A Nurse Practitioner's Approach to Healthcare: Student Aryss Richardson Interviews Dr. Angela Allen-Washington

Shandra McDonald [00:00:05]:

Today, I have a special co-host. Yay.

Aryss Richardson [00:00:10]:

Hi. I'm Aryss Richardson. So, I'm in high school and college at the same time, and I'm going to pursue nursing.

Shandra McDonald [00:00:19]:

Doctor. Allen Washington, tell us a little bit about yourself.

Dr. Angela Allen-Washington [00:00:23]:

I am doctor of nursing practice. Already in nursing for over 20 years. I originally wanted to be a physician, but, you know, life happened. And so, I, started as an LVN, RN, got my BSN, did the FNP masters and then my doctorate degree.

Shandra McDonald [00:00:39]:

That's Aryss Richardson and doctor Angela Allen Washington, a doctor of nursing practice. In this episode, we have a candid conversation about nursing, health care, and patient provider relationships. Doctor Allen Washington shares her journey, her decision to pursue nursing instead of becoming a physician, her typical work day as a nurse practitioner in primary care, and plans to open an aesthetics business. It's important to connect our youth with people in the careers they're interested in pursuing. So, if you know a young one and you have some connections of your own, make

Dr. Angela Allen-Washington [00:01:15]:

it happen.

Shandra McDonald [00:01:17]:

This is the academic survival podcast, and I'm your host, doctor Chandra McDonald. Statistics show that approximately 40% of students drop out of college every year. In fact, nearly 30% drop out their 1st year. Well, I am on a mission to improve these stats. Welcome to the Academic Survival podcast. Today, I have a special co-host. Yay. Aryss Richardson.

Shandra McDonald [00:01:46]:

Eris, introduce yourself.

Aryss Richardson [00:01:48]:

Hi. I'm Aryss Richardson. I don't really know what to say.

Shandra McDonald [00:01:54]:

Are you in high school?

Aryss Richardson [00:01:55]:

Yes. I'm in high school and college at the same time.

Shandra McDonald [00:01:58]:

Oh, okay.

Aryss Richardson [00:01:59]:

And I'm going to pursue nursing.

Shandra McDonald [00:02:02]:

Awesome. Alright. Doctor. Allen Washington, tell us a little bit about yourself.

Dr. Angela Allen-Washington [00:02:09]:

Yes. Well, I am doctor of nursing practice as you have stated. Already in nursing for over 20 years, started LVN to RN. I took the scenic route.

Aryss Richardson [00:02:20]:

Okay.

Dr. Angela Allen-Washington [00:02:21]:

I originally wanted to be a physician, but, you know, life happened. And so, I, started as a LVN RN, got my BSN, did the FNP masters, and then my doctorate degree. So happy to be here.

Shandra McDonald [00:02:33]:

Exciting. And happy to have you here. So, with Aryss wanting to also pursue nursing, I thought this would be an excellent opportunity for me to turn the mic over to her and have her ask of, you know, several questions as she is preparing to go down this nursing journey. So, Eris, take it away.

Aryss Richardson [00:02:53]:

Okay. So, my first question is really simple. What inspired you to become a nurse?

Dr. Angela Allen-Washington [00:02:58]:

Oh, what inspired me to become a nurse? Just helping people. I love helping people. I think this just is innate. You know what I mean? Not to sound cliché-ish, but it's just something that I've always wanted to do. I still enjoy doing it. You know, family and friends still call and text and ask questions. So being a nurse is just something that I wanted to do. Like I said, I originally wanted to be a physician, but life happened.

Dr. Angela Allen-Washington [00:03:21]:

And I think that nursing is the next best thing to being a physician. I think we have sometimes more hands on with the patient. You know, we educate, you know, I think we love on them. So, yeah, I, I wanted to be a nurse just to really help people.

Aryss Richardson [00:03:37]:

Like that. That's nice. That's the exact same reason why I want to be a nurse. Mhmm. Can you describe your typical workday as a nurse practitioner?

Dr. Angela Allen-Washington [00:03:46]:

I wanted to back up because I really want to speak to the reason why I became a nurse practitioner because becoming a nurse is like, yes, everything, but the nurse practitioner piece is a little bit different from just a typical nurse. So, I will just speak to that. So, there's three reasons why I became a nurse practitioner. 1, obviously, because I wanted to help people. 2, because I felt that my learning as a RN was stagnated. Like it was hindered. I wasn't able to understand, like, why is my doctor prescribing an antibiotic for upper respiratory infection or a urinary tract infection. Right? So, you know, I would just give my doctor the symptoms and they would tell me what to give and I wanted to better understand that.

Dr. Angela Allen-Washington [00:04:24]:

So, I felt like furthering my education would help me like with that understanding, you know, and not just, you know, lending to their expertise all the time. Now, my, my, my report flowed like, okay, these are, this is my assessment. These are my recommendations. Please advise at that point. And it's either, okay. Yes. We I agree with your recommendation or let me change it up a little bit. Right? And then the last reason is because I wanted to open up an aesthetic business.

Dr. Angela Allen-Washington [00:04:51]:

So that's I'm in the process of doing that as well.

Aryss Richardson [00:04:54]:

Can you describe your typical workday as a nurse practitioner?

Dr. Angela Allen-Washington [00:04:58]:

So, I graduated with my FNP. I didn't work off the bat. I took a break then COVID happened. So, then I pursued the doctoral degree, but I think that my training echoed what a day in the life of a nurse practitioner is. And that looks like, you know, you get your patient load, you look at their medical history, you look at their medications, see when's the last time they came in, you know, for maybe a cold or something, follow-up on that, and then enter the room, introduce yourself, of course. Whatever the whatever the situation is because obviously as a nurse practitioner in pediatrics and oncology and pulmonology, it looks different. And then primary care, right? So, speaking to elderly patients, you do your assessment. If there's a yearly exam for a female, obviously, you'll have like your setup for what their needs are.

Dr. Angela Allen-Washington [00:05:50]:

And then, you know, go through the visit, assessing them, asking questions, making sure that their last visit was, you know, they came in for their last visit is resolved. And then order prescriptions, you know, if they need that refill prescriptions, and then talk about preventative care, you know, because if you are looking at age related preventative care for a female 23 to 45, you want to talk about mammograms. You want to talk about, you know, making sure, you know, 50-year olds get their colonoscopies, etcetera. And then, like, if you have your patients 65 or older, you want to make sure that they're getting their vaccines. So, you talk about those and then, you know, labs are drawn, you know, my MA will pick up my equipment specimens and again, I'll order prescriptions, order medications or not, and then move on to the next patient. And then chart.

Aryss Richardson [00:06:39]:

How do you collaborate with physicians and other health care providers to provide comprehensive care for patients?

Dr. Angela Allen-Washington [00:06:45]:

So, I think collaboration with other physicians and providers is extremely important with providing comprehensive care for patients. And I say that because when you're doing when you're a primary care provider, nurse practitioner, you want to manage as much of the patient's care you can as you can in your in your facility. But sometimes, you know, conditions may warrant, you know, the collaboration with other physicians. Right? And I remember in my training, I assessed this child, pediatric patient, and I found that they had a murmur. And when you look up on that or do the research on that, it's not uncommon that, you know, younger patients will have murmurs. However, we had to send this patient out to make sure that the murmur was benign, so we collaborated with the cardiologist. Right? But, you know, and just make sure that that patient was, you know, like I said, made sure that the murmur was benign or innocent and just making sure that they're okay. Right? So, then you can go ahead and then move forward with your care with that patient.

Dr. Angela Allen-Washington [00:07:44]:

However, if the murmur needed more medical treatment, then obviously they will see that specialty. But I just think that collaboration is just really good as far as, you know, like when you look at a patient that you can't figure something out, that provider might say, hey, you know what? Look at this next time. So, then you can either call that patient back in and recommend more testing or, you know, on your next patient that you have, you can look at other things that may help, you know, you manage that patient in your facility or clinic.

Aryss Richardson [00:08:14]:

How do you approach the patient provider relationship and build trust with your patients?

Dr. Angela Allen-Washington [00:08:18]:

That is a great question. And I think as a nurse, we kind of are taught that, you know, from day 1. But for me as a provider, like sitting down eye level to that patient and really engaging and listening to what they have to say is really key and important to building the relationship. And, I mean, I've noticed that in my career in the hospital, outside of the hospital, and even in the training that I had as a nurse practitioner. They really want somebody that's going to listen to what they have to say and really engage, answer appropriately, and not cut them off. I mean, because a lot of times, you know, you go into the doctor's office and you let them know what's happening. And they're like, oh, I know what it is. You know, take this, do this, whatever.

Dr. Angela Allen-Washington [00:08:59]:

And they don't want to hear that. You know, they want to you to hear everything they have to say. And sometimes, you know, it's fluff, you know, but listening to the patient really allows you to build that relationship and trust because they know that I can talk to my provider, they're going to hear me and listen to everything I have to say. And then you add that shared decision piece in with the care and ask them, what do you think? You know what I mean? Is this important to you? What's important to you? How do you want to handle this? And then now they feel more obligated to want to follow your instructions rather than just being told what to do. So I think just really listening and engaging helps build those relationships. Mhmm.

Aryss Richardson [00:09:34]:

K. This is my favorite question. Can you talk about a particularly challenging patient case and how you managed it?

Dr. Angela Allen-Washington [00:09:41]:

Right. So, I think that there's not one particular case that I could like bring up obviously because every case has their own challenges. Right? So really the point of meeting a challenging situation is like understanding what that challenge may be. Obviously, it's going to be different for different patients or whatever. You're going to have somebody hollering and screaming or whatever for whatever reason because they just want to be heard. And it all goes back to wanting to be heard and understood. Right? So, I could speak to 1 and I literally go through every challenge situation the exact same way. So, we had a family member come in and they did not want their child to have vaccines, but it was is, you know, they have to be vaccinated in order to go to school.

Dr. Angela Allen-Washington [00:10:28]:

Right? So, I just really sat her down and just had her express to me, like, what were her concerns, you know, autism. You know, did she do the appropriate amount of research or was it somebody who told her that this was going to happen? Right? And so, hearing her and hearing what she had to say, I didn't start off by saying, well, my doctor's not going to sign a form for your child to preclude them from having a vaccine to go to school. Right? So, I we talked about alternative measures to going or, you know, having the child educated by homeschooling. Right? So, with my challenges situations, I first listen and then I offer alternative measures to help them. And then I engage them by saying, well, what would you do if you were in this situation as a child and having an adult, you know, say, well, you absolute, I believe you shouldn't get a vaccination when studies show that we really should, you know? So, I always go into the situation of listening to them and then trying to provide alternative measures and not really telling them what they need to do or what they can't do. Because once you tell somebody this cannot happen, that just kind of creates more of a challenging situation. You know what I mean? So really just kind of like bring it down, Let's talk about it and then, you know, smooth out the situation and they may not agree what I what I have to say, but however, they are better informed and then they can take their situation and handle it how they want. But, you know, just sitting and listening, I think is really key in any challenging situation.

Aryss Richardson [00:11:59]:

Thank you. How do you stay up to date with the latest healthcare advancements and best practices in your field?

Dr. Angela Allen-Washington [00:12:05]:

So joining a lot of professional organizations, they definitely have a lot of articles, up to date technologies advancements, podcasts such as this, you know, the journals, blogs, even social media can lend to advancements in the career. And then a lot of continuing education. I know that as nurses and nurse practitioners, medical professionals, we all have to go through continuing education. And I think that that's really good because you're not put in a box of only learning about your field. You can learn about other fields if you would like, but I think that continuing education is really, really important and then joining other professional organizations to stay abreast.

Aryss Richardson [00:12:48]:

Are there any specific organizations that you join?

Dr. Angela Allen-Washington [00:12:51]:

Yeah. AANP. So that's the American Association of Nurse Practitioners and then AANA, which is American Nurse Association as well. So, I haven't joined any podcast, but I'm on social media like crazy learning about new things. There's a lady named Latrana Walden who has a group, a nurse practitioner group where, you know, she talks about a lot of up and coming things and then teaching nurse practitioners how to take their exam and stuff like that. So I've joined a lot of those organizations on social media. It's like they're like communities, nurse practitioner communities. You know what I mean? So Yeah.

Aryss Richardson [00:13:27]:

Yeah. What advice do you have for individuals considering a career as a nurse practitioner?

Dr. Angela Allen-Washington [00:13:34]:

So, ask yourself, is this what you really want to do? And be completely honest with yourself. You know, a lot of people go into this field for status. They go into it for the money. There's a good and a bad side to nursing. I don't want to say a bad side, but not so pretty side. You know, obviously, this is one of the most respected, professions, you know, and a lot of us go into it for the wrong reasons. And I think when COVID emerged, that kind of like showed a lot of us, you know, it's like, this is not, it's not always pretty, you know, you have to do some things that you might not want to do, you know? So, I think first asking yourself, is this really something that you want to do? Do the research and then, you know, ask a seasoned nurse practitioner and a new nurse practitioner what are their perspectives on becoming a nurse practitioner. Why did they become a nurse practitioner? What you have to look forward to.

Dr. Angela Allen-Washington [00:14:23]:

Right? And if your goals align and this is what you want to do, then I would say pursue it.

Aryss Richardson [00:14:27]:

How do you address the stigma and misconceptions around mental health and mental illness in your practice?

Dr. Angela Allen-Washington [00:14:33]:

So, me not having a practice personally, like I said before, just it's about listening, right? So, a lot of times when you encounter patients, they have what's called existential pain. So, they, they focus on something else and they're really not, they're focusing on symptoms rather than what their situation really is. Like I have a lot of pain but they're not really talking about where the pain is. They're talking about other issues. That's like existential pain. So, for me, like I open my ear, train my ear to like listen to the patients and what they're really saying. Because if you're talking about pain, you're telling me where it is, the frequency, you know, how long it hurts, the duration, you know, when did it start, you know, those types of things, right? What aggravates it, what relieves it Rather than, you know, things that don't relate to the pain. So, when you listen to when you train your ear to hear what your patient is saying and then sometimes I don't want to sound mean, but, like, the inconsistencies in their stories, right, about what's really happening.

Dr. Angela Allen-Washington [00:15:33]:

You can see that they may need some help, like speaking to somebody about their issues. So, the way I would engage that is just listening to them and then asking them, like, what is your support? Do you have family to support you, to listen to you? And if not, you know, a lot of times we're afraid to talk to our families because they don't want to either hurt their feelings or blame them for something that's happening. But, you know, if they don't have that support then I would encourage speaking to someone who is trained to hear them and help them guide them on mental health. But then I would also ask them like what are their misconceptions? Like what do they know about mental health and talking to, I keep saying a counselor, but I mean, that's the way I would like to call it because some people say shrink or, you know, psychologists, psychiatrists and that really lends to the misconceptions, right? Just labeling the person's, field. So, it's like I would rather I want to know from them, like, what do you feel about speaking to someone who's trained to talk through, you know, situations and then, you know, lend my expertise, what little I have about it. However, I would, you know, definitely encourage people to talk about it. You know what I mean? And just let them know that it's not so bad to bounce your ideas or your concerns or your problems off on somebody who's trained to hear it. You know, who has the ear that's trained to hear it and the ear to help you or the resources to help.

Aryss Richardson [00:16:56]:

Can you discuss the role of nurse practitioners in promoting preventive care and health education?

Dr. Angela Allen-Washington [00:17:01]:

So, I think that the role of a nurse practitioner is integral in, you know, preaching preventative care and educating. And I think just kind of going back to training as an RN, that's something that we are taught. Like you educate, educate, educate, educate, educate, educate. Right? And so, as a nurse practitioner, like we are like uniquely positioned to for this role in a sense that, you know, we've had that bedside care, we've had that experience with the patient. So now when we're in the, in the clinical role, you know, we, we find it easier to educate or take the time to like tell somebody, you know, you know, about weight loss, about, you know, preventative measures like, you know, mammograms and, and vaccines and things of that sort. And not just say, this is what you need, but really educate on that. And I think that we have that ability to empower our patients, influence them, you know, to, you know, change lifestyle or make lifestyle changes that would, you know, better benefit them to prevent my chronic, you know, disease processes. So, I think it's just innate, you know, nurses just have that that innate role to like teach and educate, you know, so it doesn't become, it becomes easier as a practitioner.

Aryss Richardson [00:18:19]:

That's why I like, you know, like being a feeling a lot more.

Dr. Angela Allen-Washington [00:18:23]:

Absolutely. And educating them because, you know, like, you know, anybody will tell you, like, when you go see a physician, they have they have this situation that's called White Coat Syndrome. They get afraid. They freeze up. They forget all the questions that they have written down. Blood pressure goes sky high. You know what I mean? And it's just, you know, and then the doctor comes in. Okay.

Dr. Angela Allen-Washington [00:18:43]:

How are you doing? You know, blah, blah, blah, blah. And it just sounds almost like, you know, probably Brown, how you hear the teacher just kind of like what that muffled down. So, you don't hear a word they're saying, and then you just freeze up. You just don't ask them because they're it's like this, you know, and unfortunately, that's the way it's become. You know, the time is so limited. You know, you don't really have the time to sit down and talk. However, if you hear a lot of patients say, I like visiting my nurse practitioner more so than my physician, because they take the time to educate and talk to me and hear me. You know what I mean? Nothing against, you know, medical professionals or physicians, nothing against them.

Dr. Angela Allen-Washington [00:19:18]:

It's just, you know, sometimes they just don't have the time.

Aryss Richardson [00:19:20]:

What changes do you foresee in the health care system that will impact the role of nurse practitioners in the future?

Dr. Angela Allen-Washington [00:19:26]:

So, I think with us gaining a lot more autonomy, I know in the state of California, our autonomy is limited. In places like Nevada, they the nurse practitioners have full autonomy to open up clinics. I think that when as we gain autonomy, we will be able to reach the magnitude. You know what I'm saying? Like in rural situations where nurse practitioners have a lot of autonomy because they are so far away and, you know, they are able to reach that that population. So, when we gain the autonomy here, we are able to reach more patients. You know, there's a lot of patients, Physicians can handle the patient care load. And I think that nurse practitioners can lend to taking away some of the burden of having so many patients. And that's why you'll see where physicians will not will stop taking on new patients because it's just a lot.

Dr. Angela Allen-Washington [00:20:18]:

Right? So, I think our role in helping them is 1 by gaining autonomy. And I think also that home health piece, you know, nurse practitioners in the in the home, you know, keeping patients out of a hospital unless it's medical mess medically necessary. Right? So because we find a lot of patients, will utilize urgent care and an ER for their healthcare needs. And if we're in the home the way it used to be, you know, we're seeing these patients in the home, they're in their own environment. They're not becoming more sicker, like coming to the hospital and getting these hospital acquired, you know, infections. They're in their home. They're in their environment with their body and their immune system are used to, and you're doing preventative care. You're actually seeing these patients in their homes.

Dr. Angela Allen-Washington [00:21:06]:

And then if they need to go to hospital, they will. So I think that the role of the nurse practitioner in that home setting is going to, like, shoot up, like become very popular.

Aryss Richardson [00:21:16]:

What do you think about travel nursing? Like as a nurse practitioner.

Dr. Angela Allen-Washington [00:21:20]:

Yeah. So, a lot of it, really came up during COVID. I like it. You know, if you have the ability to do it, I would say do it because, you know, here in California, we're used to our systems. But when you go to other states, they have different systems and you may enjoy that, you know, more so than here. And I know, like, you know, in Pennsylvania per se, like, they have a lot of rural areas. Right? You may like being out there, you know, servicing that community, or you may like being in New York, the hustle and bustle of New York. So, I think it's great.

Dr. Angela Allen-Washington [00:21:53]:

I think traveling to and seeing new things and seeing different health care systems, even in Australia, even in New Zealand, you know, there's a place that is that is escaping me where I did a paper on about health care systems and how like the best health care systems quote unquote as opposed to the worst. But it was I think it was Sweden that we did the I did that paper on. It was so long ago. But, however, I think that, you know, seeing the world, seeing different health care systems, seeing different hospitals and how they do things kind of helps you with your how you're going to be how you're going to practice. You know what I mean? And where you want to practice, but I love it. I used to do travel nursing as a nurse, and I was able to see different health care systems, hospitals, and how they did things. Some good, some bad. But, you know, for the most part, it kind of gave me my foundation.

Shandra McDonald [00:22:42]:

I can tell you that my mother spent a lot of time in the hospital last year.

Dr. Angela Allen-Washington [00:22:48]:

Mhmm.

Shandra McDonald [00:22:48]:

And I can tell you that whenever I found out that the person who the nurse that was assigned to her for the day was a travel nurse, I was always relieved because I found that she got better care from the travel nurses than the nurses that were assigned to, you know, that where that hospital was their was their home.

Dr. Angela Allen-Washington [00:23:09]:

I would totally agree. And you know what that comes from? It comes from com complacency. When you're working in a hospital day in and day out, you know their systems. Right? It's like this is that whatever, you know, you become complacent. So, and I and I don't want to say that in a negative way because you learn a lot. It's almost like being in ICU. You know the things that you have to do to keep this patient alive. Right? It's normal day to day things.

Dr. Angela Allen-Washington [00:23:32]:

However, the floor nurses, when they're just knowing what to do, it becomes second nature. Travel nurses, they bring that knowledge from all over of what might be different that a hospital is doing. Like say for instance, they'll find something better, like evidence on something at another hospital that might be better than the way that the hospital that they're currently at are doing things. And so, then they lend that expertise and they're like, okay, well maybe we can do it this way. And I truly believe that that is the case because even at Kaiser, the staff, the, you know, administration, they love tribal nurses for that reason because it's like they have a lot of knowledge, you know, that they've obtained from like other facilities, you know.

Shandra McDonald [00:24:16]:

It's almost like, its own form of ongoing education.

Dr. Angela Allen-Washington [00:24:20]:

Absolutely. Absolutely. And that is something that I absolutely love clearly.

Shandra McDonald [00:24:26]:

Your turn, Eris. There was something else you wanted to talk to her about?

Aryss Richardson [00:24:31]:

Oh, yeah. You're blessed.

Dr. Angela Allen-Washington [00:24:32]:

Oh, yes. So I've wanted to do this for a very, very, very long time. Since 2016, I've been actually working on starting this and start the business.

Shandra McDonald [00:24:42]:

Tell us what the business is.

Dr. Angela Allen-Washington [00:24:44]:

Oh, yes.

Shandra McDonald [00:24:44]:

And then tell us what that means for someone who doesn't who's never heard of this before and what is it? What does it mean?

Dr. Angela Allen-Washington [00:24:52]:

100%. So, it's an aesthetics business. Aesthetics is basically providing technologies to improve the appearance. So, we'll be offering Botox. Right? So that just basically stops movement in certain muscles to give that youthful appearance. Right? And then fillers a lot of times, well, most often than not, we lose bone in our face and our skin starts sagging. We lose that youthful appearance of our high cheekbones. And so, the fillers that we'll be offering kind of help perk the facial features up to where you look 5 or 10 years younger than what you really are.

Dr. Angela Allen-Washington [00:25:36]:

And now, you know, there's other fads where people like their lips to be more plump than they are. So, we'll help that the under eye problem, you know, neck. And then also there's a lot of us who have melasma. What causes that? I know a lot of sun damage is a lot of the reasons why people get that, but I really don't know why people actually have one person has melasma as opposed to another person. You know what I mean? And that's something that that is researchable for me, you know, but just kind of correcting those areas and then also resurfacing the skin with microneedling to just build more of a youthful appearance. So basically, that's what the business is about. And then we're also going to do skin tightening. And then there's this procedure giving people more energy, you know, through the IV infusion, vitamin c, vitamin b injections, and then also the V steam and most people know it as like a Yoni steam.

Dr. Angela Allen-Washington [00:26:35]:

All it is just you sit on a pot and the herbs kind of come up into your vaginal area. There's a lot of benefits to that. You know, people that have fibroids, pain with fibroids, it helps with that. It helps kind of rejuvenate that area. I've seen research on it helping people become pregnant. You know? So there's a lot of benefits in that. So eventually, we will add more services like skin and laser hair removal and things of that sort. So, you know, using a lot more lasers and like I said, skin tightening.

Dr. Angela Allen-Washington [00:27:06]:

So yeah. Yeah. By the

Shandra McDonald [00:27:09]:

time this episode airs, you will probably be open. So, what are your what services are you starting with?

Dr. Angela Allen-Washington [00:27:15]:

So, we're going to start off with the Botox, the fillers, the vitamin b 12 injections, and then the hydration, and then the VSTEAM.

Shandra McDonald [00:27:25]:

And what makes you uniquely qualified to be able to do this? Like, can anyone just open up this business, or is there licensing or state requirements in order for you to open this type of business?

Dr. Angela Allen-Washington [00:27:40]:

Definitely. So, to be an injector, you have to have an iron license. You have to be clinical, clinically trained. And I say that to say, you know, an LVN does have a license. However, they're not by the state regulations are not allowed to do injections even with the overseeing of a physician, nurse practitioner or a PA or physician's assistant. So, you have to be an RN to be an injector. Although with IV vitamin badge, you don't you just have to have you can be an LVN, but you have to have a IV certification. So, I think just having the RN license in particular makes me qualified to do that because you don't have to be a nurse practitioner or a physician's assistant.

Dr. Angela Allen-Washington [00:28:20]:

However, it does help because we do what's called a good faith exam, where we assess the patient and make sure that they're not contraindicated for any of the services that we're going to provide. And so, you need to be a nurse practitioner or a physician's assistant or a physician for that. And a lot of us, you know, the nurse practitioners RNs, we obviously need oversight of the physician because we don't have the autonomy, but we can do the good faith exam. The NP and the PA can do the good faith exam. It doesn't always have to be a physician. But the RN without the practitioner license cannot do the good faith exam. It has to be an MP physician or a PA.

Shandra McDonald [00:29:01]:

So when you say good faith exam, that's essentially examining the person to make sure that even though they want these services, it would be financially advantageous for you if you provided those services medically, that exam might reveal or expose you're not a good fit. I cannot do this service.

Dr. Angela Allen-Washington [00:29:21]:

Is that

Shandra McDonald [00:29:21]:

what a good faith exam is?

Dr. Angela Allen-Washington [00:29:23]:

Absolutely. It's basically a history and physical, but they call it good faith because you're making sure that you're not going to injure this patient. You know what I'm saying? By doing something that they're not a good fit for.

Shandra McDonald [00:29:37]:

Yeah. Mhmm. Because people may want services because they are desperate

Dr. Angela Allen-Washington [00:29:42]:

Absolutely.

Shandra McDonald [00:29:43]:

Change or they are extremely unsatisfied with what time and gravity has done to them. And they may be super eager, but it just may not be best for

Dr. Angela Allen-Washington [00:29:53]:

them. Abs absolutely. Absolutely. And even like you said, how gravity takes place, you know, some people they are they're too far gone in in that sense. So, like the only thing that would help them is a facelift and a lot of people don't want to go through that. You know what I mean? So, you know, and one thing that I've been learning is that to be completely honest and transparent with these people, you know, even though they don't want to hear it, it's better for you to be honest with them to then to have them go through all these procedures and that really mess up their facial features. You know what I'm saying? And then you end up getting sued, you know, because they don't like it, you know? So, yeah, I saw a case like that just in, you know, be shadowing with 1 of the PAs. You know, a lady who really needs to have go under the knife is what they call it, surgical procedures, and she tried to have this stuff done and she really didn't she really didn't like it.

Dr. Angela Allen-Washington [00:30:46]:

So now we have to go through dissolving all the filler, you know, so it's just it's better to just let them know and stick to your stick to your guns, you know, don't have anybody persuade you to do anything that, you know, you wouldn't normally do, you know.

Shandra McDonald [00:31:01]:

Alright. Okay. Eris, any follow-up questions?

Aryss Richardson [00:31:04]:

No. Not that I can think of.

Shandra McDonald [00:31:07]:

Doctor. Allen Washington.

Dr. Angela Allen-Washington [00:31:08]:

Yes.

Shandra McDonald [00:31:09]:

Is there anything that you can think of that maybe we should have asked that we have it?

Dr. Angela Allen-Washington [00:31:14]:

No. I think we covered everything. I think you did a very good job of, like, asking questions to help you make a decision about pursuing the career nursing nurse practitioner. You did a fabulous job. I can't think of anything else because everything pretty much was covered.

Aryss Richardson [00:31:31]:

Thank you. You're welcome. That concludes our episode of academic survival. See you next time.

Shandra McDonald [00:31:44]:

That's it for today on academic survival. If you want to share your story on how you survived your freshman year of college, you can reach me at info at shandralmcdonald.com. We'll be back next week with more ways to survive your academic journey. Until then, happy studying.