the meaning of the results from those tests for both patient and other family members who might be silently at risk.
Her first step to meeting that challenge was to develop her own literacy by attending the Summer Genetics Institute, a 2-month laboratory- and classroom-based course offered by the National Institute of Nursing Research. This experience, Hickey said, allowed her to learn the language and then be able to read and understand the growing literature concerning genetic testing and communicate that information to patients and families in clear and concise language.
This training also allowed her to interact more effectively with other members of the health care team. As she started evolving as a professional and working with these patients and families, she began to realize that there had been little research done on how having an ICD implanted affects an individual's quality of life and perceptions of life and what the long-term implications were of having a positive or negative genetic test result.
One study that she and her colleagues conducted Hickey et al. In another study, Hickey and her collaborators examined what cardiac and genetic testing meant to their Dominican patients, who are often of lower health literacy Hickey et al. Through a series of qualitative interviews, she and her colleagues found these individuals were afraid of dying suddenly, regardless of whether or not they had the life-saving ICD device implanted inside them, and, if the device was implanted, they were afraid of getting shocked because they did not always completely understand that the ICD shock was what was terminating their arrhythmia and saving their lives.
There was also guilt about passing on a mutation to their offspring, which is one of the real-world concerns clinicians need to address. Hickey noted that this work continues. Hickey said she has been fortunate over the years to sit on many advisory boards and panels, often as the only nurse or nurse practitioner. One such panel, convened by the American Heart Association, found that there is a critical need for genetics and genomics competencies among cardiovascular and stroke clinicians Musunuru et al.
This panel developed a set of key content areas whose subject matter all cardiovascular and stroke clinicians should learn in order to avoid a big disparity between clinicians who understand this new language and those who do not. The boot camp was open to practitioners and non-practitioners alike, and anyone who wanted to attend was directed to a series of 16 preparatory videos to watch before the boot camp. The boot camp was designed to be an interactive experience, with breakout groups that would include nurses, statistical biologists, basic scientists, and clinicians looking at a series of challenging cases and discussing them.
The dialog, Hickey said, focused on pedigree analysis, risk assessment, next-generation sequencing, pharmacogenetics, and the interpretation of common gene variants as well as some rare variants. As a facilitator in one of the breakout groups, Hickey said, she found a huge difference among practitioners in terms of subject matter literacy.
She concluded from this experience that more of these types of activities will be needed going forward and that the field has to develop ways of educating the next generation of practitioners so that they can communicate clearly with the public. Hickey has also worked with the American Academy of Nursing on recommendations for how advanced practice nurses can contribute to precision medicine Williams et al.
As their colleagues in other fields had done, the advanced practice nurses concluded that there is a need for genomic health literacy resources that are appropriate for people from diverse socioeconomic and cultural backgrounds. She noted that as technology changes, patients' information needs and the consent process may also change, and, as a result, developing appropriate materials and consent processes today will not be a one-time activity but instead will require ongoing research and development work.
From her experience working with genetic counselors as part of a health care team, Hickey has learned how important it is to put genomics into a context that is meaningful to the patient and to do so long before delivering the results of any tests. Patients need to know, starting from the first contact with the genetics professional, why they are there and why it is important that they provide a comprehensive family history, and practitioners need to understand the individual's goals for seeking a genetic evaluation and recognize that sometimes this information may not be clear to the individual patient or family.
Health organizations have been playing an important role in educating both health professionals and patients about genomics, Hickey said. As examples, she mentioned the American Heart Association and the International Society of Nurses in Genetics, members of the latter were working with and caring for patients and families and communicating with the public regarding a variety of inherited disorders long before the Human Genome Project.
These organizations have also worked to get automatic defibrillators installed in public places and schools and are getting schools to test children before they take part in sports. Hickey also mentioned the work of the American Nurses Credentialing Center, which developed a new genomics competency for nurses. This competency, which was released in , calls for nurses to have a portfolio they can submit that demonstrates their proficiency in genomics.
She said that this type of credentialing activity will become increasingly important as precision medicine makes inroads into clinical practice.
This portal is designed for patients with atrial fibrillation, one of the most common cardiac arrhythmias, to get information, create their own profiles, and develop wellness goals, but it has also been used by providers who need information. Hickey's said that her goal is to expand AFIB Town to include genomic information in the future and to make it possible for a clinician to access a patient's information, including life history, medications, and symptoms, prior to meeting with the patient.
Her hope, she said, is that similar types of portals could be developed as places where a clinician would create a precision or personalized care roadmap that would enable two-way communication between the clinician and the patient. AFIB Town, a patient portal designed to provide information on atrial fibrillation.
Hickey concluded her remarks by saying that health-literate communication in the era of personalized medicine is evolving and that it will take a number of different types of professionals having various competencies and taking advantage of a range of advances in technology to produce the best outcomes for all individuals.
She commented on how useful it might be someday to download information about a person's physical activity from a wearable fitness monitor to an electronic health record and then add genomic information in a way that protects the privacy and advances the care of the patient.
This fact sheet, Gunter said, listed 40 different affiliated projects with by different organizations nationwide.
At least one-quarter of these organizations have stated explicitly that they will use social media and another 10 or so implied that they will use social media. The importance of this, she noted, is that for social media-driven efforts to be successful, they have to encourage two-way communication.
As an example of the power of a two-way social media approach, Gunter cited a paper in the journal Nature MacArthur et al. The earlier paper had stated that 27 percent of the mutations that were identified when doing genome sequencing of children in neonatal intensive care and pediatric intensive care units and that had been cited in the literature as being deleterious mutations were actually common polymorphisms or had been annotated incorrectly.
She and her colleague were discussing their concerns about these findings via Twitter, and they decided to work with NHGRI to convene a workshop at which geneticists would develop guidelines and standards for investigating the causality of gene variants in human disease.
Gunter said that, to her, an equally important part of the effort to develop standards was to get the word out about this paper and to stimulate discussion, so the group published in a multidisciplinary journal and used social media to publicize the paper, including Twitter and various blogs at NHGRI, the Simons Foundation for Autism Research, and a genome community called Genomes Unzipped, and they also worked with their own institutions to generate web articles.
Most scientists interact with the public via their academic papers, clinical interactions, university courses, or working with university press officers and then getting upset when that person gets crucial details wrong.
Gunter recommends using the whole range of new media: websites, blogs, Twitter and Facebook, videos and podcasts, and even public lectures, all of which represent new avenues for engaging the public. In a successful example, a colleague of hers used the internet news website Reddit to announce the creation of an online deletion registry for individuals with a rare 3q29 chromosome deletion and their families.
Within 1 day of posting this announcement, two clinicians had already responded that they would tell their families about this registry.
Gunter's colleague reported that this was crucial in allowing her to contact a large number of families with this deletion. Gunter's organization uses its Facebook page to announce research studies and to let the autism community know about articles about autism and also to encourage discussion. She acknowledged that many researchers are hesitant to use Facebook in their professional lives, but she said she encourages them to get over that reluctance and accept Facebook as a means of increasing their connection with the public and getting their research into broader circulation on their terms.
Prior to the advent of social media, mass communications researchers proposed a theory that the mass media disseminated important messages through a two-step process in which opinion leaders served as the conduit to individuals Katz and Lazarsfeld, More than four decades later, Gunter said, researchers at Microsoft showed that the same holds true today, with information on Twitter going through a number of opinion leaders who then disseminate the message out to their friends and followers Wu et al.
Gunter said that she encourages scientists and clinicians to get on Twitter and be those key opinion leaders. For example, the International Meeting for Autism Research set up a room in which researchers and clinicians could field questions submitted via Twitter and tweet answers using the same hashtag. Over the course of an hour, this activity generated more than 4.
Gunter then explained that autism is not only a spectrum of disorders, but that it is diagnosed by having traits on the spectrum of three different areas: social communication deficits, repetitive behavior, and restricted interests. She noted that at her institution, one of the nation's largest centers for the care of autism, a diagnosis of autism in individuals referred to the clinic is confirmed only 60 to 70 percent of the time because her institution uses gold standard instruments that most referring clinicians do not use when making their provisional diagnosis.
Due to the wide range of differences among autistic individuals, what precision medicine will be to the autism community specifically, and in mental health in general, is still up for discussion, Gunter said, and she encouraged the roundtable to continue thinking about health literacy in the context of behavioral and mental health.
She acknowledged that while neither she nor any researchers she knows have that as the goal, the fact is that it doesn't matter what researchers' actual goals are in this extreme example; the autism community will never participate in or support research if its members believe this to be true. This situation, she said, points out the problem with the deficit model of science communication, which holds that people have a deficit of knowledge and if the scientific community can just remedy that deficit, then people will take predictable actions based on new knowledge.
Gunter referred to a recent study in which parents of children with autism and scientists were asked how the media has affected the public's attitude toward individuals with autism Fischbach et al. Ninety percent of parents and 88 percent of scientists thought the media did a good job of improving public attitudes toward individuals with autism and reducing the stigma associated with autism.
However, while some 80 percent of the scientists said they would be interested in serving as a resource, only one-third of them actually were doing so. To illustrate some of the challenges that clinicians face in using social media to disseminate information, Gunter discussed the Simons Foundation for Autism Research VIP Connect Project, which in created autism resources specific to different genetic variants linked to autism. The project has created infographics see Figure and webpages for each of the genetic variants and provided links to public communities and private Facebook groups as well as to research opportunities that arise.
While all of this is great in theory, Gunter said, in practice the only people posting so far on the public Facebook page are people from the Simons Foundation, which suggests that the Foundation still has work to do to get the community to engage with these resources. This is a common problem with building new outreach sites, Gunter said. A webpage with links to resources related to a specific gene variant associated with autism.
Another effort, which serves as an example of why thoughtful messaging and engagement are important in precision medicine, involves a collaboration between the autism advocacy organization Autism Speaks and Google whose goal is to sequence the genomes of more than 10, families affected by autism. Gunter said that similar projects aimed at sequencing the genomes of people with cancer to find genetic subtypes that link to specific diagnostics and treatments have been met with enthusiasm.
The autism community, however, does not respond the same way, however, and the response to the project has been muted. The project has been hampered, too, by its name, MSSNG, which seems to imply that people with autism are missing something—an impression that prompted the creation of the hashtag notmssng on social media. In her closing remarks, Gunter explained that different members of the autism community prefers different terms to describe autism Kenny et al.
It is incumbent on the research and clinical communities to ask people which term they prefer and not let this be a barrier to communicating with the members of a given community.
Gunter also noted that just using social media is not enough to achieve good bidirectional communication. Dillaha responded to the two presentations by noting that they both highlighted the need for clear and concise communication with the public. Hickey's presentation, she said, spoke to the need for health care workers to adapt their communications to meet the needs of the patient and raised the possibility that members of the health care or PMI team could serve as interpreters for difficult concepts and jargon.
Hickey highlighted the importance of asking explicitly what new information means to the patient, to which Dillaha added that the same question needs to be asked explicitly for clinicians.
In both cases, Dillaha said, it is important to support developing competencies in training and to provide health-literate resources and tools for health care professionals and the public. The challenge, she said, is to enable the health system and researchers to interface effectively with the public and provide the public with the skills and capacity to interface with the health system and research enterprise.
These are two sides of the coin of health literacy, Dillaha said, and both sides needs to be addressed. She continued by saying that if the health literacy community has learned anything over the past decade, it is that people in health care systems often have the wrong idea about how much the general public understands. In other words, people in the health care often overestimate how well the people they serve understand the information given to them.
If that does not happen, the risk is that it will be impossible to establish the fundamental foundation of trust and understanding that Michael Wolf discussed in his presentation. Without trust, the public will react negatively, she said, and the results will be on display across social media.
Carla Easter remarked that though it has been a decade since the Human Genome Project was completed and the move into precision medicine has already begun, there is still a need to develop competencies in genomics among practitioners. She supported Hickey's idea to work with professional organizations to develop those competencies, which the Human Genome Project did not do effectively, and to think hard about what the public wants to know about the ethical aspects of precision medicine.
In particular, Easter stressed the importance of engaging communities and easing their concerns that precision medicine is the new eugenics or a means of singling out individuals as being different from the community.
After getting some experience in the field, aspiring NPs are ready to apply for graduate school. Retrieved August 10, Some NPs pursue certification in a specialty. Salary History. Dignity Health. What Is an Orthopaedic Surgeon?
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NPs typically will specialize with a focus in a particular medical specialty, disease area, or patient population.
All of the education must be obtained at an accredited nursing school. Again, this is likely due to the rise in demand for non-physician advanced practice providers such as NPs and PAs also. Get tips on how to better manage your health practice. More in Healthcare Professionals. Was this page helpful? Thanks for your feedback! Sign Up. What are your concerns? Continue Reading. Primary Care Medical Career Options. Top 3 Highest Paying Nursing Careers.
That said, the scope of practice for NPs depends not only on their chosen specialty, but also on the state in which they practice. The AANP divides states into three categories: full practice e. In full practice states, NPs are able to assess patients, diagnose conditions, order diagnostic exams, and provide treatments under the authority of their regional state board of nursing. Reduced practice states require collaboration with another healthcare provider in at least one aspect of NP practice.
Restricted practice states—concentrated mainly in the Pacific Northwest—require direct supervision or team management of at least one element of NP practice. The most popular nurse practitioner specialization is that of family nurse practitioner FNP , which according to AANP , comprises Acute care NPs —7. In addition to the specializations above, there is a wide range of subspecialty areas, each focusing on a specific condition, clinical focus, environment, or sub-population.
The Mayo Clinic recommends that NPs be compassionate, self-confident, analytical, personable, and calm under pressure. Since NPs may be confronted with time-sensitive healthcare issues, they must be able to make good decisions under duress and show leadership in uncertain situations. Having a strong grasp of math and science contributes to the day-to-day problem-solving, analysis, and diagnostic capabilities of NPs.
Effective NPs also spend much time liaising with patients, their families, and healthcare professionals, and therefore are expected to possess excellent communication skills. Other desirable traits include being detail-oriented, empathetic, and emotionally stable. The American Association of Nurse Practitioners reports that There are varied educational pathways to becoming an NP. To explore various points of academic entry—including popular RN-to-MSN programs —please check out the nurse practitioner schools main page.
That said, here is one common path to this high-growth career:. To explore in detail how to join one of the growing NP specializations, please check out the following pages:. A lack of access to primary care in the United States is one of the key reasons why the Commonwealth Fund ranks the U. Looking to the future, the impending primary care provider shortage indicates that this problem is only to going to intensify, particularly in the South and Midwest.
As a shortage of primary care providers looms on our collective horizon, lack of access to primary care has the potential to get much worse. And, unfortunately, the South is going to be the most heavily impacted.
Graduate from high school. To prepare for a college nursing program, students typically need to complete secondary school coursework in chemistry, biology, and algebra. It may be recommended to take statistics, psychology, and anatomy as well, depending on the availability. Pursue a bachelor of science in nursing BSN from an accredited program 4 years.
The Precision Health Nurse Practitioner led clinic is a private primary care centre focused on timely prevention of chronic disease and improvement of overall health and wellness. The Precision Health Nurse Practitioner team provides healthy lifestyle support for mental health and wellness as well as people looking for help with diabetes, weight management, smoking cessation, prenatal education and Well Child exams, hypertension, cardiovascular disease and more.
While both are dedicated to helping people live their healthiest life, the Precision Health Nurse Practitioner Clinic provides primary care support.
Nurse Practitioners are registered nurses that have undertaken graduate education and training in advanced clinical practice. They provide a crucial role in assessment, screening, healthy lifestyle support, education and chronic disease management all with the goal of improving health outcomes and facilitating access to services.
Nurse Practitioners NPs at Precision Health are focused on preventative health and wellness strategies rather than strictly acute care. Like medical doctors, NPs are able to diagnose and treat disease, but they are also trained to educate patients about preventative strategies, including lifestyle modifications and nutrition.
NPs weave prevention and wellness into every exam they give, and they are careful to take their time to get a complete patient history.
Patient education is at the center of prevention and wellness. They provide appropriate educational information and encourage regular follow-up visits to monitor progress and modify wellness plans. As a Pure North member you have access to Precision Health primary care services. Platinum and Gold member participants have some access to Precision Health already included in their Pure North plan.
In addition, all Pure North program members have the option of paying for services individually or joining an annual Precision Health plan. Please see below. You can send us a message via the form here or email our friendly staff directly on:. Hourly street parking is available from , and private paid parking lots are within close walking distance. Our office is also a 10 minute walk from the 3rd and 4th street CTrain stations.
Bus stop servicing lines 13, 90 and are directly in front of our building. Pure North S'Energy Foundation. All rights reserved. As a health and wellness organization, we practice in accordance with the Health Information Act in order to protect the privacy of our participants.
All health information is kept confidential and secure. Precision Health. Nurse Practitioners. Complete a comprehensive health history and assessment Formulate and communicate a diagnosis, taking a differential diagnosis into consideration Prescribe medications Order diagnostic imaging tests. Set and cast fractures and dislocated joints Order and interpret all laboratory tests Admit, treat and discharge patients from hospitals Specialist referrals as needed.
Preventative Health. Free 15 minute consult available to interested patients to discuss options. Adult Membership. Please call the office for details. Extensive Health Assessment. No membership required!
Initial Consultation 90 minutes. Full physical exam and screening Extensive blood testing including Vitamin D based on individual needs Further appointments may be required at the Nurse Practitioners discretion for an additional fee Review of medical history Preventative health education Body composition testing and analysis Nutrition and diet counselling Additional screening as required.
Follow-up Appointment 60 minutes. In-depth review of all previous diagnostic tests Individually tailored health plan based on specific needs Referral to specialist s as required Access to high quality supplements Further follow up appointments may be recommended for an additional fee. Membership for two adults and children. Membership for two adults and children years. Nurse Practitioner Access. Via Pure North Plans. Two minute appointments included in Platinum plan One minute appointment included in Gold plan.
Additional Consults available for all Pure North plan members :. Fees for Services. It seems they are equipped for crisis care and my symptoms do not register on their critical assessment scales. I am so happy. I received the blood work I needed. My problems were identified and I feel so much better. The right supplements were recommended in my healing, not just something for the symptoms. The Staff is professional, friendly and patient.
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