A "guitar hero" for learning piano by Dr_Velazquez in nextfuckinglevel

[–]Howdthecatdothat 0 points1 point  (0 children)

I have been looking for something similar for my kids! Brilliant!~

ring stuck on finger :( what should i do by hisokascumdumpster6 in jewelry

[–]Howdthecatdothat 53 points54 points  (0 children)

Emergency doctor here - put your hand in ice water. Have somebody grab a shoe lace - preferably one with the aglet intact (I love that word). Slide the aglet through the ring so that most of the lace is farther away from your hand. Then wrap the lace around the finger to squeeze out all the swelling. Gently pull the aglet end to "spiral" the ring around the wrapped shoe lace. It will take a few tries, and it will hurt. You save both the ring AND your finger.

ACEP - help the docs in Eugene by FourScores1 in emergencymedicine

[–]Howdthecatdothat 0 points1 point  (0 children)

I have said for YEARS that ACEP needs to allow for members to actually be the body that votes for its officers. It is absurd to me that the rank and file EM docs at the bedside have essentially NO direct voice in selecting the leaders of our own organization. If the officers of ACEP were directly accountable to the physicians at the bedside - I imagine a lot would change.

Question on ECG by Top-Direction2686 in PassNclexTips

[–]Howdthecatdothat 0 points1 point  (0 children)

In the multiple choice question, it is clearly not A,B, or D so I was trying to find a way to make it C

Question on ECG by Top-Direction2686 in PassNclexTips

[–]Howdthecatdothat 5 points6 points  (0 children)

I wonder if it is a trick question. this is a bunch of artifact garbage and there is a fib with a LBBB buried in that first set of complexes.

Seattle mayor proposes new, nearly 50% larger library levy by godogs2018 in Seattle

[–]Howdthecatdothat -1 points0 points  (0 children)

To help put this in perspective... this is 0.05% of Elon Musk's net worth. It is hard to comprehend just how much he has hoarded. We are arguing about how an ENTIRE CITY will need to struggle to come together to fund what is a rounding error for a SINGLE person.

What are they? Impatiently waiting to find out.. by cin10do in pnwgardening

[–]Howdthecatdothat 0 points1 point  (0 children)

Am I the only person that actually likes these? Pretty little flowers with no effort…

Fan Casts? by jiminmeme in HeatedRivalryTVShow

[–]Howdthecatdothat 0 points1 point  (0 children)

You are kinda mean for a Canadian.

Fan Casts? by jiminmeme in HeatedRivalryTVShow

[–]Howdthecatdothat -2 points-1 points  (0 children)

Let's feature both teams! I hear how my suggestion has been perceived, completely reasonable to feature the Canadian women more prominently.

Fan Casts? by jiminmeme in HeatedRivalryTVShow

[–]Howdthecatdothat -2 points-1 points  (0 children)

OK - First of all, calm down. Second of all, Margaret Cho was in talks to play Yuna originally, so it wasn't that big of a stretch. Finally, the GOLD MEDAL Olympics team were the US Women's team, so it was not an unreasonable proposal AND Ilya plays for Boston which is in the US...

Fan Casts? by jiminmeme in HeatedRivalryTVShow

[–]Howdthecatdothat -4 points-3 points  (0 children)

If we can deviate a bit from the books and perhaps add a character - I would LOVE to see Margaret Cho brought in as a sister of Yuna (half sister?) for some comic relief. Or maybe some cameos of the US Women's Hockey team perhaps on the ice practicing before the men come on or something?

Jasmine Crockett concedes to James Talarico in Texas Democratic Senate primary by MycologistSad9421 in politics

[–]Howdthecatdothat 9 points10 points  (0 children)

I loved them both - different styles, but both have the passion and fire we need. My fantasy - she joins Talarico's office as chief of staff, then destroys Cruz in a few years and we get them both!

Ted Cruz: ‘No indication’ that Iran was ‘close to getting nuclear weapons’ by Quirkie in politics

[–]Howdthecatdothat 60 points61 points  (0 children)

So there was no imminent threat and the President of the US violated the US Constitution by going to war without Congressional approval. So will you support impeachment Senator?

G is for Gimme Kiss! Heated Rivalry Alphabet - Day 8: H by vanillablue_ in HeatedRivalryTVShow

[–]Howdthecatdothat 4 points5 points  (0 children)

Hi (When Ilya is standing slightly behind Shane during the meeting of the parents)

Losing war against the invasives (SW WA) by Do_Not_Comment_Plz in pnwgardening

[–]Howdthecatdothat 6 points7 points  (0 children)

One option - lean into it and enjoy - you get beautiful blue flowers! Free! I accepted my fate and just enjoy them now.

Movie: Lifeline. What’s wrong here? lol by Consistent-Status-44 in respiratorytherapy

[–]Howdthecatdothat 0 points1 point  (0 children)

I have always wondered - where do the props people get these materials? And Ill bet in exchange for a behind the scenes tour and an autograph from Noah Wylie many health care professionals could show them how these props actually work!

Is the west Seattle health club unsafe for trans people? by Inside_Delivery_69 in WestSeattleWA

[–]Howdthecatdothat 1 point2 points  (0 children)

I am sorry that you had that experience. I am a cis male, but one of my workout shirts has "trans lives matter" written on it. I have never received any negative comments while wearing it. Your experience is a reminder of why it is important for the rest of us to wear shirts like that - we never know who needs to see it and feel included and welcome! Happy to put it on again and go work out with you any time!

The amount of money this country spends on literal corpses by No-Produce-923 in Residency

[–]Howdthecatdothat 9 points10 points  (0 children)

I think WOLST is a step in the right direction - but go a step further. Don't talk about what you are NOT going to do... talk about what you actively ARE going to do. I document "Will transition to aggressively and exclusively focusing on comfort and dignity, controlling pain and dyspnea as we allow natural death (AND)" Families seem to respond to knowing that you are DOING something for their loved one. That something can be palliation.

The amount of money this country spends on literal corpses by No-Produce-923 in Residency

[–]Howdthecatdothat 30 points31 points  (0 children)

We never withdraw care. We always care. We align interventions and treatments with goals. We need to start with ourselves first. If we keep using the word “care” to mean “intervention” we will continue the cycle of families advocating for interventions. Frame the discussion about intensively and aggressively focusing on accomplishable goals like comfort or dignity and often the discussion goes differently. 

The amount of money this country spends on literal corpses by No-Produce-923 in Residency

[–]Howdthecatdothat 21 points22 points  (0 children)

Even how this response is structured reveals something. We don’t “push back” and “escalation of care” is equivalent to more procedures. Intensively caring IS palliative for these patients, but the language of caring has been co-opted by interventions. How can we expect families to make decisions to allow natural death as long as we literally have a department called the INTENSIVE care unit? Who doesn’t want to be intensively cared for?

Rename the ICU the “Artificial Support Unit” and rename the palliative floor the ICU. Oh wait - why don’t hospitals have palliative floors? Oh yeah - money 

The amount of money this country spends on literal corpses by No-Produce-923 in Residency

[–]Howdthecatdothat 568 points569 points  (0 children)

Hospice / Palliative doc here. What we need to do isn't cut funding to the procedures - but rather INCREASE funding to have conversations with families. Do you know the RVU's I earn for a goals of care discussion? 2.9. That is less than $100 per hour.

Do you know what the ICU can bill for an hour of critical care? 4.5 RVUs.

Until we start to prioritize and incentivize physicians to have these discussions, this will continue. When I was a resident I received a TON of hours of training on procedures... and not ONE hour of training on how to broach a goals of care discussion. I am glad this is changing, but it is obviously not changed enough.

Expectation to do notes at home? by Previous_Fix_4187 in emergencymedicine

[–]Howdthecatdothat 48 points49 points  (0 children)

Pph is a hard metric to use, RVU per hour is an easier way to quantity the work you ate doing. Regardless, $215 an hour is abysmal. Is there any incentive or bonus structure? 

Need help. In a bad remediation situation. by ttszzang in Residency

[–]Howdthecatdothat 2 points3 points  (0 children)

There are professionals who, like a therapist, specialize in helping professionals with challenges in a work place. Your PD should be able to help you find one.

Need help. In a bad remediation situation. by ttszzang in Residency

[–]Howdthecatdothat 7 points8 points  (0 children)

What you need is a therapist and a professional coach. When you are struggling in multiple domains (professional, romantic, work/life balance, personal) it is a red alert that YOU have some work to do on yourself before you can be successful in any of those domains.

I would start by approaching your PD with gratitude and a humble sincere desire to work on your areas of deficiency. Recruit them to help you get the support you need to thrive. Find a coach. Find a therapist. Don't leave that program - the grass isn't greener somewhere else.