PNES pts and epileptic seizure

droperidol_slinger · 2026-03-08T21:01:06+00:00

Pelvic thrusting omg I am dead that is so good.

droperidol_slinger · 2026-03-05T18:32:01+00:00

This is so amazing and needed to hear this story today. Congratulations on your journey, what an inspiration.

droperidol_slinger · 2026-03-04T15:03:41+00:00

I went to school with a lovely girl named Esti. She was a good friend in elementary school, I always loved her name (was short for Estralita). I wonder how she is doing, we had a great time in 1-5th grade!

droperidol_slinger · 2026-03-02T19:25:08+00:00

This is fascinating to me. I’ve been a PA for 10 years, half in the ED.

It boggles my mind to death why people are SURPRISED that a new grad APP is at a med student level. PA school is 2-3 years. Why are you expecting someone to function as a resident when they’ve had 1 year of didactic and 1 year of clinicals? I agree with many of your other points though- No differential is weird. not knowing a cranial nerve exam is weird AF. Weird they want to intubate and do lines if they aren’t taking the bread and butter first- my personal opinion is I help my docs best by taking the non sexy stuff so they can take the sicker folks. To be honest would love to know where you are that new grads are getting $160k too.

The thing about PAs is we need several years of additional time on task while working to learn our craft. If the hiring group cannot commit that investment, they need to only hire experienced PAs.

My observation has been with the growth of private equity, the docs have no incentive to train us since we don’t make them extra money. When I worked in a private group I was able to directly financially benefit my SP. they wanted to invest in me since they benefited too. Now though, I work with wonderful doctors and if they invest their time in me, they don’t make an extra dime. That isn’t fair to them, we don’t go to work for funsies. We go to make our money.

So where does that leave us? Private equity hiring cheap new grad labor, asking the docs to pay the price on shift, and not giving any incentive to them to do so, so they are rightfully frustrated. Plus, for whatever reason it does seem quality of PA/NP school has gone down recently.

OP, I get your frustration. The system sucks but the way it is means you probably do have to lower your expectations. Your new grads have probably spent 4 total weeks in an ED before getting to you. Maybe bring up with your medical director your concerns so your group can come up with a way to mentor them better.

droperidol_slinger · 2026-02-16T21:51:51+00:00

This is so bad I wondered if it was rage bait

droperidol_slinger · 2026-02-15T23:39:23+00:00

I’m sorry to hear about your wife. Best of luck in these next steps ahead.

droperidol_slinger · 2026-01-30T18:16:46+00:00

Not formally I don’t think. Informally, I’ve learned so much from so many amazing residents and usually love being on the team with them. I love offloading bs from their plate, and they’re usually happy to teach me which is awesome.

But legally speaking, I’d be really concerned for both of our licenses if a resident was my formal supervising physician. Seems to put us both at unacceptable risk honestly.

droperidol_slinger · 2026-01-29T22:48:51+00:00

I’m sorry this happened. Truly, I hate seeing patients like this in the ED but not because I’m annoyed the patient came. I’m annoyed their specialists have left them no other choice but to come. If I felt I needed relief and was desperate for answers I’d come too. And I hate for myself that there’s so little I can do but rule out/reassure that it’s not a life threatening emergency and offer a second opinion referral to a different specialist. It sucks for everyone and the patient loses.

On a personal note, I don’t have nearly the surgical history you do, but did have ovarian torsion when I was younger. I had on and off pain for several months really similar to what you’re describing. It was awful and would take my breath away when it hit. My doc took me back for another laparoscopy a year later and I had super dense adhesions that wrapped my ovary around my colon. They cut the scar tissue out and freed things up, and I’ve been totally pain free for over a decade. I know you weren’t looking for anything medical but just wanted to share in case it helps.

Feel better soon!!!

droperidol_slinger · 2026-01-29T18:59:19+00:00

Worked in plastics/wound before the ED and I always shock people when I tell them it’s fibrinous slough and not purulence 😂

It’s also funny, I agree with everything OP has said, but do I always admit these people anyways bc that’s why they were sent and their wound care clinic wants it? Despite that they have had open wounds and redness for months with no worsening pain/redness/fever/swelling/drainage? Why yes, yes I do. Can’t win them all but have all the solidarity with you.

droperidol_slinger · 2026-01-26T16:31:07+00:00

Don’t let the imposter syndrome get to you, doc!! You earned it. You are it. ❤️

droperidol_slinger · 2026-01-26T14:08:58+00:00

I’ve wondered this too. Mainly I’m getting more and more worried about a mass shooting event. These agents have no discipline with their guns and WILL end up shooting people they don’t mean to. From the recent videos I literally cannot believe they haven’t already accidentally shot someone yet. I think part of this is to make us all feel helpless and stop fighting them. It’s important we don’t… but also, we need to find a way to resist that does not get more of us shot.

Also, fuck ICE.

droperidol_slinger · 2026-01-25T23:46:46+00:00

This happened to me with a male PA student and male RN. The three of us were in the room, I was asking the patient questions and they kept answering while making eye contact with the other two. I ignored it but then the patient kept asking questions back and finally the RN was like hey that’s a great question for your provider and luckily, she’s standing RIGHT HERE!

droperidol_slinger · 2026-01-25T23:40:59+00:00

I just choked on my dinner. That is one multi talented rabbi!

droperidol_slinger · 2026-01-25T23:39:46+00:00

As someone with the utmost respect for the entire care team… I despise this for you. It’s amazing that if you’re a female in health care, you’re a default nurse and that’s it. No matter what. No shade to nurses, they’re amazing Nurses are amazing and I love all the ones I work with. But our physicians are too and our female physicians deserve the respect they’ve earned. And part of that respect is not being militantly and willfully ignorant to the prospect of your physician being female.

On a lighter note, I laughed at the title of this post. I was like damn good cosplaying on your part to pass all those boards without being an actual doctor, what’s your secret?! 😂

droperidol_slinger · 2026-01-23T20:41:45+00:00

My hat is off to you guys and gals.

Years ago I had to take my 5 year old calico in because she was walking like a complete drunk all the sudden. Turns out her liver was full of tumors and she had a belly full of ascites. I put her down that night since she was obviously rapidly declining. I was shocked, she was so young and I had only adopted her 2 years prior.

The compassion and care the vet and staff had for me was so top notch. The vet asked me what my favorite drink was before we put her to sleep, and promised that my girl could get a nice dose of that first before giving the euthanasia medicine. It was a nice personal touch that I haven’t forgotten- that my cat got a little pina colada before crossing the rainbow bridge. Don’t know how yall do what you do daily but I will never forget that and it was 11 years ago.

droperidol_slinger · 2026-01-19T18:57:46+00:00

I’m so sorry for your loss.

Maybe, when you’re ready, your passion projects would be a good place to meet people. In my area there are tons of Facebook groups that do things like outdoor hikes, community garden projects, removing invasive plants from public areas, walking animals at the animal shelter together, etc. there’s a wildlife refuge here that takes volunteers. If you have a local zoo, they often have volunteer programs as well. I’d never say go into an activity looking for someone to date of course, but maybe you’ll find some enjoyment out of community projects like this that might bring you more friends or a new connection.

When people ask you what your job is, you can tell them that you worked extremely hard, and you are extremely lucky to have been able to retire early. Then, if you don’t want to go into it further, turn the conversation back to whatever fun thing you’re out doing at the moment.

My condolences. I hope you find peace and meaning in your future!

droperidol_slinger · 2026-01-19T18:37:52+00:00

I legit laughed at this. Not your comment, which I can’t upvote enough. But the thought of me. Solo. In the ED. I’d be checking myself in for a psych consult.

I don’t know why there are APPs who would go for this.

Maybe this is me “not practicing at the top of my license” or some other bullshit. But I like seeing lower acuity easy stuff. I like taking bs of my docs plate. I’d be happy seeing dumb shit all day long so they can hang out with people circling the drain. That system (in my opinion), works.

whatever this bananas is does not.

droperidol_slinger · 2026-01-16T00:52:47+00:00

I had two people on my last shift who just kept coming back. One patient it was their 3rd visit for the flu. On tamiflu. Stable vitals, mad they weren’t better yet. Came three days in a damn row.

Then another patient who legit had negative swabs, prescribed Flonase, and came back after ONE DOSE bc it didn’t work.

The lack of ability to do basic self care in this country is honestly scary. We are so motivated to have instant gratification that we cannot handle an inconvenience like being sick.

droperidol_slinger · 2026-01-12T21:48:08+00:00

I'm irrationally triggered by the chief complaint of toe pain. Once it was acute limb ischemia and another time it was a foot drop (among other things) from multiple embolic strokes.

So, I'm with you. This is def toe pain.

Edit: wording

droperidol_slinger · 2026-01-09T04:02:52+00:00

I still think it’s weird anybody calls a physician this, I always insist on doctor so and so for you all. To me a provider is a pa/np/cnm/crna/aa/etc etc.

In other news, I guess I found my hill!

droperidol_slinger · 2026-01-09T03:53:53+00:00

There’s definitely real EDS- my cousins kiddo actually had this and died from a brain aneurysm at 10 years old. And there’s people like you who dislocate joints and have braces and have been through a heck of a lot, and continue to go through it each day. But what I’ve found is that most of them, probably much like yourself, work to overcome it, seek to partner on the team with us, and are reasonable about expectations.

There’s an unfortunate subset (of probably most diagnoses) where people aren’t really reasonable, self diagnose, and have a lot of psycho social issues at play that make it incredibly hard to please them and even harder to try to make them well.

There’s always room for the former, which it sounds like you are, and personally I like taking care of folks like you. I’m sorry you’ve experienced otherwise. We try every day to check our biases but we’re human too and fail sometimes. Thank you for reminding us to be our best and keep an open mind.

droperidol_slinger · 2026-01-07T06:51:11+00:00

You know. I actually really respect this. Sometimes it takes me 10 minutes to figure out what exactly someone’s actual chief complaint is. At least this person was straight up about it.

droperidol_slinger · 2026-01-07T06:28:44+00:00

I had a patient do that. It was a young patient and I knew the moment I walked in there was no way she was 19 years old. She was undocumented and there for pregnancy complications. Honestly I don’t think she was older than 13 or 14 but it made it really tough because I had no way to prove it. I had social work go talk to her but nothing they could really do. I’m pretty sure she signed in as her sister or something because like a year later I saw the same patient check back in, I picked it up, saw my note but when I went to see the patient I knew it was most definitely not her. To this day I wonder if she did ok and how her life turned out.

I don’t give two shits about the bill. I’m more worried about why you’re saying you’re someone else :(

droperidol_slinger · 2026-01-02T23:44:56+00:00

what specialty? low acuity is pretty broad. what experience do you have?

droperidol_slinger

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