art blog(derogatory)
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"I'm Dorothy Gale from Kansas"
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#extradirty
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macklin celebrini has autism
cherry valley forever
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Origami Around
Monterey Bay Aquarium
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trying on a metaphor
bliss lane
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@destined-pa
Patient presents in clinic for followup for hypertension, diabetes, hyperlipidemia, schizophrenia, hypothyroid, and chronic kidney failure.
All of which I’m supposed to address in <15min.
But all he wants to talk about is my ethnic background.
Attending: Why do you chart in such detail, I'm not a Family Medicine doctor, I hardly read your note, you're wasting your time
Me: This is how I was trained and it makes me feel better to have a detailed record of certain key conversations with my patients in case they decide to complain later, I will keep charting like this but you are of course free to not read it
Attending: Okay, as long as you know
[Several months later]
Hospital Lawyer: Hi I'm calling you because a complaint was filed against Attending but your charting is truly exceptional and will be key in getting this whole thing resolved, please continue charting exactly how you are charting and never change
Me:
To all of my healthcare colleagues who realize that our healthcare system and administrators and EMR encourage quick sloppy notes, copy-pasting, profuse Dragon transcription errors, charting for the coders --
To all my colleagues who are tempted to just “chart” like everyone else and churn out pointless mindless progress notes --
don’t give in! keep on charting in detail!
practice defensible medicine! document your thought process!
transmit information to the next person who will be caring for your patient!
capture those small physical exam findings that turn out to be useful for a future diagnosis!
show your work!
write the kind of H&P or discharge summary that you would want to find in your favorite relative’s medical record!
fight the good fight, take the time, ignore the haters, and patiently await YOUR day of vindication!!!!!!!
This.
Also your chart may be more helpful for a specialist or another doc who takes care of your patient in the future. Your patient may move or you may one day retire, and it’s just good practice to leave behind quality notes that can actually help the person taking your place. I had to be deposed recently for a lawsuit a patient had against their insurer and my notes were at least 3 times as long as my predecessors, who was not called for deposition because her notes were so sparse.
Also I don’t do deliveries anymore but I do occasionally see my partner’s patients for prenatal visits and the resident who delivered the patient called me and thanked me for writing a thorough note because it was the only one from the patient’s whole pregnancy that had detail and explained her comorbidities.
Also ALSO: I recently saw a partner’s patient and heard a very distinctive murmur on exam. Patient didn’t know that they had a murmur so I assumed it was new. I scanned through a years worth of charts from my partner and the patient’s cardiologist and there was no mention of the murmur. I called cardiology to talk about getting an echo in their upcoming appointment and cardiology says “oh yeah she’s had that for years.” YOU ARE A FREAKING CARDIOLOGIST CAN YOU NOT EVEN WRITE AN ACCURATE CARDIAC EXAM?!
Hi, people.
So last PA application cycle was unsuccessful unfortunately.
But, that’s not stoppin’ me! I’m currently in the new application cycle for several schools. We’ll see how it goes.
On the bright side, since the last application, I have learned so much and I am so grateful to have had the time to do so. I started a new job as a medical assistant and that has helped me grow and has given me experience working with different doctors and PAs.
Some important lessons I have learned:
1. Just like people have different personalities, obviously doctors and PAs do, as well. Most of us generally tend to forget that medical providers are human, too. They make mistakes and can be emotional, grumpy, etc. You just have to go with the flow and learn to work with the various personalities around you. Just like any other job.
2. When a doctor/PA is yelling, its not necessarily directed at you. I have witnessed many “yelling fits” amongst the medical team at my job. I’d say, about 80% of the time, the screaming is something along the lines of a patient being late or a patient not having a diagnostic report or imaging with them, and the list goes on... I used to take offense when certain doctors would scream at me for giving them information. But, I discovered that they just need to be calmed (or soothed, if you will) and their raised voice is usually a result of the situation and not the messenger.
3. Always push yourself as far as you can. Step out of your comfort zone. When I began this new job, I started as solely a medical assistant. A few months later, I encouraged my manager to have me learn to scribe as that was an option I could pursue. I am so happy that I did because I have gained so much knowledge on medical terminology, chart coding, EHR, ICD10, and medical examinations. I am at the point where I can practically diagnose a patient and come up with a plan (in my head, of course). I’ve also picked up some interpretation of MRIs and xrays.
I’m sure there are many more lessons I could list and more to be discovered. However, the point is that I am back in “the game” and blogging is the only thing that keeps me sane (besides my boyfriend). So, please enjoy this Christmas GIF as my grand finale.
Pt in emergency room: “I don’t understand why you’re scared to treat my chronic pain.”
Because you already see pain management, this is not an emergency since it’s not acute, and YOU ALREADY HAVE ALL THE NARCOTICS I CANNOT GIVE YOU MORE
(via kaylynta)
Why did I take this social science class? I am bored out of my mind...
When the pt stops you in the middle of your H&P to answer a phone call and is texting the rest of the time and then says their belly pain is a 20/10 and you are actually in the middle of your cycle and cramping like crazy and feel like you’re going to keel over and die
Hey guys. I’m glad to be finally posting my “mental breakdown survival guide”. As you know I struggle a lot with mental health, and so I have been through a lot of breakdowns. So many that I actually dropped out of university after 3 weeks in 2016 and had to take the whole year off. Because of this, I’ve made it my mission to help others with mental health issues as much as I can, so you don’t have to go through what I’ve been through.
Anyway, here is my guide. I tried to keep it general, and actually useful. If you have any questions or additions please feel free to add them.
And as ever, if you want to talk to me about studying with mental illness or want to see a post on a specific topic, please feel free to message me.
Reblog because this is very important and relevant to healthcare profession students as well.
(Tagging a few of you because I think you can support or add to these pointers. @md-admissions @ermedicine @wayfaringmd @ninjatengu)
I really like this resource! I want to re-emphasize AGAIN that there is life after bad grades and school will always wait for you. Your life is more important than a letter grade. Always, always, always.
First week of senior year
It's crazy that I'm already in my senior year of undergraduate studies... it feels like yesterday I was walking up to get my high school diploma and symbolically turning that tassel over to the other side.
This week was a little hectic, I'm still getting used to juggling work and school at the same time.
In addition to this stress, my stepmom (lives with my dad and half brother, seperately) lost her baby (my half sister) 3 days ago. She was only three weeks away from full-term. We don't know exactly the reason why- doctors were saying that the baby's heart just stopped. I'm just overwhelmed with sadness because I cannot see my dad cry. I have seen him cry more during the past few days than I have my entire life...
Anyway, my point is... my first week kinda sucked. The only thing I semi-enjoyed was working with microscopic worms (C. Elegans) in genetics lab. Lame, I know, but I guess it was the only highlight of my week... besides finding out that my boyfriend is coming back home from residency auditions in 2 weeks.
Also, he is going to change one of his auditions to one near me that he really likes. So, he might not have to leave the state again until he has to do interviews. I'm super excited for that. He never fails to make me feel better... I need that right now.
What Diabetes Is
Ever since the unicorn frappucino was released, I’ve seen an uptick in “diabeetus” jokes. I’ve also seen people posting pictures of candy and cake and saying “Look at my diabeetus ha ha ha,” as if diabetes is some type of joke.
Diabetes is not a frappucino. There is no such thing as “diabetes on a plate” or “diabetes in a cup.” Let me tell you what diabetes actually is.
Diabetes is a small child dying of ketoacidosis because the doctor in the ER thought that child had the flu.
Diabetes is parents who can’t sleep through the night because they have to get up and check their child’s blood sugar during the night to make sure their child hasn’t gone into insulin shock or diabetic coma.
Diabetes is waking up in the middle of the floor covered in bruises and rug burn because you fell asleep after taking insulin but before eating the food that you took the insulin for, and your blood sugar crashed, causing you to fall off the couch and have a seizure.
Diabetes is having to decide whether there is enough insulin to last until you get paid or whether you will skip a meal or two so that you can take less insulin and save money on groceries.
Diabetes is not getting enough sleep because your blood sugar was too high, meaning that you got out of bed to go to the bathroom multiple times, or too low, meaning that you got out of bed to treat the low and then stayed awake to be sure it didn’t go low again.
Diabetes is going to a trendy eating place and discovering they don’t serve diet drinks because “aspartame is poison” and having them tell you to drink orange juice instead.
Diabetes is finding out that your kidneys or eyesight or digestive system or circulation is failing after you’ve lived with the disease for decades.
Diabetes is having people say “So lose weight and it will go away” or “Your kid got that because you fed them too much sugar”.
Diabetes is living every day with a disease that you know could shorten your lifespan while politicians blame people who have your disease for costing the health care system money, as if it’s your fault your immune system decided to attack you.
Oddly Satisfying
To all the students & studyblrs who figured out learning things on their own
👏👏👏 because our parents didn’t know either because our teachers were clueless because nobody seemed to care because we had no professional support because we can’t afford tutoring because they expected us just to know it because the system is not for everyone because we were desperate for knowledge, good grades, proud parents, a better future, whatever goal you had in mind.
all those hours spent in front of textbooks, PC screens, libraries, forums… all the frustration, tears, anger, fear… will pay off in the end.
you are smart, determined, focused, great…and just awesome, because you did it even with all the obstacles on the way.
Never be ashamed of what you have accomplished. You are not alone. 👏👏👏
Amazing photo of totality in Oregon by photographer Jasman Lion Mander.
I hope this makes some of you in a better mood. Because I’m feeling quite over the day. But this helps a bit.
LOOK AT HIM WIGGLING HIS BOOTY I CANNOT
“A patient suffering from dementia has been robbed of proper functioning, of reasoning, of relationships with their loved ones, of everything. The disease has looted them of their ability to exist in this reality. Rather than pulling them back into your world, through a door that has been locked and barred by a merciless disease, step into theirs. Grant them that composure that their reality is valid, because it’s all they have left.”
Quotes from a social worker in the hospital.
