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bike mike

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  1. I must say I have WAY more positive interactions with nurses than negative. In a previous job the CCU nurses KICKED ASS. The only negative experience I had was with a nurse who was on a team tasked with examining central line dressings. Pt had VT storm and we just got it to tone down when she comes storming in at 2am and says the biopatch on the central line is "bulging" and needs to be replaced ASAP. Pt starts having increased ventricular ectopy and when I explain that we are trying minimize external stimulation of the patient, the nurse stormed out and reported me for being "aggressive".
  2. I do agree that you should educate why they should get the shot but ultimately it is every patient's decision. I'm just pissed that mask mandates are coming back because of the rise in infections/hospitalizations due to the unvaccinated.
  3. Good Lord. I had a patient who was worried about the "tracking devices" in the vaccine. I told her if she is worried about someone tracking her she should get rid of her cellphone.
  4. Wait a minute....he is on Coumadin for CAD? What the heck? Who ordered that?
  5. I recently had a guy in with atrial flutter, ventricular rate 130 bpm. Refused Diltiazam. Refused ablation. Said he was taken off his beta blocker because his primary care doctor told him "beta blockers slow the body down" and then he proceeded to tell me that beta blockers should only be given in a hospital setting because they are so dangerous. I told him we'll be seeing him in the ER soon with tachycardia induced cardiomyopathy.
  6. No. Turns out this guy's baseline ECG was one that looked like a STEMI. We didn't have a previous to compare so obviously we were thinking STEMI all the way. We finally tracked down a previous EGG the next day from another hospital. Turns out this guy was homeless and wanted to spend the night in a warm place with something to eat. He apparently was known to go to several other hospitals in the area from time to time to get a bed and a meal. He had even had a LHC before with some vascular complications but continued to pull off this stunt.
  7. I remember seeing a guy at 10 pm who presented to the ED with CP and widespread ST elevation. We recommended a LHC of course but he left AMA. He returned around 3am with similar complaints. Needless to say the interventionalist was pissed. Interestingly, no CAD on LHC.
  8. Lots of places in San Luis Obispo county are looking for PAs. IM me if you have questions.
  9. I'd still encourage PAs to apply if they are interested in the job. I recently applied to a position listed as NP only and landed the job because I was more qualified than any NP applicants.
  10. Hmmmfff.....I'm in cardiology. Completed a residency. Saw a job listing for an NP and applied. Initially told they were only hiring an NP. After the docs saw my resume landed an interview and have not only been hired but they decided to expand my role from strictly OP as the job was originally listed, but I will also be scrubbing in and getting vascular access for the EP procedures. So to the OP if someone tells you to forget about the job you want because you're not an NP.....don't listen.
  11. https://medicine.uiowa.edu/psychiatry/education/fellowship-programs/physician-assistant-pa-psychiatry-fellowship If you want to do speciality medicine, do it well, and get a lot of knowledge in a relatively short period do a residency. This goes for psych, cards, ICU, etc. After completing a residency your opportunities will open up an you may be able to get all three: job, pay, and location.
  12. I have invested in residential real estate....not on purpose exactly as I moved when I attended residency and never moved back into my original place. It can be a great investment but a real headache. Things are good for us now that we hired a property management company so we don't deal with the day to day BS. It's can be nice as your tennants should be covering your mortgage, insurance, and property taxes in the perfect scenario and hopefully you can pull in a little profit after that. That is where we are and our little profit also pays most of our mortgage of our current house.
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