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Marinejiujitsu

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Marinejiujitsu last won the day on October 11 2019

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About Marinejiujitsu

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  1. It really depends on the mistake and regardless I would walk wary without throwing someone under the bus. If they are being admitted I defer to the admiting doctor. Sometimes there is no way around it. Such as a surgeon finding an instrument or gauze from another surgeon due to a large abscess building up. Some things you can't get around. I do let the provider know about the mistake. Anyone should appreciate you letting them know because frankly we have all made these kind of mistakes in our career. Sent from my SM-N975U using Tapatalk
  2. There's always a question if you have mental health issues that can affect your job. If you don't think it will affect it. Just click now. Ive never seen it asked if you ever had treatment for mental health issues. Sent from my SM-N975U using Tapatalk
  3. I tend to order 1st dose antibiotics if we are not too busy. I order more IV fluids when people say they are dizzy too. My attending wants us to order more respiratory panels on kids. I tend not too as much unless the patient is being admitted or pertains to treatment and plan suck as flu or rsv in the infants. I feel admissions with the attendings are turning a little watered down. Mild cellutis being admitted. Mild dka. Etc... Sent from my SM-N975U using Tapatalk
  4. Sorry phone typing. Meant to say critical assess hospital and billing Sent from my SM-N975U using Tapatalk
  5. I think we can all agree that there's over ordering of labs and imaging. I'm curious how everybody else handles critical access hospitals that are at risk of going undet and having to close the doors Do you order more then you usually would, or try to keep your standard of care and order how you usually would? ERPA btw. Sent from my SM-N975U using Tapatalk
  6. Totally agree. Besides people not really maintaining their proper preventative healthcare, and providers having to go faster and faster to keep their jobs. It's a recipe for disaster. Healthcare is going down the toilet. Sent from my SM-N975U using Tapatalk
  7. It really doesnt bother me too much. Its just an irritating part of the job. Sent from my SM-N975U using Tapatalk
  8. Yep, just looked it up. Swoop in and stole my RVUs and then used my discharge paperwork with my instructions that I use which are unique to me. I really don't care about the money but I'm like, "This motherf'er". Lol. Sent from my SM-N975U using Tapatalk
  9. Yeah, we are a productivity site and I left before the ultrasound was read, I'm sure he swooped in for my rvus. Sent from my SM-N975U using Tapatalk
  10. Yeah, I still think it's great to be a PA. I will take the negative with the positives. I have been able to get in a great standing with my company and have a lot of credibility. Almost all my attendings trust my judgement but usually there is just that 1 or 2 that sour the party. Sent from my SM-N975U using Tapatalk
  11. Yeah, it's nothing new unless you work in a solo practice ER that a PA can work alone which is rare. You're gonna be a great doc to work for seeing both perspectives. You are welcome at my shop. Sent from my SM-N975U using Tapatalk
  12. Another patient same doc; I asked him to lookat a genital lesion. I told him I think itsa chancre and I think it's syphilis but I never seen a chancre so I asked him to take a look at it. Of course he disagreed and said HSV. I was like, I don't think so. So, I ordered an RPR and a tzanck smear and guess who had to call the patient back? Another time, a person came in and got hit and beat up with a baseball bat. He canceled my CT thorax and next day I seem him and I was like bullcrap and ordered another CT. Double pneumo. I hate the piss on each other and I'm better than any other practitioner culture. Sent from my SM-N975U using Tapatalk
  13. In the ER, we see a lot of patients. I have almost 10 yrs under my belt seeing patients. I've came across my fair share of little kids with significant swelling in the neck. We think mumps, abscess, salivary gland, abscess. Sometimes I have a high Suspicion for a bacterial infection or airway compromise. Last week I had a case of a four-year-old with ludwig's angina. Today I have a 5 year old with not really too tender to palpation swelling to the left sub mandibular area almost back underneath the ear. Totally lymphadenopathy. I've seen this many times and almost every time it ends up being Epstein Barr. I ordered labs, and an ultrasound. After discussing with the parents that CT scans have a lot of radiation and my suspicion is so low for airway issues due to location and an ultrasound can show pus. I also gave the kid Steroids which was helping with the swelling. Of course the ultrasound comes back with large lymphadenopathies bilateral cervical lymph nodes greater on the left. No crap, totally expected. And what does my attending say, go ahead and order the CT scan without seeing the patient. I knew it was over kill. I am assuming the mom started questioning my ability. Super paranoid mommy. Of course it came back as lymphadenopathy with no airway compromise. Had fever and swelling for 2 days. I discharge patient with NSAIDS and said much likely viral and follow up with pmd in 1-2 days with return precautions. Then they want a second opinion because I added a CT scan I am assuming and lost confidence. Mom probably thought I am unsure of myself. After my new attending comes in; he orders an abdominal ultrasound and chest xray and decides to work up lymphoma/AML. Of course labs are normal. Of course, he agrees with me but doesnt tell the patient that. It ended up being the all too common, lets make the PA look like a lesser practicioner. ER attendings are infamous. Some attendings are cool and will just reinforce your plan if you meet the standard of care. ER attendings magically see otitis media. Or saying its strep in a 6 month old with a fever. Blah blah. Of course, in the end the patient goes home with likely viral, heres nsaids, follow up with pmd 1-2 days and return precautions. And mom and patient leaves thinking I am lesser of a provider because I didnt order an ultrasound of the abdomen or chest xray. Sheesh. Gotta love being a PA. Sent from my SM-N975U using Tapatalk
  14. Forgive the grammar. I tend to type on my phone but everyone here gets your point. You are preaching to the choir. Sorry you had such a bad interaction. Sent from my SM-N975U using Tapatalk
  15. You do know this is common practice to ask? The assumption that we dont is what I hate about medicine people pissing on each other. That this is asked multiple times. We aren't just swinging at the fences. A least most of us. Most os us work with what we have. Sent from my SM-N975U using Tapatalk
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