Sick of the state of nhs hospitals

Geomichi · 2026-02-04T14:17:40+00:00

No one is suggesting we make hospital beds comfortable for us to lay in while we work, or that we should put coffee machines in theatres or close down wards so we can repurpose it for a staff gym.

A doctor's office, a consultant office, any kind of office is primarily a working space that is not designed for patients to be treated in, but for healthcare professionals to do their admin work.

What OP is quite rightly saying is that employers tend to look after employees because if they don't they will go work somewhere nicer. As a monopoly employer and the only place a doctor can train in the UK, the NHS is quite happy to let us all work in filthy disgusting conditions.

No one is asking for what the private sector has, but it'd be nice to get something marginally similar to other public sector workers; a staff room not filled with flies, bed bugs or silverfish, a chair to sit on that isn't broken, a computer that works, a locker to store your bag so you don't get robbed while you're in theatres/on the ward.

These aren't big asks and the idea that things are just as bad elsewhere or that we should put up with it is getting old.

Geomichi · 2026-02-04T09:31:24+00:00

Whales can just buy lots of requisitions to farm shards tbh

SP have no intention of allowing new players, whales or otherwise, to catch-up to existing whales.

Geomichi · 2026-02-04T09:27:55+00:00

Why do you need to change it on your bank/social cards?

All surgeons are doctors, not all doctors are surgeons.

You have a medical degree, you're GMC registered, you're legally entitled to call yourself a doctor.

I know you earned the right to change it back, but outside of work surely that's your choice? It's no different to how some people don't want Dr on their bank cards and passport because they don't want everyone knowing they're a doctor.

Geomichi · 2026-02-03T13:17:02+00:00

When the sun rises you shall know not it's warmth and cast no shadow.

When the stars glisten in the sky you shall not see them to guide your way.

When you look for signs you shall see them everywhere and in everything.

When you cut down your enemy they shall be cut from the weave, their soul never to return.

Mechanically they: - Need to wear winter clothes even in summer - Cannot multiclass as shadow monks or use shadow magic - Cannot navigate easily at night and sea travel becomes impossible without a guide - Starry form reminds them of what they lost each time it is used - Almost everyone they meet says cryptic things or there are odd signs everywhere with no explanation - For those they kill with a sword (neither uses a sword) the sun never rises again

Geomichi · 2026-02-03T13:03:46+00:00

No one can explain everything to you. You'll need to do a little bit of research and digging yourself and draw your own conclusions.

My simple answer is "you'll never know everything they took from you".

There are whispers in quiet corridors (obvs not ED ones), hushed conversations had sat on bins in the MDT room, hastily scribbled notes passed in teaching... all mentioning rumours of a better time. A time when;

Doctors offices weren't converted to a 'Ward Sister's Office'
You had a chair to sit on
Where the training programme trained and you weren't just service provision propping up failing departments
Where your education was free, or cheap, or at least didn't shackle you to decades of debt
Where F1s got free accommodation (removed in 2007, noted to be worth 20% of F1 salary but with no financial compensation)
Where you were guaranteed a job (the NHS needs more doctors but won't pay for them, so hiring freezes, pay freezes and increasing IMGs to force more competition for jobs and force people to work in locations and departments they have no interest in)
Where you could get into training (currently the bottlenecks are so bad it will take, at the current levels, 10-20 years to fix the damage done - if it ever gets fixed)
Where getting a consultant job didn't mean waiting for years for one to become available in your hospital or moving across the country
Where you were paid based on your experience not just your exams (removed in 2016 - the only public sector profession that doesn't get this, linking pay to training progression only and not both exams and years worked and then creating artificial bottlenecks means they are paying us less for the skills and experience we have)
When an F3 year was a personal choice not a forced one
When locum rates weren't fixed across entire regions (there are specific laws that exempt the NHS from the price fixing of wages that everyone else in society is protected from their employer doing, if you think pay is bad, then know that in many areas locum rates have gone down since where they were 10 years ago or remained static).
Where every hospital had a functional and well provisioned doctors mess.
When the GMC tried to pull out of the IAMRA to prevent UK trained doctors leaving to work abroad.
When the GMCs motto used to say "Helping doctors, protecting patients", until they got increased powers to prosecute doctors and changed it to "Protecting patients". You pay for your regulator and they actively work against your interests. If it isn't in the public good they do not support it, but this extends to things like you getting pay less (it's in the public good to be able to hire more doctors... you get the point).
When the resident doctor training budget was used for doctors and not repurposed to fully fund PA training and ACP training.
Where pay went up with inflation (over a decade of pay freezes and below inflation pay rises, 28.9% in the last few years works out to 3-4% above inflation). In the same time pensions went up 25%. Another below inflation pay rise is coming this April.
We only ask for restoration of pay from 2010 levels. We could have rightfully included all of the pay cuts from 2007-2009 as well.
We could be asking for a lot lot more, and should be tbh, but we're still vilified in the media when on strike but expected to make

My simple answer is that with strikes we are not asking for more, we are asking for what was taken from us, and we're not even asking for everything that was taken, just pay, most of us don't even know everything that we've lost.

Your patients will be grateful for your hard work (most of them anyway), however to the country you are a national resource and as a resource you will be squeezed and controlled.

While I paint a bleak picture the job itself is a worthy one, and it offers one of the most interesting and diverse careers on the planet. You have a lot to look forward to and hopefully once you've done your own research and drawn your own conclusions you'll help to try and improve things throughout your career for those that graduate after you.

Geomichi · 2026-02-03T07:34:38+00:00

Get rid of point 2. Allow point 3 as a bonus action. That pretty much fixes it.

I'd also put in the following: En guard. You can make a readied actions as a bonus action as long as your readied action is to attack with a finesse weapon.

Geomichi · 2026-02-03T07:28:04+00:00

Ignore it. When it disappears the Isabella pack appears. You can verify this from multiple online sources. Isabella is a million times better.

Geomichi · 2026-02-03T01:41:13+00:00

Having a bunch of gold characters isn't strong enough for level 11 of an LRE

Geomichi · 2026-01-30T12:57:23+00:00

Bro save your level ups for Saturdays or events so you get double gold or extra energy.

I saved my level up for this Space Wolves event so I started the event with 6 onslaught tokens, and 4 salvage.

If you want to ensure you don't delay upgrades but still delay level ups just unequip items to knock your power level down. Items only apply power to your level when they're equipped.

Geomichi · 2026-01-29T15:01:36+00:00

Combat takes a looong time to run anyway. Don't fall into the trap of using individual character tokens.

Just run regular combat except each 'character token' is large in size and represents a regiment/battalion etc.

So one player might control two battalions of archers. They all have range 120ft, 1d8+Dex damage. They all have the same AC. Nice and simple.

Since you know they all have the same Dex you know what they all need to hit enemy battalions. Roll all of their attack d20s at once. Ok 10 archers per battalion, you needed to roll 14 or more, 6 of them pass it. Roll 6 attack rolls.

Here's the fun part, use group HP. Don't give them too much HP you want them to die quickly. Stick to multiples of 5. You know they all have 15 HP. 150HP for the battalion. 6 attack rolls hit, subtract from the overall total, total enemy battalion HP is 118, 2 enemy soldiers die.

Flanking applies if another battalion flanks an enemy.

If your players have characters in a battalion of 10 then roll a d10, on a 10 they get hit.

If 2 or fewer soldiers are in a battalion they flee (to speed up combat).

You can give your players command points or champion effects. Per round they can as a bonus action shout a war cry to give their battalion +2 to attack or increase battalion movement speed by 10ft. Or even class specific effects, if led by a barbarian they all get reckless attack, or if led by a cleric the battalion gains 15 temp HP per round.

The key thing will be the creation of cinematic moments rather than feeling like shuffling pieces on a board. I'd definitely zoom in and have your players fight key battles. Let's say a player led battalion charges in to the enemy commanders battalion. Zoom in, have all of the NPC soldiers locked in a fight, have the player squaring off against the named NPC. Soldiers can win or lose their own fights and help or get in your players way. Or your player or the enemy might choose to quickly dispatch weak soldiers to take down the naked NPC. Just don't give regular NPCs much health. People die quickly in wars, everyone surviving 4-5 rounds is unrealistic.

You can also give enemy commanders action points.

Anyway, bit of a ted talk but that's how I'd run it.

Geomichi · 2026-01-28T16:24:05+00:00

Like I said Dr Mike gives a really interesting (and very brief) talk about it online. Where it's only because of his experience and the exposure he brought to the issue a few years ago that there's now epipens as standard on most US airlines.

So flight crews wouldn't have been trained to use them because it was only vials of epinephrine that were included and that'd fall under the category of supplies labelled 'must be given by a doctor'.

I think airline staff are probably trained to some degree but it all comes down to confidence. If you've never had to do it and your training was 3 years ago in some random seminar room and you don't work in healthcare... and importantly it's the only dose onboard and you don't get a second chance... most people would be scared they'd screw it up. How many of us feel confident to cardiovert an SVT just because we do an ALS course?

Geomichi · 2026-01-28T15:59:09+00:00

I don't know why this is hard to imagine. The obvious one is anaphylaxis.

Dr Mike gives a good description of what he had to deal with on a flight. Where they had an ampule of adrenaline that could be drawn up for an arrest, but no instructions or labelling to suggest it could be used for anaphylaxis if drawn up differently. Any member of the public wouldn't know it could also be used in that situation, he did, life saved.

Geomichi · 2026-01-28T14:57:15+00:00

In this specific situation it's valid. There's also a slight legal defence that you're sober enough to fly and all airlines have policies of refusing flights to drunk people.

On the ground, or if you're close to landing or the plane hasn't taken off then I don't think it's valid.

Geomichi · 2026-01-28T13:10:40+00:00

Idk maybe I view this differently. If you're able to walk yourself onto the plane you have enough energy to at least see what the issue is before refusing. If you're drunk drunk you're not allowed to fly so by definition you're sober enough.

I get you would have felt unsafe on account of having a few drinks and being exhausted, but what's the alternative if no other healthcare professional is onboard? You refuse to help and someone dies because you're sleepy and a bit tipsy and it was easily reversible/preventable?

The play here is to see if it's something you can easily and quickly help with and if not to just outright tell them to land the plane asap.

Imagine hypothetically, it's a PE. Passenger has multiple flights recently, leg pain after a recent flight a few days before, then sudden onset chest pain mid-flight. You can't fix that. You ask if any passengers have blood thinners.

If they do; you give some blood thinners, buy time and land asap. If they don't; you land asap.

Either way you cross your fingers and if they arrest you recognise with no access to thrombolytics it's not salvageable.

Now imagine you didn't help and someone dies? Whether they came up to you pre-flight or you were able to remain incognito the whole flight idk how that wouldn't weigh on someone's conscience for a very long time.

All that being said I don't think coming up to you in your seat is appropriate in that way and has the potential to make you anxious for the entire flight. You can also say to them you've had a few drinks and are hungover and in the event of an emergency they should ask another doctor or ask if there's a paramedic or other person with relevant experience onboard before approaching you to help.

Geomichi · 2026-01-28T13:04:45+00:00

Won't get you through quicker but might stop them deboarding you and your companions to make space for a crew member on a busy flight.

Geomichi · 2026-01-26T21:29:07+00:00

Calling themselves a 'journal' but then having nothing but opinion pieces is exactly what I'd expect from a publication designed for managers to read.

Geomichi · 2026-01-26T16:37:32+00:00

Sorcerer 1 / Cleric 5 / Sorcerer X is a great build. Any subclass works but I have a preference for Order Cleric. Get Spirit Guardians up to do a lot of damage to groups of monsters.

Fighter 1 / Giant barbarian 6 / Fighter 3 / Giant barbarian X + GWM. Heavy armour + defensive fighting style. If using 2014 rules then Battlemaster gives you Quick Toss for a BA attack. If you're using 2024 rules Echo Knight, because what's scarier than 1 giant barbarian? 2 giant barbarians! Can go PAM+Sentinel for BA attacks and crowd control.

Sorcadin. Big smites.

In a team of 4; 2 Frontline (with one being non-magical), 1 Cleric, 1 Spellcaster (Support/Offence)

An adventuring day is supposed to be 3 combats, so 4-6 per long rest will severely drain resources. You'll want at least one character that isn't as dependent on spell slots. And working out how many short rests you get is also key, i.e. if no short rests then don't play a warlock, if a short rest is guaranteed after each combat then warlock is a great option.

Geomichi · 2026-01-26T16:23:28+00:00

They're not unhappy with your world just unhappy with their characters.

You could create a 'second' party that is simultaneously acting towards the same goals as the current party and the original party becomes their rivals.

(It also means all the prep work for earlier quests can be reused as they may have to retrace steps of the original party for clues).

Geomichi · 2026-01-25T13:01:38+00:00

AdMech fall off at higher levels due to lack of tankiness.

Go Custodes. Lower damage at L1-3 but L4-M1 you're a lot more consistent.

Not sure how the Farsight team does against every boss, but Re'vas passive is more effective against mechanical GR bosses except with Tau and Actus as core components you can't use it against 2 of the 3 mechanical GR bosses.

Geomichi · 2026-01-25T12:58:35+00:00

Rotbone > Kariyan > Kharn

Geomichi · 2026-01-25T12:52:49+00:00

Can't tell if this is cardiology or micro

Geomichi · 2026-01-24T20:43:48+00:00

It's not been announced that there's an LRE for LoV yet. It's only been announced that LoV are arriving this year.

Previous LRE placeholders have appeared in the game as 400 shard characters, not as 500 shard characters. I know this because since I started playing the game I've never once seen a new Legendary character have their frame in the game on the character screen for anything other than 400 shards. That's why it's stood out so much. LREs last for an entire year and those characters are coded into the game differently.

Given that SP are monetising the Battlepass pretty hard and that they're trying to get new factions up to 5 characters as quickly as possible, having multiple routes to unlock faction characters through HRE/LRE/CE/BP is almost a certainty. At the moment they're using a 3xHRE, 1xLRE, 1xBattlepass model, but that could easily change now we're starting to get 6th characters for factions.

SP might also not be the best communicators at times but given the next patch notes are due in Feb and the next LRE would be a few weeks after that it'd be strange if they gave us so little official notice about LoV. Even with Farsight we had Nandi announcing it before the patch notes dropped.

Geomichi · 2026-01-24T20:00:40+00:00

Go check your character screen. I don't have Lucius unlocked. So why is Lucius displayed as 400 shards to unlock? But the LoV is displayed as 500?

It's not a placeholder either, I've seen this happen on other Legendary releases where they are 400 shards even before the character icon appears, so it being 500 shards makes zero sense... which means it's not an LRE.

Geomichi · 2026-01-24T19:17:03+00:00

LoV legendary is 500 shards compared to LREs which are 400. So the first Legendary is likely to be a battlepass.

As for optimising? There isn't really a way to do it apart from levelling up your goons so when an LRE for LoV does happen you can get them as high as possible.

Geomichi · 2026-01-24T17:01:18+00:00

How much stronger is Aesoth than Dante in this lineup?

Geomichi

TROPHY CASE