Category Archives: Emergency medicine

Advanced practice, critical care, Emergency medicine, medicine, Nursing

The Entitlement of Respect

If you want respect just because of a title, go to medical school.

That may sound harsh… but I believe it to be true.  Let me explain a little further.  I have heard time and time again how demeaning and insulting the term “midlevel provider” is when referring to Nurse Practitioners (NPs) and Physician Assistants (PAs).  Arguments such as “nothing I do is midlevel” have been made time and time again by NPs and PAs who are striving to gain the respect and recognition of their peers in the medical community.  The latest term that all sides have mostly agreed upon is “Advanced Practice Provider” or APP, although I feel that this term is still a somewhat vague representation of what our role entails in today’s healthcare system.  Continue reading The Entitlement of Respect →

critical care, Emergency medicine, medicine

The power of the story

I love a great story.

There is truly no substitute for the way a woven web of words can play to your sensibilities. If you think about an incredible movie, the CGI is what makes it come alive in front of your eyes; however, without a great story line, it all falls flat as smoke and mirrors. Medicine is no different. As we come to love and embrace the sexiness that is advanced scan techniques, ultrasound, robotics, it is easy to lose the more human element of the people that stand before us.

“We need a little help down here.”

The emergency department called with a 40 year old male, diagnosed with bilateral pneumonia, who they were having difficulty oxygenating. The report that they received from the flight crew was that he had been sick for approximately two weeks. Had seen his PCP 4 days ago, been prescribed antibiotics, no real improvement. Progressive dyspnea today and his wife called EMS.
On my arrival, his 02sat was 79%. Violent coughing, froth to the OETT, normotensive, tachycardic at 135, significant JVD.
Patient was more heavily sedated, decreased tidal volumes, increased PEEP and achieved a sat of 91. I took a quick look at his CXR while someone retrieved his wife.

“So he’s been sick for about two weeks?”

She immediately gave me that look that my dog gives me when I try to discuss the intricate details of this week’s episode of “The Walking Dead” with her.

“Huh?”
Continue reading The power of the story →