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surgblumm

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surgblumm last won the day on August 18 2019

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About surgblumm

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  1. From my experience and knowledge base, a felony is an encumbrance for a medical professional such as a PA, physician and even an attorney.
  2. You are two thirds over the hump. If your grades are excellent, the didactic year is fun, interesting and a great opportunity to discover what you would like to do the rest of your life. 140,000 other PAs were where you were and they did it. Hang in there.
  3. I had it, never needed it and never regretted it. I would make it as specifically distinct as possible as a general PA can always get some type of job.
  4. Go for it. Good surgical PA jobs are difficult to get and the experience is invaluable for a new PA.
  5. And IMHO deserves it. A passion for helping and leading: Nurse leads Air Force Medical Service Lt. Gen. Dorothy Hogg, Air Force Surgeon General, pauses during a tour through the Heart, Lung & Vascular Center, David Grant USAF Medical Center at Travis Air Force Base, California, Feb. 10, 2020. Hogg visited with 60th Medical Group Airmen and recognized the positive impact they have on their community through their innovative medical practices. (U.S. Air Force photo by Heide Couch) 5/11/2020 By: Air Force Staff Sgt. Jeremy L. Mosier, Secretary of the Air Force Public Affairs Share this page Social Media Links Share on Facebook Share on Twitter Email this page Other Social Media Recommended Content: Coronavirus | National Nurses Week WASHINGTON (AFNS) — A profession that faces disease and trauma and requires long hours on their feet may deter some, but for nurses, this profession was chosen to serve and ensure the health of those who live in their communities. “I have always had an affinity for helping people and come from a family that has a lot of nurses,” said Lt. Gen. Dorothy Hogg, Air Force surgeon general. “It was just something that was part of my nature – I love helping others. From a young age, I knew I was going to be a nurse.” In 1984, Hogg would commission in the Air Force as a nurse, making her childhood dream a reality. “Every day I take care of patients is a proud day for me, because I look at it as doing the very best I can to help somebody else out with a struggle they might be dealing with,” she explained. “If I can just give them a little bit of comfort or a little bit of peace, it is all that I can ask for.” During her 36-year career in the Air Force, Hogg has climbed through the ranks and became the first nurse, as well as the first woman, to hold the position of Air Force surgeon general. “Never in my wildest dreams did I think I would be sitting here as the Air Force’s surgeon general,” she said. “I have always looked at every opportunity that either the Air Force or nursing has given me to make not only myself better, but to make the environment I am in better.” With these words echoing in her head, she reminds her fellow nurses and Airmen to never close any doors. The position didn’t come easy. Early in her career, nurses were not seen as leaders within the medical system. Overcoming this barrier helped Hogg develop her leadership acumen. Today, the medical system is much more team-based where every medical professional brings their knowledge and skills to the bedside. Hogg’s formula for success is three-fold: One is too small a number to achieve success, teamwork and attitude. All great leaders had people in front of, behind and beside them. Hogg said, “No one does this by themselves, and it’s important to grow all members on the team. And last, attitude is everything. As the old saying goes, is your glass half full or half empty?" As surgeon general, Hogg is leading the largest Military Health System transformation with her other surgeon generals and the Defense Health Agency Director. She restructured the Air Force Medical Service into a more agile, lethal force by developing the Air Force Medical Readiness Agency and installation operational medical readiness squadrons. She’s led research on pilot cancer rates, water contamination and improving human performance across the broad spectrum of operational, humanitarian and disaster response missions. “If someone says I need you to do this job, you might not think you can do it, but that person sees something in you, so go for it,” she said. “Take advantage of every opportunity the Air Force gives you, because you will learn more about yourself and become a better nurse, a better leader, a better officer and a better individual.” As the country faces a pandemic, Hogg recognized the contributions the nurse corps has made during this time of need. She has one message for all first responders. “Thank you; I thank you from the bottom of my heart for stepping in during very challenging times to take care of our service members and our nation as a whole,” she said. “Your selfless service to the profession of nursing and arms goes without saying. The human touch you provide to your patients can’t be substituted by a machine. And it’s that touch your patients will remember. I am proud to represent all our nurses both home and abroad, military and civilian.”
  6. Good subject matter. Interstate reciprosity Emergency powers after Covid-19 for all catastrophes Increased Telemedicine CME
  7. I would add, the nurses would never permit it.
  8. I would agree about the normal bridge to MD/Do as the residencies will be the problem. I do advocate for those interested in Anesthesia as a PA Anestheioslogist to be allowed into an 18 month training program in a large teaching hospital which would augment the MD, CRNA and AA staff.
  9. Building on the momentum of the temporary changes brought by Covid-19. Get new legislation in all fifty states based upon the PA response to the call for healthcare providers. Finalize a name change that is most accepted by our PA polls.
  10. This is a timely article on the metaphorof the Phoenix rising out of the ashes. The PA profession has had its bumps and bruises along with its many successes and then we were confronted with Covid-19. We experienced an epiphany and this pandemic gave birth to a new hope for all PAs. The Resurrection Of The PA Profession 4.28.20 (WGFS Revisions)-1.docx
  11. In this day of selivering bad news, I thought that this article that I saved from last year would be a great refresher. Food is food regardless of the source. The Rules for Delivering Bad News to Patients August 27, 2019 The Watercooler: Career Advice The Bookbag: Education The Rounds: Clinical Considerations General 0 Comments I've talked to some colleagues recently who've been a little down about their roles as nurse practitioners. Working in family practice, they have found themselves in the position of delivering bad or upsetting news to their patients. Cancer diagnoses were fortunately made rather than missed, but letting a patient know they've got a serious, life-altering illness or condition is tough, not to mention, this is not something most of us as NPs learn to do in school. Have you ever found yourself in the position of delivering difficult news to patients? How did you feel? Having such conversations as nurse practitioners can make us anxious or awkward. Some of us approach these discussions emotionally while others appear detached and robotic in their delivery of the news. Delivering bad news is an unavoidable part of our jobs as nurse practitioners but that doesn't mean we get used to it. Fortunately, however, conducting serious conversations is a skill that can be learned and there are many guidelines out there to help healthcare providers hone this skill set. Rule #1: Know what constitutes bad news Sometimes I share information with a patient that I perceive as not a big deal. Then, the patient starts to freak out. Or cry. Or to have some other sort of emotional reaction that I didn't anticipate. Bad news doesn't have to be a terminal diagnosis. It can be related to anything surrounding a diagnosis such as timing, personal or professional consequences. Breaking a metatarsal and wearing a boot, for example, may not be too bad in the grand scheme of things, but breaking your foot the day before your wedding is pretty disappointing. Rule #2: Full disclosure is best In the past, healthcare providers operated on a more guarded front. In the 1800's, for example, the American Medical Association even encouraged physicians to avoid sharing news that discouraged patients. Today, however, studies (not to mention ethics!) show that most patients prefer full disclosure. It's our duty as nurse practitioners to share up-front, honest information rather than sugar coat our delivery with excessive optimism, withhold details, or give false hope. Share news with the patient directly rather than directing it toward family members. Honest, trustworthy information is empowering! Rule #3: Prepare yourself Anticipate the conversation you're about to have with your patient. You may even wish to practice your delivery with a colleague. Prepare yourself to feely badly as you share the news. And, don't forget that silence is OK. Avoid the temptation to fill gaps in your conversation rather let the patient process and take the time to formulate questions. Rule #4: Frame the conversation Framing the news you're about to share is essential. Your patient may or may not be expecting to hear something difficult. And, the way you set up your conversation has an impact on the patient's reaction. Using the word "serious" (ex. "I have some serious news to share...") is better than using the word "bad". "Serious" creates a more constructive framework that inspires action and empowerment as opposed to the word "bad" which indicates the situation is helpless. Even if you're delivering a terminal diagnosis, your patient can choose how to react and what steps they wish to take in response. Rule #5: Think SPIKES There are a few well-known methods for delivering serious news to patients, my favorite of which is the SPIKES method. This algorithm lays out considerations for nurse practitioners and other healthcare providers in these situations. Here's the SPIKES protocol: Setup - Think through the conversation you're about to have, anticipating questions the patient might ask beforehand. Prepare for an emotional reaction. Gather any necessary resources that might be helpful for the patient. Perception - Gauge the patient's understanding and perspective on the news you have shared. This is best accomplished by asking questions like "What did you take away from what I just shared with you?" or "What are your expectations of treatment?". This way you know you are both on the same page as far as understanding the medical outlook, next steps and goals. Invitation - Encourage the patient to think further about their care going forward. Find out how much information the patient wants about his or her medical condition as well as who he/she would like to be included in decision making such as family members. Knowledge - This step has to do with how you as a provider deliver information. The best practice is to deliver the headline first, followed by the details. Communicate using language that matches the patient's level of education and medical knowledge. Be direct in your delivery, avoid skirting the main message. Empathy - Understandably, patients get emotional about serious news. Anticipate such a reaction and display empathy. Naming the patient's emotions can help. Asking "Can you tell me more about what you mean by that?" will also help you determine how the patient feels about the situation. Summarize and Strategize - Make a plan for the next steps in both treatment and communication with your patient. Express support and encourage the patient to tell friends and family the news to develop a personal support system. Talk about how the patient can act on this news to accomplish his or her treatment and lifestyle goals going forward. Have you ever delivered bad news to a patient? How did it go?
  12. I disagree with Cideous because I was an early PA and we have worked damn hard to first get into existence, secondly prove ourselves as capable and more than capable providers and lastly Covid-19 is and will continue to be a turning point for the positive for PAs. I am writing my monthly article on malpractice insurance and I am entitling it The Resurrection of the PA Profession. I see a very different profession with many of the entitlements that we have been seeking for years. As far as PAs and state societies: this profession is among the most apathetic and this needs to change. One person or a handful cannot do all of the work of a state worth of PAs. I wrote an article thirteen years ago called; "Apathy--The Malignancy in the Profession." I was shunned by many AAPA leaders as I was hard on the BOD and administration and the schools but it remains a guidepost of where we were then and the fact that it took until five years ago to start making changes. The article was in Advance for Physician Assistants if any are capable of getting this piece. Look up, maintain hope and read my article in two weeks. Bob
  13. I applaud Governor Cuomo and the language of this bill which protects PAs from litigation and utilizes them appropriately. A study needs to be done on the effectiveness of PAs who have had their retrictions removed after this crisis is over.
  14. As a retired PA who has seen a lot of action both as a combat medic in Vietnam, as a 911 provider at Ground Zero after 24 hours and in emergency rooms and trauma departments in NY. I am aware of the responsibilities of the military when sent to a war zone, many times without all of the needed supplies, medical equipment and munitions. A member of the military has no choice as they have taken an oath and there is the Code of Military Justice. You folks , mainly are civilians and I applaud your Hippocratic oath as well as you sense of responsibility but I think that there needs to be limitations when you have no protective equipment for yourself. The institution where you are employed, has a duty to their employees, their professionals and all their staff. If they fail to meet that responsibility than the system is broken. Today, many care, many are empathetic but do they rise up and DEMAND the equipment or THREATEN to close their facility. This is more than medical ethics, this is common sense. I applaud Dr. Smith in the NY times video on Elmhurst Hospital, in Queens, NY. She is telling the truth ,and she is afraid of discipline by way of removing her from her position, but she has an obligation to tell the truth so that patients may bypass Elmhurst and go to New York Hospital of Queens. She also has an obligation to her staff. We all need to support her and not buy into lies of the Directors of the NYS or NYC health system. You all have families and your children and your spouse did not take your oath and they are the unfortunate victims of the callous injustices of not having the proper equipment. Can your family litigate against the employers because of their inability to get equipment after you die from COVID 19. It's a moral ethical and common sense question and some of you will sound like heroes and some will say; :"I'm mad as hell and am not going to put up with it anymore." My best wishes yo you and my prayers for your safety.
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