If the Medical Intensive Care Unit has a scoreboard, I don't want to see it. Some days it feels like the home team always loses. Patients that look like they are about to recover take a nosedive. The real fighters eventually give up. The most hopeful clinicians must face the grim inevitable. But sometimes you just need one, good ...

For as long as I can remember, NPs and PAs have been repeating the mantra of ''same care, less cost.'' I am beginning to wonder if our some of our messages are now coming back to haunt us. It wouldn't be the first time good intentions turned out to have unintended consequences.   When I was a student I once discussed this very subject ...

I had a student ask me recently if I had a dermatoscope and if I could show her how to use it. The answer was simple enough. No, I don't need one. This of course led to the logical question...Why? This blog post was inspired by this exchange. The simplest answer to this question is that if I see something that looks abnormal, I biopsy it. ...

Her only enemy was time. There was too much of it. As my patient lay in her bed and slowly suffocated, each tick of the clock brought a desperate battle to stave off panic. Ms. M had dealt with her difficult lungs for years. Without explanation, the delicate tissues and air sacs had hardened and scarred; they stiffened and refused to ...

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 ...

Above, a 75-year-old patient with stage 4 metastatic melanoma. He came to us after a staged excision and graft. The black dots are new satellite nodal mets. Above, metastatic satellite lesions on the scalp of the same patient. He had the original scalp lesion treated numerous times with LN2. The lesion continued to be treated with LN2 ...

So I go from working part-time as a nurse to not really working and just doing clinicals. My preceptors were pretty good about working with us regarding schedules, which was amazing because I have 2 kids and a crazy husband. This was more beneficial than I EVER realized! Now? I realize... Let's see... In my first three weeks, I've gotten ...

As I approached high school graduation years ago, my Health Careers teacher shared the popular modern parable, Who Moved My Cheese? It is a story about mice and miniature people who look for cheese (a metaphor for happiness and success) in a maze. Silly, for sure, but I found that the story's lesson sticks its nose into my life on occasion. ...

Well, as you guys know, I've passed boards and have already accepted a position in an acute care setting. I actually started yesterday and am so excited! So far I've been in orientation and the anticipation of actually rounding and caring for patients is killing me! I start rounding next week and am really looking forward to sharing this ...

''ED personnel to the stabilization room in 5 minutes.''  This is a common overhead page in the ED where we treat patients with serious MVA injuries, gunshot wounds, cardiac arrest, respiratory failure, or altered mental status. As a student, my responsibility is to assist with CPR when needed and be the ''recorder,'' writing down ...