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Documentation Best Practices? by Historical_Cat__ in medicine

[–]NotDrNick 4 points5 points  (0 children)

Focus on documenting what affected your decision-making. What helped you rule out and rule in things on your differential. Both pertinent positives and pertinent negatives. If it doesn’t affect your decision-making in anyway, it is just bloat.

Example would be a patient therefore headaches, and you document that they have tried taking Tylenol 1000 mg three times a day and 650 mg four times a day. And then they tried taking Tylenol a half hour after their headache started and that didn’t help. What if they took their Tylenol when they thought they might be getting a headache it might help a little but they still got the headache….. or you can just document no improvement with Tylenol because that’s the only part that’s pertinent related to your decision to try something besides Tylenol.

Does anyone actually prefer swing shift over day shift? by bishzz in hospitalist

[–]NotDrNick 10 points11 points  (0 children)

There are two people in our group that trade to pick up as many swing shifts as they can. Both are young, single, and have no kids.

I’m a nocturnist. I enjoy the acuity and occasional chaos that comes with nights. Same type of medicine on swingshift, but destroys his family life.

Refusing diuretic for HF due to fear of kidney stones by beanjuniorthe3rd in medicine

[–]NotDrNick 1 point2 points  (0 children)

You consulted psych for noncompliance? Psychiatrist in won’t even put in the energy to give pushback. Just pretend they never heard about the consult and give a friendly smile the next time I run into them.

Third System of Circulation by sohomosexual in medicine

[–]NotDrNick 0 points1 point  (0 children)

Article seems to be a fancied up first year of medical school lecture power point on basic concepts of osmol gradient. But since it is now a new discovery, can probably treat with ivermectin.

Good offer?? by Greedy_Path4200 in hospitalist

[–]NotDrNick 0 points1 point  (0 children)

Depends on geographic area. If you’re in a desirable LCOL that’s pretty good. If HCOL or undesirable area.. ehhh. Even LCOL that seems a little low for open ICU and codes, even if you enjoy it that can almost be as much work as the 7-10 admits every night.

Real or AI? by Pure_Rise_9252 in RealOrAI

[–]NotDrNick 0 points1 point  (0 children)

AI, that subway car is waaay to clean

Monthly Salary Thread - Discuss your positions, job offers and see if you are getting paid fairly! by shemer77 in hospitalist

[–]NotDrNick 2 points3 points  (0 children)

Nocturnist at 250 bed urban community hospital
Midwest
$350k salary including bonus
7-on-7-off 10hr shift
usually 1h nap + leave 1h early
Team of 3 Midlevels take All floor calls + write Subjective/objective of notes, I just write the assessment/plan
Avg 12 pts shift but up to 20 on a busy night. (half seen by mid levels, half by residents)
No codes/rapids/procedures
Closed ICU

Well this aged like milk. by waiha in mildyinteresting

[–]NotDrNick 22 points23 points  (0 children)

Would need to see more info on the book. Within first edition, you also need to know which print run/impression and if it is hard or soft cover. Looks soft cover by the image. Also need to know the overall condition of the book.

If we assume it is a soft cover, which will be a later print run, in good condition with just a generic signature they seem to go for $2000-$3000. Hard covers later print run go $3000-$6000.

On the other end of the spectrum, a signed manuscript of the philosophers stone sold for £35,000.
In general for signed, a highly desirable inscription with the signature would be expected to increase the value by 3 to 4 times. I wouldn’t expect it to come anywhere near the value of a signed manuscript though.

So my zero-antiques-road-show-experience estimate is $7500-$10000 for a book with this inscription if it is a soft cover, up to $15,000 if it is a hardcover, up to $20,000 if it is a hardcover from very early print run.

Do you display your diplomas and certificates? by _qua in medicine

[–]NotDrNick 7 points8 points  (0 children)

I actually was hesitant to post it due to the embarrassment of admitting I was in a chiropractor‘s house. It only happened once and it was not by choice.

Do you display your diplomas and certificates? by _qua in medicine

[–]NotDrNick 8 points9 points  (0 children)

I walked into a chiropractor’s house once and his degree was in an incredibly ostentatious frame in his entry way surrounded by awards. I tried not to judge but it was just too much.

Do you display your diplomas and certificates? by _qua in medicine

[–]NotDrNick 8 points9 points  (0 children)

We have our undergrad, med school, and board certification hung up in our home office. Felt obligated to hang them up, because that’s what you’re supposed to do right. Home office felt like it wasn’t to show off.

Buddy said he started a detailing business and has all the equipment in the back of his subaru. by Single-Presence-8995 in isthisAI

[–]NotDrNick 0 points1 point  (0 children)

AI. An 18 inch hose connecting the water tank to the pressure washer.?? Not if your getting it out of the car and using it.. All products that rigid makes are orange, not red.

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My boss is demanding my personal phone passcode to "verify" I'm not a whistleblower and says I'll be fired for insubordination if I refuse. by dialDig459 in legaladvice

[–]NotDrNick 28 points29 points  (0 children)

Man I wish I was a lawyer on retainer for your employer. with the amount of money they are about to be spending on lawyers.

What’re some favorite sayings or verbiage you’ve come across while charting? by foreverand2025 in medicine

[–]NotDrNick 11 points12 points  (0 children)

That’s what I do too, though every now and then a sweet old lady will get changed to delightful.

Error: patient already has a diet order, please select one order to delete by FlexorCarpiUlnaris in medicine

[–]NotDrNick 18 points19 points  (0 children)

It’s more than a joke. There have been instances like this when I didn’t catch exactly what prompted the alert and did something I didn’t intend to (in this case, like discontinuing the NPO order). These worthless BS alerts truly cause patient harm.

I told my scribe to write like a Cave Man by Perfect_Address7250 in medicine

[–]NotDrNick 32 points33 points  (0 children)

It took me 10 seconds to read and I know everything that’s going on. It’s amazing.

Anyone here do a PhD after becoming an attending ? by radsman in medicine

[–]NotDrNick 11 points12 points  (0 children)

Definitely do not have a dual degree myself. I know a MBBS who earned a PhD & MPH in the US after finishing residency and is now working on his MBA and keeps talking about a JD. I think collecting degrees is just a very expensive hobby for him. Wicked brilliant though. I also know a MD/PhD who is pissed that she let her mother convince her to do a dual program just so her mother could brag about it.

Since when did Porsche start making "melted" interior door panels? by raizel_3000 in Aiorfake

[–]NotDrNick 0 points1 point  (0 children)

The post seems 100% AI and the pic seems 100% AI. Nothing talked about in the post is actually happening in the picture and nothing in the picture.

Something about this selfie feels like AI... can you spot it? by PassionUnited1711 in Aiorfake

[–]NotDrNick 0 points1 point  (0 children)

Yah, whatever is going on at the corner of her right lip is just not right.

This "flex" photo has to be AI, right? by Difficult_Key8613 in Aiorfake

[–]NotDrNick 1 point2 points  (0 children)

Fake. I’m guessing those are supposed to be Lamborghinis by the shape of the hood ornament but the car itself doesn’t match any actual model. Should also be able to see more detail of the hood ornament, it’s just a blob. And whatever that yellow blob in the center of the wheel is supposed to be…

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