#pablr

[populationpensive]

Abdominal Pain PSA

I've had a run of people admitted to the ICU after have 1-2 weeks of abdominal pain who were struggling to eat or drink that ended up having conditions leading to necrotic bowel. Dead bowel makes people incredibly sick. Like, death's door sick. Anecdotally, I'd say maybe 60% of our patients make it through such an ordeal. Every time I talk with their families, their loved ones say that they looked bad and they tried to get the patient to go get some help. Often, these people wait too long.

So.

PSA: if you're having abdominal pain and can't keep anything down for more than 48 hours (especially in the context of N/V WITHOUT bowel movements), you NEED to go to the ER. Not urgent care. Not your PCP. The ER. Please get checked out. Do not let things sit. If you have known GI disease like diverticulosis, a hernia, etc, even more of a reason to get checked out.

#critical care #medicine #abdominal pain #necrotic bowel #medblr #pablr #nurblr #pharmblr #physician assistant #physician associate #pa-c #pre-pa #pa-s #pa school #caspa

[intrainingdoc]

#inhouse #happy new year #medblr #pablr #nurseblr

[livingthepadream]

Me: hmm this patient still has an elevated A1c even while on metformin. He also has heart disease and elevated micro albumin. Let’s trial him on an SGLT-2

Insurance: sorry to qualify for that he has to have tried metformin and have an elevated A1c

Me: uhh yeah he does like I said before. But anyway here is your PA along with the extra proof of that.

Insurance: ehh still not buying that Imma need you to write a letter of necessity

Me: do you want to die

#pablr #nursingblr #medblr #internal medicine #insurance companies make me want to pull my hair out

[brooklynpa-c]

TRYING TO TELL ADMIN WE’RE UNDERSTAFFED AND IT’S CREATING AN UNSAFE ENVIRONMENT FOR PATIENTS

#pablr #pa school #physician assistant #pa-s #emergency medicine #pa-c #medicine #medblr #surgery #nurblr #internal medicine #ob/gyn #orthopedic surgery #wish i was kidding #south park #officer barbrady

[theglowstickchronicles]

Start normalizing explaining to your patients how PRN pain medications work and correlate with the 1-10 scale.

#registered nurse #nurblr #healthcare #medblr #pablr #hospital life #teaching hospital life

[medicalmiracle]

FOUR YEARS, Y'ALL

y'all know that video of the owls? the little burrowing owls and they're like all in a bucket and then this like, *hand* scoops one up and deposits it in front of a dark tunnel and it just... runs and then the rest of them are in the bucket like, *anxiety* and you just want to love them but they're freaking out on such a profound level that it's also funny as fuck? no? please find this video and watch it. you're welcome.

anygays, THIS VIDEO IS ME AT WORK EVERY DAY.

but... it's the ICU. if any place is a place where you are both dashing full speed ahead and doing all the things while simultaneously questioning everything you've ever known and having multiple mental health crises, the ICU is that place.

IT IS A BITCH BUT I LOVE IT SO MUCH, Y'ALL.

that's it. that's the post... back in two years. carry on.

#pablr #medblr #medblr is amazing #critical care #and now to disappear again #evil laughter fades away into the distance

[medblr-of-a-sleepyhead]

[30/05/2022] // ☕📚🖋️📒

#medblr #studyblr #medicine #med school #notes #college #academia #nurblr #pablr #gradblr #studyspo #mine

[harrypotterhogwartshitpost]

PABLR (people against boneless ribs)

#boneless ribs are unnatural #and they suck #thatkidnic

[docresa]

If you're in quarantine and dying of boredom (or just want to help) - consider sewing surgical masks!

Hospitals are in short supply of PPE these days and happy for every donation!

Here is a brief tutorial on how to sew them! (I do them without the lining to get more done with the materials I have.)

#Sewing #Surgical masks #Also this is fun I haven't sewed in months I like it #Covid-19 #Sars-cov2 #Corona virus #Corona pandemia #Medblr #Nurblr #Premedblr #Pablr #Hospital #Surgery #Med school #Medical school #Medicine #Med student #Medical student #RN #PA #Physician

[this-is-mdness]

Anyone have tips for ear exams? I suck at finding the TM!

#medblr #nurblr #pablr #idk are these tags even right #if you look in ears please help me

[soupsandsandwiches]

Today at work, my attending was blasting Ricky Martin, BSB, Destiny’s Child, NSYNC, etc in the office spare shared by the APPs and docs while we all did our morning chat review. After I manually disimpacted a patient in dire need, he found me in the hallway and elbow bumped a congrats and was legitimately grateful to me for helping.

I am so fucking happy in the job it’s unreal. I had NO IDEA that the work place could be fucking FUN. FUN. He also loves to teach and taught me something every dang day. And on Wednesday we did a lunch and learn about ACS.

I just. It was all worth it 😭😭

#pablr #pac #hospitalistpa #internal medicine #attending

[populationpensive]

Five Years as a PA-C

Well, 5 years as a PA-C really snuck up on me. I was at work on Tuesday and while checking my email, my hospital send one of those "Congrats on 5 years! Pick a cool thing from this random website!" To be perfectly frank, I was a little dumb struck.

In many ways, it just doesn't seem like that much time has passed. I work in such a fast paced, stimulating environment, constantly learning new things, that I didn't really FEEL the time. Well, at least the last 3 years. The first 2 were long and arduous.

Looking through my archives, I faithfully did reflections after the first and second years. Somehow skipped the others. Never too late to get back in it.

Lessons Learned

There are people that work in healthcare for a pay check. Let your frustration with that slide away.

Some people are just assholes. Don't overthink that. Again, let that shit go.

Some parts of medical education/residency are completely ridiculous, unfair, and unsafe. Try to change what you can (especially the unsafe).

Stand up for your boundaries. I was offered a chance to "move up" into management. I declined because I knew I would hate my job if I took on admin. Don't apologize for setting this boundary.

Cultivate relationships with your coworkers and hang out with them outside of work. This is so important for our critical care team. I believe it enhances our ability to work well together.

Use your vacation time.

Some families or patients will suck you dry. Prepare yourself for those interactions and have a plan to decompress what you absorb.

Always be excited to learn. Medicine is changing every day. Learning is a foundation of the profession.

The best decision I made was changing specialties. The second best decision I made was to turn down a management opportunity. You can challenge yourself in ways that do not result in more pay, more responsibility, or more stress. I am wanting to get my chest tube placement verification done this year. Would love to add paras to that. I want to expand the teaching I have done with my PA school and possibly guest lecture on other topics. There are a lot of things that advance a career that aren't management. For me, that is desirable.

So what next? Well, some of you know that I have some intense outside of work things going on. For now, I am hanging out where I am. Probably will go to a conference this year. Probably will do more teaching. I'm ok with that. I love critical care and I have no plans to leave it any time soon.

#pablr #pa-c #originstory #medicine #pre-pa #pa-s #physician assistant #physician associate

[intrainingdoc]

New on in-House, in celebration of #ThankAResidentDay, a beautiful appreciation post for #residents!

#medical school #pablr #residency #nurseblr #med school #fellowship #narrative medicine #inhouse #thankaresidentday

[livingthepadream]

X ray: incidental finding of AAA recommends CT

Me: orders CTA

Insurance: sorry we don’t see why the patient needs this even though the radiology report clearly states they do. Do a peer to peer and submit an appeal.

My office: submits appeal

Me: checks on status cause you know, AAAs can KILL people

Insurance: sorry we don’t even see that this case exist in our system start over

Me:

#pablr #medblr #nursingblr #i hate Prior authorizations #what else do you want from me

[brooklynpa-c]

WHEN THE HOSPITAL SERVER CRASHES AND WE HAVE A WEEK OF PAPER CHARTING

#pablr #pa school #physician assistant #clinical year #emergency medicine #grad school #pa-c #medicine #surgery #medblr #nurblr #college #internal medicine #ob/gyn #orthopedic surgery #downtime #dumpster fire #my everything hurts #everything’s fine

[theglowstickchronicles]

I truly feel that this verdict was the kiss of death for healthcare. An industry already on the precipice of total collapse has now been dealt the heaviest of blows. Healthcare workers and patients alike are no longer safe. As someone who is now dealing with serious medical issues and as someone who has been in healthcare for 15 years, I urge everyone to ALWAYS be cautious when dealing with anything related to healthcare, as it is no longer a culture that values patient safety above all else.

This patient’s death could have started a movement that saved thousands of lives and instead it has done the opposite. So many will be lost because of the actions of Vanderbilt and this jury.

#registered nurse #nurblr #medblr #radonda vaught #pablr #healthcare #Vanderbilt