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See, that’s what the app is perfect for.

Sounds perfect Wahhhh, I don’t wanna
populationpensive

Anonymous asked:

re: liver pt - what sort of training do you have for pts on pressors? or like ICU stuff in general?

Hi nonnie,

Well, to be honest, I don’t have any. Most physician assistant programs are primary care focused and do not discuss common drugs/drips in ICUs. I had a background in CVICU and MICU before PA school and so from that perspective I was at least familiar with the meds and how an ICU is run. But, even my pulmonary/critical care rotation fell short as it was mostly clinic based. 

I think you’ll find that many new providers, including new doctors, do not get great experience with managing patients on pressors in school. If you get ICU rotations, you certainly have a leg up, but you often are not the one ordering those medications or making those decisions. And honestly, as a student that isn’t your role. ICU management is something you learn to cultivate as a new provider, which is both terrifying and also rewarding. 

I spent time before my new job going over ICU management concepts and as I encounter patients on certain meds, I go back and review the drugs. I make my own pocket cards with dosing and stuff do that next time I have my reference handy. I sit down and look at the labs, puzzle through the decisions, and revisit diagnoses. 

It is worth noting that, at least right now, there are relatively few decisions I make for my patients on the floor by myself. We round as a team and make collective decisions. My attendings are very good at revisiting physiology on the floor and going over things so that it is a thorough learning experience. Right now, if I think one of my burn patients is decompensating and needs a pressors, I ALWAYS call the attending to verify use. Also, I am obligated to call about status changes and hemodynamic instability is a status change. 

That was a long way to say no. But I think you’ll find that is the case for many providers. School is very broad. And very different than actual practice in many ways. But, this doesn’t mean that you can’t learn on the job and be trained to manage critical patients. :-D 

-Poppi

pablr pa-c physician assistant physician associate icu critical care medblr
bunjywunjy seananmcguire
pet-interests

These are hilarious! NGL major preference for adults here. Other adult bonuses:

  • Don’t need naps
  • Can go on hikes for longer
  • Can be left alone for longer
  • Less fragile
  • Teeth don’t randomly fall out
  • Majority of teenage hormonal bullshit is over
  • Surprise fear periods done with
  • No more growing in size or coat
thegreenwolf

Pikka was five when I adopted her, and while she has her quirks from poor treatment in her previous life at least I have a pretty good idea of who she is. Any changes are more predictable because I can see the intersection of her personality and behavior patterns with how I treat and train her, and while I’m sure she’ll always surprise me, most of the time I should be better prepared. 

chemicalkin

In case anyone was wondering, these come in cat

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pet-interests

Holy shit it comes in cat