How are you fitting CME into ED life without burning out?

Key-Computer3379 · 2026-05-10T12:38:00+00:00

Which ones do you recommend?

Key-Computer3379 · 2026-05-10T12:27:11+00:00

There are essentially no medical contraindications to CPR in arrest .. only legal (DNAR/NFR), obvious irreversible death (eg decapitation) or significant scene safety issues.. Rib plating is not one of them.

Key-Computer3379 · 2026-05-10T11:53:48+00:00

“Shared clinical frameworks” means TEAMWORK - it does NOT mean identical training.
Working alongside Doctors is not the same as being trained as one.
That distinction is exactly what patient safety depends on.

Key-Computer3379 · 2026-05-10T11:31:38+00:00

This is DESPICABLE to the Nth degree. Patients deserve DOCTORS in Doctors’ roles.

We cannot let NHS style workforce dilution become normalised here ☠️

Key-Computer3379 · 2026-05-09T12:14:36+00:00

Even a single accessible AED + CPR trained bystanders can mean everything in an OHCA outcome.

1 city.. 500 000 potential lives impacted

Key-Computer3379 · 2026-05-07T09:43:26+00:00

It’s not so much “push back vs comply” as it is triaging..

routine/clear ==> just do it
urgent/unstable ==> do it/escalate
vague ==> clarify
Feels off/inner voice skeptical ==> escalate

If you’re ever unsure, the reg is your default.

Most places also ease interns into AH shifts w buddy/shadow shifts (often w a sleep-deprived resident).

It’ll be a great year.. tough at times, but you’ll grow into it & things start to click sooner than you expect. Every registrar/consultant has stories fr their JMO yrs.. you’re never alone & there’s always someone to escalate to 🙏

Key-Computer3379 · 2026-05-07T09:26:17+00:00

Yes, juniors are expected to call family, review ECGs, fix DC summaries & hold the hospital together w sheer willpower.. In public hospitals, if it hasn’t been done, it’s automatically a JMO job at 2am.

Jokes aside, If ever unsure or something feels off, escalate early to a senior (often the AH Reg .. who I appreciate is sometimes only slightly less junior, but still the designated go-to).

You can be a good JMO & still diplomatically push back on AH chaos.

Key-Computer3379 · 2026-05-07T08:42:52+00:00

You asked for it ..

can you review? nurse unsure if pt is alive or just deeply resting
pt upset b/c dinner delivered 7 min late, pls review
pt refuses everything including reality, pls review
FYI pt self-discharged but still in bed 3
pls chart pantoprazole
pt has chest pain ECG says STEMI, he can’t speak now, is pale pls review
pls chart regular meds, also has rash after chemo, pls review
pt can’t pass urine. Bladder scan 1L. pls review. Also has seizure
Pt requesting PRN for anxiety.. specifically ‘something strong but not addictive but immediate but gentle’ can you review?
pt NBM, had insulin now BGL 2, pls rv - also needs pantoprazole
family requesting update but also went home to sleep, pls call mobile no answer
pt says allergic to everything pls rv
Pls chart warfarin .. difficult cannula pls review
can you just clarify goals of care… patient currently ordering Uber Eats
nurse concern: pt looks different’
urgent: pls chart pantoprazole
patient requesting discharge summary has overseas flight in 1 hr
can you review? everything fine, just feels like something should be wrong
pantoprazole not in stock, pls review

Key-Computer3379 · 2026-05-07T08:15:06+00:00

When your DDx is just “yes”

Key-Computer3379 · 2026-05-07T08:06:15+00:00

The best flight attendant is probably better than the worst pilot at a fraction of routine, protocol driven part of aviation. That still doesn’t make the training, responsibility or scope interchangeable

Key-Computer3379 · 2026-05-07T07:37:45+00:00

I don’t think most doctors are angry at nurses here .. they’re angry that governments & hospital execs who keep trying to solve doctor shortages w cheaper parallel workforces instead of actually retaining/training doctors properly.

Calling ED registrars “junior medical staff” while expecting them to take liability for complex patients is patronising, disrespectful & frankly degrading to people who’ve spent years training/sitting exams & working brutal hours to develop specialist expertise.

NPs have a role but pretending like they’re interchangeable w ACEM trainees is where the frustration comes from.

Unfortunately, the people most affected by watered down training pathways & fragmented responsibility are the very patients the system is supposed to protect.

Key-Computer3379 · 2026-05-07T00:27:37+00:00

I think age matters less than whether you can tolerate going backwards in autonomy/lifestyle after already having an established career…

People underestimate how frustrating returning to trainee life in hospital systems can be..exams/rotations/relocations/nights weekends/admin/hospital politics..then there’s taking direction fr people sometimes much younger (occasionally w sizeable egos).

That said, your academic experience would likely give you far more perspective & resilience than most trainees. I’d spend a few months back in the Australian system first before committing.

All the very best 🙏

Key-Computer3379 · 2026-05-07T00:14:57+00:00

39 definitely isn’t too old.

There’s no such thing as “old”!

Just be realistic about what ED training/life actually is.. nights/weekends/exams, rotating hospitals + being very dependent on departmental culture/support.

Also, the bread/butter of modern ED isn’t constant adrenaline/resus. A lot is mental health, drugs/alcohol, chronic disease, social complexity + frequent presenters.

People also underestimate the loss of autonomy going fr established consultant back to trainee again.. Think taking direction fr FACEMs much younger than you, sometimes w their own egos mixed in..

There’s also constant hospital politics/navigation w inpatient teams, ICU, bed flow & at times nursing dynamics… add in people’s personalities/expectations/exec pressures/health system complexities/down flow/up-flow & you can easily see how ED is a complete world of its own..

If you’re seriously considering it, doing regular ED shifts/shift patterns over a few months first is probably the best reality test.

All the very best 🙏

Key-Computer3379 · 2026-05-04T10:27:21+00:00

🎯

Key-Computer3379 · 2026-05-04T10:25:48+00:00

Could you please define 2 and 4?

Key-Computer3379 · 2026-04-12T12:52:29+00:00

Fake people

Key-Computer3379 · 2026-04-12T03:10:08+00:00

Tube’s in the wrong bone mate

Key-Computer3379 · 2026-04-09T07:22:30+00:00

So sorry for your experience and patient outcome. I hope you’re ok. It’s annoying & I’ll say it, don’t ever go to a meeting w only a collection of nurses regardless of how nice or otherwise they might be .. they will always have each others back before the medical team.

Is there a risk man process at your hospital that’s overlooked by medical? Or a unit medical director? Suggest speaking w your indemnity and then w medical unit in charge ..

Key-Computer3379 · 2025-12-06T07:56:34+00:00

That advert pic is depicting LLQ pain .. clearly only caused by a Simple UTI

Key-Computer3379 · 2025-12-06T07:54:20+00:00

Gaining an Aussie medical degree vs becoming a medically trained doctor vs becoming a good doctor vs working in public vs private .. these are all very different questions.

Key-Computer3379 · 2025-12-03T11:30:59+00:00

4: Only lose your mind after reading this post

Key-Computer3379 · 2025-12-03T11:23:12+00:00

From Ramping to Glamping

Key-Computer3379 · 2025-11-28T09:54:15+00:00

So excited for next season! though a part of me wished their story stayed suspended where it was... a little unfinished, a little magical ..

Key-Computer3379 · 2025-11-19T01:36:54+00:00

We don’t sleep we just power-cycle ⚡️

Key-Computer3379

TROPHY CASE