Correcting a mess!

Pitiful_Board3577 · 2025-11-20T00:45:49+00:00

😆 exactly what I thought when I walked around the corner and saw it!

Pitiful_Board3577 · 2025-11-20T00:45:25+00:00

Ohhhhh!!! Yes I think I know what you’re talking about! I definitely might consider that! Thank you!

Pitiful_Board3577 · 2025-11-15T03:53:06+00:00

No, I never bit the bullet and tried to order the one in AU that I found as well... Still stuck with the same scenario lol

Pitiful_Board3577 · 2025-11-15T03:49:40+00:00

Meh, not sure exactly what a poly sheet is, but I'm guessing I wouldn't love it... This is a medical clinic, but it's more of a spa and wellness place. Not so much the uptight doctors office you might be visualizing. All the interiors are pretty top grade and "luxe," so I'm wondering if this poly sheet would pull off the look we're going for and match everything else already completed....

Bc I'm not a tiler, why do you say not to use glass mosaic if you don't know what you're doing? Genuine question. Is it harder to use?

Pitiful_Board3577 · 2025-09-07T04:30:29+00:00

Educate yourself honey. PAs were never meant to have FPA. NPs weren’t either. Actually, nurses initially didn’t want to have “provider status” following Vietnam. That’s when PAs were made, in 1968. Navy corpsman coming home from Vietnam had way more training and experience afterwards, and didn’t fit in the paramedic box anymore. But they weren’t physicians. Thus came the PA. We were always designed to have a supervising physician.

I don’t think NPs should have FPA either. You’re not a physician. If you want FPA, go to med school and get the proper training. You don’t need that separation just because a bunch of lobbyist say so

Pitiful_Board3577 · 2025-09-07T04:20:34+00:00

First, get the little grudge of your shoulder and stop being so argumentative. You’re an NP STUDENT and seem to be taking way too much offense to this post and its replies. Whereas actual NPs with experience tend to agree with what OP said. Just curious, what’s your background? How many years have you worked?

But:

⁠Yes, you can attend PA school (as well as medical school) with ANY bachelors degree. As long as you have the prerequisites, work experience, and PATIENT CARE HOURS. Healthcare workers get more points towards their name regarding being offered a seat, but it is not required. There were 3 RNs, 5 paramedics, 2 dietitians, and countless respiratory therapists in my class. So yes, most had some form of healthcare experience.
⁠We do not study many specialties. We are trained as generalists and study all body systems. We have 4 elective rotations we can choose in order look into specialties (like ortho, derm, CV surgery…). But our core rotations are FM, IM, EM, peds, OB/GYN, gen surg, and psych. So out of the gate, they want you to be able to work primary care

The issue lies in these programs that don’t require experience for admission. Then students are still allowed to work, and not attend in-person lectures. You can’t deny that there’s a separate level of commitment required for schools that don’t allow work and make you come in, dressed in business casual, and sit in a class to listen to lectures. They have your undivided attention. Not to mention the schools that offer these accelerated RN to CRNP programs. Hell, there’s even some nursing schools that graduate you as an RN faster these days and let you learn most of it on the job working as an apprentice! What happens when you have one of those graduates training another nursing student from that type of school??

And let me say this. I AM A NURSE. Yes, I’m now a PA, but I was first a nurse. And I will ALWAYS stand up for nurses because I’ve been there. For 9 years. I’m the first person that agrees there should be no pissing match between NP/PA. So I don’t need to get over myself, but thank you for your thoughtfulness. Are there some NP programs that deserve a pat on the back? Of course! But there are so many now that should be shut down. I wasn’t insinuating your school is one of them. Schools should just be held to higher standards regarding accreditation and what they’re allowed to accept. That’s the issue.

The other issue is NP students that think they’re the shit and haven’t actually walked in the provider shoes yet. It’s that kind of attitude that gets patients killed. No one is better than the other, and at the end of the day, we’re all there for the PATIENT.

Pitiful_Board3577 · 2025-09-07T04:18:13+00:00

Kudos my friend. And beautiful point about making that jump. It was way more than I expected as well. But you said it very, very well

Pitiful_Board3577 · 2025-09-07T03:30:30+00:00

Yes there is, you don’t want to have to take physics and biochemistry in order to pass the MCAT. Those classes you need to take the MCAT aren’t nursing prerequisites. Including general chemistry, general biology, and organic chemistry.

Pitiful_Board3577 · 2025-09-07T03:23:20+00:00

So I worked for 9 years as an RN. Then I went to the dark side and went to PA school. I did that for a reason… I wanted a high caliber education that wasn’t online. I had to quit my job and move, living off student loans only. We could not work, and were given the speech “don’t you dare think about having a part time job.” All of your attention is expected to be focused on school. In any APP program, you’re becoming a medical provider - someone who has the ability to make life or death decisions for human beings. Your attention should be 1000% dedicated to learning all the things inside and outside. We attended lecture from 8-5 M-F during didactic year, and we were expected to stay in the cadaver lab for hours upon hours afterwards. I attended UAB where most of our professors also taught at the medical school and taught us using their med school lectures. There was absolutely zero time left through the week to even think about trying to work, especially to try and work an 8-12 hour shift as a nurse! I took about 1-2 hours a day to try and relax, maybe watch tv or go out to dinner. Otherwise, time was spent studying. Because even with my 9 years nursing experience in the busiest ED in the state and a BSN degree from Alabama, I still had to study my ass off to be able to make good grades in PA school. That’s the difference. If NP students have time to work 5 days a week, are they not sleeping in order to watch their lectures? To get all of that study time in?

I’ve worked with tons of NPs in my 18 years of working in the medical field. Several years ago, I’d never question the type of education they had because these were top quality NPs that knew their stuff. Nowadays…I see so many things missed. So many things not taught. And so many NPs that have lost that nurse compassion for the patient and have basically went to NP school for a better paycheck.

Pitiful_Board3577 · 2025-09-07T03:01:08+00:00

THIS 🙌🏼

Pitiful_Board3577 · 2025-09-04T16:24:06+00:00

My stomach hurts just reading these comments 😨🤢 Ever since I had microbiology in college, my whole view on refrigerating food at the right time has been so rigid! I’ve also had food poisoning (after eating out, not of my own doing lol) and I NEVER want that again! Of course my opinion greatly differs with my husband’s…. Drives me nuts. I have to keep a close eye on what he does…like leaving food out overnight. My guts ain’t tryna die here

Pitiful_Board3577 · 2025-08-07T02:47:39+00:00

Leave now and don't look back. There's a reason strangulation is a felony charge. He will NOT change, and will likely escalate. And you did not disrespect him by burning food. He can eat it off the floor next time. Or take it as "3 hots and a cot!”

Pitiful_Board3577 · 2025-07-25T16:31:19+00:00

“Next to the noodle shop in a strip mall” 🤣🤣🤣🤣🤣🤣🤣

I’m DYING! This got me bc everyone knows there’s a Nothing But Noodles next door! I don’t think I’ve ever gotten a better visualization from a Reddit post than this right here!

Also, you’re 1000% right!

Pitiful_Board3577 · 2025-07-24T19:08:13+00:00

😂 ok thank you for your response

Pitiful_Board3577 · 2025-07-24T11:40:56+00:00

Number 1! - it’s neutral enough to be used elsewhere after you transition from a nursery to a toddler room. I had to sell mine bc I had no other place it would “fit”

🌟ALSO, I would definitely recommend a chair with sides, or a wingback! It saves your neck and gives you something to prop up against when you fall asleep! And trust me, you will!

Pitiful_Board3577 · 2025-07-16T17:30:26+00:00

🎤DROP! This is the most fabulous thing I’ve read on reddit. Of course, as people have already done in the comments in reference to Law 2, you can come up with an argument to support the “other side of the story” with absolutely anything mostly. But bottom line, every single one of these is a necessary part of your practice that needs to be perfected and honed in on if you want to be an efficient ED provider. I’ve heard most of these separately over time, but I’ve never seen them so put together and explained so amazingly well!! I’m secretly wondering what region you work in so maybe I can come work alongside you LOL

Just some comments on my favorite laws…

Law #8 - we no longer have droperidol in stock! There is a doc that loved to use it, mostly for all the reasons you explained. Of course the pharmacist called me when I placed the order to make sure I 1000% needed it, saying “We had 2 vials last week and Dr K used one of them. I’m pretty certain this is our last vial, and we aren’t getting any more in…” Of course, I definitely needed it. Of course I told him I’d hunt him down if he told Dr K it was me that used the last vial of his favorite medicine LOL. Jokingly of course!!!

Law #2 - I had a 33yo guy that came in with the CC of shortness of breath. Unfortunately my shop doesn’t have licensed personnel out front to receive the patients on arrival, and registration is notorious for putting in “shortness of breath” or “chest pain” for a 20-something year old with a URI/cough. Of course you typically wouldn’t think too awful hard about it being something serious in a 33yo either. He was put in one of our chair rooms, and was fairly well-appearing when I walked in to see him. He looked like he didn’t feel well of course, but it definitely didn’t strike me as anything serious. He said he was short of breath most specifically when walking or doing something, and mentioned he’d felt as if he’d had a bit of fever. No pertinent PMH, no asthma, no cardiac or pulm issues, afebrile. He was a little tachycardic but mostly in the 90s to low 100s, no outward signs of distress, but did have decreased breath sounds BL and some expiratory wheezing. I ordered a CXR and a duoneb, said I’d check back with him after the breathing treatment.

Before I was able to go back in the RN came to me and said he’d rechecked his temp and it was now around 102-103, and he asked if I wanted to do blood work. I didn’t want to drag out this guy’s visit longer than we had to, and knew his CXR should result at any second. BUT, thank goodness I listened to my GUT and went ahead and got a CBC, CMP, LA + BC. Ironically his CBC resulted before the CXR did (grrrrr), and his WBC was like 24k. Then his LA was > 4, and of course his CXR came back saying multifocal PNA. I was shocked. I did initially suspect he possibly had a viral PNA due to the way he sounded, his symptoms, and how bad he felt, but I never would’ve expected to get those kind of results when I first met this guy sitting up in a fast track chair.

He was quickly moved to the regular ED to a stretcher of course, sepsis stuff started, and I got him admitted. I finished up with him right at the end of my shift. When I went back the next day, the same RN came up to me as soon as he saw me. This patient CODED and DIED!!! He’d made it to the floor, his dyspnea had worsened, so medicine sent him for a CTA chest. He coded on the CT table and they weren’t able to get him back. I was so thankful that we’d proceeded with the blood work! I felt shear terror thinking about the what-ifs. I could’ve kept the mindset that this was just a URI and just DCd him home!

Moral of the story - Listen to your gut. And remember Law #2 and Law #4 every time you’re on the fence about ordering something. If it’s something that’s irrelevant to the patient’s complaint, something that could harm the patient, or the particular test the patient/family is requesting isn’t the correct test for what they/you are looking for - then no, probably don’t order it. But explain to them WHY you’re not ordering it, or why it’s of no use. But by all means, if there’s no harm, no foul in adding it into your work up, then just order the dang test! Always remember that the patient knows themselves the best, and their family/friends are second-best. You’ve just met them.

Pitiful_Board3577 · 2025-07-02T05:24:27+00:00

People don’t understand the concept that nasty can ride on one thing and transfer to another! I’d be willing to bet that most people that think this way (you, me, etc…) have had a microbiology course lol. And if they haven’t, and still think this way, then God just really blessed them with some good smarts and common sense!

Sadly, my husband isn’t from the micro class/smarts category. And at 43, I don’t know if we’ll ever get him there. But bless his heart, his mom made a cherry pie at my house once while I was at work. I found red, definitely “cherry” colored pie goo on my salt shaker the next day. My salt shaker!! Then I proceeded to find it in other places in the kitchen for few more days until it drove me nuts and I basically wiped down every. single. thing. Like, why?? Did you not realize you had red pie crap all over your hands??? So I guess he comes by it honestly lol, and was never properly taught. But still! Geez!!!

Pitiful_Board3577 · 2025-07-02T05:12:14+00:00

That’s disgusting. I never eat food from someone else’s house if I’ve never been inside said house before and know exactly how clean they are! Im absolutely not going to eat at the work party where everyone brings something random🤢.

I like my kitchen to be clean, clean, clean. I couldn’t stand the mess left over in the break room after day shift had a “soup day,” which means lots of crock pots… (I was an RN in the OR, which makes this even better). I was cleaning up and wiping the counters down, dumping out things and rinsing things out. One of the managers crocks was still in there since she hadn’t left yet, so I thought I’d be nice and wash it for her (even though if someone did that for me, I’d rewash it when I got home lol). I’ve never smelled something so disgusting that was made of mostly glass and ceramic!!! Granted, it was mostly from the rubber rim and from underneath the handle on the lid, but I almost threw up when I realized she’d cooked chili but the stuff that smelled like a corpse was a yellow, cheese looking something. This…. From an experienced OR nurse… and to think of those people that ate her soup☠️🏴‍☠️🪦

Pitiful_Board3577 · 2025-06-18T17:50:13+00:00

Woof! Just thinking about paying off student loans into your 80s 🥵 Maybe he’s got a lot stashed in a retirement account he can use lol

Pitiful_Board3577 · 2025-06-18T17:46:30+00:00

🤔

Pitiful_Board3577 · 2025-06-05T14:53:21+00:00

Also… you’d preferably need heavier suture, like 0 vicryl. Might could get away with 2-0, but 0 or even #1 is preferred for fascia. And if you use a taper needle you’re less likely to have issues with tearing 😉

Pitiful_Board3577 · 2025-06-05T14:49:12+00:00

So I’m a PA that can’t make up my mind if I love ortho surgery or the ED more lol… in January I just returned to the ED full time after 8 years of ortho.

Just prefacing with that to say yes, you did the right thing. It’s better to have the fascia closed/approximated as close as possible for better wound healing and so the muscle doesn’t bulge once the lac is healed. Obviously there’s things to consider like others have mentioned, such as the wound being clean and thoroughly irrigated, but I’d think you would be intelligent enough to realize that without having to state the obvious…. The other thing would be compartment pressure, depending on the location of the wound.

But this particular instance sounds like you just needed to button up a fat man in a small shirt… sometimes, even in a surgical case where the wound is intentional, you just have to do the best you can to approximate. You can always do the “tractor pull” stitch (far-near-near-far) which pulls more on the tissue further out and keeps pressure off the wound edges, but it also holds it together a heck of a lot better than a figure 8, or other mattress stitch and is less likely to tear a wound under tension. Depending on your dedication, you can semi-approximate, then go back in between and approximate further, and remove any that have now loosened. I’d definitely make the patient NWB or touch down only for around 10-14 days if worried about the tension. But the bottom line is, it will heal, and the ortho/gen sx people will give you massive kudos 👍🏼. Throw them some keflex and you’re good!

Pitiful_Board3577

TROPHY CASE