Happy Tuesday! A hot topic this week highlights U.S. District Judge Reed O’Connor’s ongoing attempts to halt preventative care and wellness services mandated by the Affordable Care Act. Not great timing considering that the American Cancer Society released new data for 2023 suggesting a rise in colorectal cancer in young people. Well crap 💩. Let’s brush up on our KUB skills.

In Today’s Edition:

• The DOJ attempts to pause a ruling jeopardizing preventative care

• Full practice authority may not eliminate physician liability

• Colorectal cancer is on the rise - options for screening

• Meet the dream team - your APP writers

• Pre-professional student pro-tips

• Abdominal x-rays giving you gastritis? We’ve got you (+free CME)

🩺 APP Trending News

U.S. Department of Justice attempts to halt a ruling that jeopardizes preventive care mandates.

Last month, a U.S. District Judge made a ruling that invalidated some of the mandates from the Affordable Care Act (ACT) on preventive care. Could this jeopardize the access many Americans have to preventive services? Providers may need to brace for possible changes to how preventive and wellness services are covered, and patients may have to pick up part of the tab. Now is the time to get active in your state organizations and legislature folks!

Full Practice Authority

Full Practice Authority has abolished physician supervisory requirements for NPs in 27 states and for PAs in 4. Are affiliated physicians still liable?

⚙️ The More You Know

Colorectal Cancer on the Rise:

Despite decades of decline, the American Cancer Society's latest update on colorectal cancer (CRC) statistics indicates an INCREASE in patients younger than 50 years and at a more advanced stage. As the 2nd most common cause of cancer mortality, it is imperative providers are updated on screening recommendations and that we are advocating for the high-quality screening and treatment now recommended for adults ages 45-49.

We’ve got you! Updates on current recommendations:

For information on colorectal cancer screening, including a full discussion on non-invasive test options, rationale, and research, we recommend visiting the USPSTF's final recommendation statement. Pro-tip: Always consider your patient's individual risk factors when making decisions. National recommendations are a (great) tool and not a substitute for your clinical reasoning skills! 💡

Blood assays are looking hopeful for the future of cancer screening:

In an effort to develop less invasive colorectal cancer (CRC) screening options, several US companies are developing circulating tumor DNA blood tests (ctDNA), and are seeking approval from the U.S. Food and Drug Administration (FDA). In a March, 2023 press release, Guardant Health has announced that it has submitted its premarket approval application for its DNA assay, (appropriately named) Shield. We are all for non-invasive, cost-effective screening! 💩

Brushing up on CRC recommendations? Here is your weekly FREE CME:

Medscape Education collaborated with the CDC to create a course for primary healthcare providers that focuses on colorectal cancer screening. Create an account and that's 1.0 CME/CNE credits in your pocket...for FREE! 🛎

More FREE CME:

2023 PCE Gastroenterology APP Bootcamp. Attend this virtual event Saturday, May 20th and earn 2.5h of CE/CME, including pharmacology CE.

💡 Inspiration for Aspirations

Meet the Advanced Practice Pulse Team:

Our APP (PA & NP) duo has 30+ years of clinical experience combined and a mutual passion for education, critical care, and advocacy for vulnerable populations.

DeAndra Chambliss MSN, APRN, CCRN, AGACNP-BC, DNP student

How did you become an NP? DeAndra entered the healthcare industry in 2010, working as a student nurse technician while attending nursing school at Hinds Community College in Jackson, Mississippi. There, she also obtained her associate degree and became a Registered Nurse (RN). After moving to Texas, she obtained her BSN from UTMB in 2013. She has a passion for critically ill patients and has worked diligently as an RN at Memorial Hermann for 7 years. Her extensive critical care experience spans across several specialties including Neuro, Shock Trauma, Medical/Surgical, and Pediatric Intensive Care Units (ICUs).

She completed her NP education as an Adult Gerontological Acute Care Nurse Practitioner (AGACNP) in 2018 and has chosen to continue clinical work as a sole nocturnal provider in a Medical/Surgical ICU for the past 3 years. She is also in the process of earning her Doctor of Nursing Practice (DNP) at UTMB.

What does clinical work look like? Her role includes collaboration with the healthcare team to admit, assess, diagnose, and treat ICU patients. She performs invasive procedures including insertion of central lines, arterial lines, dialysis catheters, and airway management (not limited to intubation). The night is unpredictable as she also attends and leads the management for emergencies within the hospital (rapid response/code blue).

What else should we know? “I have a love for the elderly population and critical care management. I have an amazing husband, 2 sons, and 1 daughter. They are 15, 7, and 1 year old respectively. I love to travel and I am a foodie. I love to dance and sing to all types of music. My goal is to unite with other APPs around the world to transform the healthcare system for vulnerable populations and inspire others to persevere no matter what to reach their highest potential!”

Katie Beaudoin, DMS, MPAS, PA-C

How did you become a PA? Katie graduated from Butler University in 2005 with a Bachelor of Science in Health Sciences (PA Studies), followed directly by an Emergency Medicine Fellowship at University of Texas San Antonio. She then earned a Master of PA Studies from the University of Texas Rio Grande Valley in 2017 and completed her Doctor of Medical Science (DMS) degree from Butler University in 2021. Katie has held multiple faculty positions which include the University of Texas McGovern Medical School, Baylor College of Medicine, Butler University and High Point University. She also has a passion for the critically ill patient and her extensive experience spans across several specialties including Neurosurgery, Oncology, Pulmonary, and Trauma. She also has experience in Emergency Medicine/ Trauma Surgery, and as a Proceduralist (port removal, lumbar punctures, vascular access, paracentesis, and more).

What does work look like? Katie's professional interests include education, mentorship, patient quality and safety, and leadership. She also enjoyed serving on the Texas Medical Center Board of Ethics and created a thriving not-for-profit to benefit patients who are underprivileged or underinsured and in need of DME (formerly Project UNION, now called RSVP). Clinical work includes independent nocturnal critical care for ICU patients including admissions, procedures, airway management (intubation), and running to emergent situations (rapid response/code blue). Day time work consists of collaborative patient care in the ICU and she has ongoing academic involvement doing research, teaching DMS courses, and is a course director for a fellowship program for onboarding FNPs and PAs.

What else should we know? “It’s no secret that I love taking care of my little elderly people. I also have a passion for mentoring both new and experienced professionals in our field. We (PAs & NPs) have so much to offer. I strive to advocate for the APP profession as a whole and believe if we work collaboratively, we can make positive changes in the U.S. healthcare system. Together, we can improve access to care and effect real change for our underserved and vulnerable populations. In my downtime I love to travel, fly with my husband, cook (and try new food), paint, and just try new things. Fun fact: I met my husband while volunteering for the Houston Livestock Show and Rodeo!”

📈 Future APPs

Let’s Start from Square One. How to Begin Your Path to APP Greatness!

Our national organizations and most state and undergraduate institutions have pre-professional clubs or memberships. It’s imperative you know what you are getting into. Pro-tip: Join them! Not one? Start one. They provide many valuable resources and look excellent on your application!

I want to be a PA. Where do I start?

I want to be an NP. Where do I start?

🧪 Clinical Conundrums: Because We Love a Challenge!

Abdominal X-Rays Give Me Gastritis:

A 3 year old was brought to you due to suspected ingestion. His babysitter only got a glimpse of “something shiny” before it disappeared. After a thorough history and exam, (kiddo looks stable), you obtain a "KUB." What finding confirms your suspicion? What is your next step?

a. radiopaque foreign body

b. normal bowel gas pattern

c. constipation

d. external item obscuring the results

🔎 ICYMI

Last week in Advanced Practice Pulse:

• Hot Topics: Say Buh-Bye to the Buprenorphine X-Waiver and Hello New DEA Mandated Opioid CME Requirements

• Let’s Be Clear…Defining APP Roles

• Free CME Resource - Opioid Prescribing

• Pro Tips for Aspiring APPs

• CME, CNE, Contact Hours, and CEUs - OH MY! Defining CME, CNE, and CEU Requirements

Don’t forget to add us to your contacts or review your “promotions” and “spam” folders. We would hate for you to miss out!