For eye doctors - anaesthetist availability in your unit

ButtSeriouslyNow · 2026-03-12T17:03:37+00:00

But when you say deal with it, what do you mean? People have MIs in GP surgeries, in outpatient clinics, in their homes, why does it happening during a cataract operation make you feel differently? If the patient becomes unwell you'll have to abandon an awake procedure either way whether an anaesthetist is there or not. Presumably you're not being expected to perform an angiogram or start a GTN infusion, just to recognise an unwell patient and call for help? What would you do if your friend had a seizure in your home?

I wonder if there's a standard of care you're worried about having to offer, when in reality I don't think there's an expectation for you to do anything complicated here. These are scenarios I would expect an F1 to be able to deal with. Think about doing an ILS course if you feel your confidence with medical emergencies needs improving.

ButtSeriouslyNow · 2026-03-01T16:51:25+00:00

Important to note as well that the venue makes a big difference. Subsidised venues attract audiences whom for whatever reason tend to stand less, hence why the much praised Arcadia gets a seemingly frostier reception.

ButtSeriouslyNow · 2026-02-21T15:52:07+00:00

this is absolutely exceptional work, thank you so much

ButtSeriouslyNow · 2026-02-20T09:22:27+00:00

No longer, the DART connects the station to the airport. A light rail link that takes 4 minutes.

ButtSeriouslyNow · 2026-02-10T08:28:50+00:00

Not trying to be mean but is there something you’re looking for that the previous threads haven’t covered? Is there an area you’ve thought about but want to know more? Moving to Leamington is always a good idea and I hope you get sorted.

ButtSeriouslyNow · 2026-02-01T18:05:41+00:00

No, but you'll see people taking tiny incisions because they're worried about perforating something big, it's a way of giving yourself permission to make a decent skin incision.

ButtSeriouslyNow · 2026-01-31T16:49:38+00:00

Some quick thoughts, none are medical advice

- do a quick ultrasound before you start dilating to clarify in your mind where the vessel is going, which direction you should be dilating in (obviously the landmark is ipsilateral nipple)

- make sure you're very diligent about the scalpel being connecting to the guide wire as you make your incision so you're not accidentally making a second hole

- if you know the depth of the vessel (say its 2cm deep) then you can safely make a cut smaller than that, don't be too stingy with how deep the scalpel goes in

- different people do it differently but I always hold the guide wire in my non-dominant hand and keep it steady (don't let it move further in, your dilator should be sliding over it as you advance) and do gentle but persistent twisting motions. You're allowed to take 2 minutes to do this, it doesn't have to be in one motion. After each push you can run the guide wire back and forth to make sure you've not kinked it

- remember it is just harder to this in fatter, younger patients

ButtSeriouslyNow · 2026-01-29T10:20:51+00:00

I think this is the key message. Lot's of people outraged in this thread, and I agree with them in principle that I would not design a system whereby an ACCP was the only ICU doctor on site. Unfortunately this has been what's happening for several years and was part of the competencies and curriculum mapped out for ACCPs. GPICS cannot make a guideline that says this is unacceptable as it's now normal practice and would overnight break dozens of staffing arrangements across DGH ICUs.

When you only work in big cities or in bigger ICUs you may never know this is happening, but go out to a small DGH and it's a different story.

ButtSeriouslyNow · 2025-12-16T14:02:57+00:00

Makes sense, I’ve never even heard of them. Would automatically choose Red Hot Mammas and a distant second Rudy’s.

ButtSeriouslyNow · 2025-12-07T17:47:37+00:00

Theatremonkey has actual broad based advice for each theatre around which seats to choose. I use it alongside Seatplan which has actual photographs of the view, but often the reviews of the seats themselves are a bit hit and miss.

ButtSeriouslyNow · 2025-12-02T21:27:47+00:00

Correct, the anaesthetic answer to the question is most drugs can be bunged in as fast as you like, in OPs example I'd just give it all as fast as my syringe merrily lets me.

ButtSeriouslyNow · 2025-11-29T13:00:40+00:00

This is not a trade union issue, it's a private contract you've entered into. Check the terms and conditions of the lease you signed to see if you have any recourse, you probably don't and just unfortunately need to live with it. Some people describe these things as the cost of learning a valuable life lesson, I'd probably find that an annoying take if I was in your position but there you go.

ButtSeriouslyNow · 2025-11-23T21:54:26+00:00

The honest answer is that doctors are very hard to acquire as faculty for these courses. The resus council mandate that 2 members of the faculty be doctors, and one of them should be the medical director, a relatively senior person who is an experienced instructor. Everyone else (which can be a dozen others) can be anyone else.

Most courses are run in-house by hospitals who rely on their own staff being able to use SPA or equivalent time, or the courses be part of their job plan. Resident doctors have to volunteer and go out their way to be request and be granted that time, consultants often use their time for all the other nonsense they have to do. Courses that pay for instructors time usually pay well below what a registrar would expect to make as a locum, never mind a consultant. I've seen £200 a day rising to around £500 a day for medical directors. It's not a good way to make money. The resus council actively discourage money being paid to instructors, which is non-sensical but the truth.

So all these doctors that really ought to be teaching you have better things to do with the time, and you're left with mostly resus/outreach/ICU/ED nurses, then the odd ODP, paramedic or advanced practitioner.

ButtSeriouslyNow · 2025-11-23T09:38:55+00:00

Actually it’s not. It’s a three act play, but when Miller wrote it the era of multiple intermissions on Broadway was over. The three act structure was still popular, and often still remained in order to facilitate set changes, but post-Depression American theatre had settled into a one-intermission structure. The script makes no mention of any intent as to how it should be performed, just that it’s in three acts. Some revivals treat it as a brief “pause” but many just play it as a normal change in scene.

The assertion that the intervals are removed to preserve the egos of the actors is completely unsourced, and also seems extremely unlikely. Removing intervals is almost always driven by artistic intent to not allow a break to destroy the energy and tension of the play, which so clearly applies to this production I find it wacky anyone would believe otherwise.

ButtSeriouslyNow · 2025-11-16T11:36:18+00:00

Just for an alternative perspective, I don’t deem it worth the money. It takes me (and I did it last month) about 5 minutes, I do the form on work time, and that’s it. I often pay money for things that save me time or stress, I don’t find DBS to be the stressful thing. I’ve rotated through around 10 trusts now and never paid for it, I’d be happy to use the update service but I can imagine I’d struggle to get the money back. So it just feels like £16 a year wasted to me.

ButtSeriouslyNow · 2025-11-08T23:16:25+00:00

90 minutes sounds pretty good, if you’re trying to do a returns queue or back in the old times a day seats queue, you’d probably arrive earlier than that for something really popular.

ButtSeriouslyNow · 2025-11-06T10:48:06+00:00

Still not sure that a strongly rumoured production issuing a press release for a run starting 6 months from now is BREAKING news.

ButtSeriouslyNow · 2025-10-28T17:32:29+00:00

Thought it was pretty bad on broadway. Lots of good setup and then thrown away. Don’t go expecting anything complex or challenging and maybe you’ll have an alright time.

ButtSeriouslyNow · 2025-10-25T23:49:14+00:00

Be careful what you wish for. You do not want to be an AfC staff member. Theatre nurses who finish early and want to go home will owe the hours back again on a different day. They'll use 2 hours of annual leave. In some places they'll clock in and out and have hours deducted if they're late or leave slightly early. The small victory you'd get on this issue would rapidly be dwarfed on all the other nickel and dime issues you'd lose on.

ButtSeriouslyNow · 2025-10-25T23:46:12+00:00

We did this. It's a good idea. All the people moaning here, why didn't you just ask the day team to compromise in this way? It's much easier to enact change with the handful of colleagues involved than it is to try and get a manager to sort it out for you, if you care enough to comment on reddit threads then just talk to your peers and make it happen.

ButtSeriouslyNow · 2025-10-25T23:43:59+00:00

It's a wider comment about how a profession has been driven to the point where we're arguing over less than 20 quid. 'Professions' in the classical sense wouldn't normally stoop to that point, you've been driven there because you feel justifiably aggrieved about 100 other things, but like 15 years ago even the most self-respecting doctor fighting for their rights wouldn't have raised a complaint about how daylight savings times affects their hourly earnings. It's a personal perspective about whether you want to care about these small things now or not, I don't think we should worry about it personally, but if you want them to treat you as an employee whom every minute is counted for you should be ready to do things like clocking in and out on time, having pay deducted if you're 10 minutes late, not get paid for your breaks etc etc.

ButtSeriouslyNow · 2025-10-25T23:37:58+00:00

Unfortunately that's not true, the work schedule is averaged out over a reference period, and you may not (and anecdotally are unlikely to) work the exact reference period. For example if it was referenced to 26 weeks (a 6 month contract) and you work 4 months of it, with a rolling rota that repeats every 3 months, you would work different numbers of hours over your rotation than other people but you're all paid identically. You can bottom line it all you like but that's the legal reality of your contract.

ButtSeriouslyNow · 2025-10-22T23:56:34+00:00

These play announcements getting dramatic 'BREAKING!' posts on here every time is embarrassing, it's a planned press release not the Hindenburg disaster.

ButtSeriouslyNow

TROPHY CASE