What are my chances? Any recommended schools to apply to?
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By surgblumm
What’s In A Spoonful?
Robert M. Blumm, MA, PA-C Emeritus, DFAAPA
Being a grandfather or grandmother is one of life’s most rewarding experiences. While reliving the early stages of life with our grandchildren we can enjoy their movies and get a second chance at some which we may have missed. I was recently watching Mary Poppins with my grandkids and found it delightful and uplifting. For days, I was rehashing that famous song in my head, “just a spoonful of sugar helps the medicine go down.” As a clinician, I paused with some concern as I had to ask myself: What, actually, is a spoonful?
It is in the purview of physicians, NPs and PAs in pediatrics, family practice, internal medicine, urgent care, emergency medicine, retail health care and geriatrics to examine their patients who present with symptoms of a cold, allergy symptoms or a cough, resulting with a note recommending some form of OTC medicine. We commonly use the phrase “one or two teaspoons” and either document (or fail) to document this dosage. Either way, the potential for creating an iatrogenic poisoning or a drug reaction is quite high. It is always important to know what medications your patient may be taking - a critical practice which should accompany every patient encounter, whether new or not. Most PAs and NPs enter healthcare with the idea of working for 30-40 years but prudent attention to malpractice prevention can never start too early. Thorough, thoughtful practice can illuminate cross-sensitivity to prescribed OTC drugs. We need to look at OTCs as carefully as we would any prescribed medication, and it is equally important to know the age and weight of your patient, as a spoonful may be too little or too much. If the patient is a pediatric patient, the parent may be confused by the description of a spoonful and give a tablespoon, a teaspoon or a pediatric feeding spoonful. Children who are taking a drug, particularly an OTC drug, have a much greater possibility of a reaction.
For many of our senior citizens on polypharmacy, there are many potential drug-drug-interactions that will increase or decrease the effectiveness of their other medications making way for hypertension, severe hypotension or rhythm changes related to their cardiac drugs. For a moment, consider the patient on Coumadin. This drug has restrictions on other medications, as well as foods and alcohol which can greatly affect the INR and create a life- threatening bleed in the brain or in the GI system. I was scolded by my cardiologist a few years ago for taking a class lll antiarhythmic with herbal drugs or vitamins and minerals. He made me wait an additional hour in his office, then had me step into his private room and asked me, “What is it that you don’t understand about taking NO additional supplements or herbs?” As a healthcare professional, he was shocked at my actions. These substances can interact with my prescribed drug regimen to the degree that I could have developed Torsade’s De Pontes. He asked me if my need to take supplements - including fish oil, glucosamine and chondroitin - surpassed my need to live. His direct approach about my nonchalant attitude regarding supplements certainly got my attention!
Being careless can lead to a poor outcome for the patient, as well as a possible lawsuit. What can the collective “we” do to prevent a patient incident that is negative or life threatening? Check for other medications, review current drugs, look at age and weight and be cautious to write an OTC medication unless aware of all of the possible reactions. Is there anything else to glean from this? Another related concern is failure to document the other medications and to cross reference all contraindications, which are frequent causes for litigation involving PAs as well as NPs and particularly in the setting of the Retail Healthcare Clinic or Urgent Care Center. The same focus should apply to Telemedicine since it has become particularly popular during the pandemic. These concerns should encourage clinicians to consider how to best protect themselves, their professional futures and their families from litigation due to negligence.
Accuracy is the name of the game and is the mandate for all healthcare professionals but owning proper professional liability is the safest solution for potential error. It is not a coincidence that you are reading this today, but a heartfelt concern of a colleague who wishes all PAs and NPs a long and successful career. You do not want to create a life-threatening situation or worse. Our ultimate goal is to retire with professional pride and satisfaction – with NO history of careless nonchalance or, pardon the expression, “sloppiness”. Perhaps this “spoonful” of advice might help…
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By futurepa1998
Here are my stats
Gpas when I graduated with a degree in Biology
Cgpa-2.93 sgpa 2.73
Took 45 credit hours post-bacc on my own
Those gpas were cgpa-3.93 and sgpa 4.0
It changed my original gpas to a cgpa of 3.13 and sgpa of 3.12
PCE hours as a CNA ~1900 by the time I apply
HCE hours as a Pathology Tech 1200
Volunteer ~200 which includes a medical mission trip to Panama for a week, starting a HOSA club at my community college, did many leadership activities, and habitat for humanity projects
Shadowing~100 half in person other was virtual
LOR’s- 2 PA’s, 1 MD, 1 from current boss
Only thing I need to take is GRE
I know my gpas are low and it was from my sophomore and junior year struggling with personal situations and also recently learning I have ADHD which caused me to change completely how I study. I am 22 btw if that helps with anything.
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By PAgirl199
Hi everyone!
I am currently a PA-S1 in my second semester, starting clinical rotations in the fall. My program offers 8 core rotations: EM, Family med, Internal med, surgery, Peds, OB/GYN, Geriatric meds, and behavioral health with only one elective. Popular electives include: any surgery subspecialty (cardiothoracic surgery, neurosurgery, etc.), cardiology, psychiatry, orthopedics... and more.
I was wondering if anyone had advice on picking an elective since there are many of these sub specialties I would love to gain experience in! if you faced a similar scenario, what helped you with making this decision, or does any one have insight on what may be best for post-grad life?
Thanks!
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By EKGTech2021
Good afternoon everyone. My name is Daniel. I am an EKG Technician. I've been in college earning credits towards a Registered Nursing program which I'm planning on attending this August. This program has a lot to offer especially in the fact that it is taking place at a teaching hospital. My true ambition, however, is becoming a Physician's Assistant. I have been very conflicted regarding this decision because I've read in certain articles that there are some PA programs out there which prefer applicants have an RN lisence. While others say they do not require it. Apart from that aspect, I understand that as an RN I'll be learning valuable bedside clinical experience. But yet I think to myself, why wouldn't I spend my time doing online courses necessary to enrolling into a PA program until I earn a Bachelor's Degree in Applied Science? While working part time getting my clinical hours as an EKG Technician or a Medical Assistant which I am also certified in. I would like to know some of your expeirences as new PA students. How many of you were nursing students before you made the decision to transition into a PA program as a career? Would you recommend a prospective student become a nurse before even considering becoming a PA? Or would it be better to comfortably go to school while working part time? I am thinking about this logically.
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By Andrea1020
So I recently found a job that would work well with my schedule as a CNA covid tester. It entails testing patients and going through screening questions with patients then reporting results to the supervisor. I am a little worried because I don’t really want to go for the job if it isn’t considered PCE. Has anyone have any info on whether or not this is PCE or HCE?
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