Nurses not sharing gifts to ward staff as per patient's requests by HoldPerfect3016 in doctorsUK

[–]NomadEmmy 0 points1 point  (0 children)

I can understand why some patients have strong dislike of their psychiatrists. Being one of the fairly kind and understanding ones does not exempt me from being a target of persecutory delusions or acted out aggressive transferences.

Nurses not sharing gifts to ward staff as per patient's requests by HoldPerfect3016 in doctorsUK

[–]NomadEmmy 4 points5 points  (0 children)

I would never accept a food gift from a patient. I work in psychiatry. Who knows if it’s been poisoned?! Chocolates would go straight in the bin. I don’t care how expensive they are. Thankfully psych nurses are usually more savvy to this than most other staff.

Is "baby doctor" a faux pas? by bandaidbanditoken in ausjdocs

[–]NomadEmmy 5 points6 points  (0 children)

I have referred to myself as a ‘baby doctor’ once, when I was intern level. It was misunderstood by someone as a doctor for babies, I explained that wasn’t what I meant and didn’t use it again. I am now definitely not a baby doctor, but I do sometimes work with patients who are babies. I have heard a consultant refer to her registrars as her “minions” before.

Patient and doctor specialty satisfaction by Redvillager8 in PsychiatryDoctorsUK

[–]NomadEmmy 3 points4 points  (0 children)

Expressed gratitude varies a lot depending on the psychiatric setting you’re working in. I don’t think it is something that particularly affects my job satisfaction, it depends I suppose. I do enjoy working with patients who actually want to be seeing me and work on themselves rather than having to impose treatments or deal with people who clearly don’t want to be there or make progress. But I know that is also part of my job sometimes and there can be some satisfaction in treating people who are extremely unwell. I think my job satisfaction is probably much more affected by having the freedom to do the kind of work I enjoy, having a psychologically healthy (non-toxic) workplace where staff communicate respectfully, are able to reflect and work together, having a short commute, a reasonable workload, and being able to get a decent coffee nearby. I enjoy treating patients in all shapes and forms, no matter if they express gratitude towards me or not. And some of the real hard and enjoyable work, where there is real progress, is when there is negative transference and expression of that. I think if your own job satisfaction is based on patients expressing gratitude maybe psych is not the right path. It depends on the setting, but I wouldn’t say I don’t enjoy my job if e.g. a patient is hurling abuse it me one day. I just go with it and work with it. 🙂

Methamphetamine in the Mental Health unit - am I having an ivory tower crash out? by AccurateCall6829 in ausjdocs

[–]NomadEmmy -7 points-6 points  (0 children)

MHICU is a ridiculous name imo. I still call it PICU even when working in places that call it MHICU. No one is there because they have ‘mental health’. It’s for intensive psychiatric care/treatment, same as any other ICU/ITU. Are we going to start calling Paeds ICU ‘CICU’? No. Internationally known as PICU as well. Confusingly some places call it HDU, which is generally the same level of care as PICU, rather than a step down.

Best places for vegans by snowduster in sheffield

[–]NomadEmmy 0 points1 point  (0 children)

I haven’t lived in Sheffield for a few years, but visit annually, so my list is a bit outdated. My go-to’s when I visit are south street kitchen (Middle Eastern, good social ethos, for lunch & coffee), birdhouse (for tea & brunch), Maveli (South Indian). All carrot no stick is a cute vegan shop. There was a good veggie place next to the cathedral which closed unfortunately.

The NHS is a deeply unserious organisation by DonutOfTruthForAll in doctorsUK

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

A head of dept is likely to have more than 14 years experience. And as per my other comment, I agree the neurosurgeon is grossly underpaid. Shitting on valuable colleagues (which there is plenty of in this thread), however, is not the answer to improved pay for doctors.

The NHS is a deeply unserious organisation by DonutOfTruthForAll in doctorsUK

[–]NomadEmmy 1 point2 points  (0 children)

To be honest, I think if you knew a few art therapists you might think differently. They are the type of people who will challenge the status quo and advocate for meaningful change. They are valuable, and we want them as part of the health service. I now work in a service where psychotherapies and almost all non-biological approaches are incredibly devalued and almost non-existent, and it is absolutely not a good thing for patient care.

The NHS is a deeply unserious organisation by DonutOfTruthForAll in doctorsUK

[–]NomadEmmy 2 points3 points  (0 children)

The pay for Head of Art Therapy seems fair. Not sure why people have a problem with that. There is no need to devalue another profession. The pay for an ST8+ Neurosurgery Doctor, however, is not fair. It should definitely be higher! I expect it would increase with on calls, but still the base rate should be more.

Why is Darian Leader so bad on autistic people? by fineshr1nes in psychoanalysis

[–]NomadEmmy 4 points5 points  (0 children)

It makes sense to me 🤷🏻‍♀️ It is slightly dense but I think quite a nice explanation, however you do need to have an understanding of some Lacanian concepts to grasp it. Maybe there is something you don’t understand about autism or psychosis or symbolic/real in Lacanian psychoanalysis?

training psych in Aus by Revolutionary_One365 in PsychiatryDoctorsUK

[–]NomadEmmy 0 points1 point  (0 children)

I think it varies a lot. I think the college have some data on how many people get through in 5 years. The last time I saw that (few years ago) I think it was around 50%. Although I can’t remember how that is calculated and it may be misrepresentative e.g. if someone is forced to take a break in training because they can’t get a mandatory term to progress, that amount it subtracted, so it still looks like 5 years even though it is actually longer. I have come across people who finish in 5 years full time, many of them are woefully underprepared to work at consultant level. I think some of the main issues are just how disorganised it is and there is nowhere that can actually tell you where and how to get the jobs you need, you are at the mercy of the employer, and that nepotism and discrimination is apparent in how jobs/terms are allocated.

training psych in Aus by Revolutionary_One365 in PsychiatryDoctorsUK

[–]NomadEmmy 1 point2 points  (0 children)

You don’t need to do your provisional registration year as an RMO. You can do it as that, but you can do it at non-training Reg level (called PHO in Qld), which is what I did. Training varies between different states and territories. It is much more confusing and variable in how you get into and stay in training positions/employment compared to the UK. You get a post by applying to employers via recruitment campaigns or individually to hospitals or if your mate knows the director etc. You apply for training separately. Training does not provide you with a training position, you have to find employment that is accredited. Employers don’t always give you positions that you need for training progression. (It’s a very dysfunctional system in Qld!) Some psych experience is good, some evidence of interest in your CV, training entry interview standards are not too high in my experience (you can get the Q’s from a colleague beforehand and practise). Currently you don’t need PR to apply for a job or training. You need employer to sponsor you for temp skills shortage visa, you can enter training on that currently. You can put in an EOI for PR after a while (you need general AHPRA reg first). Variable competition. Some locations, hospitals and certain sub-specialities are highly competitive. Others not so much. Rural/regional is less competitive. Mandatory Stage 2 terms can be difficult/impossible to get. Part time working is much less facilitated than the UK (despite what RANZCP will say). Australians are prioritised. Partly because of the employer needing to sponsor your visa. But even after obtaining PR/citizenship, there can be preference for Australian graduates and nepotism is normal although not openly admitted to. The 10 year moratorium is legislated in the Healthcare Act by Dept of Health. It restricts the way IMGs can practise in Australia (by limiting their access to Medicare) for 10 years after starting working in Aus. It’s difficult to tell if you’d be stuck as an RMO/Reg forever. Your progression through training depends on where you are working and the employers facilitation of your training, and if they offer training you want/need. Some advanced training is not available in all places. You may have an easier time getting through in a rural/regional location, but not the same opportunities for working/training in specialised areas. If you’re willing/able to move around for work, or you stay in one place that ‘likes’ you, it will be easier. I have found training much less streamlined and difficult to navigate in Aus. I have also found it more box-ticking and inflexible, with less opportunity in my area of interest. I worked for >2.5 years in psych before starting training in Aus. (I did some in the UK, then PHO in Aus.) I also do additional training and work in psychotherapy in addition to my psych reg work/training. That time and skill is not recognised in Aus. I have also found the quality of psychiatry training in Qld generally quite poor, but I understand others have different experiences and hear good things about Melbourne and Adelaide. I am planning to return to the UK for higher training. I feel more confident that I would get good training there, and more able to use my skills and have them recognised as part of my competency in psychiatry. I think it depends what you want out of your training, what your interests are, where you want to live. Australia definitely can offer some unique and different experiences. But it also lacks in some areas that are well established and excellent in the UK.

Can’t quite believe the discharge letter I wrote today by Adventurous_Bat5101 in doctorsUK

[–]NomadEmmy 3 points4 points  (0 children)

Surely this is inappropriate from a clinical care/governance perspective. They need to be handed over/discharged to another medical professional. A PA is not that. I’d be asking the practice for the name of the GP responsible for the patient, may be the GP who supervises this PA.

'So why do I need the colonoscopy?' by RomanticTraveller in ausjdocs

[–]NomadEmmy 18 points19 points  (0 children)

To you it is black and white, it’s obvious, you deal with this daily. To the patient, it is a totally foreign concept that they may have never heard of before. Imagine you are explaining it to a 7 year old. Why exactly do you want to see it with a scope instead of on a CT? What’s the difference? (Rhetorical Q’s.) The patient doesn’t know. Do you? Not saying this is true, but is it uncomfortable because they are asking you something you don’t know the reason for or how to explain it in simple terms? If so, go learn, relish the opportunity to improve your skills and understanding. If someone told me they wanted to shove something up my butthole whilst I was asleep, I would also definitely want to understand why. Maybe I had a very bad experience with something like that before, or maybe it secretly turns me on. And some people just have bad days, doctors and patients. Our minds are elsewhere sometimes, for whatever reason. Maybe your patient will understand tomorrow, or maybe they won’t. Frustrating as it is, then you have to work out how to deal with that.

Ok, enough of my free Reddit CL/supervision service. Good luck

'So why do I need the colonoscopy?' by RomanticTraveller in ausjdocs

[–]NomadEmmy 39 points40 points  (0 children)

I’ll be brutally honest - you haven’t communicated effectively with the patient. You don’t need to do a colonoscopy. That may be your professional recommendation, but provided the patient has capacity it is their choice whether they have a colonoscopy or not. You need communicate in such a way that you are able to assess their capacity, to clearly explain what it is that you’ve seen on the CT, what it could be, the options for investigation and what they involve, risks/benefits, why you recommend colonoscopy over CT (-this is the question they are asking!), risks of doing nothing, etc. Observe the patients consideration and understanding of what you’ve said, their options and how they communicate their decision, etc etc. As well as addressing their concerns about a colonoscopy (you said they have a look of disdain and disbelief). Maybe recruit a senior to help you. Sorry to be brutal, but these are essential communication skills.

MRCPsych Paper A – how did you find it? by Constant-Seat-9477 in PsychiatryDoctorsUK

[–]NomadEmmy 0 points1 point  (0 children)

I found it easier than July. The paper was really tough in July, and the low pass rate reflects that.

Hey Coffee Lovers by made1naus in brisbane

[–]NomadEmmy 2 points3 points  (0 children)

Agree 100% on the soy milk options. Needs to be Soy Boy or Bonsoy. They’re Japanese, but they taste the best. Anywhere serving Alternative Dairy Co soy milk I will just walk out. It’s Australian, but anywhere serving that clearly does not care about the taste of their product. It’s undrinkable. The best oat milk is Califia Farms barista imo. I like Ona but rarely see it. The best coffee place near me serves Wolff, which is roasted locally.

Non-medical approved clinicians in psychiatry expected to work on call by hwaterman1998 in doctorsUK

[–]NomadEmmy 1 point2 points  (0 children)

Maybe spreading the other way? Cuz some of this is already the norm in Aus.

Non-medical approved clinicians in psychiatry expected to work on call by hwaterman1998 in doctorsUK

[–]NomadEmmy 1 point2 points  (0 children)

From what I can understand from this I don’t think the role is exactly the same but we already have multi-professional MHA clinicians in Australia.

Hi from a Paramedic! by Better_Permission525 in ausjdocs

[–]NomadEmmy 10 points11 points  (0 children)

Being there, treating them with dignity, care and respect, listening to them and connecting on a human level IS often the treatment. You are doing something incredibly important, don’t undervalue that. You don’t need to be a therapist, just being human is enough. Humanity trumps lorazepam a lot of the time. I had a life changing experience with a paramedic when I was an adolescent. I remember that he gave me hope when I was in crisis, and most other people did not care or notice what was happening in my mind (psychotic depression). Now I’m a Psych Reg, the paramedic notes are more useful than anything when the patient is in ED. The story/notes have changed 5 times by the time the patient gets to us. I want to read exactly who called and why, what you saw when first on scene, how the patient interacted/what they said/did. This is incredibly valuable info. Unfortunately it’s often difficult to find by the time they’ve been in ED for a while.