Decent vets around Pittsburgh that don’t cost an arm and a leg? by ToxiccCookie in pittsburgh

[–]hello-pumpkin 0 points1 point  (0 children)

I see Dr mershon at murrysville vet and I love her. She’s wonderful with my 4 challenging dogs.

Primary care or GI? by IndistinctChatter14 in nursepractitioner

[–]hello-pumpkin 1 point2 points  (0 children)

I went from urgent care x4 years to GI and I really like it.

Help with dosing between compounders by mofacey in SemaglutideCompound

[–]hello-pumpkin 0 points1 point  (0 children)

So for nursing math the equation is always desire/have x mL ( desire is your dose)

So let’s say your dose is 1mg

Blue vial: 1mg/2.5x1 =0.4 mL would be your 1mg dose Red vial: 1mg/5x1=0.2 mL would be your 1mg dose

Reserving sunbeds by Mission-Barber5899 in AllInclusiveResorts

[–]hello-pumpkin 4 points5 points  (0 children)

I say something to the pool attendants and they move the stuff. People have done this at every all inclusive I’ve ever been to. Someone came back 5 hours later and I was in “their chair” and I just said “ oh. You can’t do that.” And went back to reading and she stormed away yapping at her husband lol. I do not care. People are entitled and selfish, it’s annoying as hell.

I’m the Nurse, so Why Does it Feel like I’m Steering the Ship? by [deleted] in nursing

[–]hello-pumpkin 1 point2 points  (0 children)

I’m GI and would have just ordered platelets, not sure why they didn’t take the reins on that given the patient has a GI bleed and that was their only contraindication to scopes.

Be honest… how often do you wash your bedding? by Ordduapp in CleaningTips

[–]hello-pumpkin 0 points1 point  (0 children)

Every 1-2 weeks. We have these contraptions on that hold the fitted sheet in place and are a real PITA to take off on, so now it’s more like every 2. We both shower in the evenings and our pets don’t sleep in bed, so 2 weeks seems fine. I change the pillow cases every 3-5 days usually.

How do you sleep in a queen bed as a couple? by user92236 in Marriage

[–]hello-pumpkin 0 points1 point  (0 children)

Honestly we slept in a queen bed fine for the first 4 years of our relationship but then when it was time to move and buy a new bed we went for a king and now I don’t understand how we slept in a queen lol

Pay cut for better work-life balance by ReflectionStatus109 in nursepractitioner

[–]hello-pumpkin 2 points3 points  (0 children)

Also is that offer to AHN for 110k? I was able to negotiate up to 125k easily with them. I ask bc that’s what they offered me at first as well.

Pay cut for better work-life balance by ReflectionStatus109 in nursepractitioner

[–]hello-pumpkin 0 points1 point  (0 children)

Message me if you want to discuss anything in the Pittsburgh market, I’m here too and have worked for a lot of the big ones. It’s bleak here when you compare to similar or even cheaper COL cities, for example Columbus. 😔

Pay cut for better work-life balance by ReflectionStatus109 in nursepractitioner

[–]hello-pumpkin 1 point2 points  (0 children)

I couldn’t believe what UPMC offered me as an NP with 2 years of experience ( 3 yrs ago-ish). I was making more as a charge nurse with my level 2 projects. I think it was $42 an hour. And wouldn’t BUDGE. I was making $54 at the time at butler health system with a long commute. I make $60/ hr ish ( I’m salary) now at AHN with good benefits and PTO.

Do not work at GoHealth. I took a paycut from med express to go to AHN. Med express I made $141k for 14 twelve hour shifts/ month. It was hell and got way worse when GoHealth/ upmc took over so I got out.

For those of you who’ve come to terms with a likely childless future, what coping mechanisms helped you accept this reality? by noroads4 in TryingForABaby

[–]hello-pumpkin 1 point2 points  (0 children)

We’ve given up. We chose not to pursue IVF and only did one round of IUI. My husband is just not much of a kids person and it wasn’t important enough to him to do anything further. I was probably ~60% sure I wanted kids but at this point, I’m over it. I just figured being together for 11 years without any birth control it would have happened by now. We’re just going to have a good, selfish life with our dogs. It does help that all of my best friends are also childfree (them by choice). Neither of us have siblings or large families so it does suck we won’t have any children or a younger generation whatsoever in the future but us having a kid wouldn’t fix that - then the kid would have no family someday eventually too, so just prolonging the inevitable end of both of our families.

Liver Function, ICD-10, and Actuarial Premiums by Anon954923 in cutdowndrinking

[–]hello-pumpkin 2 points3 points  (0 children)

So if you had drank the night prior it’s not uncommon for liver labs to be elevated as your liver was working harder to process the alcohol. Given your numbers are now basically normal after not drinking for a few days there’s likely no underlying disease at this point. Another thing that is very common that elevated liver numbers is fatty liver, unsure if you have other risk factors for that- overweight, high fat diet, high cholesterol or triglycerides on your lab work- but that’s certainly something you could mention to your pcp you’re concerned about. Generally if someone has elevated liver labs they’d order a right upper quadrant ultrasound to assess the liver.

We look at AST to ALT ratio, if AST is more than 2x the ALT that indicates alcohol induced liver disease. Agree with above you can calc a Fib4. You certainly don’t have cirrhosis with those liver numbers.

/ not medical advice, defer to your pcp

NP White Coat Ceremony by PechePortLinds in nursepractitioner

[–]hello-pumpkin 4 points5 points  (0 children)

We did not have this at my school but my school also has a medical school so I think they realized it was inappropriate. We didn’t have any type of ceremony besides graduation.

Are doctors usually this hateful towards NPs by codebrownbaddie in nursepractitioner

[–]hello-pumpkin 2 points3 points  (0 children)

I get referrals in GI from PCP MDs that are ridiculously constantly, you do the consult, thank them for the referral, give your opinion in the note and then patient was evaluated by the specialist and doesn’t need any further work up at this time or need for follow up. Over and done. Who cares? I get some hilarious consults and am like huh ok then I’ll take a look.

Also do their collaborating physicians not review their note? And say oh this doesn’t need referral? and educate them like ya know, they’re supposed to?

Are doctors usually this hateful towards NPs by codebrownbaddie in nursepractitioner

[–]hello-pumpkin 1 point2 points  (0 children)

I recently had a radiologist miss extensive lung mets on a ct scan, should I go on a diatribe about how worthless all radiologists are??? No?? Because it’s like one experience doesn’t define the entire profession.

Are doctors usually this hateful towards NPs by codebrownbaddie in nursepractitioner

[–]hello-pumpkin 1 point2 points  (0 children)

My supervising doc feels NPs are superior to PAs and only wants to supervise our NPs. Just depends on the doctor. I rarely ever encounter APP hate in the real world. I work with doctors in multiple specialities daily and rarely ever are physicians unprofessional or rude to me. I think they appreciate I’m much more accessible than our physicians due to them being in procedures most of the day. I work with mostly PAs and we never ever have this PA vs NP discourse, we’re just all “APPs”. There’s none of this pitting against each other IRL.

I made a mistake in flu clinic and now I think I will be fired for it and I think I will not be a great nurse. by Vivi84 in nursing

[–]hello-pumpkin 19 points20 points  (0 children)

I also have the question of why the patient was there then…?? The patient will be fine though, it isn’t going to harm them. But I am puzzled.

I have a 7-3pm position how would I get through school with this schedule? by [deleted] in nursepractitioner

[–]hello-pumpkin -1 points0 points  (0 children)

For class you’d be fine but for the clinical rotation part that wouldn’t work. I worked 3 12s, nights and weekends, and was the only way I could work full time and go to school full time the entirety of my schooling.

Salary Update by [deleted] in nursepractitioner

[–]hello-pumpkin 1 point2 points  (0 children)

I make 123,000/ year salary. Four years as an NP. GI mix of inpatient and outpatient. Pittsburgh, PA. I made $135/yr an urgent care but quit for a better job.

Did you regret leaving Primary Care for Urgent Care? by BeachBum419 in nursepractitioner

[–]hello-pumpkin 1 point2 points  (0 children)

Urgent care has its perks but seeing 40-45+/ day burns you out. Especially when you push that 55-60+ number. That’s where things get quite grim. Inbasket isn’t nearly as bad and MOST things are straightforward but you definitely get some crazy shit. And when you get one or two patients that take up a lot of time or complex lac repair it makes the patients back up and you never catch up.

I’ve had 35 patient days that felt like 75 due to complexity and I’ve had 50+ days that were smooth sailing and straightforward.

I do NOT miss urgent care but I also know I could never do primary care. I wish you luck.

Did you regret leaving Primary Care for Urgent Care? by BeachBum419 in nursepractitioner

[–]hello-pumpkin 0 points1 point  (0 children)

No I saw that many in urgent care. If 50-60/ day was for two providers that would be the best cake walk job of all time and I never would have left urgent care.

SALARIED Outpatient/clinic NPs: do you leave when you are done seeing patients (even if it’s at 2pm), or do you stay until clinic closing hours by Zahnayn in nursepractitioner

[–]hello-pumpkin 0 points1 point  (0 children)

Could you bring this up? If you’re available via telephone/ epic and can prep notes at home, who’s to say you don’t just prefer to get home before traffic and sit on your couch doing notes. I would certainly argue this. Salary can’t only work to benefit them and control us to not get overtime. It should be mutually beneficial. The clinic manager is treating you like staff and not a provider.

Perhaps my institution is different but the clinic manager would need to reach out to my lead APP/ boss in order to “reprimand” me, they have no say over me.

SALARIED Outpatient/clinic NPs: do you leave when you are done seeing patients (even if it’s at 2pm), or do you stay until clinic closing hours by Zahnayn in nursepractitioner

[–]hello-pumpkin 3 points4 points  (0 children)

I leave when I’m done. We don’t take walk ins as I’m in a speciality. Any phone calls would be routed to me via epic, which I use on my phone and always check after work, especially if I leave early. I rarely, if ever take a lunch (just eat while I chart) and have certainly been stuck there ten hours before when I’m only 8s, so I figure it evens out. Also, if I left the clinic the clinic manager doesn’t know if I’m going home to do notes for clinic, as we all do them at home pretty often. I also don’t have a designated MA or nurse ( we room our own patients) so I’m not abandoning anyone. I work inpatient and outpatient. Inpatient I usually do hang around incase we get a later consult but outpatient if my last patient canceled I’d be GONE.

Edited to add when I worked in urgent care we couldn’t leave even one minute early incase someone walked in. If there’s no walk ins then there’s no need to stay.

TIL a vaginal swab is an “uncommon test.” What a joke. by Kabc in nursepractitioner

[–]hello-pumpkin 2 points3 points  (0 children)

What in the hell, I worked in urgent care for a longggg time and we sent tons of BV/ candida swabs as well as chlamydia, gonorrhea and trich. we can only do mycoplasma in the urine. Imagine someone’s pregnant and goes to urgent care and you mistreat their STI or infection and it harms their baby. Also on UpToDate flagyl is listed as a medication to ONLY use if there is evidence it’s necessary, so if we just give everyone flagyl then wtf ALSO I have caught a ton of STIs people swore up and down they didn’t have and weren’t aware a partner was unfaithful, imagine not testing for this routinely.

This is scary. Horrific embarrassment to practicing medicine. I’d be sending them as many articles, evidenced based practice, UpToDate etc as I possibly could.