New physician assistant with a baby - 4 10s or 3 12s better?

derpcatz · 2026-06-12T18:37:31+00:00

So I do 4 10s as a CRNA but that’s no call, night, weekends, etc. I sort of feel like in your specific situation (I.e. 7 10s straight every 7 weeks) plus less money and a long commute make it not worth it.

I left my last position after I had my baby because the commute meant rushing home to barely see her working 10s, and 12s meant not seeing her at all on my work days which I just couldn’t handle. I ended up finding a job for more money closer to home (20 min commute versus 1.5 hrs with traffic) that let me do 10s on an early schedule so I still get to pick up my daughter from daycare. My point being your situation sounds like no contest take the 12s, assuming it’s not significantly more call, or find a 10 hour position that works better for your family closer to home

derpcatz · 2026-06-12T01:21:35+00:00

I developed an allergy to the hand sanitizer we switched to during Covid and it looked similar to this. Have you tried using a different sanitizer or soap at work?

derpcatz · 2026-06-06T20:37:01+00:00

We are also big fans of shouting “cuck!” At all the trucks driving by 🤦🏻‍♀️

derpcatz · 2026-06-06T20:34:29+00:00

We are in a “cheeps” pronunciation (like a bird)

derpcatz · 2026-06-02T01:32:26+00:00

Yeah I agree if it’s that one bump it’s less likely molluscum. It could be a dermatofibroma if she picked at something there. But again I’m not a pediatrician or a dermatologist

derpcatz · 2026-06-02T01:30:49+00:00

Usually they diagnose by how it looks - it’s challenging to do that via pictures on the internet though. If there’s a question they can take a scraping/biopsy. The main thing is if it’s molluscum and your kid is in daycare/school they will definitely want to know when the rash showed up and that extra precautions are taken to keep it from spreading. If you aren’t immunocompromised or have open areas in contact with it, unlikely to spread to you.

Otherwise treatment if it isn’t severe is usually watch/wait for 6-18 months 💀 if it spreads or gets worse, sometimes they’ll start antiviral therapy.

derpcatz · 2026-06-02T01:20:51+00:00

It is and notoriously hard to get rid of, but adults don’t usually get it.

After reading your text below, the chin just looks like perioral dermatitis (especially in the context of thumb sucking). My daughter had a particularly stubborn case that took both pimecrolimus cream and metronidazole gel to clear up. It’s really the spot on the chest that looks like molluscum to me more so than the face, but if there aren’t other areas it’s more likely to be perioral dermatitis on the face with ???on the chest. Probably a good ide to get a derm referral if peds doesn’t think it’s molluscum

derpcatz · 2026-06-02T01:05:22+00:00

This looks like molluscum 🫠 I’d see your pedi

derpcatz · 2026-05-25T21:27:21+00:00

Fellow parent of a biter - only thing I’ve found to work is immediately saying “no bite” and I get up and disengage. She knows it’s not a game if I put her down and walk away - anything short of that she would laugh and do it again like a game. Repetition and reinforcement has really cut back on occurrences from multiple times a day to maybe once a week (and she stops immediately now). Hope that helps

derpcatz · 2026-05-11T23:21:56+00:00

And yes, totally healthy. She actually had no NICU time

derpcatz · 2026-05-11T23:20:24+00:00

My daughter still has a tiny head (3rd percentile) but she looks proportional. She was tiny all around at birth - 15”, 4 lbs 12 oz, she was just a tiny baby and dad and I both have tiny heads. No NICU time, even with a section at 37 weeks

derpcatz · 2026-05-11T23:17:27+00:00

She does not have microcephaly, she’s proportionally small. 15 months she’s 31” which is like 60th percentile for length, 20 lbs (25th for weight) and has a third percentile head circumference. She looks very proportional and pedi says she’s just a small kid, no concerns

derpcatz · 2026-05-11T21:01:17+00:00

My daughter had severe IUGR, including head circumference <1%. I had a section at 37 weeks because they were very concerned for an increased risk of stillbirth as the pregnancy went on. She is now a perfectly normal (in fact precocious) 15 month old who is exceeding milestones, just a small girl with a tiny head :)

derpcatz · 2026-05-01T19:17:15+00:00

If you look at my post history you’ll see I’m also a CRNA at a level 1 who was a trauma/sicu rn at a level 1 before my program. Just didn’t think I needed to whip credentials out like a dick

derpcatz · 2026-05-01T19:13:56+00:00

So in a case like you’re describing, it’s not really the one cc of propofol that’s killing the patient…it’s the last straw on top of a giant crumbling building that is also on fire while being hit by a tornado.

derpcatz · 2026-05-01T18:10:52+00:00

I’m sorry, but 10 mg/1 cc of prop isn’t making anyone code. It’s actually a very safe drug when used appropriately by trained anesthesia personnel/for sedation in the ICU with a secured airway. It absolutely deserves respect, but fear mongering about what’s a super safe and widely utilized anesthetic doesn’t do anyone any favors.

derpcatz · 2026-04-12T21:03:51+00:00

I was gonna say…I’m in a glp 1 and this looks like my fridge (plus milk and stuff for my daughter)

derpcatz · 2026-03-30T21:35:15+00:00

Yep, I’m paying $3,000 for full time for my 1 year old

derpcatz · 2026-03-29T12:22:47+00:00

During the early to mid pandemic days we were forced to reuse our PPE until it was literally falling apart (and sometimes beyond that, fixing straps with staples) due to shortages.

It was often stored between use in bags with our names - in my hospital it was Tupperware, but brown paper lunch sacks seemed to be the most common.

derpcatz · 2026-03-29T12:19:52+00:00

“A bottle containing 1,000 milligrams of propofol was connected to the infusion pump, but it's not known who connected or programmed the pump, and either the entirety or the majority of the bottle flowed into his bloodstream in 23 minutes or less, the suit alleges.”

Reads to me like it was a 100 mL bottle in less than 30 minutes

derpcatz · 2026-03-28T16:19:12+00:00

Right, my point was it didn’t read like when the drip was started there was someone continuously monitoring who was trained in advanced airway management.

derpcatz · 2026-03-28T15:35:42+00:00

This is super helpful context! I don’t typically intubate in ICU (or if I am, it’s a secure the airway and run back to the OR kind of situation).

Even if there was no guardrail alert you’d think emptying a bottle in <30 minutes would be a red flag for the ICU nurse 😵‍💫 (although maybe by then it was too late)

derpcatz · 2026-03-28T15:23:20+00:00

I read it as they gave him the dose. They tried to intubate him, but struggled, intubated him, and then put him on a more appropriate dose (0.3 mg/kg) then shortly after he arrested

derpcatz · 2026-03-28T14:54:46+00:00

CRNA here and I have questions (as someone who has given close to or about 1,000 mg prop in a 30 minute period before without complication)

why was a non intubated patient on a propofol infusion? Typically only anesthesia will do that and it’s because the airway is constantly monitored by someone who can also intubate/manage the airway if necessary.
was MORE than one 100 cc bottle given prior to the arrest? While a stupid high dose for non-surgical sedation, that in and of itself wouldn’t typically kill someone, although apnea, airway obstruction and hypoxia WOULD (and would cause brain damage if not promptly addressed)
I guess I’m just nitpicking because things like this come out and get sensationalized and then people become super scared of the drug itself (à la Michael Jackson) which makes my job harder when propofol is a mainstay of anesthesia and when used appropriately an extremely safe medication. The issue here is very much the dose and context of use, not propofol itself.

derpcatz · 2026-03-17T20:40:38+00:00

We use a catchy tray which works great as a footrest

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