I give my perspective on being an APP in the ED, be humble and teachable and strike an affect that allows the physicians to speak into your practice

When in doubt, consult the specialist

Julie talks about what makes her proud about her career

She is proud of the connections she made, that she treated her patients how she would have wanted to be treated

Remember to take that intentional time with patients to help reassure and connect with them

Julie talks about a the expectation she sets for patients with abdominal pain - that we don’t find a clear answer most of the time and when we do it’s usually something emergent and surgical so sometimes no answer is good news

Set the right expectation for the ER visit early

She talks about how she reassures patients that may be embarrassed for coming in when they end up not having anything emergent going on

Julie highlights the need to eat and hydrate on shift

Julie talks about the next generation of providers and how she hopes they continue to keep their observation skills and clinical thinking skills intact considering technology advances and AI incorporation

Julies advice to her younger self would be to not let people drag you down

A big thing we need to learn is to not let others poor behavior or flexing of their ego affect us personally, it speaks more about them than us

We need to learn to give constructive criticism without judging

Support the show

Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care.

Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics

Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.

If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.

1st Phorm | The Foundation of High Performance Nutrition

Mindsets to avoid burnout – Julie humanizes the patient and understands that whatever difficult things we are dealing with are temporary and have gratitude

We must constantly recognize possible anchor bias and avoid cynicism to appropriately treat our patients

We talk about our interactions with EMS

Both Julie and I remember working in EMS and the value that EMS brings in their report because they often see a lot of things we don’t get from the history of the patient

Julies advice for the new APP/ER doc - don’t come to premature closure on a diagnosis, don’t be afraid to ask questions, pay off your loans over buying the biggest house and latest toys

We talk about the baseline level of stress we deal with

We talk about technological changes over time and imaging improvements

She talks about the challenges that the Covid pandemic presented and the shortages of different things we have now encountered

Julie still finds meaning in finding the hard differential diagnosis and working towards positive patient interactions, the teamwork in the ER

I talk about the importance of creating an approachable affect so everyone feels free to voice concerns

Go look at the patient when the nurse is concerned

Julie talks about the benefit for new EMT’s and paramedics to reach out and ask for feedback and follow up on their patients, often we don’t have time to pull them aside

EMS doesn’t have the best mechanisms in place for good feedback on every case like we do in the ER, where we see in real time how accurate our assessment may have been when the work up comes back

Support the show

Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care.

Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics

Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.

If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.

1st Phorm | The Foundation of High Performance Nutrition

Started out her medical career as an EKG tech and in EMS as an EMT for one of the first ambulance companies in the area

She saw the disconnect between the provider that people wanted to become and who they became, and she didn’t want that to be true for herself

She became an attending in 1991 and now has close to 40 years in emergency medicine

She became a physician when it was predominantly a male field

Julie talks about some of the things that have changed over time

We need to have empathy for the people that come in for non-emergent complaints and realize that we have the honor in the ED to fill all the gaps in the wider medical system

We talk about the increase in transparency with patients and the access they now have to their lab work, imaging and chart and this helps us increase trust with patients

Julie talks about a paramedic partner she really admired and how well she treated patients, and how there wasn’t a lot of female role models for her in med school

I talk about how I also had partners that really improved the trajectory I was on as a new EMT

Seek first to understand is one of the 7 habits of highly effective people and this relates directly to taking care of patients

Julie talks about how it was to be a woman in medicine and how her voice got dismissed as well as the dynamics that are at play with patients

Julie talks about burnout and how labyrinth therapy helped her. How you need something that helps you look beyond yourself to have a moment of awe and gratitude

Support the show

Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care.

Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics

Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.

If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.

1st Phorm | The Foundation of High Performance Nutrition