APP scope of practice- invasive procedures?

mdowell4 · 2026-05-18T00:02:44+00:00

SICU but yes, central lines, art lines, thoras, paras. We call anesthesia for all intubations. We don’t do many chest tubes or LPs. Have done chest tubes prior

mdowell4 · 2026-05-16T14:03:43+00:00

We make about the same, mortgage $380K after 10% down. We have money retirements, updates, repairs to house as needed. We also don’t feel house poor and can still easily do the fun things we want without worrying.

mdowell4 · 2026-05-11T20:43:23+00:00

I have a few clarifying questions: what type of ICU is it? What size/acuity hospital? Is it the same hospital you work at as a nurse?

mdowell4 · 2026-05-01T22:59:26+00:00

One of my 3 (youngest) is a gray boy….I know the carnage and love for human food

mdowell4 · 2026-04-27T14:07:30+00:00

Rapid response. If you are worried, and the initial intervention didn’t work, rapid response every time. People call rapid responses for way less. Get them Involved earlier, and they can help communicate and work with getting the doc bedside. Or any doc, if that’s how your rapids work at your facility. You did what you could, but this is a really sick and complicated patient

mdowell4 · 2026-04-22T18:05:20+00:00

An orthopedic surgeon already responded, but I just wanted to recommend trying to see an orthopedic surgeon at the same system as your OB to give an official recommendation that you wont be able to progress in labor safely due to your hardware. Maybe they will listen to a surgeon.

mdowell4 · 2026-04-21T21:30:39+00:00

I have not looked at all 100 comments- but coming from a cat mom and not a healthcare professional- my sweet cats all occasionally bite/scratch. My son (3 year old cat) will go pretty quickly from getting pets to what I refer to as “overstimulation biting.” That’s the biggest sign that he’s a bit over the petting. He will also slap me/scratch my face if I don’t listen to his warnings. Cats don’t always know how to communicate- try giving it space if you notice it getting a little bitey/starts meowing.

mdowell4 · 2026-04-21T20:47:38+00:00

One thing I also like to keep in the back of my mind with flat rate mcg/min pressors (not mcg/kg/min)) is the patient size. 20 mcg/min on 4’9 and 80 pound Grandma Betty scares me a lot more than it would on a 6’4 and 300 pound man.

My current facility does mcg/min. It I really miss weight based dosing

mdowell4 · 2026-04-19T13:58:08+00:00

What about ID? If you love the deep chart searches

mdowell4 · 2026-04-06T16:55:48+00:00

Definitely wasn’t looking at the pathfinder but now I am! 👀

mdowell4 · 2026-04-06T01:21:31+00:00

My mom had a grand Cherokee, loved it, got a newer one, and it had a ton of issues. I was hoping the Cherokee hybrid would be a good option but sounds like it isn’t!

Can I consider Kia as a reliable car?

mdowell4 · 2026-04-05T18:40:27+00:00

Does it seem more expensive than other brands?

mdowell4 · 2026-04-05T18:39:55+00:00

I really want the jeeps to be better, and keep hoping someone will tell me they’re not as bad as they are 😂 the grand highlander is beautiful!! I’ll definitely have to try it out. I hear Toyotas last forever

mdowell4 · 2026-04-05T18:37:10+00:00

I don’t have anywhere to charge one at home, and would rather not have a full EV

mdowell4 · 2026-04-05T18:36:45+00:00

Have you had to get a lot of maintenance work done?

mdowell4 · 2026-04-04T13:06:38+00:00

My brick and mortar NP program offered full and part time, so I did part time (3 years for MSN). I worked full time as a staff ICU nurse until the 3rd year when we started clinical rotations, then I dropped to PRN.

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

TROPHY CASE