Pediatric Nurse Practitioner · Lafayette, Louisiana

JoshLeJeune

I look after children in a primary care clinic, and I precept the nurse practitioner and physician assistant students who rotate through it. The rest of the time I build the software the clinic was missing, and I self-host almost all of it.

In most of medicine, being a little goofy is a liability. With kids, it's the job. Everything below is the same instinct pointed at a different problem: I have never once left a broken workflow alone.

Josh LeJeune

The Work

Hand-written PHP and Laravel on a shared host, plus a rack at home that runs the rest. No CMS anywhere. I ship small and useful over big and generic, and a feature earning nothing gets cut the same day. These are described rather than linked: every one of them either sits behind a login or is deliberately kept out of search.

  • The 308 Chronicles

    A 366-day serialised workplace comedy about my own clinic, published one illustrated day at a time, plus two browser games. The audience is roughly 25 people who work here, which is why the humour is affectionate and the faces are drawn accurately. It is a staff room, not a publication.

    Live Plain PHP, no framework, no database

  • C.A.R.E.

    Clinical Access And Referral Explorer

    A pediatric referral directory for Acadiana: 360 listings across 331 organisations, with 186 providers and every office attached. It replaced a 20-tab spreadsheet nobody could search. It holds no patient information and says so on its own print sheet.

    Live Laravel, MySQL

  • V.E.R.A.

    Vital Education And Rotation Assistant

    The companion I hand clinical students instead of a paper black book. A visit coder, an antibiotics gateway, a dose decoder, vaccine schedules, and an eardrum trainer. Its medication cabinet has been independently recomputed across 23,207 doses.

    Live Laravel, MariaDB

  • A.R.C.

    Advanced Rotation Command

    The system behind the preceptorship: applications, schools, seat capacity, documents, and sponsoring letters signed in-house. Signing runs on its own separate origin, because the one page strangers open should not share a cookie jar with the admin.

    Live PHP, Auth0

  • A.T.L.A.S.

    Automated Team Logistics And Assignment System

    The call scheduler for our seven-provider group. Weekend load is a hard fairness rule, not a preference. Its best bug: at a quarter rollover the public page quietly stopped answering who was on call, on the one morning that question matters most.

    Live PHP, MariaDB, Auth0

  • C.L.A.R.A.

    Credential, Licensure And Accreditation Renewal Assistant

    Three renewal cycles with different rules, different clocks and different definitions of what counts. The insight it encodes: earning a cycle and renewing it are two different dates, and a spreadsheet will eventually get one of them wrong.

    Live PHP, SQLite, Auth0

  • Peptide Reference

    Reconstitution calculators and evidence-graded monographs. Every entry carries a grade and a primary source, because a vendor page is not a citation.

    Live Static, no build step, no network calls

The Log

How the above got built by a nurse. Everything in order, newest first, quests completed and quests abandoned both. Filter it down if you only came for one part.

Outcome
Track
  1. Open Active Quest

    The Next Degree

    Undecided, and it has been undecided for two years.

    A DNP buys clinical and academic legitimacy. An MBA or MPH buys the administrative lane. A second master's in AI or health informatics buys the lane most of this page already points at. I have priced all three and picked none of them.

  2. Ongoing Side Quest

    The Homelab

    14 domains, 11 subdomains, and a rack that runs most of what is on this page.

    Docker and Portainer on the network edge, a shared cPanel host for the public sites, Cloudflare in front. I self-host because I would rather own the data and the uptime than rent both.

  3. Ongoing Side Quest

    Four Books For One Kid

    Written for my godchild. One is in production, one is parked, two stayed concepts.

    The rhyming dinosaur book has all 16 verse couplets and its illustrations. The pirate book has 6 chapters of 10 and 4 continuity conflicts I have never reconciled, and it may simply stay a thing I made for him rather than a thing that ships.

  4. June 2025 Quest Complete

    ParentingU Podcast

    Guest expert on ADHD and behavior management. Wrote it, recorded it, it shipped.

    Roughly 20 minutes, 9 scripted sections. Worth naming because most of what I have written on ADHD is still sitting unpublished, and this actually went out.

  5. July 2024 Item Acquired

    PMHS Certification

    Pediatric Primary Care Mental Health Specialist, PNCB.

    The credential the fellowship was for. It is the reason a behavioral visit in my clinic does not automatically become a six month wait for somebody else's.

  6. August 2023 Party Joined

    Started Precepting

    Nurse practitioner students, 2 to 3 a semester.

    Capacity is capped by the organization, not by willingness. Turning a student down is a scheduling constraint and it always feels worse than it sounds.

  7. May 2023 to June 2024 Quest Complete

    KySS Child And Adolescent Mental Health Fellowship

    The Ohio State University.

    Thirteen months, done alongside a full clinic schedule. Pediatric mental health was the gap I could actually see from my own exam rooms.

  8. February 2022 Item Acquired

    FNP-BC

    Board certified, American Nurses Credentialing Center.

  9. March 2022 Item Acquired

    APRN License

    Louisiana State Board of Nursing.

    Louisiana is an eNLC compact state, so it travels to 39 others without a second license.

  10. May 2022 Party Joined

    Lourdes Physician Group

    Pediatric primary care. My own panel, on the campus I used to work nights in.

    Suite 308, which is also the reason a comedy site about this clinic is called The 308 Chronicles. I am the person the clinic calls when Epic breaks, which is a job title nobody prints.

  11. November 2021 Quest Complete

    Sigma Theta Tau International

    Delta Eta Chapter, with the Exceptional Service Award.

  12. December 2021 Quest Complete

    Daisy Award

    The one nurses get nominated for by families.

    Of everything in this column, this is the one I would keep.

  13. December 2021 Quest Complete

    MSN, Family Nurse Practitioner

    University of Louisiana at Lafayette. Conferred 17 December 2021.

  14. July 2020 Quest Complete

    Franciscan Service Award

    FMOL Health.

  15. 2018 to 2022 Party Joined

    PICU, Women's And Children's Hospital

    Pediatric ICU. Charge nurse, PALS instructor, preceptor for new nurses.

    Also where I learned that I would rather teach the thing than be the only person who can do it. Sat on the Nurse Council and the Nursing Retention Committee, and led the Nozin universal MRSA decolonization initiative.

  16. May 2016 Quest Complete

    BSN, Nursing

    University of Louisiana at Lafayette.

    Undergraduate research: "Perinatal Staffing During Labor of Women with Medical or Obstetric Complications."

  17. July 2016 Item Acquired

    RN License

    Louisiana State Board of Nursing.

    I keep a nursing pin for every year I have been a nurse. This is year one of that set.

  18. 2016 to 2018 Party Joined

    Adult ICU, Lafayette General

    Trauma, burn, post-surgical, sepsis, respiratory failure. Rapid Response Team.

  19. Summer 2014 Side Quest

    Aquatics Director, Fairbanks, Alaska

    BSA Midnight Sun Council.

    A summer running the water program roughly 3,500 miles from home. The following two summers were spent as health officer at Louisiana Swamp Base, which is the same job in considerably more humidity.

  20. 2012 to 2022 Party Joined

    Boy Scouts Of America, Evangeline Area Council

    Administrative assistant, ten years.

    It ended the same month I left the PICU. I started at Lourdes the month after.

  21. May 2011 Quest Complete

    Associate Of Science, Biological Science

    LSU Eunice. Graduated with High Honors.

    Picked up along the way through a biological engineering track, not as a destination.

  22. 2011 to 2013 Quest Abandoned

    Biological Engineering, LSU

    Transferred to Baton Rouge to carry the same program into its third year. Left without finishing it.

    Two thirds of an engineering degree and no bachelor's to show for it. It is the single largest thing on this page that did not work out, and I would make the same call again.

  23. 2010 to 2022 Party Joined

    American Red Cross

    Health and Safety Instructor. Twelve years of it.

    CPR and AED, wilderness and remote first aid, and lifeguarding. This is where the teaching habit actually started, well before anybody called me a preceptor.

  24. May 2009 Quest Complete

    Iota High School

    Graduated, and left for an engineering degree.

  25. September 2007 Quest Complete

    Eagle Scout

    Boy Scouts of America.

    The Ranger Award and the Venturing Silver Award came out of the same years, along with an LPB Young Hero award. Scouting stayed on the payroll a long time after it stopped being a hobby.

By The Numbers

All precepting, since August 2023, because those are the numbers I actually care about. Seven came back for another rotation, and that is the one I would put on a wall.

  • 12 Students Precepted
  • 7 Came Back For Another Rotation
  • 1,360 Clinical Hours Taught
  • 19 Rotations Completed
  • 4 Schools