When Experience Isn’t Enough: Learning Across Borders as an APN in Singapore

You’ve spent years becoming good at your job. Then you step into a role where that isn’t enough.Michelle Segal-James is an advanced practice nurse (APN) in Singapore. I talks with her about what changes when you move beyond experienced nursing and into the NP role: how you think, how you make decisions, and what you have to let go of before you can build something new.We also compare how Singapore and Australia approach advanced practice, and what each country can learn from the other.It is a conversation about growth, uncertainty and being willing to start again.For any nurse asking what comes next, and any NP still finding their feet. Tune in to this episode of NP in Progress

In this episode of NP In Progress, I sit down with Corinne Dunningham, emergency nurse practitioner and NP Masters coordinator, for one of my deepest and raw conversation since starting the podcast, we talk about the messy middle of becoming, and being a nurse practitioner.We unpack the expert-to-novice transition, why endorsement is often “just admin”, what full scope practice really means, and why nurse practitioners need to stop justifying their existence and start building the evidence for what comes next. Corinne also breaks down clinical reasoning as the “how and why” behind decision-making, reframes feedback as advice, and speaks honestly about uncertainty, collaboration, nursing identity, and finding your confidence without pretending you have it all together.This episode is for NP students, new NPs, educators, and anyone trying to practise safely in the grey while still backing themselves

In this episode, I sit down with Lesley Salem, one of Australia’s first Indigenous Nurse Practitioners, for a raw and powerful conversation about culture, clinical reasoning, remote healthcare, and what it really means to serve people well.Lesley shares how her culture shapes the way she connects with patients, why hierarchy damages care, and how simple human connection can break down fear and mistrust. We talk about remote primary healthcare, Aboriginal Medical Services, pathology-led diagnostic reasoning, rheumatic heart disease, Medicare barriers, and why Nurse Practitioners need access to full scope if Australia is serious about health equity.This episode is also a masterclass in practical clinical reasoning. Lesley explains how she works backwards from abnormal pathology, how she thinks through differential diagnoses, and why anatomy and physiology sit at the centre of safe advanced practice.It’s honest, political, clinical, and deeply human. A conversation about hope, access, advocacy, and the Nurse Practitioner role Australia still hasn’t fully learnt how to use.

What happens when an emergency NP and a heart failure NP compare notes? A lot of laughing and a surprising amount of clinical growth. In this episode, I am joined again with Dr. Haunnah Rheault heart failure NP for an honest conversation about diagnostic momentum, cognitive bias, and why your specialty lens might be your biggest blind spot. We also get into the messy middle of becoming an NP, failing vivas, practicing the wrong technique 10,000 times, and why your CST saying "you're doing great" might be the kindest form of sabotage. Because real growth looks less like a lecture and more like being coached like an athlete. Featuring a reflective case on inflammatory breast cancer and why "it's probably cellulitis" can cost a patient everything.

In this episode of NP in Progress, I sit down with orthopaedic registrar Dr Dan Brimm to break down the septic joint ; a limb- and sometimes threatening diagnosis you can’t afford to miss.We work through real ED cases, including a swollen knee after a “pimple squeeze” and a 30-year-old with a history of Intravenous drug use and severe wrist pain at 3am. We cover when to aspirate, when not to, why X-rays still matter, what bloods can and can’t tell you, and how metal in a joint changes your risk calculation.We also talk bias, pain management, and the importance of collaboration between ED and ortho.Practical. Case-based. No fluff

Sometimes the diagnosis hiding in plain sight is the one everyone keeps missing. NP Dr. Leanne Brown breaks down what really happened to the young CKD patient and shares a humbling case where “musculoskeletal pain” fooled an entire team. This episode is a masterclass in staying curious when the answers seem obvious.Peptide clinical trial : https://clinicaltrials.gov/study/NCT06383390

Dr Leanne Brown NP joins me on this episode as we unpack the reality of dialysis decisions, the power of patient choice, and why listening matters more than ticking boxes.This one’s for every clinician who’s ever stopped to ask what better really looks like.Websites discussed in podcast https://eprints.qut.edu.au/107136/1/Leanne_Brown_Thesis.pdfhttps://kidney.org.au/health-professionals/ckd-management-handbook

Clinical reasoning sits at the centre of this chat with GP Dr Henri Coombs. We cover the “golden minute,” the ICE model (ideas, concerns, expectations), and how to keep notes rich without stealing time from patients using ambient scribing tools. Henri shares how he balances risk in GP, when to refer to ED, antibiotic stewardship without arguments, and why concise GP letters matter. We also walk a fatigue case step-by-step, including iron, thyroid, sleep, mental health, and when tests help versus hinder.You’ll hear about:Patient-centred consults that actually save timeShared decisions that reduce bounce-backsAmbient documentation (Heidi/Lyrebird) improving note qualityRisk tolerance in GP vs ED; red flags that change your planFatigue work-up: ferritin, B12/folate, thyroid, vitamin D, CRP (used wisely), sleepCoaching culture, feedback, and teaching registrars without panic referralsPractical discharge/GP letter do’s (short, clear, actionable)Perfect for NP students, ED clinicians, and any GP who wants fewer returns and better follow-up, without longer consults.

What happens when you're the first NP in your specialty and everyone’s watching?Linda Bradbury was the first rheumatology nurse practitioner in Australia. In this episode, we talk through clinical reasoning in complex pain, setting up nurse-led gout clinics, NP prescribing limits, and the real work behind changing national policy. We also cover health literacy, fibromyalgia, methotrexate safety, and why ballroom dancing beats burnout.For NP students, early-career NPs, and anyone managing chronic disease in real life. https://www.safetyandquality.gov.au/our-work/patient-and-consumer-centred-care/health-literacy/tools-and-resources-for-health-service-organisations

What happens when a nurse practitioner stops waiting for the system to change- and builds something better? In this episode, I sit down with Chris O'Donnell, one of Australia’s most successful private practice NPs and the founder of MyWeightLoss Clinic, a nationwide telehealth service. We unpack how Chris scaled from ED Fast Track to 120+ staff, 500,000 patient encounters, and a model of care that delivers medication via Uber Eats. You’ll hear: • Why obesity is a metabolic issue, not a willpower problem • How NP-led telehealth is reshaping chronic disease care • The four pillars of obesity medicine • AI, patient safety, and managing clinical risk remotely This one’s part clinical reasoning, part healthcare rebellion- and all heart.