Macon Conference Summary

Alexander Warren
NURS 6310
09/19/2014

This being my first conference for advanced practice nurses; I was unsure of what to
expect. The speakers were professional, interesting, and were obviously well informed. I look
forward to the next SGANP conference here in Valdosta in November.
The first day began with an excellent speaker, Victor Czerkasij FNP-C, who was a gold
mine of dermatological information. He began with the basics of skin anatomy and simple
conditions that nurse practitioners who practice family medicine would see on a day to day basis.
I believe this was the most beneficial presentation of the entire conference to me. The scope of
dermatology is so large that it has always been a daunting topic. His presentation of the top 20
conditions that practitioners encounter was beneficial and gave me a better understanding of
what conditions I needed to concentrate my knowledge base. The education on drug reactions to
skin was perfectly timed as this week I had a patient in clinicals who was having a drug reaction.
The patient had blisters on his hands/feet, a secondary infection on his ear from scratching, and
maculopapular rash on his trunk. This was the exactly the case presented in Mr. Czerekasijs
slides, and I was able to diagnosis it correctly when my preceptor asked me what I thought it
was.
Mr. Czerkasij spoke again that day, and his main topic was about how skin conditions
present differently across races, and it was a real eye opener. As if the diagnosing of skin issues
is not hard enough, now you have to consider the fact that the same condition can look
completely different on a person of another race. Even the treatment of a common condition
such as acne should be different when treating a patient with skin of color. The inflammatory
response is different as is the propensity for hyperpigmentation (Davis, 2010). All things
considered I believe that I learned the most from his two presentations. I feel that I not only

learned valuable information about dermatology but was given a direction as to what I needed to
learn in that specific field.
There was an excellent presentation on opioids from Brett Snodgrass. Although I do not
live in a state where nurse practitioners can prescribe the majority of the medications she
lectured on, it does not mean that we will not encounter them. In practice, you will always see
patients who have these medications on their profile and will need to know how they work just
as if you can prescribe them. She spoke on the dangers, addictive quality, and precautions that
are needed in relation to opioids. I think the most important piece of information she shared was
that opioids are always considered in the trial phase, no matter how long the patient has taken
them. They should be weaned off, or the dose lowered whenever it is safe to do so. The
potential for accidental overdose where the patient continues taking the medication too close
together was a concept I had not considered. There was a lot of good information, and she still
had a lot to go over when she ran out of time.
We had a lunch and talk, where Catherine Maxwell Pharm-D, discussed the management
of type II diabetes. Diabetes and its management is a topic that has been drilled into us ever
since we first started nursing school. She covered most of the basics, but she did get into the
different mechanisms of action in regards to the different medications which was helpful.
Honestly, it was a little on the bland side because of how often we have heard this information,
but it was information that bears repeating.
We then had a presentation on oral oncolytics by Angie Knoll. I have neither worked in
oncology nor been around it in my nursing career at all, so this was all new to me. She covered

barriers to patient adherence to their oral regimen and how patients felt that if their physician
started them on an oral regimen that they had given up on them.
The second day of the conference had three presentations on documentation, coding, and
billing. We all realize it is an important part of practicing, but that makes the information no
easier to swallow. Kathy J. Smith spoke on E/M coding; this is something we actually had a
decent base to build on from our Intro to Primary Care class. This presentation gave us a
detailed breakdown of how your charting determines what level of care you provided. It really is
a complicated process, and we could probably discuss coding for a whole semester and still need
more education. She had another section where she spoke on incident to documentation.
Incident to works as a guideline on how the NP/MD relationship needs to be shown in the
documentation. How the NP is supervised directly affects reimbursement rates, and of course,
documentation is key to proper billing. The last documentation set was on the new ICD-10
coding. This was like reading a calculus book. I understand the importance of monitoring
diseases and providing the proper compensation for services, but ICD-10 just feels clunky and
convoluted. She did a very good job of trying to explain a very difficult subject. I do not feel
that I have a much better understanding of ICD-10 now than I did before the lecture. If ICD-10
goes into effect, I will need a significant amount of training to use it properly.
Lane Edwards ANP, gave two presentations, one on the prevention of heart failure and
another on the new standards of hypertension. He had a lot of information on heart remodeling
after an acute infarction that was exceptionally helpful. He also broke down heart failure
patients into classes and stressed the importance of learning how to prevent the patients from
advancing to the next class. Also, his discussion on how patients who have a normal EF and also
some type of heart abnormality technically have heart failure was educational. His heart failure

lecture stressed early treatment and how it can decrease mortality and increase quality of life.
The new 2014 hypertension guidelines were discussed in length and how to prevent target organ
damage. He spoke on certain drug classes but ran out of time before he could get to them all and
the specific medications in each class. Several studies have been done in regards to these new
guidelines. Most show a very high improvement in hypertension control with as much at 87% of
the patient sample gaining normal blood pressures when the physician follows these guidelines
(JACC, 2014). His understanding of the heart and how medications affect its mechanisms was
impressive. I would have liked more time to hear him.
I enjoyed my first nurse practitioner conference. I learned a lot and met quite a few nurse
practitioners from around Georgia. There is another conference coming up in Valdosta, and I
plan on attending. The information I learned can easily be put into practice.

References

Davis, E., & Callender, V. (2010). A Review of Acne in Ethnic Skin Pathogenesis, Clinical
Manifestations, and Management Strategies.The Journal of Clinical and Aesthetic Dermatology,
3(4), 24-28. Retrieved September 18, 2014, from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921746/
Go, A. S., Bauman, M. A., King, S. M., Fonarow, G. C., Lawrence, W., Williams, K. A., &
Sanchez, E. (2014). An Effective Approach to High Blood Pressure Control. Journal of the
American College of Cardiology, 63(12), 1230-1238. doi: 10.1016/j.jacc.2013.11.007