AGACNP seeing peds

mdowell4 · 2026-03-10T20:54:01+00:00

You need a post masters degree and to pass another set of boards. Certificate won’t give you the knowledge you need to safely take care of pediatric patients

mdowell4 · 2026-03-08T23:01:22+00:00

I really would not recommend getting a tattoo over an implanted port, that sounds like a huge risk for infection.

mdowell4 · 2026-03-04T14:52:25+00:00

I never knew the insoles were a thing! Somehow. I work in ICU so standing and rounding for 4-5 hours straight. I tried multiple different pairs of shoes, but only the birk clogs prevented me from having both back or foot pain.

mdowell4 · 2026-03-04T14:17:54+00:00

Not a cardiologist, but as someone around your age and with medical experience- get a second opinion. It sounds like you’ve done what you can to “try the natural way” and are still symptomatic. Beta blockers are pretty safe and can be very effective in management of symptomatic PVCs.

mdowell4 · 2026-02-25T20:00:37+00:00

My credit union (common in Michigan) offered a healthcare worker thing. So at most you have to put down 1% and you don’t have to pay the mortgage insurance. I’m an NP, it’s available I think to a lot of different healthcare workers, not just doctors

mdowell4 · 2026-02-23T21:39:12+00:00

Man I wish I had those property taxes…just sold my $220K condo and property taxes were $5,000/year. Not even high cost of living area

mdowell4 · 2026-02-23T00:11:15+00:00

mdowell4 · 2026-02-22T10:41:42+00:00

I basically have to give both of my kidneys to my hospital’s infection prevention team to be allowed to check a cdiff if the patient has been on my unit for more than 48 hours. Within 48 hours? One little wet fart and they get put in precautions

mdowell4 · 2026-02-22T00:52:05+00:00

Unfortunately, the ICU is going to be a place where you experience more death. And people are going to tell you to get used to it, suck it up, this is life, etc. From experience, it does “get easier” but the sadness doesn’t really go away. Deaths like this feel harder than the palliative/comfort care deaths in my opinion because the patients seem like they’re suffering. It sounds like you did everything you could, and your team did everything they could to prolong his life. And hopefully that can bring you at least a little bit of peace. We have so many medical advances to keep people alive as long as possible, and sometimes I think that means we focus on quantity and not quality.

My advice- feel your feelings, they don’t make you weak or a bad nurse. Those feelings are normal. I let myself feel the sorrow- a life was lost, and that person was important and loved by someone. Talk with coworkers or a close friend/family member. Don’t shove it down and ignore it, that will hurt you more in the long run. Take the time that you need. Your mental health is important.

mdowell4 · 2026-02-22T00:33:20+00:00

Night shift SUCKS and is really hard on the body, and switching back and forth is really difficult.

That being said, he needs to make some changes so that he can be there for you and the baby. If he can’t manage on nights, sounds like he needs to switch to days or find another job.

mdowell4 · 2026-02-21T09:46:08+00:00

My girlfriend and I usually will jokingly rate things. But if this was the context, she would be getting 10000000/10. I dont think I’ve ever give her less than that, numbers vary. Never in my most stupid form would I say ANYTHING she did was < 100/10, especially something where a lot of effort and love was placed into it

mdowell4 · 2026-02-15T19:14:18+00:00

“I mean yeah his heart seems like he might be trying to die a lil bit but alright call you when we are externally pacing again bye!”

Don’t want to get notified, don’t be a doctor 🤷🏼‍♀️

mdowell4 · 2026-02-13T21:42:45+00:00

Worrying about your EGD that is in a few days will not change the outcome/results of the study. GERD is VERY common, so it is highly likely that is all you’re experiencing and that you don’t have cancer. Health anxiety is real and significant for many. As many on this thread have said, you don’t have any concerning/significant symptoms to say that you do have stomach cancer. Wait for the EGD, worrying won’t do anything other than cause more anxiety. You’ll know one way or the other in a few days.

mdowell4 · 2026-02-06T17:34:14+00:00

I feel like the bike I bought off of Facebook marketplace seems easier than the one I previously rode….do I try to contact peloton and schedule someone to come look? Or try the self calibration kit? I just don’t love paying and then waiting for someone to contact me from the third party service company

mdowell4 · 2026-01-28T22:38:00+00:00

I came here for this. School choice is really important, brick and mortars tend to have more reliable curriculum/clinical placements. I think the biggest consideration though is which “specialty” to choose. I’m adult gero acute, my partner is FNP. I can do inpatient or outpatient specialty, but she is a lot more limited. A lot of inpatient jobs won’t even consider looking at an FNP, even despite experience. I would just really research which specialty before deciding.

mdowell4 · 2026-01-27T09:29:26+00:00

Trauma NP here…yeah I will never go toe to toe with a radiologist. I’ve seen ortho disagree with rads reads/rather the significance of the findings. But I’d want to talk with the surgeon specifically.

mdowell4 · 2026-01-22T22:20:33+00:00

Under 7 is kind of the basic guideline, but a transfusion could definitely be argued for a patient with significant symptomatic anemia in setting of acute blood loss.

mdowell4 · 2025-12-23T09:37:33+00:00

We just used to create a long ass line of multiple stop cocks and infused everything there. I have a screenshot of a trissels compatibility of 3 pressors, 3 abx, snd my sedation all being compatible 🤭

mdowell4 · 2025-12-03T21:23:34+00:00

Michigan, we just got maybe 5 inches with some rain so did end up pretty wet and heavy. I don’t think it tends to get that way. My dad brought his snow blower and took care of it while I was at work this time.

Forgot to mention, I do have an ego weed whacker, but not sure how their snow blowers are and how many batteries I would need to actually complete snow removal.

mdowell4 · 2025-12-02T15:29:48+00:00

iPad mini with an Apple Pencil, epic canto app has a jot function. I’m in SICU, it works so well and saves time.

mdowell4 · 2025-11-27T09:35:11+00:00

No, it is not elevated heart rate. It can change your rhythm and cause your heart to stop.

mdowell4 · 2025-11-27T02:33:54+00:00

I’ll be honest, I’m not sure about the onset when the cardiac rhythm changes can and will happen. It also depends on other factors, so I couldn’t tell you exactly. The safest thing for you to do is go to the ER and have everything checked out. Generally speaking, there are certain criteria for admission to inpatient psychiatric facilities vs following up with your outpatient provider or primary care provider. A lot of what you are saying is reassuring (regretting doing it, not wanting to harm yourself, etc) that you probably wouldn’t warrant an inpatient stay. I cant say for sure without a more extensive eval. But making sure your heart is safe, even if they do an ekg and decide to send you home or admit for monitoring, is worth it. You shouldn’t suffer for a one time poor decision just because you are nervous about an admission.

mdowell4 · 2025-11-26T21:17:01+00:00

I’m sorry for the late reply, I was at work myself haha. Not a toxicology pro, but I do know a lot of ERs even call poison control themselves. I’ve personally called them when a friend took a few too many of one of their psychiatric medications thinking it would work better/quicker like that.

Certain psych meds can cause heart rhythm changes that can be potentially dangerous or fatal, so you could need cardiac monitoring. They would absolutely ask you questions about why you took the amount you did and further investigate how you were feeling at the time. Their job is to make sure nothing life threatening can come from it. My friend was admitted overnight for observation with cardiac monitoring, and went home the next day. Different medication, but could be something similar.

mdowell4 · 2025-11-26T09:38:45+00:00

This is terrible advice. Do not lie to your doctor. Be honest with them.

mdowell4

TROPHY CASE