coast2coast, MSN, NP 9,145 Views
Joined Jul 9, '10.
Posts: 405 (42% Liked)
Thanks all - the original post was from me but I had lost my login credentials.
I have done a lot of boundary setting with this rep in no uncertain terms and he clearly isn't listening. Hasn't brought me any good offers either - similar to BCgrad, he seems to deliberately ignore my interests and push sub-optimal openings which I'm sure they have a hard time filling. I think my next step is to just block his number.
Anyone have a great experience with another locums company?
Anyone have recent experience with locums salary in and around Chicago, or IL in general?
I see this frequently with psych patients - they want you to engage in a power struggle. Drives me nuts, every single time.
I worked in a FQHC through the National Health Service in an urban community health center. The facility was really nice, but we were treated a like indentured servants (which we kinda were). The staff (MD, NP, PA) were extremely supportive of each other and it was a wonderful learning experience, but I burnt out fairly quickly. We had to see upwards of 30 patients a day and got 15 minutes per visit, be it a URI or a full physical with Pap. A lot of time was spent waiting for available interpreters, as many of the patients did not speak English. I saw conditions I never would have seen in a suburban primary care practice, but we did n't have the resources to spend time with our patients and do sufficient teaching. I never got out on time, never took a real lunch break, and would spend hours of my free time charting. So, I have mixed feelings about it. I did get my loans paid back, I learned a ton and met some great people, but I had no life for almost 3 years and was always stressed.
Minimum 30 days ... My last position I gave them a 'soft' warning at 6 months and official resignation at 90 days, but that is probably an extreme situation (large patient panel being left and clinic couldn't retain adequate number of providers).
There's no way you will see 25+ patients/day and leave at 3pm if this is family practice/primary care. The 'productivity' bonus is a joke, as is lack of benefits. Keep looking.
No offense was intended, I was merely trying to counter what I see as a widely-held belief that things like legal status are not a routine part of healthcare delivery.
An acute care example would be someone needing dispo to rehab or skilled nursing. Sure, a patient can come in emergently and by EMTALA be treated, and immigration status I would agree does not impact that emergency treatment, in general. But what do you do with someone who ends up profoundly disabled, but without the income or health insurance to be accepted into some level of rehab? Like any inpatient who overstays their welcome in acute care, the barriers to dispo become a matter of common knowledge and therefore, at times, judgment. It shouldn't impact care but the potential is there.
I apologize if my original comment seemed to negate your personal experiences, on re-reading I can see how it could come off like that. I just want to engage in a discussion on a topic that I am obviously quite passionate about, not looking to cause offense.
I'm not aware of any healthcare facility that makes any sort of determination of the immigration status of individuals presenting for care. Everyone has been treated the same and no one has asked about immigration status, in my experience.
I think there is a lot of misunderstanding between RNs who perhaps are not familiar with the APRN role.
I've been an APRN for 9+ years and I did absolutely love bedside nursing. However, I equally love my roles as provider and prescriber. Like other APRNs have mentioned, I do help pts. My pts are for the most part seriously ill with a much shortened lifespan. I discuss end of life issues almost daily.
I do provide a service but mostly I provide care.
Best decision I ever made was to leave a doctoral program (pre nursing career). Don't be scared to do what you need to do.
Pediatric Emergency Care:
January 2013 - Volume 29 - Issue 1 - p 63â€“66
Comparison of Rectal, Axillary, Tympanic, and Temporal Artery Thermometry in the Pediatric Emergency Room
Batra, Prerna MD; Goyal, Sudhanshu MBBS
I don't understand this one- I thought that elevated TSH always indicated hypothyroid. Can someone explain this to me?
The highest TSH I've ever seen before was 157. Pt very fatigued, low heart rate, low B/P, overweight, and so on.
Chronic hgb in the 3.5-4.0 range. Dying of metastatic probably rectal dancer, survived almost a year.
a1c 16.9, very alive and one of my best-behaved diabetics now.
TSH 490. Manic but definitely alive
a1c's of 15, systolic BPs in the 200s, and trigs of 3000 sadly become very mundane very quickly in community practice. It's amazing how resilient the human body can be.
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