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surgblumm last won the day on August 18

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About surgblumm

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  1. There are courses and materials that can help you to do deep closures. Surgery and first Assisting takes time and devotion. Laparoscopic and thorascopic techniques also take time and you need to continue to try your best, ask other PAs for advice and remember that you can visualize externally the area that you are approaching internally. there are also laparoscopic courses which could be helpful to you. I have done this for four decades and have never done a robotic procedure. I am amazed at the agility of all of these young, female PAs who have been birthed over the last ten years. In the military of many countries, females are used as snipers because of their steady hands. You will master all these things in due time, Penny.
  2. I appreciate the forum moderators as they are very balanced. The PA forum is the best social media group for PAs and if I were to trash a form because of interference it would be Huddle.
  3. Contact Frank Crosby of PAFT who started a program and worked in the UK. He is the immediate past president of PAFT.
  4. This is a great answer for the PA who has a cheap Doc who gives a 29% reduction in salary for fringe benefits. Let his eyes google this. Good work Ventana.
  5. There is plenty of information here for someone to write a great article, do a research project, call upon AAPA or NCCPA to respond intelligently to the question. Great question for all practicing PAs except I don't see it happening.
  6. Send him the AAPA Salary Report ora report from your constituent chapter or specialty society that has a salary scale for PAs in terms of hourly pay plus benefits. If he does not like it, seek new employment.
  7. I cannot read every response to this age old question but agree that many of us , myself included, have practiced without the on-site supervision and practiced within our education and knowledge and were gifted with intuition which told us when to turf to the physician who was our SP according to the office management. For those patients which desire to see a "real doctor" , I would simply tell them how this corporation works and they have invested their trust in you and if they are not satisfied, they are welcome to contact management or find a UCC or practice that has a physician.
  8. Nurses are the backbone of American healthcare and the last bastion of protection between the patients and medical professionals such as physicians, PAs and NPs. They are intelligent and a HN in ICU has a hell of alot more experience than a 2 year PA or NP or a resident or new physician. They have very excellent suggestions and the reason you are perturbed is that it is hard to understand that they are driven by protocols and guidelines and are responsible to another nursing supervisor and then the DON. They have saved many a PAs butt and likewise for NPs and physicians. Thank them, explain your rationale , be courteous and above all remember that when you screw up they are charting everything and will be supeoned at your EBT.
  9. As the residents assist on more cases and more diversely, the surgical errors will increase. A good, well trained SPA is equal to another surgeon at the table and can make constructive criticisms. Keep your scrubs on.
  10. Truth or Consequences Robert M. Blumm, PA, DFAAPA, PA-C Emeritus PA Advisor to CM&F Group The Bible records a Roman governor, Pontius Pilate, inquiring of a man who was brought before him for judgement. He asked Jesus: “What is truth?” To many, truth is akin to the spectrum of the rainbow with many interpretations. What is truth in our profession when it relates to providing care and counseling to our patients? There is an assumption, as healthcare providers that we will not lie concerning disease or prognosis. We are trusted PAs. The Oxford English Dictionary defines truth as a belief that is considered accurate and factual. Based upon this definition, does a physician or PA or NP have an obligation to be truthful or can they “shade the truth” to a patient? The Charter on Medical Professionalism, endorsed by more than one hundred professional groups worldwide, and the US Accreditation Council for Graduate Medical Education require openness and honesty in physician communications. One can and should not expect less from PAs or NPs. Why is lying wrong? It endangers and is an abuse of patient trust. Trust is essential to the relationship that we build with our patients. The most important tool in your medical bag should be character, as demonstrated by your virtue and your honesty. There have been national studies with physicians on this subject and, without outlining the many details, the conclusion is stark: MDs can do better. You can construct your comments with positive percentages and honesty, which states that we will work together to do everything in our abilities to treat a present illness. But you cannot sugarcoat a prognosis to give undue hope to the patient or family. There is evidence-based practice and reality-based practice; both are partners on the dance floor. I proposed a question on Physician Assistant.com asking PAs, whether it is ever ethically responsible to lie to your patient. A majority of the responses were a flat and short “lying to the patient - never.” A PA in Texas had a patient who had had a stroke two years prior; the man had not walked since. When asked if he was ever going to walk again, the PA replied, “Never.” The wife was furious because she felt that the PA had deprived them of hope, despite his answer being honest, simple and polite. The patient had to know, that when the PA tells him something, it is the truth. Otherwise, he would not be able to trust anything that the PA said or did. As a healthcare provider, you may choose not to reveal the entire differential diagnosis with the goal of alleviating stress. But to offer paternalistic statements, one PA said, is just plain bad. There are some “nevers” in our world that are not only wrong, but could lead to litigation. Never tell a patient that they have cancer without a biopsy. A smart, experienced PA related that the manner in which you present a potential diagnosis - without lying or giving false hope - is the art of medicine and patient care. I have seen patients with pancreatic cancer expire in a month and I have seen others live fruitful lives, re-creating their relationships, and living for four years. There are no absolutes when giving a prognosis, but we must share what we know to be clinically correct, as well as offer hope. Rather than play the part of the Grim Reaper, we have the ability to, as Maya Angelou writes, “Be a rainbow in someone’s cloud.” Trust is gained in small steps with each encounter, but when trust is violated it runs away as fast as a locomotive. Trust is sacred for a PA and their patient. Trust is accountability when we are speaking of the relationship between a PA and their patient. And accountability means credibility. If we lose our credibility, what are the consequences? Lack of credibility and trust invites scrutiny and becomes a barrier that can result in anger, frustration and action. That action can easily become litigation because of a medical error, a prescribing error, poor communication, or a failure to diagnose or to treat. Behind that litigation is often a person who feels violated by a healthcare worker whom they thought they could trust. Should this problem ever come knocking on your door, it is of tremendous value and comfort to know that there is a company that you can trust to defend your interests. Personal Liability Insurance is a must for active professionals and CM&F Group has been developing and providing such coverage for over seventy years and is endorsed by the AAPA. CM&F’s policy is underwritten by the Medical Protective Company, who enjoys the A.M. Best Company’s highest rating for financial strength - A++ (Superior). For more information please contact CM&F at info@CM&F.com.
  11. Someone once said, I am learning all the time. The tombstone will be my diploma. This is true of all of us as every day of our lives from birth to death is part of the (-) on a tombstone. Even as we learn , we still have the ability to add to the knowledge or answe the questions of the generations behind us. I was perusing through the last issue of JNP which is also part of my reading matter and discovered an editorial called;The Voice of Nurse Practitioners. I thought for a moment and while the NPs chose to place statistics in the article about when NPs retire, what they do, what was their age, etec. I thought that we could have an available discourse, perhaps on this forum, where PAs can ask questions of retired PAs and have this as a monthly source for our colleagues on Physician Assistant. Any retired PA can be part of the responding group and many of you may have questions of any sort. Let Michael and the administrators know your feelings on this idea. Have a great weekend. PS, I think this would be better on this forum rather than send it to AAPA or huddle for two reasons. Not every member of this forum is an AAPA member and Huddle is far to restrictive and some of us like to cuss.
  12. Thanks for the information Lightspeed. If this was going to remain as it has in the past I would tell all PAs not to be concerned with losing their jobs to NPs because time would be the deciding factor on ability.
  13. I appreciate your comments as I too have met a number of NPs akin to this and one who knew nothing about prescribing in a surgical practice after three years. It is becoming sad. I had one substituting for my primary care at the VA and she too was worthless. I had received great care up to that point and am now. They need formal training, not theory.
  14. A subtle infiltration occurred. NPs were pumped out. The AANP started their propaganda campaign, "Heart of a Nurse, Brains of a Doctor". There was a shift in educational platforms to cheap, poorly supervised on line programs that promised the moon. These higher institutes of learning jumped on the bandwagon of money grabbers and instantly, they started producing ready to work, nicely starched, "physician" equivalents with 100% acceptance, self regulated shadowing for experience and NP boards that looked the other way. And just for a nice touch, they offered rapid fire "doctorate" degrees so now these substitutes could even usurp the term "Doctor"
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