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Kaepora last won the day on January 1

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  1. Marinejiujitsu, you feel bad for that? Ok... I'd like to know where you're working and what salary you're making because shoot, I'll move. I just wanted to chime in and say Lightspeed tore up this thread. Nice job. Said it better than I.
  2. "Fairview (the hospital / hospitalist) and Essentia (the clinic / NP) had a working agreement that it would be Fairview that took these calls and did the admissions. Providers at the Essentia clinic did not have hospital admitting privileges, and they typically talked with a Fairview staff doctor, known as a hospitalist, who made the decision." Also, how often do physicians cover for their colleagues on call overnight or on the weekend, and take calls from nurses, and prescribe meds and other therapies based on their report - without ever seeing the patient. I think it's fair to say if the NP made the call to the hospital, she knew the patient met admission criteria, and, that was the intent of the conversation. Further, I have, more than once, told a patient to go to the ER (my office is right across the street) and they didn't! I had a patient a few months ago with critical carotid artery stenosis who called the office c/o amaurosis and hemiparesis and he refused EMS, refused my recommendation to go the ER emergently, and WAITED 2 DAYS TO GO TO THE ER! Obviously, I chart the heck out of this stuff, but it happens. We don't know enough about this case, but let's not pretend hospitalists are agreeable to every admission - even when it's clearly warranted. More than once I've had to have my attending get on the phone because some hospitalists are just difficult.
  3. Yeah, this doesn't sound like a curbside consult. This physician was blocking an admission from a NP. The NP did not have privileges to admit. This physician didn't just "fail to diagnose", but actively blocked the admission of this patient despite recommendation from the NP. The NP had the diagnosis, the physician ignored it.
  4. Really, this is the case in a lot of states that aren't "full practice authority" for NPs. California, Pennsylvania, etc.
  5. I currently work surgery - 5x8s plus call. I have 3 interviews with 3 different health systems for intensive care - all 3x12s. I think that's pretty typical. Our hospitalist service APPs do that as well.
  6. I have severe UC and I would never list that as a disability. I do get IV infusions every couple weeks and I have to take off that day. I am rapidly approaching a colectomy and trying to get my affairs in order for that. But my group has been more than understanding. As long as you are good at your job and don't make excuses when you are there, most reasonable people won't mind if you need a couple minor considerations.
  7. Credit hours are so subjective though. Each PA program sets its own credit hours, but that doesn't necessarily correlate to difficulty. I do agree that on average the typical PA program has enough credit hours to award a doctorate. The schools near me have 82, 94, 89, 94 and 94.5 credit hours. The local DNP program has 81 credit hours.
  8. What most people don't understand is that the DNP is not a specific degree for NPs. You can be a DNP without being a NP. You can be an Informatics nurse, a CRNA, CNM, an administrator, etc. It is not a clinical degree whatsoever. It's the worst thing nursing leadership has decided to implement to date.
  9. I get that this sounds nice... but this doesn't differentiate PAs at all from physicians, as physicians are also practitioners of medicine. They are the original MP - the OG MP, if you will. I have a hard time seeing this becoming the new name if the name change thing ever happens.
  10. "Chronic Lyme Disease" is one of the absolute worst. It's in the same vein as fibromyalgia, interstitial cystitis, etc. Ugh. Supratentorial... It makes me so glad I work inpatient and I can just ignore this for the most part. "Continue home medications..." I also really, really, really, really dislike DKA patients. And, from a surgical perspective, biliary dyskinesia.
  11. Honestly, this is the strategy that NPs have in gaining independence. Overwhelm the system. Pump out as many NPs as we can. Quality be damned.
  12. Make sure you have a list of questions ready to go. Things such as: Is there call? What does call entail? OR/procedural call vs call for orders and nursing questions vs coming in for consults, etc. Call pay rate?Type of clinic patients - pre op vs post op? Initial encounter vs followups? # required to see - ramp up period?Hours expected to work each week? 40? OT compensation - is there a cap on OT pay?Any opportunity for bonus? What is the structure?Vacation time? How much initial? Accrual?CME time (days/hours) and stipend ($$$)?License fees and yearly fees for organizations covered? Preferably not included in CME.Health insurance? Can family be on plan? Dental/vision? 401K and is there a match? Life insurance? HSA?Loan Repayment? Did you have any applicable experience prior to PA school? Do your clinical experiences relate to this specialty at all? If so, how? Talk it all up in the interview.
  13. Devil's advocate here. There are plenty of pre-hospital RNs, and even more flight RNs. As far as flight teams go, they are nursing led (at least the 2 in my region), with teams comprised of 2 RNs or 1 RN and 1 medic. It is typically these nurses who return to NP school and seek positions such as this. Case Western Reserve actually has an Acute Care Nurse Practitioner Sub-Specialty in Flight and Critical Care Transport. I'm not supporting this actually. Perhaps I don't know much about the utility of having APPs work in this manner.
  14. This has already passed in the senate and has been in committee forever in the house. It will pass at some point, like it or not.
  15. Honestly, I wish NPs and PAs would just team up. Compared to the nursing lobby and medical lobby, the PA lobby is a drop in the bucket. The nursing lobby, I'm sure, would be happy to get some extra $$$, and the PAs would actually have a powerful backing for a change.
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