Provider Decision Fatigue
Briana Juskowiak Briana Juskowiak

Provider Decision Fatigue

One of the best perks about leaving bedside was the reduced physical strains. No more tired back and aching knees. No more needing to sleep for a solid day following a stretch of work shifts. That was the expectation at least. The universe quickly let me know how mistaken I was. Not because of aches and pains, but mental exhaustion. The day after work stretches were still demanding of recuperation but for very different reasons now. I would race through each work day, moving from one set of problems to the next, trying to outrun the fear of making a mistake. It was exhausting. And after I left for the day, the endless rehashing of all the hard choices I made and the associated burden left me in a hazy state of indecision for even basic life decisions. Chicken or fish? Can the youngest go for a sleepover tonight? Should I shower or just go straight to bed??? The inability to make rational decisions after a long day at the hospital (especially in the beginning) was unexpected. It’s something I talk to training and new NPs about a lot, because in my mind, if you are aware of it you will experience less isolation and imposter syndrome. In this post I’ll talk about what it is, why it’s so bad in this new role as a nurse practitioner, and what you can do about it.

Read More
Clinical Pearls: Is it DKA or HHS?
Briana Juskowiak Briana Juskowiak

Clinical Pearls: Is it DKA or HHS?

Should be pretty straight forward, but even amongst seasoned providers this can sometimes be debatable. Especially when you don’t have all the labs back. Often we are called to admit a patient for DKA because they do not seem appropriate for a routine floor or even step-down ICU admission. The Internal Medicine/Hospitalist team may not feel comfortable taking a patient but on your evaluation they do not seem to be on the severe end of the spectrum. You aren’t alone, my friend. Let’s talk about admitting a DKA vs HHS patient and how you make a diagnosis.

Read More