u/Local-Butterfly9669

I've been driving a 08 Nissan Maxima for what feels like forever, and it finally died on me. I'm excited to upgrade to something a little nicer, but I still want to make a smart financial decision and buy something that'll last.

Here are the three I'm considering:

• 2023 Toyota Corolla SE - $22,300 - 59,431 miles
• 2024 Toyota Camry XSE - $21,900 - 70,217 miles
• 2022 Toyota Camry Hybrid XLE - $24,900 - 61,231 miles

My thought process:

• The 2024 Camry XSE is the cheapest despite being the newest, which makes it tempting. The downside is it has the highest mileage. But 70k miles on a Toyota may as well be brand new.
• The Corolla has fewer miles and should be cheaper to insure and maintain, but it's also a smaller car with fewer features.
• The Camry Hybrid XLE costs about $3,000 more, but it's a Hybrid so I'm wondering if I'd make up a good chunk of that in gas savings over the next couple of years since I drive quite a bit.

If all three have clean titles, no accident history, and good maintenance records, which would you choose and why?

I'm traveling to Puerto Rico from the mainland U.S. with a friend for 4 days next week and am trying to decide which rental car company to use at SJU.

Seems that the cheapest options are Sixt and Hertz. The reviews for both are pretty mixed, but TBH that seems to be true for almost every rental company.

One thing to note: I don't own a car back home, so I don't carry personal auto insurance. I have a valid driver's license, but I'll need to purchase the rental company's insurance.

I'm willing to pay a little more (within reason) if it means an easier, smoother experience. Sixt is the cheapest, but I've read about hidden fees and the need to take a shuttle to the rental location. Since we'll be landing in the late evening, I'd really prefer to avoid shuttles and extra steps if possible. I could also very well rent off site but Ideally, I'd like to walk off the plane, head to the rental counter, and be on my way.

Has anyone rented a car at SJU recently and had a genuinely easy, hassle-free experience? Which company would you recommend?

I'm starting to plan a Mother's Day trip for May 2027, and I'm looking for destination ideas.

The trip would be for me, my mom, and my grandmother. My grandmother has never traveled outside of the U.S., and I'd really love to make her first international trip happen while she's still able to enjoy it.

The challenge is her mobility. She is a wheelchair user 70% of the time. She can walk short distances (think walking around the house/to her porch swing or standing just long enough to take a shower or cook a quick meal), but anything beyond about 10–25 feet requires a wheelchair or mobility scooter. She isn't completely immobile, but sightseeing on foot or a lot of logistical hurdles isn't realistic.

On most family trips, my mom ends up spending the entire vacation pushing the wheelchair, figuring out accessibility, and making sure my grandmother can participate. I don't want that this time. The trip is for both of them, and I'd like my mom to actually get to relax and enjoy herself too instead of being a full-time caregiver. We are not picky with things to do and I believe anything will be exciting to her since she has never really traveled outside of the Southeast US.

I'm looking for an international destination that's:

• Good for a 3-5 day trip from the SE U.S.
• Very wheelchair accessible.
• Easy to get around without constant physical strain.
• Has enough to see and do without requiring lots of walking.
• Preferably somewhere that feels like a genuine international experience since this would be my grandmother's first time leaving the country.

I'm open to pretty much anywhere under a 10 hour flight. I'm also willing to pay extra for things like accessible transportation, guided tours, or other services if they make the trip easier.

Are there destinations that surprised you in terms of accessibility, or places you'd avoid?

I'm about 3.5 months into my first job as a new grad PA and I'm in a very high-acuity inpatient specialty at a large hospital. I trained on days for about two months and absolutely loved it. The pace, the teamwork, the workflow, I genuinely looked forward to work.
Now I'm on the shift I was actually hired for, nights.

The problem isn't that nights are "harder." It's that the workflow is completely different, and I've realized I just don't enjoy it nearly as much. There are only three of us on nights versus around ten people on days, so everything feels different. I also don't really click with my night shift coworkers the way I did with the day team.

It's gotten to the point where I dread going in. Not because anything terrible happens at work, but because I just don’t enjoy the work as much as I did on days.

Complicating things:
- I specifically asked for nights when I accepted the job, so now I kinda feel obligated to it. Nights are not the problem. I still prefer nights but maybe just not in this role..
- I took a $10,000 sign-on bonus with a two-year commitment, and realistically I couldn't pay it back right now because it helped me get back on my feet after PA school, so I am just starting to build my life back.
- I genuinely like my manager, my attendings, and the organization. I want to continue working for this company for the foreseeable future. They've been incredibly supportive of me as a new grad. I don't want to burn bridges or bail after only a few months.

I also work 7-on/7-off, which I actually love. The schedule itself is fantastic. I like being able to stretch PTO into long breaks. The downside is that because our night team is so small, taking PTO means my day shift coworkers have to cover my shifts. I don't care if the hospital is inconvenienced, but I do feel bad putting that burden on people who have been good to me.

So right now I feel...trapped isn't quite the right word, but close. Part of me says, "Give it a year. You're a new grad. Everything feels overwhelming." Another part of me is already mentally counting down the two years until my bonus obligation is over.

Has anyone else realized early on that they didn't actually dislike the specialty, they just disliked the shift or workflow?

If you stayed, how did you mentally get through it? Did things improve after you became more comfortable, or were your first instincts right? I plan on staying the two years because financially it makes more sense but man, am I counting down.

I'm struggling with some serious cat mom guilt and would love input from other cat owners.

I have a healthy 2-year-old male cat. No medications, health issues, or behavioral problems. I'll be gone for 8 days/7 nights, which is the longest I've ever left him. Anytime I'm gone more than 2 days, I get a sitter, but even with a sitter the longest I've ever gone away was 4 days.

Even then, I feel so anxious that something will happen and so guilty like he'll think I am abandoning him. It takes him about a day to warm back up to me.

I currently have a Rover sitter booked. She came for a meet-and-greet and seems fine, but she's new to us since we recently moved to a new city. The plan is for her to visit twice a day:

• 30 minutes in the morning for food, water, litter, etc.
• 1 hour in the afternoon/evening for playtime, attention, and company

At the same time, I've also reserved a spot at a feline-only boarding facility near my house. The cost is almost identical. It's attached to a feline-only veterinary clinic and they have my card on file, so if something happened medically, he'd already be where he needs to be.

He wouldn't be spending a week in a tiny kennel like most places. I've reserved a private 50-square-foot suite with vertical climbing space, a window with a bird feeder, a TV, water fountain, toys, beds, and a webcam I can access throughout the day.

I know the standard advice is that most cats are happiest staying in their own environment. But 8 days feels like a long time for him to only get 1.5 hours of human interaction per day and otherwise be alone. I also don't currently have cameras in my apartment, so I wouldn't be able to check on him myself (and ease my own nerves throughout the day.)

A few other factors:

• He's an only cat, so there's no other pet for companionship.
• We're relatively new to this area, and I don't love the idea of a stranger having access to my home.
• My apartment isn't really set up for a cat to have unrestricted access while I'm away, so he'd be confined to the living room and one bedroom (roughly 400 square feet total).
• When I return from the trip, I'll immediately be starting a 7-day stretch of 12-hour shifts, which means he'll still be getting less interaction than usual for another week.
• I really like the idea of the webcam and veterinary oversight at the boarding facility.
• I also feel bad canceling on the sitter at the last minute. However, the boarding facility is already holding a spot for him as well.

Part of me feels guilty leaving him home for over a week. Another part of me worries that boarding could be more stressful than staying in a familiar environment.

If this were your cat, what would you do and why?

Doing a weekend trip for a friend’s event next month in North Aurora. I lived in DC for over a decade and have been to Chicago multiple times, so I’m very familiar with the city itself and comfortable using public transit. On previous trips though, I mostly stayed in Chicago proper and relied on CTA/Metra, so I don’t know much about the suburbs/outskirts.

I’m staying in my usual hotel in River North because I still want to spend most of my time in the city. Looking at GPS, North Aurora seems about 45-50 minutes out depending on traffic. I’m only going to this event for maybe 8-10 hours max.

I’ll also be traveling with my 50-year-old mother this time. She’s fully mobile and independent, but she does have some neurological issues and can get overwhelmed if there are too many transfers/steps/chaotic situations. We do fine navigating DC Metro and using Uber when needed, so I think we’ll be fine getting around downtown Chicago with transit like usual. For the event though, I’m willing to spend a little extra money or time if there’s a much simpler/more direct option.

My first thought was to use CTA/Metra normally while in the city and rent a car just for the day of the event, then return it that evening or the next morning.

I’m assuming Uber/Lyft that far each way could get expensive and would definitely limit us being able to get around if the event lasts long or shifts locations as parties sometimes do, and public transit looks doable but inefficient once you get past Aurora itself.

Does renting a car for that one day sound like the smartest move, or is there a better option locals would recommend? Open to Metra + Uber combos too if that’s the better move.

Noob question I’m sure, but just wanna make sure I’m understanding this correctly.

My job gives us a free UpToDate subscription, and from what I understand the searches/reading count as Category 1 CME. Of course, NCCPA says I need 50 Cat 1 CME + 50 additional CME hours over the 2-year cycle.

I’ve been stressing trying to find conferences/courses/subscriptions that fit within my job’s CME budget without eventually coming out of pocket. But am I correct that I could technically fulfill the whole requirement just through UpToDate credits?

I work in a high-acuity/high learning-curve environment and already have 30ish credits in a few months just from using UTD at work. Realistically I’ll probably hit 60–70 by the end of the year, maybe even the full 100 by the end of the cycle.

Just making sure I’m not misunderstanding this before I stop hunting for extra CME stuff lol.

New grad here looking for documentation efficiency tips/dot phrases before I lose my mind lol. I’ve been at my ICU job about 10 weeks now. I work 7 12s in a row, so by sign out I am VERY ready to go home, but I keep finding myself staying late at least 2-3 times a week finishing notes.

I don’t usually even necessarily mind documenting, but lately, it has become my 2nd least favorite part of the job. (The first being the nonstop exposure to whatever bacteria/virus/prion/disease process the universe decides to spawn that day and the non-zero chance you walk into work & end up treating patient zero for whatever that thing might be.)

Anyway… ICU documentation feels brutal because every patient has like 10+ truly active problems and everybody is so sick that I end up being overly detailed. And it was nailed into my head to be THOROUGH and document EVERYTHING because you can’t prove what you did in a courtroom a decade from now if you never wrote it down. Which I think is good advice to a degree especially as a rookie still getting my feet wet, but my notes are sometimes insanely long. I genuinely hate imagining the poor soul reading them after me.

A lot of it is because I work so many days in a row so I’m usually following the same person for the entire week, so I write notes almost like reminders to my future self so I remember what to follow up on, trends, pending studies, consultant recommendations, etc.

I know I’m not magically gonna become one of those seasoned people who somehow finishes all their notes before breakfast, but there HAS to be a better system than this.

Does anybody have:
- good ICU dot phrases/templates?
- a repository of useful smart phrases?
- formatting tricks?
- ways to document thoroughly without writing a novel?
- tips for separating “important for billing/medical record” vs “important for my brain”?

Would appreciate literally anything that made your workflow faster as a new grad.

LONG POST ALERT.

New grad PA here, about 6 months in, 26F, and I can’t shake this feeling that I might have stopped short. I know the advice for under 30/40 is “you’re young, just do it” but I have a lot to consider as far as what I want my life to look like as well.

Not trying to be dramatic, but ever since clinical year I kept thinking “I could’ve done that” watching the residents and attendings. Not in a cocky way, just in the sense that I didn’t feel out of my depth (with additional training of course). I don’t even know if I could’ve or would’ve gotten into med school but I did get into 9 of the 12 PA schools I applied to.

For context, I grew up pretty poor in the deep South, and I am a single woman and take care of everything alone so after graduating HS, getting stability and making money quickly were big factors in choosing my undergrad degree & eventually PA school. The need for a decent income & stable life was urgent. And coming from my background, I am genuinely grateful for this opportunity. I like my job, I respect the role immensely, I’m supported, and the money is solid. I make almost triple what my mom made my entire childhood, so I don’t take that lightly . I acknowledge that I went from making $10 an hour to being in the top quintile of earners. I’m extremely grateful. I can’t express that enough.

Right now, I’m working in a high acuity setting and so I am still in that new grad phase where I’m lowkey scared all the time but managing and starting to get the hang of things. But as I learn more, I can already see the ceiling, and that’s what’s bothering me. I’ve also had several physicians ask me why I didn’t go to medical school and tell me I should have. I think I’m in denial because my response is always the parroted “too long, too much debt, etc”

In all honesty, I have almost 200k debt. I don’t imagine med school would’ve been THAT much more. Now I keep wondering if I chose the quicker path when I should have just stuck it out.

Tim matters too. At 18, when choosing a career path, I was like 12 more years of school? NO WAY. Now at 26, 30+ doesn’t seem so old/far away after all. If I had gone the MD route from the jump, I’d either be finishing med school or well into it by now.

I did 28 months of PA school, so part of me is like, what’s another year and a half? Except it’s not a year and a half anymore, it’s completely starting over. I feel like I have wasted time and money.

And having seen what residents do honestly, residency doesn’t seem as terrible as I once thought. The hours suck, but it’s still just a job. And after all, it’s temporary. My best friend is in med school right now and going through it, but there’s a very clear end goal and the opportunities after seem wide open.

At the same time, there are real things holding me back:
- Like I already said, I have about $180k in PA school loans and I’m planning on PSLF but still, Med school would easily double or triple that.
- I’m planning to start a family within the next 2 to 3 years. Not in the traditional sense but I am planning to go the SMBC route, which severely complicates my decision making. To note, This is one of my most important goals/priorities in the next few years.
- I’d need more prereqs and probably a post-bacc or SMP, so at least 1 to 2 more years before I can even apply, which would cause me to either go part time or need to stop working altogether. During schooling (if I got in), I could probably work a day or two each month, but I can’t bank on that. As a single income household, this matters.
- I have a lot of travel planned in the next couple of years.
- I was miserable in PA school and swore I’d never go back to school for any reason
- I finally have stability and can breathe, which I didn’t experience growing up

I also can’t ignore the long-term thought of being 50 or 60 and still taking orders from people who, as of today, aren’t even born yet.

If I’m being honest, I used to talk a lot in the MD vs APP debates, and now I’m questioning whether I was just convincing myself.

I’m not aiming for anything ultra competitive, probably IM or EM. I’d love a little 7 on/7 off role as a hospitalist at a little country hospital or manning an urgent care. This isn’t about prestige. It’s more about autonomy and not feeling capped long term.

I don’t want to make a rushed decision this early, but I also don’t want to ignore this and regret it later.

Someone talk me through this, Be real with me.