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narcan

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narcan last won the day on February 17 2019

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About narcan

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  1. Austin has both one PA (Mr. Baker) rolling solo in a Ford Explorer as well as a community paramedic team.
  2. 1) Agree with taking your resume and cover letter personally to practices where you want to work. 2) I have commuted for 2 jobs, one was 60 miles away and one was 80 miles away. Both were the job I wanted, just not the location. It was worth it to get that experience.
  3. Is that the going rate for outpatient medicine in California? How is minimum wage $15/hr, but you're practicing medicine for $25/hr? How much do nurses make there?
  4. EM:RAP still has good content, and has added a lot of "core content" over the past few years, despite a lot of the monthly topics being fluff pieces. ACEP has an online "academy" for new practitioners that's a good overview. Dr. Smith's ECG blog is excellent. The other recommendations above are also good resources.
  5. Another option to consider is transferring to another department within the hospital. I would document all of the conversations you've had about this and thoroughly document your recollection of the incident in question. It can be really hard to navigate office politics, especially when an NP has their big girl pants on. Since you're a new grad, I assume you're still in orientation and perhaps that's why this person feels they have such direct control over you. The most sinister part of this story is how presumably this lead NP got all of her friends to file complaints against you. This situation is not going to get better unless you fall in line and win this person over or switch departments/leave. At the end of the day, big hospitals and organizations are just minefields and you're in the middle of a big one. Perhaps most importantly, don't listen to a bunch of randos on the internet who aren't in your shoes and aren't going to suffer the consequences. You're in the room, trust your gut, and proceed accordingly. Have your CV ready and start getting a parachute packed in case you need to jump ship, but if you can avoid that outcome for your first job, that's probably preferable.
  6. I would just ask them to match your salary and agree to a 2 year contract or something so they don't feel like they're getting screwed on the OJT period. I don't think $200K is that much of a reach, but the real hurdle you're going to have is how much the other PAs there are already making. They can't bring you in and pay you substantially more without pissing off others. What I will say also is that the PA profession is likely underpaid and that in high paying specialties where there are fewer competent people, the salary range can be quite broad. Also true is when you start a new job is the best time to negotiate your best salary.
  7. Can you clarify if these are "fringe" benefits like CME, parking, bonus, free food/coffee vs actual benefits like health insurance, retirement, etc. Also, never discount the real value of a good match. Free money in your retirement is worth several times what it is today when you cash it in at retirement.
  8. You're putting the card ahead of the horse a bit, but what I will say is not knowing anything about this particular transplant residency and what it offers, you would probably be best served by a more generalized surgical/critical care residency where you will learn valuable procedural and operative skills and a good, broad physiology base. I doubt you'd have any problem getting a job in transplant surgery after a surgical residency if that's what you end up wanting to do, but you may pigeon hole yourself a little bit if you focus just on transplant in residency.
  9. Agree with above. Do the residency if you can get into a legit one. Avoid the corporate internships.
  10. One thing about this I haven't understood is how are there no restrictions on other areas of practice? I'm an NP, so I can just start practicing cardiology independently? Can I do surgery and critical care? I get the argument for primary care, but any specialty should have some barriers in place.
  11. There are three emergency medicine residencies in NYC and one in critical care. What's the objection to applying for those?
  12. THIS. Have a good foundation for when you start. Know the red flags and what you can't miss. Know the basics and you'll impress upon your attendings that you can be trusted not to kill anyone. Also, subscribe to EM:RAP and/or UrgentCare:RAP. The EMRA antibiotic guide is a good, pocket resource as well. It's not step 1 or even step 3, but attending an ultrasound course or learning ultrasound procedures as mentioned above is requisite moving forward for new grads and experienced providers alike. For a dose of reality, be sure to read Bouncebacks. https://www.amazon.com/Bouncebacks-Emergency-Department-Cases-Returns/dp/1890018813/ref=dp_ob_title_bk And if you don't have a good handle on ECGs, read Dubin (https://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Dubin/dp/0912912065/) and then get advanced knowledge from Steve Smith's blog (http://hqmeded-ecg.blogspot.com/) For FOAMED sites, be sure to check out ALIEM (www.aliem.org) and Rebel EM (www.rebelem.org).
  13. This wouldn't change the liability of the attending, would it? With so many CMGs running emergency medicine now, if the attending on shift can avoid co-signing a chart, perhaps the "corporate physician" can become the co-signer/collaborating physician of record and thus take away the biggest source of anxiety for EPs who feel less than excited about working with APPs on a daily basis. While I am not looking forward to the increase in malpractice premiums, if we're seeing patients independently with no physician involvement, we really need to own the liability for disposition. The only way to raise the standard is to raise the standard.
  14. I've done multiple interviews on Skype prior to committing to flying out for an in-person interview. Screen jobs the best you can and then schedule a few over 2-3 days. I'd highly recommend going and seeing the facility and meeting the docs you'll be working with face-to-face before taking a job. Like others have said, don't quit your day job without something in place unless you truly can afford to go 6 months or more without a paycheck. Definitely find a good therapist/counselor. I don't know much about the online apps, but it might be worth it in the short-term, especially if you're so overworked you can't make it to traditional appointments and need the day-to-day availability of someone to talk to.
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