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A Day in the Life - Juliana Ivanof

What’s it like to be in the Pediatric Primary Care Nurse Practitioner program? Meet Juliana Ivanof, an Amy Gutmann Leadership Scholar.

9:00 PM: I set up my cold brew pot so that it can steep overnight. Living in Massachusetts my whole life, I’m thoroughly committed to drinking Dunkin’ Donuts iced coffee, and this is the easiest way for me to prepare it in my dorm room without a kitchen.


7:00 AM: My alarm goes off, telling me it’s time to rise and shine for another beautiful morning in the Quad! I open up my shades and look out into the courtyard while sipping the coffee I prepared last night. Today I’m going to the CHOP Primary Care South Philadelphia site, so I will be wearing scrubs. In pediatrics, I can wear more “fun” scrubs, so I choose my top with penguins and hearts. I can often distract my patients by asking them to point out their favorite characters on my shirt!

8:00 AM: Time to head out to take SEPTA to the clinic. Ware is pretty quiet this morning, but I say hi to the couple of residents I see. I’ll see them later tonight.

On campus and on time!

8:45 AM: I make it to the clinic and begin looking at the patient schedule for the day. I usually see around 10 patients, ranging from a few days old to over 20 years old. In the Amy Gutmann Leadership Scholars (AGLS) program, we just discussed our “career cartography”, so I think about what I can do today to support my career goals. One of my goals currently is to work with more newborns and mothers to improve my lactation education skills, so I make a mental note to request any infants on my preceptor’s schedule today.

9:00 AM: First on the schedule is a 2-month-old infant coming in for a well-child visit. I start off by having a conversation with the parents regarding sleep, nutrition, growth trajectory, developmental milestones, home life, and any concerns they are having. I then examine the infant from head to toe. He’s a happy patient, at least until I try to look in his mouth! Everything looks good, except for some diaper rash.

9:30 AM: I document my assessment and patient education, and then I leave the room to discuss the infant with my preceptor. Together, we agree that the diaper rash can be managed with basic over-the-counter diaper cream, so this little patient won’t be needing any new prescriptions today.

9:45 AM My preceptor and I return to the room to check in one last time with the patient and his parents. I provide education on how to help clear up the diaper rash— making sure to change the diaper as soon as possible, wiping gently with fragrance-free wipes, and applying the diaper cream with each diaper change. The parents have no other questions, so my preceptor and I sign for the typical 2-month vaccines: rotavirus, DTaP, Hib, PCV13, and IPV. He already got his hepatitis B vaccine last month, so he gets away with one less shot today!


10:00 AM: Next patient! Luckily, there is an excellent team at CHOP South Philly, so the medical assistants have my next patient ready and waiting for me in an examination room. This patient is a 3-year-old, here for her well-child visit.

Noon: Lunch time! Now I’m able to catch up with my preceptor and discuss my questions from the morning cases.


1:00 PM: My preceptor heads to see our next patient without me so that I can listen to the case presentations from the medical students on clerkship here. Today, they each present us with cases that were referred to ophthalmology. I’m grateful for the chance to learn in such a supportive, interdisciplinary environment.

1:30 PM: I catch up with my preceptor in the next room—a 13-year-old girl and her 15-year-old brother. As adolescents, my preceptor and I spend time with each patient individually, with no parents in the room. This opens the conversation to topics that they might otherwise not feel comfortable discussing with parents in the room. The 13-year-old girl shares how she wants to be more physically active, but she is scared to leave her house in her neighborhood due to the violent crimes that have occurred in the area. This makes me think of our last discussion in the AGLS program on the Future of Nursing report. Nurse leaders must engage with the community and advocate for its needs. I jot down a note to look at how to access a safe environment for exercise in Philadelphia—maybe my fellow scholars know of community resources or initiatives I can look into so I can support the patient on this.


5:00 PM: That’s a wrap! After an afternoon full of children and families, it’s time for me to head home. I hop on SEPTA and head back to campus. As a Graduate Resident Advisor in Ware College House, I’m on duty tonight, so I head straight back to the dorm to grab the duty phone.

6:00 PM: Duty phone on hand, I gather ingredients from my dorm room to take to the communal kitchen. I don’t want to make anything too involved in case I get called away to help a resident, so tonight is just pasta with sauce.


6:30 PM: Dinner in hand, I head back to my dorm room to eat. Along the way, I knock on a fellow GRA’s door to see what she’s up to. We have great camaraderie as a team here in Ware—my coworkers are all so nice! She invites me into her room, and we eat dinner together while chatting about our days at placement.

11:00 PM: Time for the first round of the night! It’s a Friday night, so the freshmen are all pretty excited. Quiet hours, when students must be quiet in their dorm rooms, don’t begin until 1:00 AM on Friday and Saturday night, so the dorm is noisy!

Enjoying some well-earned downtime


Midnight: Round one is done! Back in my dorm room, I finish up any Information Reports regarding student behavior that violated Community Guidelines. Then, it’s time to relax with some video games! Tonight, I’m playing Bioshock 2, a story about an underwater city that has fallen into ruin.


1:00 AM: Second round time! Now it is quiet hours, so I stop at any noisy room to ask them to please quiet down.

1:30 AM: All done—time for bed! I set the duty phone’s ringer on high so that it will wake me up if anyone needs the RA on duty. No need to set an alarm tonight since there’s no clinical tomorrow! I listen to a few songs on my phone, and then I hop into bed for the night.