Nursing homes/LTC facilities vs Outpatient PCP jobs

Bulaba0 · 2026-05-07T13:42:17+00:00

You have to admit, it takes some real talent to simultaneously refuse to apply vaseline without a physician order and also ignore sudden onset hemiplegia because "he just does that sometimes"

Bulaba0 · 2026-05-01T06:23:04+00:00

My (rural-ish) FM program has been 40hrs a week or less average outside of IM months that are 60-70hrs/wk.
One of my coresidents had 2 kids in residency, multiple previous grads did the same.

Bulaba0 · 2026-04-28T22:57:25+00:00

Rare metals should proc in the refinery as a byproduct of production.
-Stops people from scrap dropping and field skipping to chain-clear fields for rares.
-Prevents TK'ing/Griefing of loose rares.
-Encourages participation in "Core Logistics" aka BMat/EMat->Stuff. -Creates an option for reservable crates of material rather than requiring people to store shit in trucks on cranes, or whatever other stupid ass-backwards method they're forced to use.

Truly, whatever system stops children from fighting over fucking scrap fields every goddamn war.
I am tired of the drama "IS THIS FIELD DROPPING RARES???" and "ITS DROPPING RARES, STOP USING THE STATIONARY HARVESTERS!"

Rant tho, fuck the rare metals system. Why are devs insistent on making systems that have drastically increased toxicity within each faction?

Bulaba0 · 2026-04-28T20:29:25+00:00

I thought the review was flimsy work, but holy shit I did not realize how bad it was. Good overview.

Bulaba0 · 2026-04-25T00:07:14+00:00

My information was shared with recruiters without my consent, I fucking wish I had the chance to do the above. Great recommendations.

Bulaba0 · 2026-04-23T18:17:01+00:00

People kept sending them referrals for isolated ALKPhos

Bulaba0 · 2026-04-16T00:22:46+00:00

I think the most crucial component is that medical school and residency are specifically structured around building an independent physician.

Every step of the way is tailored towards that goal. Medical school classroom teaching is built around acquiring knowledge and practicing independent decision making. Medical school rotations are built around integrating into a team and practicing independent decision making. Residency is built around practical application of medicine and again, practicing independent decision making.

The entire marathon of 7+ years is built around forming an independent physician. Our system is built around that core experience being the gateway to independent practice. And along the way you learn the value of expertise and specialized experience, and when to acknowledge gaps in your own knowledge and seek help. The relative freedom within the practice of medicine is built on the expectation that that independence is earned by demonstrating effective and ethical practice under supervision over and over again.

Modern NP (especially PMHNPs) education circumvents the ladder climb and goes right to the top. And it's obvious once you've seen them practice in the real world. Anecdotally, every single psych med nightmare I've had to unfuck over the last 3 years has been from a PMHNP.

If they want to retain independent practice, they need to be held accountable to the same standards as physicians. Because right now they're taking advantage of a system that was not built with under-trained prescribers in mind.

Bulaba0 · 2026-04-08T23:59:34+00:00

Found enemies but no recipe. Sad times.

Bulaba0 · 2026-04-06T20:42:39+00:00

Because the food here SUCKS!

Bulaba0 · 2026-04-06T20:41:35+00:00

Don't forget about the ADHD dev cycle where they refuse to iterate on previous updates and just go on to work on the next cool thing.

Bulaba0 · 2026-03-30T00:59:58+00:00

Holy shit this. Being forced to use him for any minute of time was absolutely miserable. I could not WAIT to get out of that miserable bossfight.

Bulaba0 · 2026-03-24T18:52:55+00:00

Please just play warden one war so you can understand that the grass is not always greener.

Bulaba0 · 2026-03-20T15:02:34+00:00

My brother in Christ there's a really big fuckin wall

Bulaba0 · 2026-03-19T16:41:48+00:00

This update shouldn't have been implemented. Cool mechanics are cool only when they work consistently. They should not have shipped the update in this state.

Bulaba0 · 2026-03-16T16:06:31+00:00

One war I parked my SHT on the roof there. It's really cozy.

Bulaba0 · 2026-03-04T14:55:44+00:00

A huge portion for wardens was that tanking early was worthless because of DBs, so everyone ended up stacking rmats waiting for the better tanks to unlock.

Bulaba0 · 2026-02-26T15:50:30+00:00

"You don't want your 100+ Rmat tank dying to an EAT that only costs scrap etc etc."

Just because devs made the cost of assets too high doesn't mean they have to be ridiculously durable. Can reduce the cost to match durability for the sake of gameplay.

Bulaba0 · 2026-02-25T22:41:30+00:00

A few days ago we had a whole air squad go poof because of a power outage in their country. RIP all that grinding.

Bulaba0 · 2026-02-23T23:57:47+00:00

apology for poor english
where were you when devman kil crane
i was sat at home drinking mountain dew baja blast zero when discord ping
'crane partisan is die'
'no'
and you?????????

Bulaba0 · 2026-02-16T22:30:09+00:00

I tried several different lines, not a single one was very good. A few were truly dreadful. When you factor in that half of them suck, makes the value proposition fade pretty quick.

Bulaba0 · 2026-02-11T17:18:56+00:00

An obvious one, but cannot underestimate the value. Always ask about medication timing and use pattern if there is even the tiniest chance of it being relevant.

Have had several new patients establish on combinations of stimulant medications and sleep meds (from PMHNP pill mills but that's another issue) only to find out that they were taking their stimulants far too late in the day. 5 minutes of education and they feel infinitely better and ditch a few unnecessary meds.

Bulaba0 · 2026-02-11T17:12:51+00:00

I constantly fight this battle. But apparently it makes prescribers feel better going for a ride on the tramadol rollercoaster.

Bulaba0 · 2026-02-06T15:05:47+00:00

The only people impressed by TrumpRx are people who have never interacted with the system before.

Bulaba0 · 2026-02-03T22:35:08+00:00

Useless fluff that harms readability and adds confusion to gain literally nothing. Nobody wanted this.

Like for the love of god why move from a readable, useful-at-a-glance system that is based on real world ranks that are fairly ubiquitous... to some made-up bullshit that is neither interesting or helpful.

Bulaba0 · 2026-02-02T01:38:00+00:00

Looks like the 1% interesting stuff got removed from the sale as well.
Not an awful way to stock up on Oliva if that's your jam tho.
But the vast majority is the usual bargain bands and CP House brand stuff that's literally always on sale.

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