MediMike

In doing a bridge through University of Texas Rio Grande Valley (UTRGV), happy to speak to you about it if you want, feel free to PM. Only reason I'm doing it is to teach. Got offered some curriculum development opportunities but won't be able to actually teach until I get that MS...

Trazodone seems to work ok if they can take PO, but I prefer Seroquel. Trazodone can leave them pretty darn groggy the following day. I mean, just about any of these things can but...

A dedicated behavior response team? That's fantastic.

Sent in mine as well from the opposite corner of the country!

Yeah I've been working in an ICU nocturnist role for a while now, 10 shifts/mo... scrambling to find something to get me out of the house before my spouse murders me

I think FP has its own pitfalls, as many people can attest to here, with working late, taking work home with you, following up on labs on days off etc...Are there options for you at a different facility? Somewhere with a better schedule? Seems pretty unfortunate to spend that 12-18mos postgrad and then not be able to utilize the knowledge and skills. Certainly seems like the tide flows in the other direction FP>ED Good luck though!

Oh did we change our lobbyist?! I thought it was the same gal we've been sharing with WSMA. Interesting that we're seeing progress now...

I'd (personally) avoid having any kind of social media footprint in regards to my place of employment as well. Makes you easy to find and you don't always want that...

It would likely be waiting until ~3 months after you graduate, pass the PANCE, get your license and have credentialing go through. Not meant to come across as snarky as it probably did...

A quick Google search will give you a long list of online NP programs which require no nursing experience. I think where you are confused is in regards to the clinical hours requirements. The 2000 clinical hours we are discussing in regards to the PA program are 2000 of clinical TRAINING hours. This is the minimum amount required by our educational accrediting body. NPs have a minimum of 500 hours. It is disingenuous to attempt to include prior HCE as clinical training hours, as you are operating in a completely different role. It is not the same. It is likely hard to grasp until you enter the training yourself, but I am willing to bet that once you make it in to whatever path you choose you'll likely understand. Where I start running into problems with your analogy is the thought that the majority of your learning is performed as OJT. As a medic that's actually pretty easy to accomplish. If you can master the basic skills of airway management, scene coordination and a couple other monkey skills you're good, because you take the patient, stabilize and then pass off. When you graduate from PA school you ARE the drop off point, and depending on what specialty you end up in you can kill a patient a lot easier than a medic ever could. This is why the clinical training component is so important (in my mind). To obtain the foundation of knowledge required to practice medicine isn't something that should be done part time in the equivalent of 3 months of FT work. You say that they are "different types of positions", but other than some legislative concerns NPs and PAs are utilized interchangeably in the vast majority of settings. It may serve you well to research the differences in positions, while a FNP is theoretically designed to practice family medicine they can work in just about any setting, similar to a PA, so "specializing" isn't necessarily a thing. There aren't any studies demonstrating a change in clinical outcomes between PA/NP to my knowledge, and I agree, I've seen terrible PAs and terrible NPs as well as vice versa. And as much as I'd love to say that prior HCE plays a role I cant, by the numbers, but anecdotally it does without a doubt. Good luck in your endeavors, I do hope you choose to pursue a brick and mortar school with high clinical standards whichever path you take, for your own benefit as well as that of your patients.

Interesting statements, I fail to see the truth behind them. There are direct entry NP programs which require no nursing experience, there are an incredible amount of all-online didactic based programs with exceptionally high acceptance rates. Do you think this is because there is such a plethora of exceptional experienced nurses returning to school or does it make more sense that the standards may be low? How would you change the clinical time in a program? What would your approach to developing rotations be to ensure an adequate quality education? (Honest questions, as an educator I appreciate input) You bemoan low quality applicants on one hand then suggest increasing the number of spots made available? I can agree with your statement that we have watered down the PA profession, but until there is evidence that there is a difference in patient outcomes well...I don't have much of a leg to stand on. And while we're sharing anecdotes I'm happy to sit down over a beer and tell tales of idiot firefighters who couldn't manage to obtain an accurate history, obtain a basic set of vitals or develop the most rudimentary of differential diagnoses. Hell, I worked with a lot of them. So anecdotes are worth about as much as the paper this reply is written on.

Charged you for rotations? Are you kidding me? I guess I'm not highly involved in PA education but this blows my mind. Was this on top of your regular tuition?

I think if you look at the items listed, outside of U/S, they almost all fall within the realm of forced to act. If you have a patient with suspected tamponade or massive hemothorax then that individual needs a thoracotomy/thoracostomy. EMS has been RSIing for years and while the first pass success rates vary widely based on geographic regions, all in all it's a safe procedure when performed appropriately in the right situations, and oftentimes necessary because if you don't manage that airway prior to getting in flight you're going to have a hell of a time doing in en route. Same with crich, that's not something you're going to do unless you have to, definitely not an elective procedure. These interventions should be performed prior to leaving the sending facility or on the ground and I'm sure they have a good idea of when to stay and play and when to load and go. EMS has been limited in their interventions in trauma situations, other than managing an airway, needle decompression and holding pressure there's not much they can do. With this HEMS service you are essentially bringing the resus bay to the patient. It's a model that is used in Australia, England and other countries with success in my understanding. To touch quickly on the studies of EMS in trauma, it's kind of a tough nut to crack. There was a somewhat recent study released which showed a much higher mortality rate for ALS transports as opposed to BLS...But it also makes sense that those who are sicker are more likely to be transported ALS right? They use the ISS to determine how "sick" the patient is but that score can be skewed as it is based on anatomic regions. A score of 6 for extremity injuries receives the weight as a score of 6 for head trauma. They also looked at the city of Philadelphia which is unique in that law enforcement will just toss the patient in their cruiser and haul butt to the hospital, found that they and ALS both had worse outcomes than BLS, again bringing to mind whether it's a selection bias thing.

This. I had a young ED RN shadow me recently as she was considering PA over NP due to her perception of better training/education/skill set, she later went on to perseverate on fears of litigation for quite some time. This factor was a major driver in her concerns for furthering her career. Frankly this astounded me as I've always been more along the lines of the eff it attitude. I mean, you do what you can, as best as you can all while not being rude, condescending or an overall butthead. Not much else to it. Of course, I'm often considered naive for my lack of concern for many things these days...

The absolute BEST part of this situation with MinuteClinic though...go to their website, click on Phys Asst. jobs and it takes to you their "Beauty Consultant Professionals" job listings. I kid you not. https://jobs.cvshealth.com/minuteclinic?prefilters=none&CloudSearchLocation=none&CloudSearchValue=none