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About km88

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    Physician Assistant

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  1. I think they are true to size. I love the Casma top and Yola pants. The graphite color is by far my favorite.
  2. Definitely Figs for scrubs. Worth the high price. I also like Medelita's scrub jacket - huge pockets. Both sites have frequent sales of 20-30% off.
  3. Yes, without a Medical Director I'm not sure that Assistant Medical Director is an accurate description. In my case, they were offering an MD Assistant Medical Director so the plan for me to be Associate was intended to be a lesser position. Now the 2 of us have equal titles so I'm happy about that
  4. I recently was given the title of Assistant Medical Director (2 emergency departments)... Original plan was for Associate Medical Director but that changed at some point during contract revisions. I don't use LinkedIn, however, so can't help you with that part.
  5. Scrubs +/- white coat or athletic jacket Check out Medelita -- just got new white coats and scrub jacket from here. It's a PA owned company! The quality is great. Prices are high, but I just used CME $. They seem to have a lot of sales too.
  6. I completely understand your desire to keep your hobbies. I'm more "work to live" than "live to work" too... I am happy that I went the PA route and I love what I do. I work in EM which allows for a lot of schedule flexibility. I prioritize travel in my free time and love that both my schedule and salary allow me to do so. I work 12 shifts a month and get to pick my 12, as long as my coworkers are ok working when I am gone. We have a good system - we all cover for each other. I've already taken two 2 week long international trips this year and just booked a 3rd... plus have made several trips
  7. "Hi, my name is _ and I'm the PA that's going to be seeing you today." "What's a PA?" "I have a masters in medicine and am the provider that will be taking care of you today. What can I do to help you?"
  8. Where in Iowa? What is the hourly rate?
  9. I am lucky enough to have an ER job that allows me to plan around long vacations AND get one month paid time off to use if I ever need it... I work twelve 12s a month and scheduling is very flexible. I'm about to leave for my second ~2 week long international vacation since the start of the year. I had to use 1 PTO shift in January but don't have to take any PTO for my next trip. It kind of sucks to come back jet lagged and then work 12/16 days but I obviously can't complain. I can also cash out any unused PTO at the end of our contract year at my hourly rate. When not traveling, I give myself
  10. PS - The urine issue is probably exaggerated in my department because our hospital refuses to restock our disposable urinals, and we have only 2 bathrooms for our patients to share. Add these issues to a patient who can't ambulate without assistance to the restroom, and we've got a nursing disaster. It honestly feels like practicing in a 3rd world country at times :(
  11. Yes I agree -- fluids for any patient with signs of dehydration. In those without evidence of dehydration, sure, a liter bolus won't hurt them. But, it also isn't necessary. It does make them more likely to become fountains of urine. And the cost of nursing time is significant if needing to hold them down, they're a difficult stick, or end up needing to be bathed. The literature shows no difference in length of visit (even though there are few relevant studies). Obviously practice styles and patient populations may differ... but my point is that giving IV fluids doesn't have to be an automatic
  12. What's your reasoning for IV fluid bolus being included in every drunk patient? Obviously, if they appear ill, have abnormal vitals, any signs of trauma, or significant medical history etc then IV placement +/- fluids depending on situation. But why do it in the stable, uncomplicated intoxicated patient? It doesn't sober pts up faster or decrease average visit length. Instead, I find that it makes uncomplicated drunk patients urinate more and increase fall risk because they try to get up to find the bathroom. Also makes nurses angry to place the IV and then clean up more urine if they're the b
  13. I work in an ER where alcohol intoxication is our #1 yearly diagnosis. In my 3 years there, I've seen too many of our homeless alcoholic frequent flyers die. Head bleeds, sepsis, freeze/overheat, hit by cars, etc. Last week I had a patient with the highest ETOH level I've seen yet -- 0.649! Workup was otherwise unremarkable and he was walking within 4 hours. Generally, in my ER we don't do much with our drunks. Of course, everyone has a very low threshold for a workup if they are new to us, frequent flyer but looking worse than usual, have any signs of trauma, or have significant past medi
  14. $3500 for PAs in my ER. My coworkers and I were getting this from our private ER group when we lost our contract to a big national group. They agreed to match it but wouldn't cover DEA/license separately, which was a change from our previous employer. A couple coworkers and I will also be at the Costa Rica conference in a couple weeks :)
  15. Unfortunately, sometimes there is nothing you can do to change the outcome. This is probably the hardest thing about emergency medicine. I've been in EM for 2 years and have had 2 cases that I've lost a lot of sleep over and still think about often. In my patients' cases and yours, it doesn't sound like the outcome could have been changed. I dread the day when this isn't the case and I can find some reason to hold myself accountable.
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