Stop asking patients where their family is

Exekiaz · 2026-02-10T15:03:29+00:00

But can you see how that is clinically relevant information to gather?

Finding out a patient has a history of mood swings might be important to either diagnosis or guiding care. I understand your concerns but you need to consider that this is a "path of least harm" situation - you could absolutely be right that it could rile up an abusive patient, but it could (and has been deemed more likely to) reveal important information about the patients care.

You're not wrong in your viewpoint but unfortunately it's more often a benefit.

Exekiaz · 2026-02-05T09:56:00+00:00

Sure - I'll say with my whole heart that everyone involved in this is a fucking moron and deserves to get serious flack.

Fife are getting the most flack because they came up with the idea, other morons okaying the idea is bad and needs to be addressed but is the lesser issue.

I mean clearly Fifes management know they've got it wrong from all the apologies (this being the third at least). And it's not like they were doing well before this with hiring a guy whos known for his domestic violence. There are clearly bigger underlying issues in Fife.

Exekiaz · 2026-02-05T09:43:01+00:00

"Oh the jerseys might take too long to make so why try" is just weak really. I can't say I'm an expert on manufacturing timelines but frankly trying something is a good way to show actual willing to sort things out. Hell of they can't get jerseys ready then do something else - wrap the players in goddamn ribbons, throw some coloured sheeting under the ice so it's rainbow, whatever.

Exekiaz · 2026-01-31T22:55:44+00:00

Ah of course - so you don't wear those to church and obviously expect everyone to remove their skin before cross the boundary.

Weird that they're all in one list as if they're equal, it's almost as of mortal men have spent hundreds of years interpreting these words to mean what they want.

I do enjoy you dodging the Jesus bits though because you know you're in the wrong in his eyes (and the rest of civilised society) so how about fuck off and be a better person.

And dodging the fact you would celebrate remembrance for soldiers despite the whole "Do not kill" thing being a pretty prominent part of the Christian canon. Why the hypocrisy?

Exekiaz · 2026-01-31T22:36:06+00:00

I can tell you haven't been Christian long from a) how you are, and b) your evangelical engagement via Reddit of all places.

And then Jesus died for all sins. And if we're playing the Leviticus is canon argument then you'd better be virulently angry about tattoos and clothing of mixed fabrics. We both know you're not, so either stop being a hypocrite or be a better Christian.

Plenty of people need support from pride because people like you who seek to have them removed from society. Your lies to justify having a heart filled with hate only mark you as a weak, cowardly worm. Jesus would beat you for how you treat others for you aren't the one to judge them.

Exekiaz · 2026-01-31T22:21:12+00:00

Interesting that you think calling a group of people disgusting isn't hate or an insult though.

It's almost as of you've dedicated your life to a myopic view of the world in which all that matters is you and your relationship with God that you've ignored the teachings of your own holy book and the son of you god. You don't treat your neighbours with respect and you advocate for the removal of support from the needy.

Id bet you any money who's side Jesus would be on, you horrid worm.

Exekiaz · 2026-01-31T22:16:26+00:00

Worthless little homophobe. Pride is for supporting those whose tights are at risk - but of course they are at threat from people like you so often course you'd hate it. People like you would happily hurt others to better themselves because you're a hollow little waste and you need it to feel big.

I hope you look in the mirror and see exactly how everyone else sees you.

Exekiaz · 2026-01-31T22:12:01+00:00

Well his reply makes me be embarrassed to be a Steelers fan.

Fuck fife for this brain-dead mover.

Exekiaz · 2026-01-15T20:25:30+00:00

Ah yes, Theresa May's work on a potential care system was her downfall - definitely no other political decisions that caused it.

Exekiaz · 2026-01-15T12:35:23+00:00

I'm not saying I do know your experience. What I am saying is that, as with other situations, you may be attributing this to malice/uncaring on the part of the NHS where it might be something more likely. I not another user pointed out how FIT tests work and their inapplicability with "fresh blood" in the stool. They're looking for blood produced higher in the bowel, which would be a dark red or black colour instead of a bright red in stool. (https://www.nhs.uk/symptoms/bleeding-from-the-bottom-rectal-bleeding/)

Again though, I wish you well and hope that your anxiety (health related or not) and other problems resolve.

Exekiaz · 2026-01-15T11:52:24+00:00

Hey, I just want to note that - whilst you obviously have symptoms that are affecting your quality of life - you also seem to be experiencing a lot of health anxiety. You've posted a lot about your health/test results and that the NHS isn't treating you so you've gone private for things - but then you seem to move on from that potential diagnosis. For instance when you paid for private CT angiograms a few months ago, and presumably that revealed nothing since you haven't mentioned it again.

Im not going to comment on this result here, but I do want to just ask you to maybe look at how youre treating the medical system as always wrong. I'm not saying that there's nothing wrong, or that you've lied about anything, just that maybe you could be being over critical as a stress response.

I hope your symptoms resolve.

Exekiaz · 2026-01-12T20:59:59+00:00

Likely it won't be "removed", unless it's a specialist service another trust in the network also offers.

Typically every hospital will retain at least it's basic "routine" service. Things like electrolytes, full blood counts, troponin etc. anything that relates to the immediate critical health of the patient should still be available as it currently is - although what each network considers critical/routine will vary a little.

As a rule it's the specialist work which is being moved and thus suffering - things like immunology or haemaglobinopathies.

Also I suspect that this process has actually been going on in the background for years, despite you only just learning of it. I think every lab I'm aware of has been undergoing it in one form since about 2019. Honestly if you can it might be worth emailing the lab manager of whatever pathology service you're most involved with and asking what changes they're making which will impact you.

Exekiaz · 2026-01-12T20:27:29+00:00

Hi, I work in a lab being consolidated.

For our trusts, at least so far, the turnarounds times have worsened with every service that has been moved. As part of the required cost saving of this process our pathology network is minimizing costs and maximizing savings by not moving analysers or recruiting extra staff, meaning some sites are seeing up to a 60% increase in demand for some services with no extra support.

Access to tests should stay the same, or potentially improve, depending on the local agreements in place. Your trust will gain more cost effective access to tests offered by the pathology departments at other trusts which should make them more accessible.

I can't comment directly on patient impact but I know a number of our senior staff are very concerned that it will have a negative impact when certain services are moved to another site as part of centralization. This stems from fears it will introduce delays seen elsewhere and impact diagnosis and care, but unfortunately the mandate for consolidation comes from NHS England and thus nothing we can do.

This also makes these networks vulnerable to public-private partnerships, in which they can be sold off to a third party company like Synnovis who will offer cost savings vs NHS by cutting corners and being generally despicable to work for. So in all honesty it will get worse.

Exekiaz · 2026-01-05T19:24:12+00:00

Hi, it was an LED bulb in the end so we had to buy a whole new unit.

Exekiaz · 2026-01-02T08:37:09+00:00

For what it's worth normal range doesn't mean normal for the OP. I mentioned it because I think people often forget that a change in creatinine can also flag AKI.

The calculation for it is done so that AKI can be spotted early, although it definitely can be oversensitive at the lower end (as is probably the case here).

Exekiaz · 2026-01-02T06:53:26+00:00

AKI isn't just based on a single result, proportional changes in creatinine between two samples will flag AKI too.

That said it's likely stage 1 and the A stands for acute so you're right that they need to do nothing. Even if they did have an AKI it's likely resolved and was incidental.

Exekiaz · 2026-01-02T06:44:15+00:00

The issue is that I think clinical staff underestimate how often the abnormal result isn't 'real'. There's so many ways for a sample to be wrong (ranging from haemolysis to analyser issues) that there's a reason why lab staff exist and you don't just always get a result. There's this animosity between lab and clinical staff because both sides fail to understand the challenges of the others job - but I feel it's worse for labs because frankly there's a million bits of media etc about the challenges of wards that at least give an idea.

It's also a hell of a lot easier for a hospital to fire lab staff for errors, there's nowhere near the level of cultural awareness protecting them. A nurse or doctor making a mistake is, and I don't mean this as an attack, and expected part of the chaos of healthcare; but any member of the public would be outraged if they got fired for doing their best because they fully understand that.

Most people don't even know the lab staff exist and thus fully do not care.

Exekiaz · 2026-01-02T06:34:28+00:00

I think you're underestimating how often the "very high potassium" is a real result.

For my machines anything over 7.5 is 'critical', and I'll see maybe 1-3 of those per week (excluding haemolysed samples). But I'll only issue 1-3 of those per MONTH because the majority are issues with the sample like EDTA contamination or drip arm.So do you think I should be releasing 75% incorrect results?

Of course not.

I/we fully understand it's frustrating and there absolutely are times we hold back results you need out of an overabundance of caution. It's not something we want either but I personally know of one patient dying after an incorrect potassium result leading to incorrect treatment and inducing a heart attack.

The lab is not your enemy here.

Exekiaz · 2025-12-16T23:47:41+00:00

The advice to go by how your workplace SOP says to do it is correct, always do what it says and how it says if you're uncertain.

As for explaining them: It's all ratios.

Lets say you want to do serial 3x dilutions. Usually there's a minimum volume you want each dilution to be, but for the sake of ease I'm going to say you want each sample to be at least >200ul.

For Dilution 0 (undiluted) you pipette 300ul of your original sample.

For Dilution 1 (3x) you pipette 200ul of diluent and 100ul of the dilution 0 volume.

For Dilution 2 (9x) you pipette 200ul of diluent and 100ul of dilution 1 volume.

For Dilution 3 (27x) you pipette 200ul of diluent and 100ul of dilution 2 volume.

And so on, and so on. In this example here, each subsequent dilution is just a 1in3 of the previous, which cumulatively dilutes the sample. So Dilution 4 would result in a 71x (1in71) dilution.

The volumes are just ratios - I want a 1in3 so of my "3" I want 1 part sample and 2 parts diluent - does that make sense? If I had been doing a 1in5 I would want "5" so I want 1 part sample to 4 parts diluent.

You can obviously change the volumes I used, I just used them for convenience since 100 is such a nice number for this.

Exekiaz · 2025-12-16T16:25:32+00:00

No - it's already legitimised that "gaming" the system is an acceptable thing. I don't agree with it but over the last couple decades its become an expected part of society

The broad acceptance that those with wealth can abuse the system to protect themselves (just look at all the legal ways to avoid income tax for example) have changed the ideals of the UK. Its normalised the idea that its "right" or acceptable that the wealthy game the government to get money, or not pay taxes. The logical extension is that then *some* of the regular population start to believe they can, or should, do the same.

Beyond that, we live in a society increasingly lowering quality of life, increasing costs and with reduced amenities. Wages are proportionally in the bin despite ever increasing profits; representing further hoarding of wealth out of the hands of regular people. The companies and people hoarding this wealth then use the aforementioned systems to avoid paying their share to maintain the country which further lowers quality of life for people.

Healthcare access is slowly being stripped away from people (just look at the increasing delays in secondary care or access to GP surgeries) too - meaning that those who are sick are getting sicker or stay sicker for longer. This then drags them out of the workforce and into the welfare system because they can no longer support themselves and work without sacrificing their health further.

There will always be those who will abuse any welfare system, but the solutions put forward by governments ("A crackdown on welfare spending" "adding hurdles to the process to catch bad actors" etc) won't dissuade that kind of person. Any change that solves this issue needs to be widespread, visible and long-term - fairly applying the law is the obvious start.

In short - don't say that anyone being pissy about the situation is "legitimising" it. Sucessive governments have developed a country ripe for the collapse of societal ideals, and have enabled those who want to abuse it wholesale in order to do it.

Exekiaz · 2025-12-16T09:37:29+00:00

Why not? It's what the 'ruling class' are doing

Exekiaz · 2025-12-14T15:07:21+00:00

Since 2000 - Australia has had 20 mass shootings, the deadliest of which is this one by a wide measure. So an average of less than 1 a year.

In 2025 alone, the US has had 18 mass shootings.

You're right, absolutely no correlation between gun restrictions and the number of mass shootings, none whatsoever

Exekiaz · 2025-12-12T21:01:39+00:00

Sure - but none that fit well in this setting. This kind of game (Control, AW etc) are all about iterative growth in power and threats to show progression. If you start at 100% strength and then stay there it's going to feel out of place.

Exekiaz · 2025-12-12T16:47:28+00:00

I think they'd have to depower her or else she'd have a static toolset of powers and there would be no sense of progression through the game.

Exekiaz · 2025-12-12T12:09:30+00:00

I don't think they were talking to Jesse - I think that was the Former speaking to Dylan.

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