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We used the PAD guidelines did extensive education before we went live. That included provider education and nursing education. It went surprisingly well and quickly became part of the culture. It helped that we had early buy in from our nurse manage...

Caveat, I work in a surgical/transplant ICU so things may be different in other ICUs. Separate out the drugs by what they do. Fentanyl is an opiod so it affects the opiod receptors and provides pain relief with some sedation. Propofol and Versed wor...

Not sure where you work or what general family practice physician is. It sounds like you are combing general practitioner and family practice. For the record a family medicine is a three year residency according to ACGME. Also the med students we wor...

The OP will probably get a better idea of the PA role at http://www.physicianassistantforum.com/ There are several Army PAs or former military PAs that routinely post. The Army routinely uses PAs at the battalion level as battalion surgeon. However,...

here is the direct quote from the rule: "If the delegating physician authorizes the APRN to order an X-ray, ultrasound or radiographic imaging test, the nurse protocol agreement shall contain provisions whereby such tests shall be read and interprete...

I've scanned plenty of wounds and never seen suture. When we US the liver transplant you can't see the suture and that's much larger than what the OP was talking about. Also, why would you use Vicryl for a vertical mattress? Something nonabsorbable w...

The sutures won't be visible on US. Its unlikely they are there at all. More likely this is scar tissue or early keloid formation. I've never seen a vertical mattress retained if it was taken out in normal fashion.

We have very broad privileges. EKG is a separate privilege. The usual issue is the report not people reading them. I had a patient with a STEMI treated sent to cath lab. Got a phone call the next day when they read the EKG that the patient was having...

We have 9 ICUs in three hospitals. Around 90 PAs and NPs. We work 13.5 hour shifts (6a to 730p) with an hour overlap on each end for sign out. We are salaried so we don't get overtime. We pay extra shift premium if you work extra shifts. There is als...

Probably not. The real answer is that when the patient had an indication for dialysis (hyperkalemia, acidosis, or volume overload) they should have been transferred to a center capable of doing CVVH. In answer to the OPs question, in the ICU RIFLE is...

I'll say as a PA it doesn't make sense. If you look at the time you are looking at 24-29 months full time (ie little to no outside work). In addition its unlikely you have all the pre-reqs so factor in that time. Around here post masters FNP is three...

The issue is the hospital employment. If you were employed by the surgical group then the group could bill for your services. If you were independently employed then you could bill for your services either directly (as an NP) or through a separate co...

Dumb rule. There is a lot of confusion on this. The FDA correctly pointed out that POC glucometers have not been tested in critically ill patients. They proposed a rule that basically took POC glucometers outside of the CLIA waiver process. It would ...

With a large organization there should be two departments that can help you here. The first is credentialing. They should be doing the paperwork for licensure and making sure everyone is following the rules for licensure. Ask them for your standard p...

You are correct. It isn't a Medicare term. I'm guessing that its either their term for shared billing or trying to bill under the physician NPI without seeing the patient (ie fraud).

For what its worth, shared visit allows the physician to participate in one part of the E/M then bill the entire visit under the physician NPI at 100%. Shared/Split Service - The Hospitalist The ins and outs of billing for shared visits

For Medicare to bill shared billing you have to have a 1099 or W-2 relationship with the same group that employs the physicians. Most private insurances do not credential PAs or NPs so billing is done under a physician. Theoretically, you can be empl...

There are a number of problems with this. The biggest problem is you won't be able to bill. You need to have a W-2 or 1099 relationship with the physician group to bill. Also there a number of issues medicare issues. Finally if the hospitalist group ...

I'll point out that this does not support your claim that the elderly have a higher rate of pneumonia related mortality, only that the vaccine does not appear to change that mortality. Also I don't see any evidence of a "10 year NIH cover up". The ar...

I would add always have a plan B. What if you can't get a job as an ID NP? Would you be satisfied with something else. If not you may spend a lot of money for a job that isn't there. ID is a very narrow niche where jobs are few and far between. There...

This seems somewhat doable. Its going to depend on your case mix. If you are being shunted all the URIs etc then you won't have as many RVUs as if you have more complex patients (although if you can see more you can make up for this). Here is a pre...

The market is pretty limited up there. There is only one hospital in Cumming and its a smaller community hospital that does a lot of L&D. You have to go a ways toward the perimeter to find more inpatient work. There is a fair amount of Urgent Car...

Why does anesthesia get any say in an ICU patient? How does anesthesia secure OGs when then send them from the OR? I would bet its taped to the ETT. We have a tube holder to secure the tube and then tape the OG to the ETT.

One of our centers now has a night shift. It goes from 10 to 3 AM or so. The thought is people can sleep in the chair and still get to work.

I was actually replying to a previous post that listed ER and hospitalist. Our hospitalist group only uses ACNPs. There are a few family medicine programs out there that admit adults and kids to the same family medicine floor (in some relatively larg...