TakeBack

Hello all, I am a PA and would like your feedback. When recruiting for any given position, do you feel that the hiring practice should have a preference for one credential over the other? E.g., should a Family Practice only/preferentialy recruit for ...

Thanks for all your feedback. I'm eager to hear more examples if you have them.

This is a great example. I agree that out of the box an NP with this specialty focus in training and RN experience wins hands down. I still feel that I wouldn't NOT recruit a position excluding one group because, as you said, there are experienced PA...

The question for me is how to recruit. Is it appropriate to recruit for a position SOLELY to one or the other. Do you post the Surgical job ONLY to PAs, the Family Practice SOLELY to an FNP, etc.

I think we're getting at the same idea from different sides.It's impossible to predict the result of one intervention (say, volume loading/increased SV) when the other variables are not fixed. It sounds like we agree that textbook scenarios don't uni...

It is really difficult to say that volume loading will have any absolute effect on SVR. Resistance results from the interplay of flow (CO) and vascular tone. With fixed tone and CO the SVR would increase with IVF. However EVERY pt responds differentl...

The main reason they require volume is due to the massive third spacing from cardiopulmonary bypass/inflammatory response, and the use of vasodilating agents for anesthesia and postoperative sedation. The thoracic pump mechanism you are suggesting wo...

why was the pt unresposive w/ a SBP 180? 300 amio IVP is usually given w/ VF/unstable VT. This sounds like hemodynamically stable VT if I'm reading you right.

The pacer will protect the pt from bradycardia caused by dual therapy, but NOT from potential ventricular arrhythmia 2/2 dig toxicity. Levels should be monitored.

Here's the latest comparison, PA-NP head to head per specialty In some the difference is marginal, in others, significant. National Salary Report 2011 on ADVANCE for NPs & PAs

noncardiac chest pain- musculoskeletal pain esophageal spasm pneumonia/pleuritis PTX abd source etc

Bengin in spectrum of postoperative complications, overall arrhythmias, and epidemiologic data on liklihood of acute decompensation. Numbers are numbers.

certainly- just sharing my clinical experience. My Masters specialization was in AF and I have taken care of easily >1000 AF pts. Most tolerate it, FWIW. Instability is rare and the most common reason they seek treatment is palpitations/anxiety/fa...

AF in and of itself is benign. Having dealt with easily >1000 pts with AF, most tolerate it very well. I have had to cardiovert pts for instability but it is rare. As I said above the greater risks are from the treatment not the condition, as you ...

There will typically be some shift after pneumonectomy. The concern for shift is with a tension situation- pneumo or hemo. Tension effects re assessed with echo, invasive monitoring numbers (swan) and clinical parameters.

Cardiac Surgical ICU acute control, target IVP- hydralazine, metoprolol/labetalol gtt- NTG, nicardipine, fenoldopam, esmolol

I'm thinking you meant A fib, not V fib? Your initial rhythm was likely AF, flutter, or an SVT. AF is extremely common after thoracic procedures- cardiac, pulmonary, esophageal. The numbers for cardiac pts range from 20-50% depending on the type of o...

I appreciate that- my point is that it's not a blanket statement. The OP posits a specific scenario- a pt with initial ECG changes and unreleived CP, refractory to initial medical therapy. The medical necessity aside, there is the medicolegal concern...

the OP was discussing patients admitted to a coronary care unit...which means they have made it there on the basis of CP PLUS one of the following- ECG changes, enzymes, angina hx, family hx, or risk factors (to name a few). That is the context of th...

Not everyone with CP. But patients with unremitting CP despite NTG and antiplatelet/anticoagulation, yes. Unless they are not a PCI/CABG candidate.

Unremitting CP gets a NTG gtt and intermittent MS. And a trip to the cath lab.

-I've had one anesthesiologist give lasix in the OR but it is not common in my experience. BUT....every practice differs. Cardiac pts suck up volume so it would be an odd choice to diurese during that period. -Transfusing to a hct of 30 is a thing of...

Keep in mind that for now, you still have the option for the masters NP but you will need the BSN first. Also, NP education is structured such that you can work as an RN during the schooling, allowing you the income. PA programs are full time so you ...

i have to post this to your group..... a recent post on pa forum said that on the np boards the student "was asked to supply a reason for why an employer should employ a np instead of a pa". is this true?

That's my point. Most are ready on POD#0. Perfunctory "rest time" is a thing of the past and has proven worse outcomes. All stable pts with adequate gas exchange should get a breathing trial on the first day.