Play it smart. Avoid the shotguns. Use it from behind, from above, from the side. Those minions? Well if they were going to kill you no matter what then by killing that dreg you delayed your death so that's a +1 in my book. Also if the shotgun doesn't kill you you'll get your health back anyways from the transfusion. Plus shoulder charge is amazing for mobility, great for getting you through the abyss or across the arena in prison of elders. It can work wonders in PvP. Seriously, what's not to love about a one hit kill with no cooldown?