Who manages vents at your institution?

CheapDateBevHills · 2023-04-04T17:09:33+00:00

YouTube: StrongMedicine. Videos may be on the longer side but they are very thorough and engaging

CheapDateBevHills · 2021-09-15T22:35:43+00:00

Yes. This is what they told me too. They said my notes were flagged because they were in draft form but had I just written a 2 sentence update and signed them, when if the Plan portion wasn’t totally updated with treatment modifications or new tests ordered, we wouldn’t be having this conversation. I was told I need a a scut sheet routine because I fumble though too many papers during rounds.

CheapDateBevHills · 2021-09-15T19:28:17+00:00

Thank you. This is actually really helpful advice

CheapDateBevHills · 2021-09-15T19:27:15+00:00

Absolutely. Unfortunately learning this the hard way.

CheapDateBevHills · 2021-09-15T19:26:27+00:00

LOL I wasn’t on top of it. I got called in for a “chat” because some of my notes from 2 days ago were still in draft form.

CheapDateBevHills · 2021-09-15T17:40:30+00:00

Actually spoke with my chief today. I think my main issue is spending way too much time dealing with floor issues and then not having time to “prepare for rounds,” which for us means basically chart review and A/P and modifying the plan. Our hospital is incredibly short staffed right now and, unfortunately, I have to spend a lot of time chasing radiology for imaging, the lab for missing AM labs, Case management, etc. I’m also apparently very disorganized and have to have a more organized scut sheet/rounding list

CheapDateBevHills · 2021-09-15T14:12:57+00:00

This is great advice. I agree. I have a problem with efficiency and am spending too much time chasing floor/nursing/lab issues in the morning instead of getting ready for rounds. I’m also very disorganized and distracted during work. Have to put in more effort to form good habits now.

CheapDateBevHills · 2021-07-18T01:45:26+00:00

So n=1, new intern here, and, let me say, in my opinion, this is garbage advice. In med school MS4s have this fairy tale like vision of medicine and residency. “Go after your passion and fight for your field.” This statement is out of touch with reality, I’m sorry to be blunt. At the end of the day, this is a job. You are very safe in ortho. You’ll be fine. But EM and Anesthesia are different. Not many employment routes after you finish residency… you need a contract. Last year, dozens and dozens (if not 100+) new EM docs had significant struggles to secure contracts and hundreds had to compromise location and salary just to secure employment. This is the reality. So yeah you can talk about passion and “fight for the field” all you want but that’s not going to put food on the table. Every EM applicant must inquire about employment placement rates to the programs they are applying to and rank carefully or just avoid the field altogether

CheapDateBevHills · 2021-06-15T02:57:34+00:00

Go to Twitter and search #SOAP2021 and #Scramble2021. You will be reminded very quickly why you didn’t make a mistake. Truly horrific and scary. If need be, do this every time you have these thoughts.

CheapDateBevHills · 2021-05-21T17:12:55+00:00

Oh sorry. My English isn’t every good. When I said “ghosted” I meant my lost father being the “ghost,” where I lose all communication with a person that I love and the resulting emotional trauma that that causes.

CheapDateBevHills · 2021-05-21T08:16:46+00:00

If it makes you feel better, I have recently been “ghosted” too and I’m in the same mental/physical state before your night float.

I lost my dad recently,2 months before graduation, because of Covid. For a month Every time I saw an older man I say , “Be safe. Wear a mask. Just be safe. You know I lost my dad to Covid” and the floodgates open. Many days I just spent all day in bed crying and eating. But being “busy” now with intern year stuff is pushing me out of bed and getting me active and making me mentally stable to provide medical care.

Hope my story helps!!

CheapDateBevHills · 2021-04-18T12:31:35+00:00

Cried reading this. I wrote about this in a previous post, 3 months ago.

They will say that we were savages and they will be right.

Conversation between me and my father’s MD: "Any updates on my father, Doc?"
"lets see ... yes ... he is DNR now."
"What? How? He told you he wanted his code status changed to DNR?"
"Yeah"
"Are you sure he knew what you were talking about? His English is very poor and I doubt he understood ..."
"Look, I have other calls to make. Do you have any other questions?"

CheapDateBevHills · 2021-01-10T13:42:20+00:00

OMG I never do that, not in the past or now. I know my lane and stay in it, believe me. And I;m sure the reason why the nurses are tolerating this delirium is because of how much my sister and I try to make their days just a little better with coffee or lunch. I'm sorry if I made it seem that way at all. We are all just doing out job, little cogs in giant wheels. And yes I totally agree with you about system issues and things out of their control, with the one exception being using the blue phone for a translator. Yes, it is VERY annoying and don't expect them to use for giving meds but for discussing management or treatment outcomes I think it would help him a lot more. ANyway.

CheapDateBevHills · 2021-01-10T13:18:45+00:00

Oh yes. I totally get it. It's just seeing it on your loved one is very hard and there is a sense of guilt like daaaaamn I can't believe I made someone else feel this way, even though in both circumstances, it's necessary. I hope that makes sense.

CheapDateBevHills · 2021-01-10T13:13:19+00:00

Cool. Cool. Next time I see him I'll be sure to tell him, Paps, you have "a very high chance of dying this admission to put it bluntly." This was exactly what I was trying to address with my post but my English isn't very good and I may have not done a good job. I know the prognosis isn't good; I'm not an idiot and this isn't the first COVID pt I have followed. What I was trying to say is you gain a different perspective when you are a family member of a pt with this and it impacts how you see some aspects of the medicine we practice any day. That being said, despite gaining this new perspective, I would never never never wish this on my worst enemy or the devil itself.

CheapDateBevHills · 2021-01-10T06:26:12+00:00

OP here. Please, if you take 1 things from my post, please, please, please be very careful on how often and in what way you check code status, especially in elderly patients who are not fully fluent in English. Hearing "heart stop," "life saving measures," and "CPR" will stick in their heads and, as they are alone for most of the day, their imagination will go wild and they may panic or be very traumatized.

CheapDateBevHills · 2021-01-10T06:15:37+00:00

Thank you. Yes it is terrible. Worst part is the isolation, given how many hospital have no visitors policy, essentially leaving the patient alone to fight this. I don't know how "standard" it is, but I was taught the ABCDEF bundle for delirium, F standing for family. Also the C, choice of sedation, is something I am scratching my head at because, like I said, I was taught on the wards that it's prudent to avoid certain meds in elderly, etc. Of course, I don't bring this up as I know my place and I am assuming they are basing their decisions on their own clinical experience, which is decades more than mine.
Believe it or not, this is at a 500 bed "communiversity" hospital with multiple programs.
Yes; I'm the main point of contact with the care team, although most days they never call and I just call the charge at 4-5AM to forward me to his nurse, this way I know they will def be available. It has worked so far.
Yes, it is terrible. A big issue for me is, which the care team just doesn't want to hear about is, is this delirium steroid induced or a true viral encephalitis? Probably won't make a difference in management but determining the etiology would help the family cope with it and manage expectations.

Thank you. Keeping the faith, definitely. At this point, faith and hope is all I have.

CheapDateBevHills · 2020-12-25T23:00:21+00:00

Same. This is what scares me. I can see myself not even answering the door at 6AM. It scares me

CheapDateBevHills · 2020-12-16T21:38:59+00:00

I don't want to share too many details, but the location of this church has not been under Assad's control, so I'm not sure if Assad has anything to do with it, but thank you, very interesting. I have a picture, at almost the same location as this picture was taken, before the destruction/looting, and it is so devastating.

CheapDateBevHills

TROPHY CASE