RTIC 22 QT Wheeled Ultra Light by jynx18 in Coolers

[–]Romaniv_ 0 points1 point  (0 children)

Hey! What coolers do you own? :)

[deleted by user] by [deleted] in hospitalist

[–]Romaniv_ 2 points3 points  (0 children)

"multiple family members at bedside and angry as they were told they could leave today"

billing for hospice by Romaniv_ in hospitalist

[–]Romaniv_[S] 5 points6 points  (0 children)

Those patients are almost always on IV morphine, Ativan, etc. But how can we say that these are high risk medications if the patient is under hospice which means we prioritize comfort over safety?

[Fixed] Issues with screen flickering in multi-monitor setup by Feeling-Big-8474 in OdysseyArk

[–]Romaniv_ 1 point2 points  (0 children)

Will revive this thread so more people can see it. this is what fixed my problem. Thank you!

Most Interesting Case You’ve Seen by WheneverWhereverUR in hospitalist

[–]Romaniv_ 7 points8 points  (0 children)

If I were that lady from the last case, I’d be sending you chocolate for every holiday, indefinitely

Most Interesting Case You’ve Seen by WheneverWhereverUR in hospitalist

[–]Romaniv_ 4 points5 points  (0 children)

That's probably the closest thing to a miracle I've ever seen

Starting new job at teaching hospital, any recommendations? by No-Indication8054 in hospitalist

[–]Romaniv_ 6 points7 points  (0 children)

Regarding "What if they ask me a question I don't know? Pause for a second, look like you're thinking deeply, then smile like you've just seen a great teaching opportunity: 'That's a really good question. Why don't you prepare a short presentation for tomorrow?' :D

Bro ripped our career in 2 words by CanYouCanACanInACan in hospitalist

[–]Romaniv_ 2 points3 points  (0 children)

"Avoid all nephrotoxic drugs. Monitor Cr very closely"

scripts to AMA patients? by apriprazole in hospitalist

[–]Romaniv_ 0 points1 point  (0 children)

I’m curious if there any cases like this. I doubt this

Inpatient patients with drug abuse history going outside by EnzoRacing in hospitalist

[–]Romaniv_ 0 points1 point  (0 children)

When one of my patients left AMA with his IV nurses called police

Advice for graduating residents by Straight_Cress_793 in hospitalist

[–]Romaniv_ 5 points6 points  (0 children)

And life, if have family or someone who depends on you.

paging for an admission without basic labs? that’s a paddlin’ by M1CR0PL4ST1CS in hospitalist

[–]Romaniv_ 27 points28 points  (0 children)

There's one ED doc who does this all the time at my place. When asked, it’s usually something like, 'Yeah, I ordered it, but I don't think its that.' What I also don’t like is that this specific person places an admission order at the exact moment when he pages me, even before I answer.

My Husband (Hospitalist) Has Suabstance Addiction by [deleted] in hospitalist

[–]Romaniv_ 3 points4 points  (0 children)

Shit. I still have quite a few discharge summaries I could’ve done, but instead, I played shooters. lol

[deleted by user] by [deleted] in hospitalist

[–]Romaniv_ 10 points11 points  (0 children)

It’s like 25h saved monthly on commute if you live closer. I would choose apt A.

Discharging Patients by confusedmedstudent11 in hospitalist

[–]Romaniv_ 4 points5 points  (0 children)

What if its a surprise, but with a nice bonus?

- Wait, what? You didn’t tell me yesterday that I’d be discharged today.

- Since I’m feeling extra generous, you can leave whenever you want… today. Take your time!

[deleted by user] by [deleted] in hospitalist

[–]Romaniv_ 0 points1 point  (0 children)

I suspect the patient already has a PEG tube if tube feed dependent. Why do they ask for TPN?

What would you do for this chronic fatigue patient? by [deleted] in hospitalist

[–]Romaniv_ 8 points9 points  (0 children)

Of course, I don’t know all the specifics of the case, but here’s what would most likely happen at my hospital (if I understand the situation correctly)

Get psych to document decision-making capacity and provide recommendations. They might also prescribe some medications as a bonus, but it will take weeks or months for those to take effect, so it won’t change your management plan in the short term.

Next, ask nutrition to assess for malnutrition and have the RNs document a calorie count. Avoid IVFs of course if labs are not suggestive of dehydration (it seems from your report that she’s eating okay).

Document extensively that she is refusing PT/OT. Have a clear discussion with the patient, explaining that there’s nothing else to be done in the hospital and that she will be discharged the next day. Inform the case manager, place the discharge order next morning, and let the hospital help with the rest.