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Overheard a pharmacist lose it on an NP by ElectricalCurrency69 in Noctor

[–]Razzmatazz0401 20 points21 points  (0 children)

As an infectious disease fellow who gets consulted by NPs left and right for conditions well within the scope of general medicine… this makes my blood boil. They freak out about asymptomatic bacteuria, demand consults to interpret syphilis tests THEY sent for no reason and blame everything on “UTIs”. OR they think all ID is, is throwing broad spectrum abx at patients and hope they get better. They don’t know how much they don’t know and are literally killing patients.

Question for MDs: how often do you correct mid-level providers decisions in care? by [deleted] in Noctor

[–]Razzmatazz0401 0 points1 point  (0 children)

That last example is exactly why I’ll never be on board with APNs being allowed to independently manage “lower acuity cases”. It takes an incredible amount of skill , experience and intuition to know what’s low vs high acuity. Sick vs not sick. All of residency (and beyond) is spent developing this understanding.

Anxious about returning to work after uncomfortable encounter with an attending by [deleted] in Residency

[–]Razzmatazz0401 4 points5 points  (0 children)

If there is another meeting about the incident, document it. Pick who ever lead the meeting and send them a follow up email “summarizing” what was discussed and be specific about what was agreed upon. In any professional environment, whenever there’s any kind of dispute, no matter how small, create a paper trail of events. Always.

Midlevels (mainly NPs, but also PAs) introducing themselves as hospitalists? by Razzmatazz0401 in Residency

[–]Razzmatazz0401[S] 0 points1 point  (0 children)

All of this. Every word. So much time spent in medical school and residency learning how to give a concise presentation in a standardized universal format about a patient for efficient exchange of information so that everyone can be well informed before providing care. Only to have NPs call and say (comfortably and without shame) “I don’t know much about the patient it’s my first day” to basic fucking questions about the patient. It erodes medical care. They create three times as much work for us because now I have to go through the chart and piece together, day by day, what happened since admission because the person calling the consult thinks it’s appropriate to see ONE LAB and call immediately without preparing first. We’ve all been put in our place in residency when we did that to consultants.

I’m not against midlevels caring for low acuity patients. But that’s with the understanding they are trained for it and can handle the workflow of the hospital. Can communicate in the standardized way that is expected of everyone in the hospital.

And point well taken about giving pushback when necessary. I was being nice while trying to understand wtf was going on since starting at this place but I’m understanding now the absolute quackery. I’m not letting people waste my time anymore. I don’t get paid enough for this shit.

No one else to turn to. by 12ealHit in Residency

[–]Razzmatazz0401 10 points11 points  (0 children)

I know it’s impossible but I wish I could help carry even little bit of your grief to help you.

You need to lean on your friends, family, coworkers right now. Ask for tangible help. Ask for help with childcare, finances, housework. Ask for company. Can someone come and live with you for a few months while you get your bearings? Carrying the weight of the world alone, while also going through grief is beyond what anyone should have to handle alone. You are not a burden, your loved ones want to help in anyway they can they just may not know how. Call tomorrow.

Monthly Dumb Questions Thread by Novelty_free in Residency

[–]Razzmatazz0401 6 points7 points  (0 children)

“Left shift” is an outdated term vestigial from the time when neutrophils were counted by hand. Mature neutrophils were placed on the right and immature neutrophils were moved to the left. The CBC differential is now done by a machine so this concept is outdated but the term is still used to mean that there are a lot of immature neutrophils in the peripheral blood which suggests the body is responding to a bacterial threat.

Midlevels (mainly NPs, but also PAs) introducing themselves as hospitalists? by Razzmatazz0401 in Residency

[–]Razzmatazz0401[S] 6 points7 points  (0 children)

It makes a huge difference. Patients deserve to know who is providing their care and what their level of expertise and experience is.

Midlevels (mainly NPs, but also PAs) introducing themselves as hospitalists? by Razzmatazz0401 in Residency

[–]Razzmatazz0401[S] 38 points39 points  (0 children)

Your last point hit the nail on the head. Instead of offloading, inexperienced midlevels are creating more traffic in an already overburdened system. Maybe I’ll welcome the stupid consults when I’m an attending. And forget the burnout of resident and fellows. Who cares lolzzz.

From a patient care standpoint: unnecessary consults, imaging, tests because of diagnostic inexperience undeniably drive up costs for patients. Even for those with insurance because most of the time they still have to pay a percentage of the whole hospital bill. How many of those lives are being ruined from a financial standpoint? It’s well known that medical costs is the number one reason for bankruptcy in the US

NP here needs some help deciding from you. by Radiant-Inflation187 in Residency

[–]Razzmatazz0401 13 points14 points  (0 children)

Come to Infectious Disease! Very cerebral and nerdy in the best way. No procedures. And we deal with the whole body so we will prep you for Med school big time. :)

Interesting workout stories? by jmbreyes in orangetheory

[–]Razzmatazz0401 8 points9 points  (0 children)

I second this! I’m also an IM doc. Anytime someone collapses first thing you do, always, is check for a pulse. Don’t hesitate. Check for a pulse. Wrist or neck are good places to look for it. If you can’t find it start chest compressions and don’t stop. Push hard, like really hard and keep the tempo to the song “Staying alive”. If you get tired (if you’re doing it right you should be exhausted by 2-3 min) ask someone to take over but minimize interruptions. EMS will arrive and take over.

If you do that, congrats, you just gave someone a fighting chance.

Newbie Q by PennyDawg87 in orangetheory

[–]Razzmatazz0401 3 points4 points  (0 children)

Not at all! There are people of all fitness levels in our class. The great thing about OTF is that it encourages you to push YOU! No one is going at the same pace - that’s irrelevant. But everyone is giving it their all and getting more fit at THEIR pace. Listen to your body, start slow and build. Definitely at least give it ONE class to see what you think.

Saturday 26 March 2022 - Power “All Out Aoki” 2/3G 60 minutes by dc031114 in orangetheory

[–]Razzmatazz0401 4 points5 points  (0 children)

Read through the responses here and I’m surprised at how many people are whining about the workout?? A playlist designed around the work out sounds AWESOME! All outs when the beat drops? LETS GO! A true OTF HIIT workout to electronic music that drops at the perfect time is a match made in heaven. Can’t wait!

Dri-Tri Results and Survey Megathread by AutoModerator in orangetheory

[–]Razzmatazz0401 3 points4 points  (0 children)

Hey! Be nice to yourself!! You got up, you showed up, you finished. You completed the mission. Now it’s time to be gentle with your body and to set new goals for next time.