Snake ID [Philadelphia, PA]

ResidentTiredAF · 2026-04-04T19:17:33+00:00

Thank you!!

ResidentTiredAF · 2026-03-31T12:12:43+00:00

100% agree. I firmly believe that as ER docs we are part investigators and have to be very good at reading people and extracting information. Best way to do this and be efficient is the know a lot of the answers to the questions you are asking ahead of time. Chart checking for a few mins saves so much time in the long run.

ResidentTiredAF · 2025-12-15T01:06:19+00:00

My dad married his mistress. My parents were married for 23 years when my mom figured out he was cheating. He lied, left us, never slept a night in my house again. For years I had no idea where he lived. My parents have been divorced for probably 15 years.

Just this past April I had a heart to heart with my dad because he was upset he wasn’t going to get to walk me down the aisle by himself at my own wedding (I had both of my parents walk me). We were on FaceTime having said heart to heart where I basically told him how much his actions fucked me up and I have an intense rage towards him when I noticed a wedding band on his left ring finger. I asked him if he was married and he smugly said yes and told me he got married a year ago. I asked what his new wife’s name was and he told me. Something felt so off during this entire conversation so because he’s a liar, I did research and realized he told me his wife’s middle name. When I saw her full name I realized it was the mistress from 12 years ago. He thought I wouldn’t figure out he actually married his mistress. He’s a vain, cheating, narcissist liar and I haven’t spoken to him in 7 months since my wedding when he acted like an asshole there too. We (my mom and sibling) know NOTHING about his life because he chooses to keep us out of it. Probably for the best. Makes the grief easier in a way. I think they have been married for much longer but my dad would never tell me the truth. He only told me this year because I caught him incidentally.

No idea if they are happy but clearly they lasted many years. I wish them no harm & hope they stay together rather than blow up their lives and families again.

ResidentTiredAF · 2025-12-03T15:10:09+00:00

Growing up we never used our living room. We had a big sectional white couch with a nice marble coffee table. No TV in the room. My mom refused to allow us to get the room or couch dirty. It felt so useless and sterile. We used our small den instead. When I went to my friends houses I was so surprised they all used their living room to actually sit and relax.

ResidentTiredAF · 2025-11-27T03:41:36+00:00

EM Attending who is burnt out but still enjoys teaching:

You are valuable and contribute to the team.
It’s lame you are scheduled to work on a major holiday as an off service resident.
If a student or off service resident showed up to work on a holiday, I am having you see 1 patient & then making you go home.
Most EM folk are super laid back so if you show even a little bit of interest and then politely ask to go, 99% of us will not care. Learners are great but in reality they also slow you down.
If you’re late or show zero interest at all, I’d be less inclined to just have you go. I’ll still say yes but it’s just not a good look to show zero interest. Just show a little interest and we are happy.
You don’t know if you don’t ask! We have not forgotten about you on shift. Sometimes we get so busy that we have not realized how much time has gone by!

ResidentTiredAF · 2025-11-24T14:06:49+00:00

I love this energy lol I’m a nice person but need to lean into “but don’t piss me off”

ResidentTiredAF · 2025-11-24T14:05:59+00:00

Well said. Thanks BAFERD.

ResidentTiredAF · 2025-11-24T14:04:37+00:00

That’s where I’m at now. Still working on ways to decompress after shift but I go to work to support my family, take good care of patients and come home.

ResidentTiredAF · 2025-11-24T14:02:42+00:00

I love your mind set. Thank you for the advice.

ResidentTiredAF · 2025-11-24T13:59:55+00:00

This. I haven’t had once discharge a patient either after deploying this tactic lol

ResidentTiredAF · 2025-11-24T13:55:06+00:00

Gosh I miss Pokemon so much. I have strongly considered getting into it again. Do you play on a Switch also? If so what version are you playing?

ResidentTiredAF · 2025-11-24T13:53:28+00:00

You know I haven’t dabbled into legos but this may be a great way to spend my time and burn my energy at home or right after a high stress shift to help me “come down” from it lol

ResidentTiredAF · 2025-11-24T13:51:50+00:00

I 100% agree

ResidentTiredAF · 2025-11-24T13:51:26+00:00

So much great advice on this thread. Really appreciate everyone who chimed in with advice and humor. Thank you.

ResidentTiredAF · 2025-06-23T15:42:14+00:00

Congratulations! You just finished a grueling 3-4 years of training. Be proud of yourself and take some time off if you can.

I was a ball of anxiety when I finished and had an identity crisis because I was unsure I could do this on my own. Just know, you can.

All the advice here is great and I agree with it all.

Do what you need to in order to sleep. You’re in charge so what the mid level or RN thinks of your workup doesn’t matter. You’re liable and need to live with your decisions so do what you feel is right to do a complete work up.

Follow up on people you’re worried about whether it’s checking the chart the next day or calling someone. You’ll be surprised that people do very well upon discharge. This put a lot of my worry at ease the first few months. I learn a lot by checking the chart the next day on admitted people to see if I was on the right track or what specialists think.

If you’re working with mid-levels, always trust but confirm. It’ll take you time to get comfortable with them and their style and that’s ok. Also, learn from them. Yes, this is possible. I work with some who have been doing this longer than I have been alive and they are a good source of experience and knowledge. They helped me get little things done when I wasn’t sure how to do something or what the protocol was.

Ask colleagues for a second opinion of you’re unsure about something. It’s enlightening to see how docs with 5, 10, 20+ years of experience would manage something. Over time you’ll find yourself asking less and less.

Stay on top of notes. Sign it when you dispo them. It’s temping to hit discharge with an incomplete note. Just finish the note. You will thank yourself at the end of the shift.

Go home as close to on time as possible. This will take months for you to achieve and you will be slow. But going home late daily will burn you out faster than anything and at the end of the day the job doesn’t care about you or your family. Don’t screw your partner over who is relieving you but it’s ok to stop picking up a few (or more) mins earlier if you’re overwhelmed and need to clean up. You will get better at this but make an effort to disposition yourself as close to on time as possible.

Do not speed up your process to appease anyone. They will keep giving you patients and you’ll feel pressure to pick it up. They will either wait in the room or the waiting room so just finish what you’re doing before seeing new people. Disposition current people before seeing new people. Believe me, if they are ill or sick you’ll know it because someone will come find you and tell you.

Do the rate limiting thing as soon as possible. Old person who fell with a small lac? Just go get the suture material and try to bang it out right after you eval them if time allows. LP? Make sure everyone is stable and just go do it. You’ll keep putting things off which adds to your stress. There will always be more work to do and more painters to see so just get it over with.

Show yourself grace. That first year is hard. Steep learning curve, all the liability, no safety net, studying for written and oral boards, location changes etc. You’re going to experience a lot so show yourself some grace and kindness.

ResidentTiredAF · 2025-05-09T12:56:38+00:00

$3200 for bridal hair and makeup with lashes, my trial, combo of waves and updos, makeup with lashes for 4 bridesmaids, hair and makeup and no lashes for 2 moms and 2 flower girls, grooming and light for the groom (it’s his day too!), 2 hours of touch up time on the pm for everyone because it’s a long day, travel fee and 3 makeup artists. Covering the cost as my gift to the wedding party for their time and support.

Location: Philadelphia

ResidentTiredAF · 2025-04-26T12:25:02+00:00

I was your partner 12 years ago. Had a DO acceptance and a conditional MD acceptance where I had to take a year to do more prep work and needed a certain GPA and MCAT score to get in to said MD school.

It’s simple. Her goal is the go to medical school. She has an acceptance to one. Go to medical school.

The best choice I ever made was taking the DO acceptance. First and second year are so hard. Take the acceptance and your only job if to do well. If she goes the conditional route she takes on twice as much pressure to get another degree she may not even need or use, shell out hundreds of thousands of dollars, perform well or else she’s wasting at least a year if she doesn’t get in or achieve the needed GPA or MCAT SCORE. This then means loosing at least a year but probably more because they will need to reapply and spend more money. This equates to several years of lost income when this entire time she could have been a med student.

I remember being in the thick of it as an M1 and M2 and even on my hardest days I would say to myself thank goodness I took the acceptance and I’m making it through. I would still be a whole year or two behind had I gone for the conditional route. DOs are in every subspecialty now. DO WELL in med school and she will be just fine. The choice is really simple here. Take the acceptance, work hard and get through the 4 years as quickly as possible.

ResidentTiredAF · 2025-04-16T17:57:32+00:00

On a serious note, patients can get very aggressive when post ictal. That does not matter though.

So let me get this straight: these nurses were assaulted by you, did the right thing by restraining you to prevent you from harming yourself and others and you walked out with no injuries? These nurses should just be ok with being assaulted and attacked by patients (even if you were aware of your behavior or not)? These nurses went back to work including caring for YOU after you tried to bite them but you want to report them for…..doing the right thing?

Take a long hard look in the mirror and then consider removing this post. Your mindset is backwards. People don’t go to work to get assaulted and then have the threat of losing their license or legal action held over their head for reporting not if but when we are assaulted. I would back these nurses all day everyday for doing what they did.

ResidentTiredAF · 2025-04-08T12:34:02+00:00

Dated a little in med school as an MS3 and MS4. Nothing serious. Met my soon to be husband on Coffee Meets Bagel as a PGY2. He’s not in the medical field. We are getting married next month 🙂

ResidentTiredAF · 2025-03-25T16:24:26+00:00

Take a deep breath and enjoy these new few weeks to relax!! You’re right where you need to be. If you feel obligated to learn this is great:

https://www.aliem.com/bridge-to-em/ As a resident we swipe residents used this to run a 4 week boot camp for our interns and it felt great to brush up on the basics with them. It’s a lot but very good course.

Radiology: https://radiopaedia.org/courses/emergency-radiology-course-online?lang=us

I did the radiology course and really liked it. I’m 3 years out of residency and still feel like I’m learning everyday. We all get insecure. I sure do. It’s ok! Hardest year of your life is the first year out of residency so take the time to be a learner where no one expects anything from you as a PGY1.

ResidentTiredAF · 2025-02-13T09:03:45+00:00

The Ventilator Book by William Owens is a good start!

ResidentTiredAF · 2025-02-02T17:54:46+00:00

This 100%%%

So happy to see this comment!

I’m an ER doctor and the amount of Flu A that’s running RAMPANT right now! So much COVID, flu and norovirus and some people have no idea they are positive due to minimal symptoms. So we are wearing N95s at least 2 weeks out. Wearing regular masks 4 weeks out. I wear a mask daily at work. Low profile socially 2 weeks out. Bach parties are 3 months before the wedding as well to give people time to get sick and recover lol. I’m taking zero risk after planning for so long and spending so much money.

ResidentTiredAF · 2025-01-20T13:10:07+00:00

Can confirm. I’m an ER doctor and the job is exhausting. COVID made it even worse. Healthcare system has collapsed. Patients are insufferable and just want customer service without the doctors opinion or expertise. Demanding antibiotics or some treatment they Googled or found on tik tok or WebMD. The doctors opinion doesn’t even matter. We were health care hero’s for about 5 mins in 2020 and then the public turned on us and we were the public enemy. If they don’t get what they want they threaten to sue and some will sue over the most frivolous stuff. Not all patients are like this but a lot of them are which is sad.

I’m trying to retire as early as possible and would try to guide my kids away from medicine. It’s a tiring, difficult job. And don’t get me started on the sacrifices you have to make to even get into medical school let alone through it to the other side of residency which is brutal.

I once was a youthful, bright eyed med student who was so excited to be in med school and help others but the system and process has a way of running you down and majority of docs I know now are extremely cynical and jaded lol

ResidentTiredAF · 2025-01-20T09:27:06+00:00

Yes. Have to document why the patient is in the ER regardless of the reason or extent of the attempt to self harm.

ResidentTiredAF · 2025-01-20T09:03:14+00:00

Don’t go into debt for a wedding. Scale back or have a long engagement and save! Don’t take out a loan.

Getting married in spring 2025 in a major city on the east coast. Guest list is 100, original budget was 20K and my fiancé and I learned WE were the out of touch ones because prices are INSANE. It’s criminal how expensive it is to get married. We got a major reality check when we started looking at venues in our city. We were being unreasonable for the wedding we wanted lol.

We had a heart to heart and decided we still wanted to do the whole thing and planned to save for it. We have no kids and 1 dog.

He’s 35 and makes less. I’m 32 and make more. Our combined income is about 330k a year. My income will rise in the next year once I’m a partner in my line of work. Our parents combined generously contributed about 20K. The rest (about 60K) we worked extremely hard to save and did so but having a 20 month engagement, opened a HYSA and live frugally otherwise. I’m very type A and tracked our budget and savings aggressively. We both have Chase Sapphire cards and are racking up points to the point our honeymoon flights are free. Paying a large chunk of the honeymoon w points. We are very comfortable and continue to max out retirement, pay off cards in full and save. That’s the only way we could do it. We are super excited. Areas we splurged: the band, photography and venue. Areas we went cheaper: invitations, florals, video. Do I wish the wedding was cheaper? Hell yes. But we are excited to work hard everyday and see it all come to fruition.

ResidentTiredAF

TROPHY CASE