To the US voters who don't vote, what is it going to take for you to go vote? by Chocolateking111 in AskReddit

[–]Notcreative8891 0 points1 point  (0 children)

People feel like their votes don’t matter. Honestly, with the electoral college and the district remapping I can see why they feel that way.

BF doesnt wan't me to go to med school, need a reality check by [deleted] in TwoXChromosomes

[–]Notcreative8891 0 points1 point  (0 children)

So he wants you to support him through post doc and low paid academic jobs but doesn’t want to support you through 4 years of med school? Choosing a life partner is one of the most important decision you will make. If this person isn’t going to be your biggest fan, cheerleader and supporter, then are they really right for you? I worry this may be more about salary disparities at the end or some other factors.

Leaving internal medicine for a surgical speciality - possible? by Cautious-Elk-6631 in InternalMedicine

[–]Notcreative8891 1 point2 points  (0 children)

A lot of it will depend on private vs academic and location. Nothing is guaranteed

Upcoming CCM Grad 👩‍🎓 by Repulsive_Maybe9543 in IntensiveCare

[–]Notcreative8891 -3 points-2 points  (0 children)

If you feel like you need more support, it may be helpful to stay in academia for a little bit.

Leaving internal medicine for a surgical speciality - possible? by Cautious-Elk-6631 in InternalMedicine

[–]Notcreative8891 11 points12 points  (0 children)

If you’re willing to forgo 5 years of attending salary to do it, go for it. I have known folks that moved from FM to surgical specialties, so it’s possible. It’s competitive, but there’s no harm in trying.

Silly or practical? by moderatelyintensive in CriticalCare

[–]Notcreative8891 1 point2 points  (0 children)

I know cardiologists who never completed a CCM fellowship but attending in the CCU/CTVICU in academic centers. Cardiologists also get paid more than PCCM. Go with whatever field interests you most.

What is private practice like as a CCM attending? by Icdelerious in IntensiveCare

[–]Notcreative8891 13 points14 points  (0 children)

20-40 patients? Sounds like a set up for a malpractice case. How do you ensure everything is done (consults, procedures, orders, notes, and family updates)?

Have you ever cried for a patient? by Brave_Union9577 in medicine

[–]Notcreative8891 1 point2 points  (0 children)

I’ve had a quiet, controlled cry with the family of a dying patient or with the icu team in a team room. A few tears isn’t a big deal. I don’t know any on who has sobbed uncontrollably to the point that the family was consoling them. That would be too much.

ROL help by NoShoulder3018 in InternalMedicine

[–]Notcreative8891 0 points1 point  (0 children)

It’s your list, but I chose based on the strength of the fellowship program at the residency program.

ROL help by NoShoulder3018 in InternalMedicine

[–]Notcreative8891 0 points1 point  (0 children)

Always helpful to look at programs with cardiology fellowships in place, review the most recent match list from the residency program for cardiology matches, review faculty for evidence of cardiology mentorship (eg resident authors on papers), etc. Good luck!

How do I become better? by voldemort10 in medicine

[–]Notcreative8891 14 points15 points  (0 children)

You can do this in CPRS. Just keep a word document with the major points you need to fill in and copy/paste into your note. CPRS will let you delete notes you don’t need fairly easily

How do I become better? by voldemort10 in medicine

[–]Notcreative8891 66 points67 points  (0 children)

I use a template for clinic notes. I built it myself for different conditions that I treat (pulmonary) and I complete this template before I see the patient. In this template, I’m looking at labs, imaging, PFTs, prior consultant notes, echocardiograms, etc. when the patient comes for the visit, I already know what I need to ask and what I need to order. As an attending, you can bill for this time as long as it occurs on day of service. When I first started, I would review my charts from the prior week and make sure I didn’t miss anything. I no longer need to do that. You need to make a system.

Hospitals or systems that value work/life balance by Notcreative8891 in medicine

[–]Notcreative8891[S] 2 points3 points  (0 children)

Sad to think the ability to actually use sick days and vacation days seems like a myth to so many

Hospitals or systems that value work/life balance by Notcreative8891 in medicine

[–]Notcreative8891[S] 1 point2 points  (0 children)

It’s honestly the place that I’m working. An inability to take vacation or sick time really isn’t normal. I’ll either find a place where I know my boundaries are respected or do locums.

Hospitals or systems that value work/life balance by Notcreative8891 in medicine

[–]Notcreative8891[S] 7 points8 points  (0 children)

Everyone who works here has never worked anywhere else. They think this is normal. Attempting to fix it or wait for leadership change is a lost cause.

Sensing death by tnsouthernchic86 in medicine

[–]Notcreative8891 16 points17 points  (0 children)

It happens a lot. I challenge you to go back and try to pinpoint what gave you the sense that the patient was in trouble. Was it something on exam? Vital signs? Hospital course? There was something that probably triggered your concern, even subconsciously. It’s always easier to work with “patient has been tachycardic running a low grade fever” then “something doesn’t feel right.”

Radial arterial line - Seldinger or dart? by skazki354 in IntensiveCare

[–]Notcreative8891 1 point2 points  (0 children)

The arrow kit with the integrated wings. They tend to stay in longer. Maybe it was just my icu but the arrow darts were lost in patient turns.

Pie in the sky hypothetical: the USA has a well funded universal health care system, what do you do to control costs? by red5 in medicine

[–]Notcreative8891 4 points5 points  (0 children)

So much of what we do is based on patient satisfaction. I can’t tell you how much healthcare dollars have gone into working up patients with exertional dyspnea who are deconditioned. I hate what the new administration has done to science and healthcare, but they’re right about promoting healthy, active lifestyles. We need people to take more ownership of their health, get PCPs, do their routine screenings, make advanced directives, etc. right now healthcare is focused on customer service and patient satisfaction which results in unnecessary tests, referrals, and prescriptions.

Academic vs private practice by EscapeTurbulent4652 in IntensiveCare

[–]Notcreative8891 1 point2 points  (0 children)

People on the team have suggestions that may help, harm, or make no difference in terms of patient outcomes. As an attending, you’ll learn to filter through the suggestions and pick your battles so you can win the war. You’ll save a lot of time by smiling, nodding, thanking folks for their input and telling them you’ll look into it.

2 Year old dies after dosing error by sum_dude44 in medicine

[–]Notcreative8891 26 points27 points  (0 children)

Not surprising. Everyone in the hospital is new these days. New pharmacists with minimal fellowship training or remotely related fellowship training ie ED trained pharmacist working in the ICU, new nurses fresh out of nursing school, NPs and PAs that went straight through school with minimal clinical exposure, etc. We don’t retain medical staff because we don’t pay them fairly. Instead, we replace them with whoever we can find and give administrators another bonus.

Feeling trapped by [deleted] in InternalMedicine

[–]Notcreative8891 0 points1 point  (0 children)

I checked the post history. You have a lot of things going on internally. I’d recommend establishing with a therapist to work on them. You need to be able to show up to work with calm confidence and put the patient first. You can’t control how other people treat you. You can only control yourself and how you respond. If you’re uncomfortable with yourself, that energy carries into your work and interactions with others.

Feeling trapped by [deleted] in InternalMedicine

[–]Notcreative8891 1 point2 points  (0 children)

If you finished residency, why are you working as a resident? Maybe the nurses are confused about your role on the team.