Aristus
Aristus's JournalHad a nice moment of clear thinking yesterday from the nurse practitioner who is replacing me.
We got called on a Code Blue for someone who had lost consciousness in the bathroom. She wasn't a patient of mine, just a client who comes to the clinic to use the shower and laundry services.
We found her slumped over on the toilet, and helped her regain consciousness. We made sure she was okay, then did an after-action.
Me: "What do you think? Urination syncope? Defecation syncope?"
ARNP: "Fentanyl."
She was right. The patient was on a nod, and no one on the team had caught it when they directed her to the restroom. I tell my team not to bring back patients who are high or nodding, because they can't consent to examination or treatment. Unless it's an emergency, we let them sober up in the waiting room, and then address the problem.
One of the things I really respect about ARNP's is their practical, hard-headed approach to clinical medicine. A simple, no-nonsense method of medical practice.
I think my patients are going to be in good hands.
Last day of clinic at the old job. I guess they wanted me to "finish strong".
I've got so much shit piled up on my schedule, I'm starting to look for a window to jump out of.
Please, don't let this be the day my heart finally gives out...
Last Monday in clinic at my current job.
My health organization's comical ineptitude is on full display here. The provider who is replacing me is pulling a one-patient-per-hour day, to kind of get her feet wet before starting out on her own. I've got a full schedule today, however.
Here's the thing: We only have two exam rooms. They should have cut my schedule today down to account for that. But as usual, it's only $$$ with admin.
One more day of clinic after today, then it's basically cleaning out my desk for the rest of the week.
How come aunts get a cute nickname like 'auntie', but uncles don't get one?
I'm not saying I'd want to be someone's 'uncley', but I think we deserve a cute nickname.
Every time I say goodbye to one of my nieces, I tell them "Bob's your uncle", because it's true. 
Friday Night Bourbon Buzz. Ask me anything.
Enjoying a Rob Roy tonight. Bourbon, sweet vermouth, and a dash of Angostura bitters.
Just finished my last Friday in clinic at my old job. Monday and Tuesday, then finishing up. I’ll need to get a large carton for my office stuff.
They made me work for it today.
Ready for the weekend.
I love you all… 
My last Friday in clinic at the old job. Next week, Monday and Tuesday, then it's clean out the desk.
I hope you will all join me in The Lounge tonight for a celebratory drink.
Have a great Friday, Loungers! 
Enjoying a Kamikaze cocktail tonight.
I thought it would have saki in it or something. But it is vodka, triple sec, and lime juice. The vodka I used is my brand new bottle of Deep Eddy Lime Vodka.
So this is a pretty citrusy drink here. No danger of getting scurvy…
Friday Night Tequila Buzz. Ask me anything.
Enjoying a blue Margarita tonight. Not too bad a day in clinic, but looking forward to the weekend.
I’m really not crazy about blue curaçao. But I have to use up the bottle. So, bottoms up!
I love you all…
I visited yesterday with what I hope is my last anti-vaxxer at my old job.
One more week of clinic to go, so we'll see.
Shame.
We had a fairly pleasant visit, and after I said goodbye, I went up front to give my instructions to my team. My MA came back a few minutes later telling me he had declined the flu vaccine. I sighed, and entertained a vision of myself as a cartoon character cracking his knuckles, balling up his fists, and striding grimly into the fray.
I asked what his objections were to the vaccine, and that I would be happy to clear up any misconceptions he may have about immunization. He hit me with the eye-rollingly stupid "Well, I just avoid the flu by eating right, lots of fruits and vegetables, you know." I skipped past the 'it's a respiratory virus; all the fruits and vegetables in the world can't prevent infection with it" argument, and simply pointed out that immunization isn't just about him, it's about preventing infection in anyone within breathing distance.
Then he tried the seemingly reasonable, inarguable "I'm making a personal choice not to blah-blah-blah..."
I let it go. I'm not empowered to fire patients, but I usually let anti-vaxxers know that they will not be happy having me as their primary care provider. I use science in all my clinic visits.
In this guy's case, I just neglected to tell him that I was leaving the organization in a couple of weeks. If he wants to switch to a witch doctor who rolls chicken bones and recites incantations, I won't stop him.
During orientation for my new job, I'm going to ask if I will be empowered to fire anti-vaxxers and other anti-science nuts. I have plenty of patients waiting to visit with me who trust medical science. I don't want to waste valuable clinic time on the nutjobs.
Friday Night No-Drinking Post.
To my beloved Loungers: I’ve been sick all week, and am feeling a little better. But I’m staying away from alcohol until I feel 100% again.
Don’t let that stop you, and as Joe Biden would say “God love you”. Have a strong one for me, because right now, I’m feeling a little weak and fatigued.
I’ll reply if I can. Otherwise, talk amongst yourselves.
I love you all…
Profile Information
Gender: MaleHometown: Puyallup, Washington
Member since: 2001
Number of posts: 66,316