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ERCat

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ERCat last won the day on June 13 2018

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About ERCat

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  1. I would absolutely not test the patient for COVID-19. This wouldn’t even be considered in my hospital. Clinically I don’t think it makes sense (but would like to hear rationale for why it does make sense?) VERY very sad scenario.
  2. I work in the ER. Been a PA for 4.5 years. There’s no “requirement.” We have slower PAs and faster ones. The docs love us all equally - we all do a good job. But nursing staff and hospital admin? They like the fast ones. The speed of the providers does get brought up in meetings. We do hear complaints sometimes. But really, no one has been threatened to be fired for not being fast enough unless they were realllllly slow (I.e. one patient per hour slow). We’ve actually had more issues with providers (not PAs... NPs specifically... just being honest) who were way too fast and careless and
  3. Sorry if this has been posted before. I am involved in quality improvement at two hospitals and already review charts as a lead PA. Thought it would be cool to take a side gig reviewing charts. Anyone know any companies that would hire a PA? My Google search doesn’t come up with much.
  4. The abdomen was checked an hour and a half prior. During that hour and a half, I saw maybe five other new patients and talked to a few other specialists, followed up on labs, discharged old patients, etc. I did my initial examination and was in the room with the patient updating them on results and was about to reexamine them when the surgeon called...
  5. Of course I did my belly exam...this is the ER. I wouldn't have ordered a CT without doing a belly exam in the first place. This was an hour and a half later when everything came back. I was in the room talking to the patient about their results when the surgeon called me. He asked for a repeat belly exam, which I hadn't done because I had done my exam an hour and a half before and moved on to other things.
  6. The other day I was in a patient's room letting him know he had a small bowel obstruction and that I had put a page out to a surgeon for him. The surgeon called me while I was in the room, so I answered and politely mouthed to the patient "This is the surgeon!" I sort of stepped aside in the corner of the room to have my brief conversation with him but stayed near the patient in case I needed to ask the patient questions on behalf of the surgeon. The surgeon asked me a few questions that I already knew the answers to, and then asked me another question I needed to run by the patient. I told hi
  7. I have not had any issues. My pay checks and my employee name at work is my legal married name. But my charts and prescriptions show up as my maiden name. DEA and NPI are maiden name. No issues.
  8. I agree that it is probably mainly about liability. When the gynecologist gets sued because he screws up someone’s toe after doing an ingrown toenail procedure the first thing that he will he asked in court is “What kind of doctor ARE you? A gynecologist? Is ir within the scope of practice of a gynecologist to treat an ingrown toenail...” I agree with you. But realize so many providers choose to “stay in their lane” not because they don’t care and want to shrug your concerns off; it’s all about FEAR of potential malpractice.
  9. HOLY CRAP. Are you joking me? You are the ONLY one for a good chunk of the day? In all honesty I can't even fathom that. So you're running codes, sticking in chest tubes, intubating, starting pressors...by yourself? One thing I lack as a PA less than four years out is critical care skills. Even though I work in the ER...I never have to do that stuff because the docs do it. I legit can't imagine. How long have you been a PA? Thanks, everyone, for the responses. Never thought about working in a lower volume facility but it sounds tempting and maybe worth the drive...
  10. So much of what you’re describing is... my life. I have been doing ER for three and a half years and still usually feel like I am running around like a chicken with my head cut off because there’s six things to do (I need to discharge room six, close the laceration over there, and crap - I am getting a phone call from the orthopedist). It’s like that all the time. I stopped eating on my shifts and am lucky if I get one bathroom break or a drink of water. I also get very annoyed when patients perseverate. You have the ones who seek needy and hold you hostage with questions... and you swear they
  11. I just wrapped up a fourteen hour day today. I am frigging exhausted. My shifts are twelve hours, but I stayed late charting. I only saw about 26 patients, but a lot of them were nightmares and very labor and time intensive (huge dog bites on the legs, two distal radius and ulnar styloid fractures that required multiple attempts at reduction, a cervical laceration that would not stop, a hypotensive upper GI bleed... I could go on and on). I have been staying super late in the last year, and I am sick of it. Usually an hour, two in a blue moon. I think it all started when we started to ge
  12. Thanks for this. Strangely it is comforting to realize maybe the expectation is I am a representative of the APPs rather than a manager. That kind of takes a little bit of the pressure off. Maybe I am the one creating unrealistic expectations.
  13. You are not a jerk! I am confused by what my role means. I think I am a little more than a scheduler, though. I do the interviewing and hiring (hiring with approval of the head doc, of course), chart reviews, working with the hospital to determine credentialing requirements, helping find coverage in emergencies, addressing behavioral issues, setting up educational lectures, those kinds of things.
  14. I have been the lead PA for my small group of ER PAs for a couple years now. I think I was chosen because I am smart, do a good job taking care of patients, I don’t miss things often, and I was the one who gave a crap about the group and going to meetings. Unfortunately I am finding these traits don’t translate into being a great leader because I lack other traits that matter. I am disorganized at times. Not very proactive. When I’ve tried to be proactive in the past a few times, I ended up making a decision that was overruled by the physician director, which has totally killed my credi
  15. Yikes, this thread is making me think twice about my documentation of EVERYTHING I do for the patient. My entire chart for every patient is CYA. If they have an allergy to penicillin and I am giving ceftriaxone, you'll see a note in there that states something like "reaction to penicillin is a mild rash; has had cephalosporins before" (even though we all know the low rate of crossreactivity - CYA!). If I have given a patient a narcotic, I document that they said that they had a ride home. I document reasons for delays in labs and CTs. Therefore it is obvious that I document anytime I spoke wit
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