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Boatswain2PA last won the day on January 19

Boatswain2PA had the most liked content!

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About Boatswain2PA

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    Physician Assistant

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  1. Boatswain2PA

    ED case.....

    Good thoughts. Forgot to mention lactate was normal (1.1 I think). Yes, pt meets sepsis, but so would most 40 yo who is flu +. So you have 40 yo male, no comorbidities, moderately ill appearing so you do labs which are normal except for flu A, and a CXR which is questionable for increased vascular markings, improved with fluids, nebs, steroids, and azith, and sent home. This is a common patient in the ED. What saves his life, and you from a lawsuit? Like LT said, it's the return precautions. I told him and his wife to come back if he worsens, difficulty breathing, worsening chest pain, or new or concerning symptoms. He went home, and got worse. Came back 14 hours later and I saw him again, severe resp distress, tachypneic to 50, spo2 at 82. Labs still normal, but cxr showed ARDS. Bipap improved, transferred to ICU. Transferred again to tertiary and placed on ECMO for 5 days. Return precautions, they can save your patients, AND you! All stories told here are completely hypothetical and sanitized for HIPAA nazis.
  2. Boatswain2PA

    Options for paying off student loans

    Unless your loan rates are outrageous I would decline the offer, live frugally, pick up per diem shifts at an UC, and pay the loans off within 1.5-2 years.
  3. Boatswain2PA

    ED case.....

  4. Whoa...you personally? Hope you are recovering quickly!
  5. Boatswain2PA

    ED case.....

    Gentlemen...I believe I put this in student forum, right?? trop, ddimer, lactate normal. EKG = sinus tach. students please chime in....this is scary case.
  6. Boatswain2PA

    Physician assistant mortgages

    I do the same thing, although I will throw out that because we have followed the Dave Ramsey plan, we can afford to splurge on whatever we want.
  7. Boatswain2PA

    Physician assistant mortgages

    You are not being delusional at all...this IS how the math works out over 30 years. The problem is that's not always how LIFE works out. You are taking a huge risk (and making PMI payments) with only putting 5% down. All it may take is a personal or family illness, a new hospital CEO who changes your work environment, a new hospital merger and now the ED is physician only, a tank in local housing markets, or a multitude of other things that can (and do) happen and suddenly the math changes because your goals change.
  8. Boatswain2PA

    ED case.....

    40 yo male comes to ED in January with sudden onset fever and myalgia x 2.5 days, cough and chest pain (aggravated by cough) x1 day, hurts to breathe. Smoker, did not get flu shot. Has been taking mucinex. No other pmhx. Moderately ill appearing, slightly tacky and tachypneic, spo2 92-93%, temp 102.5. Exam otherwise normal, lungs CTAB. Due to pts moderate I'll appearing, ordered labs, rapid flu, and CXR. Flu A pos, otherwise normal labs. CXR shows markedly increased vascular markings vs slight pulmonary edema. Nighthawk reads as normal. Cbc/cmp normal. Fluids, steroids, azith, and apap given in ed, pt feels better, tachycardia and tachypnea improve but dont totally resolve. Pt d/c home with ex for azith. What wasnt mentioned here that, in the ED will (and did in this case) save the patient, and you from a lawsuit?
  9. The board that licenses these dangerous quacks are.....full of other dangerous quacks whi do the same stupid stuff.
  10. Lab rat- your plan probably makes great sense mathematically (although your plan may prohibit you from chasing any exceptionally high paying positions which could skew the math against you). But what your plan doesnt take into account the risk you are taking with this plan. 20+ years ago most Americans would work at the same place for decades. This is no longer true, ESPECIALLY in healthcare, and ESPECIALLY for PAs. The odds that you will spend 10 years at this position is small. The chance that you will WANT to be at this position in 10 years is even smaller. Just look on these boards for the repeated stories of PAs who are miserable in their jobs. I truly hope you wont be one of them. With $135k in stuloan debt you could reasonably be out of debt in 3-4 years giving you much more freedom to as you build wealth. Good luck!
  11. Boatswain2PA

    Finding a per diem position

    Sounds like you are in a tight market area.....lots if PA and NP programs in the area?
  12. Boatswain2PA

    Feeling like I'm crazy

    That is AWESOME! Relax my friend, you have tons of great options, from continuing your status quo (remembering you are 2 years from being out of debt), to walking away tomorrow and taking your time finding another job....and everything inbetween. I think what I would do is push back more against admin (why kill yourself seeing 32 pts a day without staff support? Just see 12, the rest will LWBS after sitting 6 hours in the waiting room) as I kept collecting their paychecks (while building up my savings more), while looking for better pastures.
  13. Boatswain2PA

    Physician assistant mortgages

    I would suggest that those rates are .5%-1% above what you could get putting 20% down. That's much better than other professional loans I have heard about. I hope those are locked in for you.
  14. Boatswain2PA

    New tab in Epic EMR

    Wait a minute....because I don't care how one self-identifies that will drive them to suffer a mental illness?? I'm not disparaging them, treating them disrespectfully, or anything like that. We are all children of God regardless of what you "identify" as. I literally don't care about what they identify as, I DO care about treating them medically, and treating them with respect.
  15. Boatswain2PA

    Physician assistant mortgages

    Ohio - traditional mortgages like yours arent "wrong", neither are "physician mortgages" or other high-cost products. I just like highlighting the point that people forget to factor in the RISK of having such debt. As someone who has played both sides of the debt-fence, I can tell you it's awesome to own your home, own your cars, and have no debt. Then you truly can appreciate how much money you make.

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