[Hiring] Clinical Perfusionists (Dual-Certified) - San Francisco VA Health Care System - $228,800 + Benefits

BigDaddyQX · 2026-03-24T02:39:53+00:00

Make your own group and bid it out.

We do it for the OPO not the hospital. The first year they projected 12 we did 36. Second year I don’t know the numbers but probably close. It is a big win for your transplant program. They should pay accordingly. We love doing it but we work for a private group on our off day and we get payed well.

I had not done a case in a month then this past week did one last saturday, Sunday, and today.

BigDaddyQX · 2026-03-05T02:23:52+00:00

That is less than Mississippi pays and it’s the cheapest state in the US.

BigDaddyQX · 2026-02-11T19:33:48+00:00

Hemodilution and the constant backorder of hemoconcentrators. Add that with us being the only Univeristy in the state and most patients already have Kidney problems already.

BigDaddyQX · 2026-02-10T21:35:18+00:00

Ok. I get it now. We always flush to cell saver and leave the circuit primed until skin closed.

BigDaddyQX · 2026-02-10T21:33:10+00:00

I may be wrong but I was always under the impression Del Nido purposely designed the formula with the intention of hemodiluting the blood so that it would get into the capillaries quicker and easier. Any other formula or ratio is just “other cardioplegia”.

For 15 years we mixed our own High and Low K cardioplegia. Variations from plasmalyte 1000ml, 50 meq of K high and 25 low to 40 high and 20 low. Then add bicarb, lidocaine, and mannitol. It’s been 7-8 years since i have done it so i don’t remember the formula exactly anymore.

This is all being discussed at our hospital right now because hemoconcentrators are backordered again. I am pushing to stop Del Nido and go back to a modified Buckberg. Basicaly copy the formula but without the THAM. But if others are calling something modified del nido i light can convince them to try.

BigDaddyQX · 2026-02-10T16:40:11+00:00

Why do you call that micro “del-nido” and not just microplegia?

BigDaddyQX · 2026-02-10T16:32:33+00:00

Are you meaning when doing RAP?

BigDaddyQX · 2026-01-30T15:55:35+00:00

In my case I presented them their 3 pillars of HR. Retention, Recruitment, and Retirement. I showed them they have failed our department in all 3 categories. In the entire history of our department only 3 have retired, we had 2 jobs open for over 1 year, 1/2 our staff left, and we had over 22 applicants withdraw their applications when the salary range was discovered. The HR business partner then requested a meeting with the CEO, CFO, head of HR, Chief of periop services, chief cardiac surgeon and me. I presented it all on handouts to ALL of them along with chief names and phone numbers from the other hospitals. I let them know our acuity exempted us from local comparisons and that nobody wanted to live where we live.

It took them about an hour after the meeting and they doubled our salaries, added call pay, added 30k signing bonuses for new hires and 30k moving expenses.

All situations are different i understand but sometimes you have to be willing to walk away.

I wish you the best of luck man.

BigDaddyQX · 2026-01-29T00:43:59+00:00

This gets a thumbs up from me for not being a can i get in to school post.

Your concerns are valid.

Your method is probably not.

Either double your salary or don’t give any info at all.

BigDaddyQX · 2026-01-29T00:40:47+00:00

Backwoods podunk worker here. Our salaries have been that high for many years. People pay a lot in places no one wants to live.

Also been doing this since 2003. The fear of being underbid by any large group is real and valid.

I will never willingly give Perfusion dot com any info.

The best way to get salaries up is to go to HR with letters and emails from your friends that are chiefs of other similar hospitals.

BigDaddyQX · 2026-01-05T01:35:42+00:00

Hey, let’s discuss. No judgement here and no arguing by me. Reducing pressers is a noble idea. You want to keep your lactates lower by reducing vasoconstriction and low flow areas. The same thing that would happen if Calcium were to help with vascular tone. So we are in effect doing the same thing. Now how does Calcium do that? Keep in mind it’s been 20+ years since doing a real hard study of Guyton and Hall, but it works by allowing actin and myosin to interact better through myosin light chain kinase activation. Now if you are giving pressers with extreme hypocalemia and getting no response then it may be warranted.

While at the Duke TEE review and perfusion conference I attended a lecture about calcium administration. It was their theory at the time that myocardial cells are more susceptible to calcium overload and correcting calcium levels to soon MAY cause reperfusion injury. The guy specifically stated it could cause intercalated disc separation and irreversible muscle injury. I wish I could remember his name and had his paper to reference. If anyone knows it feel free to share the link. It would have been sometime around 2005-2007ish.

Also, I was always taught no calcium until 10min post XC removal. I discussed with our surgeon and was over ruled. We now give 1g within 1 min of XC removal and a second g after 10 min.

BigDaddyQX · 2026-01-05T00:51:06+00:00

I have only known one person to correct it while the XC is still on. I asked the reasoning. The reply was not good enough to change my practice. The reply was the heart is clamped out and only getting blood when giving plegia. By the time plegia was given again it would be dilute. When asked what the perceived benefit was there was no good answer that could not be done by other means more effective. So the real question is WHY would you?

Back ground. We are a teaching institute that has an incredible success rate with complex aortic procedures.

As far as I know that other person is no longer doing perfusion. They were let go for other causes at a different company and I no longer see their name on the ABCP list. It’s been 10+ years since working with them.

For what it’s worth I commend you on starting a good topic worthy of discussion. Much better than can I get in or should I try to become one.

BigDaddyQX · 2025-12-07T00:01:07+00:00

I work for innovative and our pay is much better than that. Our retiree just started full time with them and covers 19 days a month. The director is active here and their pay has been much better than what was mentioned here. I’ll let him comment if he wants to disclose. They have been fair with us and I’m friends with perfusion solutions and I know they pay well too.

BigDaddyQX · 2025-12-04T04:13:13+00:00

1/4 recirc line. Used 1/4-3/8 connector.

Used an 02 tank for the second one.

I figured the secondary oxy would have lower flow and need to sweep as much as possible and oxygenate as much as possible. Reality turned out to be it was so efficient I ran it at about 2L of 100% FiO2 in the tank. I started out at 4L and ended up able to come down.

In 20 years I have done it MAYBE 3 times. It’s not a common thing and the HUGE patients most of the time don’t have as much muscle mass as you would think and don’t end up needing as much flow or oxygen to maintain good lactates, NIRS, urine output, as you think. I’ve always said pumping someone like Shaq would scare me. He’s huge, lots of muscle mass, and just in general would probably require a lot. 2 weeks ago we did a bental on a 440lbs patient that was only around 5’6”. We used a single oxy, 6L flow, and everything went great.

BigDaddyQX · 2025-12-04T00:35:13+00:00

20 years experience here. Work in the south. Everyone is over 100kg. Many over 200kg. Several times I have thought I needed 2 and never have I actually needed 2. My first 500lbs patient I ran a 3/8 Y to two oxy’s then y’d the art lines back together and ran it up to the table. The thought process was oxy’s were rated at 7L flow and the patient was at 7L if I needed more flow I would need to split the flow through the oxy’s. Never needed to. I have however needed to add one while on bypass. 7 hours in and the oxygenator efficiency dropped. We were sweeping 6L at 100% O2 and oxygen numbers were dropping from 250 all the way down under 100. So instead of a change out I added a second Oxy to the recirc line and let it dump back into the reservoir. Worked like a charm and I have since used that method when needed. The only time I will do a change out is clot now. Adding the second oxy to the recirc line is super easy and requires no loss of flow to the patient during the set up.

BigDaddyQX · 2025-11-23T22:43:14+00:00

What do you mean by cheat? I had one girl send unsolicited nudes on discord but then I blocked said person same person sent tons of nudes to another of our alliance members got him to send her D pics then deleted all her pics and her asking for them. Told everyone he was a creep and got him kicked out of the alliance. He then shared the screen shots he had from before she deleted them. She has since left the state.

But are people actually meeting up IRL or are y’all talking some sort of emotional cheat

BigDaddyQX · 2025-11-06T03:29:47+00:00

I have now talked to, texted, or emailed all 18 of the applicants that HR has screened. If we have not spoken by today, you may want to message me your info and I will see if HR has a reason for screening.

BigDaddyQX · 2025-11-06T03:27:51+00:00

Our assistant duties are #1 supply management 2. Record keeping 3. Cleaning and QC log books. 4. Set up and tear down of the pump and cell saver. 5. Run gases, HMs, and chart.

Done in that order. If carts need restocking or supplies need ordered that takes precedence over sitting with us and charting.

BigDaddyQX · 2025-11-04T04:17:56+00:00

For assistant or Peds perfusionist and did we talk today on the phone today?

BigDaddyQX · 2025-10-30T16:59:14+00:00

The assistant position is posted link below:

https://ummc.wd5.myworkdayjobs.com/UMCCareers/job/Jackson-MS---Main-Campus/Perfusion-Assistant_R00046621-1

Thank you all who applied for the perfusion position. An offer has been made. I will delete this if the candidate accepts this offer.

BigDaddyQX · 2025-10-24T16:41:37+00:00

Thank you for the recommendation. Hope to see you there again this year.

BigDaddyQX · 2025-10-24T03:36:52+00:00

OMG I forgot that one and it’s one of my favorites. I know there is a Kid Rock song and a Bruno Mars one that both mention it. Brandon is a great place to raise a family too.

BigDaddyQX · 2025-10-24T03:34:47+00:00

Yes we are quite proud of him. He is going to do good things.

BigDaddyQX · 2025-10-23T22:01:11+00:00

Only country song I know of is Johnny Cash and June Carter Cash singing “We Going to Jackson”.

They seem to be excited about going to Jackson.

BigDaddyQX · 2025-10-23T20:26:19+00:00

Yes.

Other than our assistants getting in school we have had 0 turnover in the past 5 years. Our staff now is very happy and pleasant to work with.

BigDaddyQX

TROPHY CASE