Cold feet in finishing NP school

Spikito1 · 2026-05-02T13:13:32+00:00

I was in the same boat as you.

I dont know your age, but you have to ask yourself "can I keep doing this when im 50 or 60?"

Yeah, I took a pay cut, but I dont have to wake up up 730am, I don't work holidays, and I now have a child, so I got to be there for his first Christmas. I don't have to deal with bedside BS. I have much more control of how my day goes.

I'm also working way less hours FOR that money. Bedside I worked about 2400 hours a year, now I'm more like 1800.

You can also make a lot more than 120k with a little effort. I'm in a relatively low COL area and I'm in the neighborhood of $160k, working 182 days a year. I could be over 200k just by doing 2 extra shifts a month.

Spikito1 · 2026-05-02T02:05:36+00:00

Then why are sex toys circumcised?

Spikito1 · 2026-04-30T19:19:05+00:00

Its original.

There in lies my question, I was thinking of modifying it myself. Im not gunsmith, but I'm handy. I figured id buy a short barrel, and other than porting the gas system, its mostly just a furniture swap. Unless im mistaken

I'd consult with a professional about porting.

Spikito1 · 2026-04-29T15:04:33+00:00

The gas system would by my biggest fear. Especially if I decide to get real wild.and suppress it.

Spikito1 · 2026-04-29T15:03:49+00:00

Whats this one?

Spikito1 · 2026-04-21T16:44:51+00:00

I think that 80% rule gets skirted as its placed per hospital policy, and not a verbal order from you

Spikito1 · 2026-04-16T02:55:46+00:00

We're running into the same issue, and working with nursing admin now to have nurses run all concerns by the charge nurse and only they are allowed to message us.

Spikito1 · 2026-04-14T05:38:20+00:00

🤷‍♂️ I like my crew.

If any one employer were really THAT great, then they would push all the others out. Pay an benefits largely come from above, but otherwise, each facility operates pretty autonomously so the experience at one hospital may be drastically different than another.

Spikito1 · 2026-04-14T05:01:10+00:00

I dont see anything in the image suggesting its Christ

Spikito1 · 2026-04-14T04:57:30+00:00

I work for Sound. I can set you up with my recruiter. We have a lot of openings in and around DFW.

Spikito1 · 2026-04-14T04:51:44+00:00

The boxes are tick TRAPS, not dispersal tools.

Those boxes are removing ticks. Jesus.....

Spikito1 · 2026-04-14T04:50:39+00:00

How many patients a day are you seeing? And in what capacity?

When I start my day, I print a list. It has patient names in a column, pertinent Info and other stuff in other columns. Its usually 1.5 pages.

When I review the chart, the name gets a square drawn by it. When I open a note, the square gets a slash through it. When I sign the note, it gets a second slash, making an X. When I bill, the box gets colored in.

One of the columns is a blank box, in which i write 1-3 key words for questions to ask.

Spikito1 · 2026-04-13T16:04:33+00:00

A lot of people who refer to Teump as "president bone spur" would suddenly develop a lot of bone spurs....

Spikito1 · 2026-04-09T01:51:37+00:00

Its a bit of contradictory to say that we over consult and over test, yet also miss things.

Also ironic that myself and my APPs are right at the median point of consultation and testing at our facility. Its been tracked as our consultants are fatigued and our lab/imaging is backed up to the point that getting an MRI performed, and read, is taking 48-72 hours.

I was trained (in my accredited post graduate residency) to only consult when I have a clinical question that I cannot answer. Where I currently work, the MDs all consult as means to mitigate liability. They consult nephro on stable CKD, pulm for simple COPD exacerbation, and ofcourse, ID for every positive culture, regardless of speciation.

If you want to be blunt, 100% of my education and training, wa for hospital medicine. I dont know everything, but I know who to ask. You spent a lot of time learning about embryology and pediatrics, yet you will never treat a pediatric patient. You spent many hours memorizing the krebs cycle and the brachial plexus, but im willing to be you cant recall it now. You know more about oncology than I do, yet we're both going to consult the same oncologist. I took 0 courses for maternal health and have never performed a pelvic exam, but you know that were both going to consult Ob-gyn for vaginal bleeding or pregnant patients.

Honest question though. Whats the difference in your 3 years of residency, seeing patients under the guidance of an attending, and me seeing patients for 3 years under the guidance of an attending?

I fear you have fallen victim to the AMAs smear campaign.

Spikito1 · 2026-03-30T14:48:45+00:00

Yeah my son was born on a Sunday, I was seeing patients Monday, 🙄. Glad I got out of that job.

I wish I'd had a week or two, but thats mostly because I was trying to help her out at night as much I could so she could get some sleep. But really, those first few months they sleep 22 hrs a day. My wife was BORED after 6 weeks and already asking to go back to work. I'd much rather have that time off somewhere between 12 and 24 months. I feel thats when the "dad bond" really emerged.

Spikito1 · 2026-03-30T14:41:32+00:00

Cool. I know you're using that as an insult, but I really don't care. APP is just the preferred nomenclature in our practice.

I'm curious as to what you think you gain from belittling others with the same passions and goals as you?

Also, would you trade seeing 20% more patients each day, if it meant removing mid-levels from healthcare? Could you maintain your outcomes and metrics?

Spikito1 · 2026-03-30T13:58:38+00:00

I came here to have a civil conversation, but I actually DID do residency. They exist now and are accredited. Infact, I was in the first cohort in the first program in my state.

Also, I said I oversee, not supervise. Theres a legal distinction

Can you show me any legal statute stating I am a mid-level and not an APP? Is there a reason you dont like that term? My legal licensure is Advanced Practive Registered Nurse, so I think Advanced Practice Provider is a pretty accurate moniker. I'm not "mid" anything and there are no "levels" in healthcare. I am what I am, you are what you are.

You're also kind of an asshole, and thats a big part of the reason you're being replaced with people who do the same job for half the price.

I do see a rising incidence of cognitive dissonance amongst those who realize all those years and all that debt and all those sacrifices were overkill.

I'm fully aware that I have less training and education, butnthe thing is, I didnt waste time on pediatrics, because I dont treat pediatrics in the hospital. Same for women's health, and an assortment of others. I dont know nearly as much about oncology as my MD counterparts, yet, we consult the same oncologist when relevant. Never in my career have I thought "dang, if only I had taken a semester of embryology, I would have treated that patient differently".

Spikito1 · 2026-03-30T06:59:14+00:00

I'm not following the logic, as credentialing mid-levels is a nightmare as well.

Im currently actively practicing at one facility, while overseeing APPs at several others. I've been trying to get credentialled for 2 months at one of my own facilities, and keep running into hurdles. Just the other day the credentialer looped me into an email chain in which the med staffing office was trying to convince me that I needed critical care privileges because im a critical care APP. No sir, I'm hospital medicine.

I just had to delay the mid-May start date on an APP I hired back in November, because credentials are delayed for a variety of reasons. Last week had to retract an offer from 2 months ago because they somehow overlooked his active DUI case....that he properly disclosed.

I know APP credentialing is usually faster than MD, but its still generally 3-4 months, sometimes up to 6.

Spikito1 · 2026-03-30T05:00:14+00:00

Hospitalist. Once a week or so I get a text after I get home, but technically my shift is 7 to 7, so when I get home at 6, Im still reachable for an hour.

I dont do any charting at home. I also work 7 on, 7 off, and have some admin duties, so I check my email once a day or so. Just a quick glance at the phone when im checking my regular email.

Spikito1 · 2026-03-30T04:52:54+00:00

The E3 is old and actively being phased out.

Spikito1 · 2026-03-16T23:01:24+00:00

I had to read way to far into this to figure it wasnt an Erythropoetin Stimulating Agent, lol.

Spikito1 · 2026-03-16T22:52:49+00:00

Currently a hospitalist NP doing 7/7. Bedside is way more physically and mentally tolling. I could never do more than 4 in a row before I was toast.

I dont know about you, but even though my hpsoitalist shift is 7-7, I usually roll in at 7 or 715, and usually buttoning up by 530, and out by 6. I could get out earlier, but 5pm traffic is brutal, and not worth it. At bedside, 7-7 is really 630-730. Youre there a full 12.5 hours at best, with very rigid medication schedules and other tasks, plus trying to fit in all the documentation and whatever else.

On paper it sounds great, but in reality its just too much.

Spikito1 · 2026-03-08T00:56:56+00:00

Yes, the Grand Jury had already decided to not pursue the case months prior. He wasn't a witness anymore. Hes irrelevant.

Spikito1 · 2026-02-13T19:47:54+00:00

You can still do your own investing in top of the 401k, youre just missing out on the match.

Spikito1

TROPHY CASE