Eye complaints, particularly vision complaints, can seem daunting to a provider in an urgent care or emergency department setting. The eye is a complex structure. The anatomy and the neurology behind vision is intricate. Often, you may be practicing in an environment without the ability to consult an ophthalmologist. An understanding of urgent and emergent eye and visual problems is crucial. This post will deal with painless vision loss.
Healthcare workers know that their job never ends. Patients don’t stop coming to the hospital because it is a weekend, holiday or late at night. Therefore, we provide 24-hour coverage and support in order to take care of our patients – because that is what we do! We are super-humans who save lives! But at what cost? At some point in your career you have likely had to take on night shift and that means that you have to fight your own circadian rhythm in order to stay awake! How messed up is that?!? This is my personal survival guide (with help from my nurses) for surviving the vampire shifts! I will start this list of with more serious topics to take note of. Then, in true night shift fashion, we will take a 90 degree turn and jump off the deep end with some fun suggestions from those who have made a few life mistakes previously![Read more…] about Night Shift Survival Guide
In our last edition, we discussed some ways of altering practice models or properly documenting patient care so that we stay within the current MIPS guidelines while continuing to provide the highest quality care. In this edition, we will discuss some of the MIPS guidelines as they pertain to Radiographic studies that are commonly ordered in ER/Urgent Care settings. As always, appropriate documentation as to why, or why not, a test was ordered is crucial not only for MIPS, but from a legal standpoint as well. So, let’s get into it![Read more…] about Decoding MIPS in Emergency Medicine – Radiology Edition
“Don’t Hurt Anyone”
My first job as a nurse practitioner was ideal. I knew all the physicians. I knew all the nurses. I knew all the administrators. Yet, I was scared beyond belief. First and for most I did not want to hurt my patients. Second, I wanted the staff that I worked with to accept me as a competent nurse practitioner. I remember clearly two conversations from those first few days; “John, don’t hurt anyone” and two, “John, one of the most important things is know what you don’t know”.
In case you have been in a news and media blackout recently, Measles is back. I have seen headlines such as “Measles cases rocket toward record level”, “555 Measles cases spread to 20 states,” and “Measles outbreak hits ‘completely avoidable’ 25-year high”…despite being declared eliminated in the United States in 2000. If you are still in current practice, odds are that none of us have seen measles in front of us or thought that we had pretty much eliminated it. Personally, I have only seen one case a few years back and it was in an un-immunized child of a migrant farm worker. To be honest, it could have been very easily overlooked as just another “viral illness” or “viral exanthem”. Sometimes, it pays to be lucky rather than good. The purpose of this blog is to help prepare you in case this walks into your practice setting…making you both lucky and good.[Read more…] about MEASLES: Coming soon to a practice setting near you (Are you ready?)
“This is it!”
This was my thought as I am aboard the plane from Phnom Penh, Cambodia on my way back home to Dallas, Texas. I had just spent 2 weeks in Cambodia – my first time after having been lucky to survive the Khmer Rouge. I was both exhausted and emotionally charged after a week of providing anesthesia on the medical mission trip and another travelling through Cambodia.[Read more…] about What’s Your Mission: Part 2