Not a leap year

My mom's birthday is Feb 29... sounds cool in theory to have a birthday on a day that only occurs every 4 years but unfortunately it doesn't mean that time is standing still in those passing years, so she actually gets jipped - aging without a special day to celebrate although I say she should celebrate for the last half of the day of 2/28 and the first half of 3/1 or get two days to celebrate every year she doesn't actually have a birthday. When I was a kid, I thought it was kind of neat that we celebrated our 10th birthday in the same years, mind you we weren't both turning 10.

March is practically here and that means just 4 more weeks until Mesa AZ!! Can't wait!! Sunshine, vacation and most importantly, Cubs baseball - the last few games before the start of the regular season!

Return to Os

Did 2 paps today - a third one scheduled for tomorrow - only after I sheepishly told the MD that I (and 2 nurses) couldn't find the speculums yesterday (and the last provider told me we had none because we dono't do them) and he opens one drawer that I didn't even know existed and woot - there are 15 speculums - egg on my face, guess I will be apping my RLQ abdominal pain with a white count and some other random woman complaint. Hadn't done any since Ecuador - I was worried I had lost my skill and I was in a bit of dread knowing that sometimes personal hygiene is not on the top of my populations to do list. But all in all great success - all on my own with my cytobrush and spatula in hand I followed the yellow brick road to the land of Os - even managed to find a retroverted one. Yay!

The Boss

My supervising doc called me The Boss about a week ago and has proceeded to occasionally call me boss when I'm in clinic... I do for all intensive purposes run the clinic - with his guidance of course, but I am not the boss of the clinic. So perhaps good readers one can empathize with me in my frustration when I get over ruled to send someone to the ER for a possible ostemyelitis or septic ankle joint. Slightly elevated white count at 13, no osteomyelitis on the xray - just evidence of an old fracture, no abscess, and a couple pieces of hardware. The ankle is now warm, red, pt is afebrile, still weight bearing, and is no other medical concerns(transient HTN) but I know if I saw this person in clinic - I would send them straight to ER. But in my setting we do things a smidgen different - the object is not to send them out, do as much as we can in house as it poses a threat to the community, the hospital and officer safety for people to go from our facility to one in the "free world". I may sit on a chest pain until troponins are sent back and read elevated from a stat lab, despite not having any change on the ECG. I wait on a hyperkalemic patient until they are above 6.2 - even though at 6 they can have fatal ectopy, not sending someone with lower right abdominal pain with a fever until blood work is back and a KUB, which both turn out to be normal. It's a slippery slope and an awkward phone call to a seasoned professional to say doc, I think the pt needs to go, because I am uncomfortable and you have not seen the patient, the command staff is asking me to override you.

In light of the not 1 but 2 or 3 contorted articles in the paper about a particular facility, I cringe knowing there is a slippery slope being a PA, using my best judgement but working and consulting with a physician - someone who is seasoned to make the best decisions to present to the patient. This is the one and only time I have thought to myself, I wish I were the doc right now.