Dedicated patient advocate and FNP, with over ** years of nursing experience

QUALIFICATIONS

Experiencing caring for patients of all ages from 24 hours old to geriatric. I assess for developmental delays and acute problems along with wellness visit on all children. I assess for acute and chronic conditions on all adults while providing specialized individualized care.

I enjoy caring for patients and taking care of their needs or problems. My love and experience with psychiatric patients allows me to vary my customer service skills in how I care for patients. I utilize my psychiatric experience motivating patients into participating in their treatment plan. This is particularly helpful with non-compliant patients who have chronic conditions.

Caring and compassionate: I not only treat patients for their acute conditions, but I get to know them as humans with emotions and a strong culture. This allows me to grow meaningful patient/provider relationships and develop a treatment plan that will realistically fit into their lifestyles. I help the patient set a meaningful goal they are easily motivated in achieving. I then negotiate different ways of achieving those health goals. My patients are always motivated in achieving those attainable goals. I have been able to get non-compliant patients motivated to achieving health goals.

Experience working with patients who display addictive behaviors and insist on narcotic or controlled medications. Experience assessing these patients, performing a chart review, evaluating their motivation for such behaviors so that I was able to prescribe medication that would cease these negative behaviors without enabling the addiction behavior. I am experienced with alternative medications for pain or psychiatric disorders that are preferred by psychiatrist to avoid enabling these addicting behaviors.

Member of the pain committee where we developed treatment plans for patients who have chronic pain or are taking long-term narcotics.

Experience working with multiple patients who walk into the clinic daily with 600+ glucose levels on who need immediate treatment to stabilize glucose levels in addition to their other chronic and out of control conditions. After working at the reservation, treating elevated sugars in symptomatic patients is standard procedures in addition to carrying for their other needs.

On the Indian Reservation, there was always some patient who would walk into the clinic who was high risk and had to be sent to the nearest trauma hospital due to their critical condition. It was standard practice to rise up to the challenge of getting these patients stabilized while waiting on transportation. At times this transportation could take several hours even by helicopter. Conditions: severe acute on chronic CHF, severe SOB, respiratory distress, active bleeding esophageal varices, pseudo-aneurysms on femoral artery, multiple DVTs, MI, and various other conditions. It is important to understand the indian population does not trust government medicine. Thus they do not come into the clinic until the last minute. When they finally come in, we have one opportunity to develop that trust and care for them.

Care at a reservation is different than other places. Our patients hated the government provided medical care. They only came when they were sick. More than half of the providers were contractors who only cared for urgent issues and would never run blood work or deal with chronic issues regardless of requests by IHS directors to so such. Permanent providers, such as myself, took every opportunity of a patient coming into the clinic to provide them with quality care. The standard was to treat every visit as an annual visit and get labs and check all chronic conditions to get things up to date. All permanent staff had to be well versed at reading labs and tests to properly diagnosis and treat liver disease, CKD, diabetes, CHF, and various other things. One moment a patient had no history of kidney disease and with testing in one day will be diagnosed with CKD stage 4. One moment a patient came into my clinic because he wanted to get rid of his chronic cough like his sister did by getting off of Lisinopril and the next moment he is on his way to the hospital due to severe blood loss, needing a blood transfusion, and active bleeding esophageal varices. The patient did not even know he had liver disease.

Getting referrals approved for specialty services was very difficult and often took months to achieve. If patients had a medical emergency that required them to be sent to the ER, they got those services much sooner than those who did not need the ER. Patients who were not sick enough to require a transfer, had to be taken care of by their PCM until such a referral was able to be obtained. I was able to get CHF controlled long before the patient got an approved referral to cardiology.

While waiting for referrals to specialty services, I was able to get all the lab work, any tests or radiology reports, start or stop any medication and develop a treatment plan for the disease. I was the one who educated the patient on their new chronic disease and would get them stabilized. I learned these skills by working with the internal medicine providers in various clinic across the reservation. I had strong mentors who taught me how to care for these patients so I would be able to care for them when they were not available.

Experience with patients walking into a clinic with acute/life threatening conditions such as bleeding varices, sepsis, osteomyelitis, acute on chronic CHF with ST elevations, chronic blood loss where patients compensated for life threatening critically low blood values, MRSA infected osteomyelitis/charcot foot.

Experience managing liver disease and kidney disease patients until the patient can be connected with a specialist. There have also been some cases where I had to assume care of patients who had kidney failure and liver failure but never got connected up with a specialist. I had to perform the necessary liver or kidney workup and get the necessary care. Managed patient who were on liver transplant list, received frequent draining of ascites, kidney dialysis, and various other interventions.

Experience getting patients who have cardiac disease who have been uncontrolled with their BP get converted to the appropriate cardiac mediation per the type of HTN they have and manage it until I was able to get them into the cardiologist. Often the patient would be well controlled by the time the patient got in due to the 3-6 month lead time to get into cardiology.

75% of patients were diabetics. Frequently these patients would come in with BS over 400. It was common to have at least 3-5 of these patients present daily with blood sugars in the critical/fatal range or BP of 191/105 or higher. I have had patients present with BP of 179/65 with a HR of 46 and reviewing the chart found that other providers have been struggling to get her BP under control. I am used to switching medication from one class to another gently in a control and methodical way to control the isolated hypertension and the bradycardia.

I am not saying that I am the best or someone who knows it all. I recognize what I don’t know and seek those who know better to educate me. I have done that at Pine Ridge reservation and I continue to do that at the Army base. I use that knowledge I gain and progress to caring for that patient and many more like that one. I use uptodate and mentors among other resources. I have a saying, “If I don’t know, I want to learn.” I use that knowledge and grow from there.

I have keen assessment skills and can pick up on the most subtle neurologic and physical changes that patients present before their health starts rapidly declining. I have spotted these changes, made the appropriate assessment and delivered the appropriate intervention to save each of their lives. This includes recognizing: sepsis, respiratory distress, DVT, small bowel obstruction, shock, and various other life threatening conditions.

Utilized resources and creativity to learn how to communicate with Spanish-speaking patients to ensure they received excellent health care. Incorporated their culture into all health care plans to build a trusting team approach for nursing care. Language has never interfered with me giving the best of care and learning ways to communicate with my patients.

Excellent computer skills: Previous software and electrical engineering. I pick up on any and all software due to my software engineering skills. Trained on VA’s CPRS and CHCS, UT and ETMC’s MediTech EHR, and Christus Epic EHR, Army AHLTA and CHCS, EHR software used by Texas State Hospitals.

WORK HISTORY

US Army FNP 6/2020-present

Indian Health Services, Pine Ridge, SD FNP 9/2019-6/2020

Christus Trinity Clinic Sulphur Springs, TX FNP clinical rotation) 20-30 hrs/wk.2/2018-10/2018

UT Health Northeast – Overton Clinic, TX FNP clinical rotation) …20-30 hrs/wk...8/2018-1/2018

Angles of Care, Tyler, TX…(working in Sulphur springs during last phase of clinical rotation) 8/2018-9/2019

Terrell State Hospital Psych RN Full-time… 6/2015 – 8/2018

Advancing at Home and Happy At Home Health Care………Psych RN Full-time. 3/2012 – 5/2015

Providing psychiatric services and assessments to patients in nursing homes and various living conditions. When I

stopped seeing patients for them, they ceased their psychiatric services.

Glen Oaks Hospital in Greenville TX Psych RN 40-60 hrs/wk 3/2010 – 3/2012

VA Hospital Bonham, TX Psych RN full-time 9/2010-11/2011

US Air Force Reserves Capt/RN 4/2010-1/19/2017

US Air Force, Lackland AFB, WHMC, 59IPOG Squadron………LT1/RN 1/2007-3/2010

Electrical Engineering & Software Engineering 1991-2004

(Quantum Corporation, Red Hen Systems, Ball Aerospace)

EDUCATION

University of Texas at Rio Grand Valley

Post MSN with specialization: Psychiatric Mental Health Nurse Practitioner MAY2021

Procedure Workshop course and Certification JUN2019

(Needle decompression, chest tube insertion, tracheostomy replacement, shoulder reduction and immobilization, upper extremity joint aspiration, trigger point injections, nail trephination, nail removal, foreign body and fish hook removal, basic and advanced suturing, lumbar puncture, incision and drainage of abscess, hip reduction, IUD insertion and removal, patella reduction, ankle reduction, lower extremity splinting, lower extremity joint aspiration, intraosseus access, central venous catheter insertion, splint application and removal, common suturing techniques and wound closure, routine emergency care, EKG interpretation, management of pulmonary disorders, radiology interpretation, fracture care, trauma management, evaluation and management of critical skin diseases)

Pain Course through PAINWEEK 12 CEUs MAY2019

Education and training on management of chronic pain, opioid and other narcotic use, matching treatment with diagnosis, mitigating legal risks and issues associated with opioid and other narcotic use.

ISSWSH Course & Vulvoscopy Course NOV2018

International Society for the Study of Women’s Sexual Health. Education and training on procedures for Vulvovaginal disorders.

CHAMBERLAIN COLLEGE OF NURSING, Illinois

MSN with specialization: Family Nurse Practitioner OCT2018

USAF Transition to Nursing AUG2007

UNIVERSITY OF NORTHERN COLORADO, Greeley CO

Bachelors in Nursing AUG2006

ITT TECHNICAL INSTITUTE, Thornton, CO

Bachelors in Electrical Engineering AUG1994

CERTIFICATIONS

APRN-FNP-C through AANP.

BLS, ACLS, PALS

Provider Acute & Emergency Procedure Certification

HONORS/ACHIEVEMENTS

Departmental Scholar – Nursing Department – 2005, Awarded to 5 out of 1300 students in the college of Nursing each year for excellence in academics, leadership, and community service.

Golden Key Honor Society: Lifetime Member since 2005

Sigma Theta Tau Honor Society: Lifetime Member since 2005

National Society of Collegiate Scholars (Honor Society): Lifetime Member since 2005

Sigma Alpha Lambda: Lifetime Member since 2005

Annual Sophomore Recognition: Golden Key International Honor Society honors sophomores in the top 10% of class.

Alpha Beta Kappa Honor Society: Lifetime Member since 1994

Exceptional Achievement award: Quantum’s Recognition and Reward Program ($1500.00)

George and Marian Gates Nursing Scholarship 7/29/2005

Dean’s List: The National Dean’s List from 2004-2006

LEADERSHIP/MEMBERSHIP

ISSWSH Member since 2018

AANP Member, Since 2018

TNA and ANA Member, Since 2016

Student Nursing Association Member and officer, 2004-2006

US Air Force Active Duty Officer, LT1, JAN2007- MAR2010

US Air Force Reserves Officer, CAPT, APR2010-JAN2017

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