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Adult Internal Medicine, Hospitalist
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BostonFNP specializes in Adult Internal Medicine, Hospitalist.


BostonFNP's Latest Activity

  1. BostonFNP

    Hot Cheetos are a public health menace

    They should use the line from the article above.
  2. BostonFNP

    Hot Cheetos are a public health menace

    "To purchase a bag of Flamin' Hots is to dance with the devil, to throw one's fears of an inflamed brown eye to the wind in favor of the spectacular, mouth-searing present." I just love this line.
  3. BostonFNP

    Worried sick that I may have caught MRSA?

    What do you mean 'what .. does that have to do with the topic'? It's literally the basis for your whole post that you are concerned you have MRSA from indirect contact with a patient you (incorrectly) assumed had MRSA because they were on Bactroban.
  4. BostonFNP

    Worried sick that I may have caught MRSA?

    Are you saying you looked up this information because it was pertinent to his care or because you were concerned about your interaction with the patient? Is Bactroban an appropriate treatment for cutaneous MRSA infection? It's not so I have some doubts it was in his record that he was being treated with it for this reason. I am really not trying to pick every single word, I am expressing concern at a lack of basic nursing judgement and understanding. I really don't mean to offend you but I would expect a nurse to know that Bactroban isn't used to treat an active cutaneous MRSA infection.
  5. BostonFNP

    Are We Letting Our Patients Suffer?

    The DEA does not have any regulations that limit the dosing of CSII meds. There may be state regulations or insurance quantity limits that impact this. Also, it is important to note, trial dose reductions are recommended at regular intervals to ensure patients remain on the lowest possible effective dose. Beznodiazepines are also addictive, associated with poor outcomes especially in the elderly, and vastly over/inappropriately prescribed.
  6. BostonFNP

    Reportable BRN incidents

    The main issue isn't the "late waste" (as the waste never occurred) its the willful falsification of documentation. You are in some trouble here, hope you can get a lawyer. Your colleague is also in some significant trouble. And it sure makes it seem like this type of thing happens with some frequency..
  7. BostonFNP

    Worried sick that I may have caught MRSA?

    These kinds of posts really worry me on so many levels. Starting with the entirely off base assumption that the patient is being treated for cutaneous MRSA with topical medication and ending with "checking the record" on a patient you weren't directly involved in the care of.
  8. BostonFNP

    Are We Letting Our Patients Suffer?

    I'm not sure that this is how we should be teaching nursing students, perhaps it is time for nursing to update the way we think about pain management to be more dynamic and patient-centered than just having pain be pain.
  9. BostonFNP

    Can I please get a Parking Spot!

    Why do you think the doctors get the free parking and no one else does? They aren't unionized so it isn't the union picketing for them to get free parking and I haven't seen them on the corner holding signs demanding it. So what then? As I see it there are two reasons: they directly make money for the hospital and there are far fewer of them. I am a nurse. I also do directly bill/generate revenue. I don't "consider" myself that because I'm snooty it is a pure fact. Bedside RNs get screwed because they don't bill for services. Its not that nurses are "lowly": its that they are treated like hourly labor. Nurses need to change that and with that will come more specialized treatment. I've been there too, I understand. If nurses were given free on-site parking with the doctors but the housekeeping and sanitation employees weren't would we be as up in arms about it?
  10. BostonFNP

    Hot Cheetos are a public health menace

    Be honest here: have you ever read any research on this topic? It can be rhetorical but it is something to consider. I am willing to wager most people commenting here have not. There is a vast amount of research and data on this. I hesitate to suggest a single article to read, but if nothing else, people should consider reading this: Drewnowski, A., & Specter, S. E. (2004). Poverty and obesity: the role of energy density and energy costs. The American journal of clinical nutrition, 79(1), 6-16. I'd be happy to provide the full text to anyone that can't access it. It is an older article that has been reaffirmed by major papers dozens of times and has been cited nearly 3000 times in other scholarly work.
  11. BostonFNP

    Oversupply of Nurse Practitioners

    Sorry about the job loss, hope it all works out for the best. I have to say in some ways I am jealous. I've been trying to persuade my wife that when we get a bit older to sell the house and live on a trawler and move as we see fit. I was fortunate to spend a month a year with my aunt and uncle every year growing up in the cruising community in the out-island Bahamas. They had a 38' Krogen and it was some of the best memories of my life. Recently we cruised by a Nordhaven 52 that was for sale and I started talking about doing the Great Loop and then moving on to other cruising and she looked at me like I had 10 heads. If I was single I would have done it yesterday. I am fortunate to be a partner in a practice. I love my patients, and like my aging partner, I will have a hard time exiting practice when the time comes. Interestingly enough I have been talking recently with several successful independent NP derm practice in hopes that when my time comes (either age or reimbursements for PCPs hitting a no longer feasible number) I'd slide over into some cash derm/cosmetics business.
  12. BostonFNP

    Hot Cheetos are a public health menace

    Unfortunately here your observations are subject to your implicit bias: those with means want to assume that those without means are without means due to their own bad decisions. It it is as simple as looking at the readily available data and publications. Poor families are subject to limited access to full-service markets, limited access to a vehicle to do their shopping with. Overall healthy food is more expensive and more perishable. The healthy foods that the poor have access to tend to be of poorer quality. And the poor have far better access to fast food than healthy food. Add to that the building of generation on generation of less healthy choices. Its convenient for most of us who have never had to go without a meal to assume that others made their own grave, but largely that's not the case. And for those posters that like to joke around about social justice warriors and sour faced saints: I'd much prefer to be that than a bigot, I take it as a compliment over the alternative, including complacency.
  13. BostonFNP

    Hot Cheetos are a public health menace

    I patient just brought me in a bag of "Takis" Fuegos. Talk about timing, I had never heard of them prior to this thread.
  14. BostonFNP

    Hot Cheetos are a public health menace

    I don't either. I guess some people feel like the poor is spending their tax money on things they don't approve of so they have the right to judge them. I wonder if the poor approves of spending $8 on a pumpkin spice latte?
  15. BostonFNP

    Hot Cheetos are a public health menace

    Absolutely and for both sexes! Combine it with nutrition. Get kids to start changing their parents way of thinking. I do think that the poorest in out country still have trouble with this because of reasons most of us don't even think about: having the electricity and gas turned on, having a working stove or refrigerator, having a safe kitchen/home to cook in, having a responsible adult at home to do the cooking, having the time to shop, etc.
  16. BostonFNP

    Are We Letting Our Patients Suffer?

    Are you a prescriber? How it works for me: Prior to writing any script for a schedule II, chronic or acute, I need to login to the Prescription Monitoring Program (which interconnects with 33 other states) and assess the prior CS history and document my assessment. I can then write a 7-day (acute initial) or 28-day script (acute additional or chronic) which needs to be on hard copy and hand-signed. That script can either be handed to the patient or mailed to the pharmacy. Patients can not fill another script until 2 days prior to the end of the previous script. If the pharmacist has concerns they will call. If the insurance company requires a prior authorization, then that needs to be done or the patient has to pay cash.