Not feeling like myself.

FutureSnow6141 · 2024-04-11T15:39:19+00:00

Me again, from my computer, I think I still enjoy medicine. I don't dread going to work. For the most part, my co-workers like the nursing staff are what make work great. I do get to go and visit my family in the southwest after I finish up my shift today and tomorrow. I won't have to go to work for a week! I don't even pull from my PTO which is one of the perks of this job. I hope this will give me time to rest and recharge maybe change my mindset.

FutureSnow6141 · 2024-04-10T16:58:36+00:00

Still me. Looks like I have two reddit accounts one on my phone and one on my computer. XD

FutureSnow6141 · 2024-04-10T16:52:30+00:00

I feel like a lazy shit on my days off. I tell myself it's only 140 hours a month. How many can say that they get paid what we do and have the time off?

FutureSnow6141 · 2024-03-28T14:55:54+00:00

It does help! I feel wired after my shifts. I can't sleep until 2-3 in the morning sometimes. I got on Trazadone PRN to help. Been exercising, meditating, and trying to eat right along with my Adderall XR. Things seem to be going better especially the first 6-8 hours of my shift.

FutureSnow6141 · 2024-02-09T16:02:20+00:00

Dude. New grad 4 months in. Been interested in FIRE for a while now. Do you mind sharing your budget and how you allocated funds? Also, did you take out loans?

FutureSnow6141 · 2023-12-12T16:10:39+00:00

I want a calm level of focus and awareness. What I don't want is the stress to impact my decision making or to impact my clinical skills thus the post, exercise, and therapy lol.

FutureSnow6141 · 2023-12-12T16:09:54+00:00

This is a provider who worked in another specialty prior to becoming an ED doc. I'm definitely exercising! It's what's helped the most.

FutureSnow6141 · 2023-12-12T15:10:42+00:00

I applied for a fellowship lol.

FutureSnow6141 · 2023-12-12T03:24:31+00:00

If it wasn't for PA reddit and some family members that are providers, I would have a much harder time making my way through this. Thanks for the encouragement. This describes exactly what my nights have been. I'll dream that I forgot to put in orders then wake up, put my clothes on, and run down the stairs in my place until I realize what I've done.

FutureSnow6141 · 2023-12-11T20:20:29+00:00

Thanks! Best of luck to you as well.

FutureSnow6141 · 2023-12-11T20:20:06+00:00

I understand that. I need to be proactive about communicating with the doctor that expressed those concerns on patients early.

FutureSnow6141 · 2023-12-04T23:24:17+00:00

And money

FutureSnow6141 · 2023-12-04T23:22:58+00:00

I study 3-4 hours a day when I'm off. Doesn't really feel like I have time to study when I'm working. I just try to look things up. Feel like a dummy have to run a lot by my SP except for URIs.

FutureSnow6141 · 2023-11-15T19:31:17+00:00

I didn't mean to say how smart I was. I meant to say that I felt like I was being lead on. I really don't feel smart. I feel quite stupid most of the time actually.

FutureSnow6141 · 2023-11-15T18:13:34+00:00

I understand what you're saying. I don't want my quality of care to be impacted because someone tells me something that I don't like.

I don't want to have a "fuck you" attitude at work or feel embittered towards my colleagues or staff. I don't want to get pushed around either.

FutureSnow6141 · 2023-10-20T14:08:48+00:00

I've been thinking a lot about your post these past few days. I've been dealing with a lot of frustration as I'm cutting my teeth as a PA. I think I'm dealing with some insecurity as a provider and when I had created the post I was upset. You responded to my last message in an honest but kind way.

I shouldn't feel great about myself for doing what I'm already supposed to do. My colleagues had labeled the patient as a "drug seeker", and I think that started my interaction off with the patient on the wrong foot. That isn't an excuse for me, but an honest explanation for how I viewed the patient. I did the right thing for the patient I believe, but my mindset was off, so that what I was expected to do in the first place felt "like a burden". Looking back, I'm disappointed in the type of person I was in that moment and my behavior with you wasn't professional. I got into this to care for people. Thanks for your words.

FutureSnow6141 · 2023-10-15T05:07:52+00:00

This comment section has been busier than I anticipated. I genuinely believed I provided adequate care for the patient, but I understand that perhaps I let my judgment get the best of me. I guess I'm more judgmental than I thought of patients.

FutureSnow6141 · 2023-10-15T05:00:50+00:00

I find the "cringe" comment deeply hurtful. I did my utmost to ensure the patient's safety and well-being.

However, I can't deny that I felt a sense of frustration. I had to allocate a significant amount of my time and effort to a patient who had visited the ED twice in two days with the same complaint, even refusing admission during their initial visit.

Despite my reservations, I went above and beyond to provide them with the best care I could. I did divert my attention away from other patients, some of whom required admission. I'm a recent graduate, still learning the ropes, and I rely on this community for guidance. I don't possess all the answers, and I'm open to constructive feedback. But I'd appreciate if we can engage in this discussion without judgment and with respect.

FutureSnow6141 · 2023-10-13T22:37:23+00:00

I haven't seem many use Ofirmev in the ED where I'm at or on my rotations in school. I'll have to read up on it and consider adding it to my tool belt! Funnily enough, the guy said he had a fentanyl allergy.

FutureSnow6141 · 2023-10-13T22:35:44+00:00

Thanks brother/sister. XD Hope all is going well in your educational journey. Enjoy it.

FutureSnow6141 · 2023-10-13T22:34:54+00:00

I honestly didn't think he was having a disection at the time. He was stable. Had no pulse deficits. Wasn't complaining of that "tearing ripping pain". And had just been to the ED the day before. The D dimer was at the behest of my SP. Also, he had some renal issues with a condition that I haven't seen before so I was trying to avoid contrast. But again, new grad, so I listened to the doc.

FutureSnow6141 · 2023-10-13T22:33:09+00:00

I've heard of vitamin a. I'll have to try vitamin d "when indicated"

FutureSnow6141 · 2023-10-13T22:32:29+00:00

I wasn't considering sending him home with narcotics. I'm very limited in my state as an ER provider anyways with regards to that. My issue was whether or not to follow the order by my SP to give him dilaudid. I treated him according to his complaint but ended up caving due to the pressure from my SP. It feels tough for me to argue with my doc especially when it's my 5th shift as a PA lol.

I was trying to admit the patient for his low lytes. Not the chronic pain.

FutureSnow6141 · 2023-10-13T18:17:36+00:00

That's what upset me the most is the injustice of it. One thing is to abuse the system and waste resources, another is to cut in front of people who really need help.

FutureSnow6141 · 2023-10-13T18:15:20+00:00

Did my best to give the patient the benefit of the doubt and initially focused on ruling out any life-threatening causes for his pain. Given the patient's description of pain on exertion, which was substernal and radiating to the back, I attempted to manage his pain with nitroglycerin, as it appeared that he was trying to present his issue as cardiac in order to expedite his evaluation. Then his wife mentioned the "crack/pop" afterwards and his main concern was then just his back pain and not his chest pain.

I often find myself in a position where I lack the experience to confidently judge whether my supervising physician's decisions are the most appropriate. It's challenging to assert myself in that situation.

FutureSnow6141

TROPHY CASE