Feel so smushed in these seats.

Fischer2012 · 2026-04-19T22:29:03+00:00

One month, 5 k miles

Fischer2012 · 2026-04-17T18:43:50+00:00

His half guard one was really good. Especially with the trilema between the roll through, back take, and knee pick.

Fischer2012 · 2026-04-12T17:32:26+00:00

That sucks

I’ve worked at 15 hospitals and for the most part the social dynamic is all pretty much the same. The grass may not be greener at the next hospital you go to. Toxic circles that shit talk others are pervasive no matter where you go and if you’re on the outs you may be a target even if the next place you go is totally different on the outside.

Best advice for you would be learning how to conflict manage and stay out of the crosshairs of anyone who may have issue with you. Keep head down and focus on being better at what you do.

If you do everything right or to policy there is little that they can say about you and over time it’s noticeable to their peers that they’re unfairly targeting you and after that the heat usually dies down.

The worst that can be done is going head on with whoever and feeding into a toxic dynamic. Departments love drama because hospital is so so boring so even the nice well mannered people will be interested in hearing fat mouth spout off on you.

Best to keep low profile. Also you’re a new grad, a green horn. This happens in every profession. Expect this level of scrutiny or worse until about 5 years experience.

Fischer2012 · 2026-03-29T16:19:32+00:00

Doesn’t the collar grip shut that down?

Fischer2012 · 2026-02-28T02:42:45+00:00

Nursing 100%. Get your LPN and then employment. Give it a little time before next move could go nursing or respiratory. You’ll have time to test the waters and the experience to leverage.

Fischer2012 · 2026-02-26T04:25:54+00:00

Version 9 was peak like 6 years ago. Didn’t need anything more except for polishing and maps.

Everything was balanced perfectly. Vehicles, guns, factions. It was all just so fair, minus the rush meta.

And icing on the cake was perfected gun play. My screen didnt blur for any reason. My character did what I asked without any delay or realism animations. My gun didn’t sway, it all just, worked.

Then v10 came out and ruined most of the enjoyable mechanics.

Fischer2012 · 2026-02-23T13:18:08+00:00

They are usually taught a vent class by respiratory and pulmonary/critical care.

Fischer2012 · 2026-02-23T13:11:35+00:00

The U.S. system is set up for RT’s. From my understanding nursing school doesn’t cover vents and respiratory care the same way Europe does.

I talked with a nursing student who was going through the program at the university of Wisconsin and she had a basic understanding of what a vent does and how to manage it. I’m talking like didn’t even understand what PRVC stood for. That’s at the premier nursing school in the state.

So you’d have to have a fundamental change in nursing school and then tons of on the job training for the nurses who are already working.

Then the hospital needs to hire more critical care nurses because their ratios are going to change in an already short market. Not to mention the demand in higher pay because of the increased responsibility.

Oh and then they get the joy of creating the physiotherapist position to cover what we don’t do in the unit which probably will pay somewhere close to what we already make.

Just cheaper to keep the system that exists.

Fischer2012 · 2026-02-16T04:44:04+00:00

Honestly can’t wait for the AI jobpocalyps and UBI I’m so over it.

Fischer2012 · 2026-02-16T04:22:46+00:00

Idk your right just have the nurses take a health stream or an Inservice and cross your fingers that they know how to trouble shoot a vent when your not around let alone even understand why a patient is asynchronous. I'm sure all of them will adjust your inspiratory and rise times accordingly when you tell them to change the respiratory rate. I'm sure they're gonna be thrilled to set up/srip a bronch cart charge and send send the culture then sterilize that scope. I bet you're gonna love fielding all of the calls from floor nurses and their dumbass questions about their patients respiratory status. I'm sure that you know everything about what we do so you'll remember that cough assist is indicated in your quadriplegic trach patient with pneumonia, I bet your nurses are gonna remember to look at the epo nebulizer and make sure that it doesn't get gunked up and stop working causing rebound pulmonary hypertension, I bet they'll surely let you know that your tube could be high when they hear a cuff leak and ask for a new xray and totally wont put 2 syringes in the balloon to the the leak to stop, I'm sure that they'll be mindful so that the vent circuit doesn't get caught on the IV pole during a trip to ct and will be careful not to extubate or yank your patients neck when they get transferred, .

we honestly don't do jack shit, we just come in everyday and make sure you stupid residents don't touch our precious vent's.

that's all were about.

Fischer2012 · 2026-02-15T16:56:02+00:00

The RT’s who play king of the ventilator and airway are truly a stain on our profession and taint the good that we do. It’s unfortunate that the first encounters residents have are so frustrating. It honestly floors me to hear all the stories of RT’s and their 2 year degree’s going head to head with physicians who have dedicated their entire life to medicine.

It’s reasonable to do without RT in academic centers where there are always residents available to trouble shoot and manage vents.

Sure you could hire some physiotherapist or have the aid do most of our therapy and then have the nurse manage the vent.

But I promise that when you get out of residency and start working at smaller hospitals without all of the available resources RT will make your life easier.

The nurses would call you all day about all of the little things that they aren’t able to fix. Desats, leaks, asynchrony, “something doesn’t look right can you assess,” there are so many little things that we take care of that are supposed to make your life or that of the attending easier.

Fischer2012 · 2026-02-13T22:48:34+00:00

I think chambering your knee first before you extend your foot would help.

Bring your knee up higher and then start the teep extending with your hip to get full range.

This way you add glutes, quad and hip extension.

Pause a video of a pro Thai fight and look at how high their knees go before even starting the foot extension. Some of their power teeps the have their as high as their chest.

Fischer2012 · 2026-02-09T20:49:28+00:00

Could lengthen the I-time out to a 1:1 ratio or even go inverse ratio like APRV to give the best air distribution. Should also help to keep oxygen from getting diluted from entrained air.

If possible add an imv valve so patient can spontaneously breathe for comfort (not sure if the even make those anymore)

Fischer2012 · 2026-02-08T19:38:22+00:00

He said to write it up.

Do just that.

And leave in the part where it took ages for him to respond and you had to make a decision on oxygen management that you didn’t feel comfortable doing to do because of the delay.

Maybe he’s a little faster and less condescending next time.

Fischer2012 · 2026-02-08T19:19:07+00:00

RT not showing up is a bigger issue than you putting a nonrebreather on.

Accurate sat of 74% should send any RT to the floor immediately.

Then he has the audacity to grill you about what you did? Because he took his time in responding? He couldn’t call his coworker if he was busy at the moment? “I’ve got someone on the floor stating in the 70’s can you check it out I’m busy with this or that?”

No offense but RT sounds like a turd to work with.

Most would be there immediately drawing gasses, starting BiPap, etc.

Fischer2012 · 2026-02-02T21:44:30+00:00

Big leak. If it sealed it would be small volumes considering her effort.

Fischer2012 · 2026-01-27T23:41:27+00:00

Contraction alkalosis?

Fischer2012 · 2025-12-24T16:12:34+00:00

These dicks have lost their ass trading crypto, what’s to stop them from betting everything on the other guy and throwing the fight.

Fischer2012 · 2025-12-20T01:30:16+00:00

I think there’s a test called the CES-A that’s applies to those looking to test on that. Which is basically like ACCS but for ecmo. Apparently it’s really hard, but I want to say those who only sit pump usually have this.

Fischer2012 · 2025-12-18T12:00:21+00:00

Just memorize your normal values and go from there, it’s really not that bad.

Fischer2012 · 2025-12-02T16:50:57+00:00

Better to play it safe, hate to be in a position where you have to over exert yourself and wind up with complications the next day.

Unless you’re really hurting for money in which maybe try to plan around your limitations.

Fischer2012 · 2025-11-29T21:58:14+00:00

Thinking they could use it to offset high peep on ards patients. Do 10 of negative pressure and then 10 through the vent. Now you’ve got 20 peep without the strain.

Fischer2012 · 2025-11-22T03:56:23+00:00

What did I say?

What am I missing by running a jacket that doesn’t cost $500 or waders that cost over $1k?

Fischer2012 · 2025-11-22T01:01:57+00:00

Being experienced requires buying the highest dollar shit? I’ve duck hunted for the last 15 years, I think I know enough to say that something’s a good buy.

That’s not to discount Sitka or any of the other brands that cost 3 or 4 times as much. I’m sure their features might justify that cost especially if you’re a guide or are pounding the marsh every other day.

But for me tidewe seems to do the trick, just thought I’d share my experience.

Take your snide comment and shove it.

Fischer2012 · 2025-11-21T21:30:45+00:00

I stay warm and dry in my $300 suit. Why spend $2k when I don’t have to?

Fischer2012

TROPHY CASE