In Practice: Recent Episodes
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Reflections from nurse practitioners and physician assistants on the frontlines of clinical medicine
Sarah The neighbors called the police when they heard screaming. An officer discovered her hiding in a closet in a trailer. In the emergency room bay, I find Sarah naked except for a T-shirt. Her legs are drawn up, arms wrapped around her knees, head down. She looks severely malnourished, and her teeth are broken […]
As I first ventured into motherhood, I was often asked by my sisters, friends, and colleagues how I did it. Not only how I was able to be a mom while also working full-time as a regional nurse practitioner, in a role that involves frequent travel, but how I made it look so easy. To […]
When I met my doctor in the hall for rounds this morning, it occurred to me that I hadn’t seen her for a good month. We had each been alternately away — me camping in Iceland and my doc on her own holiday in sunny Spain. As she gave me a warm hello and asked […]
It’s one of my favorite times of year. The colors of the leaves are changing, there is a crisp feel to the air, and it’s Halloween time. The candy aisles are decimated, kids have donned their costumes and hit their preplanned routes or parties, and even some of the grown-ups have dressed up and managed […]
Yet again this year, a familiar tale has dominated the news cycle: allegations of an individual who weaponized his power and influence to abuse colleagues and coworkers. While the high-powered world of Hollywood producers and movie stars might not resemble most of our workplaces, the underlying abusive mentality of Harvey Weinstein’s decades-long rampage is probably […]
Emergency medicine is a life of interruption. Physicians, nurses, PAs, radiology techs, registration clerks: we are all constantly interrupted or interrupting. Unfortunately, interruptions and distractions and the consequent attention shift may lead to error. Sometimes, we fail to return to the original task, make an error in that task, or waste time on less urgent […]
“My heart hurts,” said Brooklyn, then three years old, as she grabbed her chest and sat down. Quickly checking the girl over, Brooklyn’s parents felt her heart indeed pounding in her chest, and took her to the emergency department. There, they were shocked to hear that their daughter was in cardiac arrest. Shortly afterward, Brooklyn […]
First I noticed it all over my social media feed — the story of Alex Wubbels, a burn unit nurse at a university hospital in Utah who was arrested and manhandled by police for not allowing them to take a sample of blood from an unconscious patient without a warrant. Then came a slew of […]
A year ago I wrote a blog for In Practice and an editorial in the Journal of the American Academy of Physician Assistants (JAAPA) that discussed the factors contributing to the opioid epidemic in America. If the passionate reaction to those articles is any indication, the topic stirred both intellect and emotion. Since then, the issue […]
A 34-year-old male presents to the emergency department with right arm weakness. He woke up 2 days ago unable to move his arm. The patient reports having hypertension but has no history of diabetes, stroke, cardiac disease or tobacco use. He drinks alcohol daily. The patient complains of numbness and tingling in his arm. He […]