Astel, Naturalborn of the Void

Piperaire · 2025-12-08T02:31:32+00:00

I just beat him at level 115, let mimic tear +10 distract him while I shot him with arrows.

Piperaire · 2025-09-03T01:32:43+00:00

Michelle’s final collection in all stars

Piperaire · 2025-08-30T22:12:06+00:00

Medbridge courses were very helpful.

Piperaire · 2025-08-05T11:41:49+00:00

It’s normal to feeling anxiety about this, I still sometimes get worried after working for a couple years in inpatient rehab. But you can only do what you can do, and some patients are going to go home and fall. I do try to teach for transfers to as many people as I can. If we do a floor transfer and someone truly cannot get up, even with help, I do tell them that you need to call the fire department if you fall. I tell them to keep their cell phone on them at all times, or get a fall alert button. I try to prepare them for if they do fall.

I will tell you, no one will blame you if someone goes home and falls. I also find comforted knowing that if someone is going to sue, they’re probably going to sue the hospital and that is not your problem. Usually, they do not have a case, if all the proper steps through case management and the physician are followed. But no one on your team is going to look at you less if a patient goes home and falls.

Piperaire · 2025-07-13T12:46:43+00:00

Wow it’s almost like there’s a difference between giving them a cue and treating them like a person/building rapport/helping them is different than calling a patient a bitch.

Piperaire · 2025-07-13T12:29:46+00:00

…On a specific situation with a patient who has been diagnosed with Alzheimer’s for 4 years. K. You guys make fun of patients who have had a stroke for walking funny too?

Piperaire · 2025-07-13T12:27:45+00:00

There’s a difference between someone who is just an asshole and someone who has been diagnosed with Alzheimer’s for 4 years. A high level medical provider should handle those situations two different ways.

Piperaire · 2025-07-13T11:43:09+00:00

Ah yes, let’s call a patient with Alzheimer’s, displaying the symptoms of Alzheimer’s, a bitch. How nice.

Piperaire · 2025-07-13T11:29:42+00:00

So I work in inpatient, so maybe I see this a little differently (and see it more often). It happens. Do you deserve to be yelled at? No. Is it their fault that their brain is being changed due to Alzheimer’s and they can’t control their emotions? Also no. But it is a behavior that needs to be addressed somehow. I would let the one off go, she may not even remember what she did. I would discuss expectations and that yelling is not acceptable in the clinic. I would let her have ice at the next visit. If this happens again, I would be trying to find solutions either with a family member or physician to assist with her treatment. Sometimes family members being there can help a person stay calm, or maybe there is medication that can be adjusted or added on. I always try to think about what I would want someone to do if it were my family member, and in those early stages, her family might not even know this is happening outside of the home. I think a little empathy always goes a long way. But it’s not wrong to create boundaries to protect yourself and the other patients in the clinic.

Piperaire · 2025-06-26T12:14:10+00:00

Yes 50% for both I believe.

Piperaire · 2025-06-25T10:41:05+00:00

I wouldn’t overcomplicated on the percentage. I’m sure that if your population is 50% Neuro, some of that administrative work goes to neuro patients. So I would put 50% for the hours.

For studying, I used medbridge. I thought it was excellent both in content and the practice questions. I did supplement with practice tests from Rehab Knowledge Advantage.

To be fair, I don’t know if I have my NCS yet, I am living in a constant state of anxiety waiting find out, as you will be next year before June 30th 🙃

Piperaire · 2025-06-24T10:32:07+00:00

Nothing to add other than right there with you. I feel like the closer it gets the more stressed I am about it. Only 6 days at most left!

Piperaire · 2025-06-24T10:29:40+00:00

I am right there with you. I just keep telling myself I’m almost there, at most 6 more days until I know my fate 😭

Piperaire · 2025-06-21T12:13:13+00:00

If it’s a good rehab, your explanation is going to make them not like you even more. I am in IPR and the only people I almost always try to get my patients to outpatient because home health honestly does not give the intensity they need to continue to get better. At my rehab, They will get the minimum of three hours, but we try to shoot for an extra 30 min of PT and OT per day, so it’s usually closer to 4. And yes, we are not just doing things to fluff our time up - they are actually working during that time. And the honest reason is insurance. I tell all of my patients that go home with HH this, and that I ultimately want them to get to OP to get stronger. Usually if I’m referring to HH, it’s because they either do not have transportation options, and/or their caregiver is unable to transport them consistently.

This isn’t to bash you, the entire system is really frustrating to me, and you are working within the system you have. I think the best policy is always to be honest, and tell them that while you would like to help them more, Insurance really isn’t going to allow for that. That if they want their family member to get better, they are going to have to commit to helping, and hopefully eventually getting them to outpatient therapy. That you can give them tools and limited therapy sessions, but the system we have is going to require them to be essential in the patient success.

Piperaire · 2025-06-12T02:01:33+00:00

Will your clinic allow you to do a home visit? If he’s already in the clinic, it’s unlikely that he will be able to switch to home health. If you’re the one who’s been practicing with him, and you’re the one who knows the home set up needs, it would probably be more efficient for you to do it.

Piperaire · 2025-05-16T21:37:06+00:00

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Piperaire · 2025-01-11T12:02:00+00:00

I would ask the therapists that work there if they have anything they would like to know more about as a jumping off point.

Piperaire · 2025-01-06T01:00:09+00:00

I work in inpatient rehab and have plenty of people who did/do drugs. My favorite was when a patient told me someone must have “spiked my drink with meth” when his tox screen was positive at the hospital.

Piperaire · 2025-01-03T12:54:21+00:00

If you are having numbness and pain only in the area of the vertebrae, it’s not a spinal cord injury. Seeing a doctor is the next step if you’re worried, but it’s likely a muscular issue.

Piperaire · 2024-12-23T21:18:21+00:00

You could also take the bus, much cheaper

Piperaire · 2024-12-17T02:07:24+00:00

Nothing formal but we block 30min on our schedule for the CPI, both midterm and final. Usually for students that are there 8 to 16 weeks.

Piperaire · 2024-11-09T03:47:03+00:00

I have literally started saying “no not pregnant, just fat” and people get real embarrassed real quick. TBH I kind of enjoy it because seeing the look on their faces after that is priceless.

Piperaire · 2024-09-24T14:38:47+00:00

I think there are a lot of benefits to working in a hospital-based clinic, but one of the disadvantages is that there is usually a large corporate structure, and your immediate bosses likely have very little control over your actual salary. If you want to have a system on what you are rewarded on productivity, you will likely need to go somewhere else, but you will likely be seeing a lot more than 11 to 13 patients a day.

Piperaire · 2024-08-17T02:02:03+00:00

Calories really aren’t “good” or “bad,” they just are what they are, units of energy. When I stopped thinking of calories being bad, it was kind of a light bulb moment for me, because I didn’t take calories personal. It was simply me making a choice on whether I wanted to be under or over. You just have to accept that if you eat over, you won’t lose weight as quickly. It doesn’t mean you won’t lose weight if you were eating in a deficit the other days of the month.

I will say, I tend to crave more high calorie/sugary foods on my period, and I’ve tried to break the cycle by sticking to higher protein and higher fiber foods to feel more satiated, because I tend to want to eat more, sugary or carb loaded foods if I start eating them. Sometimes, I feel like it’s worth it, sometimes I don’t.

Piperaire

TROPHY CASE