I had my first jaw dropping patient last week. You know, working in cardiology, you see a lot of the same thing. Acute coronary syndrome, atrial fib, heart failure...Turn 'em and burn 'em, that's my motto. Thursday, I had my first patient that I was completely side-bombed over. That day, an 86-year-old female presented to the ED for ...

My first encounter with homelessness was while living in Ecuador. Homelessness there is pervasive and hard to miss. It is present on most street corners and does not discriminate, affecting both old and young; it is quite merciless and ruthless. I remember seeing kids as young as 3 years old with plastic cups begging on the streets. They had a ...

You don't have to break the law to fail a pre-employment drug test. In fact, you could lose your job just by using countless products hanging on the wall of your local gas station. That's because at my hospital, when an employee's urine drops into that little plastic device during a pre-employment drug screen, it is checked for ...

If I could give any future medical student advice about the ER, my three most important words would be: Vicks Vapor Rub. When I first entered the ER, I was prepared to be jaded, but I was not prepared for the smells: abscesses, STDs, rotten teeth, body odor, mildewed t-shirts, alcoholics, chain smokers, drug-addicts, and diarrhea diapers, to ...

''Mr. Lee'' is a 35-year old Asian male with HTN, HLP and DMII who had s/p stent placement in his LAD two years ago. He has stopped taking simvastatin, lisinopril, Metformin and aspirin, does not exercise, continues to smoke, and does not check his blood glucose at home. Despite adequate amounts of patient education (and a psych evaluation), ...

Over the past month I have had some very challenging patients. I will often question, why and how did someone end up here at the correctional facility? I believe it is better I do not know. Actually, it is none of my business; it keeps the care unbiased and pure and it does not impact how I treat them. If one of the inmates upsets the ...

''Suicide is so frowned upon in this society, but honestly, life isn't for everybody.  It's sad when kids kill themselves 'cause they didn't really give it a chance, but life is like a movie: if you've sat through more than half of it and it sucked every second so far, it probably isn't gonna get great right at the very end for you and ...

I was going to write a blog about neuro-syphilis because I just recently treated a 29-year-old patient for this condition, however, on reflection it seems more apt to discuss the enormous financial costs associated with her care. That being said, neuro-syphilis is a tricky diagnosis; I advise clinicians to read up on it. Syphilis is commonly ...

Last week, NP and PA readers submitted questions to our communities asking for advice from fellow clinicians. Below are a sample - if you have any advice for these NPs and PAs, comment on the respective article or share with us here and we'll make sure to pass along the wisdom. Have something you'd like a clearer answer on? Let us know on our ...

My contact with pain patients was extensive during my residency in Aurora, North Carolina, a coastal town of about 400, with a patient population compromising of retirees, commercial fisherman and above-ground miners from a phosphate mine. I knew from that experience that even if I never found a job as an NP, I would not choose to do pain ...