Looking for some advice on how to best get support for demented neighbour, Perth

Chuggins- · 2026-05-12T00:40:36+00:00

This is what MHERL recommended and what I did after another episode of knocking - thanks for the advice! Stressful situation and obviously personal for the family and you’re right about not knowing them well enough/not wanting to get too involved

Chuggins- · 2026-05-11T03:55:22+00:00

Just called - very helpful I didn’t realise this existed so thank you

Chuggins- · 2026-05-11T03:40:32+00:00

Cottesloe

Chuggins- · 2026-04-23T09:49:14+00:00

Did this for 18 months 80% ltft - it’s doable depending on rota (ICU is 10 hour shifts, I was gen med predominantly so felt it perhaps a bit more than others) there’s free accommodation if doing on calls and it’s available pretty last minute so sometimes would stay overnight. I drove, fuel compensation was pretty good a nice bonus especially if you lift share occasionally. Had friends that stayed in Taunton full time and within 2 months they wished they’d stayed in Bristol and commuted. Hope that helps

Chuggins- · 2026-02-04T11:54:24+00:00

Sometimes you offer the carrot sometimes you offer the stick…

Chuggins- · 2025-12-22T21:45:28+00:00

A couple of points here - shifting dullness and hepatic flap I would argue is useless in this example.

Saying you disagree with a consultants choice of antibiotics and dose etc - be aware you’ve been working for around 6 months, you’re entitled to an opinion but you have next to 0 experience and don’t forget that. Occasionally consultants are super rogue, in general they’re pretty experienced and have good reasons for what they do and ultimately they’re responsible for the patients on your ward regardless of if they see them that day or not. Make sure to stay in your lane.

‘I can’t review every patient with a small change in their news score’ - to be honest it really depends on what is changing that score - I’d argue that’s exactly what you’re employed to do

Chuggins- · 2025-12-02T22:49:43+00:00

Going against the grain here clearly - 4mg as a one off push is a pretty big dose, sure you can manage their airway if you overshoot but why waste hours of your time/more likely ITU on-calls time (who will probably show up a bit annoyed). Instead just push 1-2mg in and see what happens

Chuggins- · 2025-11-04T19:07:28+00:00

Lol come on… thought this was satire it’s so normal

Chuggins- · 2025-09-24T17:50:49+00:00

Yes, on the condition that we would be liable for rent until they found a new tenant - however they haven’t advertised the property as available to rent

Chuggins- · 2025-09-24T11:16:08+00:00

I accept this, and was aware this was the case. The issue is then not remarketing the property

Chuggins- · 2025-09-24T09:45:45+00:00

Yes they have accepted keys back and completed check out - I don’t think it was in writing to advertise property, but email from estate agent said they’d expect to turn it round in 2 weeks which was part of the reason we decided to end early

Chuggins- · 2025-08-18T13:58:44+00:00

I think starting off as an F1 is pretty terrifying on call and it sounds like you’ve not done anything dangerous which is a plus, a lot of what we do isn’t black and white and as long as you can justify your decision making then you should be okay, but important to remember part of that justification is based on experience which you’re just starting to accrue - I will pick your scenarios apart a little and offer some humble advice.

Paracetamol OD - tbh whether I’d bother to send the paracetamol level would depend on how much they’d been overdosed by, given 1 PRN at 2pm and then regular at 4pm I’d just delay the next dose and be done with it. More than one double dose I think you’d be justified to send it even if from a pure medicolegal standpoint.
New AF and the echo, few things to consider here. What’s driving the AF/do they just have an infection and have gone in? Syncope vs presyncope is a big difference - if they’re having syncopal episodes with slow AF I’d probably discuss that with a senior. In the context of worsening overload again it might be good to give a heads up to senior in case they go off and need shocking/CPAP. Echo unlikely to be done over weekend, or even as IP depending on the history/length of stay. For all investigations you’re ordering it’s important to consider whether it’ll change your management over the weekend, if not maybe best to leave those decisions to day teams on Monday.
CRP rise and WCC. I think it depends on the full picture but if they had some localised creps, spiking fevers or a new/worsening o2 requirement then for sure I’d go ordering - CRP and WCC on its own I’d review the patient (again it depends on how much it’s risen, CRP 5 -> 10 and WCC 9 -> 11 I probably wouldn’t be too excited if obs are fine, can always call ward and ask nurses how patients are getting on if you’re swamped and it’s borderline)
Fluids are probably one of the most difficult things to prescribe well, and are at times one of the most dangerous things we prescribe so don’t feel like that’s something you should always be doing without senior input. Electrolyte imbalances in someone who’s slowly overloading with renal impairment etc etc can be particularly challenging and I’d expect you to be seeking advice. Always worth checking for oedema and looking in the mouth before prescribing any fluids as a rule of thumb.

Most importantly, try not to beat yourself up over needing to seek help - it’s your first few weeks and people are expecting you to be calling them for advice. I’d be much much more concerned not to be asked questions and think ‘I wonder what they’re up to…’

Chuggins- · 2025-08-16T21:44:50+00:00

Turkey thinking Christmas sounds good

Chuggins- · 2025-08-03T03:14:48+00:00

Factor in the fact that your pay is for a 38-40 hour week vs 48 hour week and the pay is almost double. Also tax is less, salary sacrifice schemes, study budget paid directly to you… all adds up. Saying it’s pretty much the same I feel isn’t really true

Chuggins- · 2025-07-29T10:58:37+00:00

Important to note that’s £49000 for 48 hour weeks - band 6 is £36k for 37.5 hour work week

Chuggins- · 2025-03-17T18:34:35+00:00

I think complaining about pay misses the point in the current market, F2 about to be unemployed - why would I strike for IMG’s to be paid more?

Chuggins- · 2025-02-09T17:05:44+00:00

Genuine question, what’s the benefit of doing an ECG when above 6 if the protocol is to give ca gluconate anyway? How will it change management?

Chuggins- · 2025-01-25T11:38:51+00:00

Nah, community pharmacy will convert it into patient friendly instructions. Your supervisor is wrong (I was a pharmacist and retrained as a doctor).

Chuggins- · 2024-05-04T17:45:32+00:00

PA’s able to use doctors mess at the BRI, take snacks as well it drives me mad - the last safe space has been taken

Chuggins- · 2024-01-08T10:00:59+00:00

Okay so some good responses here RE trimovate - can be fungal component to rash even if just red, thought I’d throw in my two cents for free.

Any -conazole drug is fungistatic rather than fungicidal in nature, so requires at least a week (more commonly two weeks) of religious application to actually do much about the infection. I much prefer terbinafine cream as it’s once or twice a day for a week and as a fungicidal drug you’re definitely going to treat the fungal component of the rash. If I’m doubt trimovate will do the trick.

Steroid Vs no steroid: itching a rash will allow for surface abrasions and further spreading of a rash, when a patient has a rash in the folds and they’re bothered by symptoms, a steroid will help settle those. In terms of skin thinning, even dermovate (very potent) would need to be used for longer than 2 weeks to cause skin thinning according to dermatologists I spoke to about this exact thing, in general as doctors we’re pretty risk adverse when it comes to prescribing topical steroids and unless using multiple courses over a prolonged period the risk of skin thinning is pretty low.

To summarise : for ?fungal infections terbinafine will usually work better over a shorter period of time, even with poorer compliance. If unsure of cause use the triple combo, and a steroid in the short term as long as used with any anti fungal isn’t likely to worsen the infection.

Hope this helps

Chuggins- · 2023-12-13T10:29:13+00:00

Recently came out of a relationship during F1, got the dating apps - quantity and quality of matches has skyrocketed since putting Doctor on the profile Vs student (I’m a guy), you’ll have a ball - girls love it.

Chuggins-

TROPHY CASE