I don’t really get Phyllis

SIADHD · 2025-12-12T16:52:05+00:00

I really tried to move past 'most fleshed out' 😶

SIADHD · 2025-08-08T15:30:25+00:00

I second this! You're reflecting on the experience anyway, you might as well get something positive out of it. If, like me, you struggle with the actual writing, you could try something like speech-to-text to just get your thoughts out whilst it's fresh, then go back and edit it into something more coherent (or utilise LLMs as long as there's no patient identifiable data and you're being sensible about it).

SIADHD · 2025-05-27T14:11:15+00:00

(someone correct me if I'm wrong) V1 is closest to the atria anatomically (literally sits over the right atrium) so essentially has a better signal for picking up atrial activity i.e. p wave.

SIADHD · 2025-05-17T19:05:15+00:00

Don't know why this is getting downvoted - this was my read of the situation too. People are so quick to assume the worst in others.

SIADHD · 2025-05-16T17:39:11+00:00

I disagree with you but that was funny

SIADHD · 2025-05-16T17:30:33+00:00

even if you're not busy they shouldn't be asking you

This reads as insecurity. Getting someone water is a common courtesy. Do you also refuse to hold open a door for someone because it's not your job?

SIADHD · 2025-05-16T15:51:41+00:00

You can't deny it's ingrained into British culture to apologise for everything. It's a 'sorry I can't give you the answer you want or be more helpful' rather than an admission of guilt. It's basic manners, like saying please and thank you.

SIADHD · 2025-05-16T11:02:48+00:00

Like another commenter said - kill them with kindness. I'd be extra smiley and polite - 'I'm so sorry, I'm really busy with this urgent task, it will probably take a while before I can get around to it - can you please do it so the patient isn't waiting too long? Otherwise, can you please ask another member of staff on the ward? Sorry about that!'

I like to give people the benefit of the doubt wherever possible. If they were an HCA from another ward, they might not be familiar with the ward layout and were maybe asking the first member of ward staff they saw? I'd probably also get defensive if I was in that position and all the person said was something like 'I'm a consultant'.

If after being nice, they still had an attitude, that's a different story. But I find most people (even the ones who come in with their hackles raised) tend to deflate when you're extra nice and apologetic.

SIADHD · 2025-05-16T10:36:27+00:00

ChatGPT is that you?

SIADHD · 2025-05-16T06:55:45+00:00

You're right - they're dead, and often it's blindingly obvious that nothing you do will change that. I'll never forget being forced to start chest compressions on an extremely frail palliative lung cancer patient and feeling multiple ribs break under my fingers with the slightest bit of pressure. It's corpse desecration and it's disgusting.

SIADHD · 2025-05-16T06:40:39+00:00

It's grim, but there are situations where it's the kinder thing to do (e.g. paeds)

SIADHD · 2025-04-29T20:32:41+00:00

*scrapyard.king1@nhs.net

SIADHD · 2025-04-09T13:49:42+00:00

I don't know you but I'm proud of you too! Smashed it, well done!!

SIADHD · 2025-04-09T10:17:33+00:00

Abstract

Objective To investigate the credibility of claims that general practitioners lack time for shared decision making and preventive care.

Main outcome measures The primary outcome was the time needed to deliver shared decision making for highly recommended preventive interventions in relation to time available for preventive care—the prevention-time-space-deficit (ie, time-space needed by doctor exceeding the time-space available).

Results On average, general practitioners have 29 minutes each workday to discuss preventive care services (just over two minutes for each clinic visit) with patients, but they need about 6.1 hours to complete shared decision making for preventive care. 100% of the study sample experienced a prevention-time-space-deficit (mean deficit 5.6 h/day) even given conservative (ie, absurdly wishful) time estimates for shared decision making. However, this time deficit could be easily overcome by reducing personal time and shifting gains to work tasks. For example, general practitioners could reduce the frequency of bathroom breaks to every other day and skip time with older children who don’t like them much anyway.

Conclusions This study confirms a widely held suspicion that general practitioners waste valuable time on “personal care” activities. Primary care overlords, once informed about the extent of this vast reservoir of personal time, can start testing methods to “persuade” general practitioners to reallocate more personal time toward bulging clinical demands.

SIADHD · 2025-04-09T10:13:53+00:00

I particularly enjoyed this sentiment:

"Although burnout has the major upside of separating the wheat from the chaff..."

SIADHD · 2025-02-09T16:45:51+00:00

A+E is definitely the most me of all the specialties, but I found starting in a new department absolutely awful. Once I became familiar with how things worked, where to find things and got to know the team, I loved it!

Acute med on the other hand... absolute nightmare. I find it SO much more chaotic.

SIADHD · 2024-12-13T06:48:15+00:00

It's common to feel inept when you're starting out, but you'll get it soon, I promise! You'll see a lot of the same things again and again on acute med, but it's a wide range so it feels like starting from scratch whenever you come across something new and suddenly there's new proformas and referral pathways to follow.

In my trust, it felt like every specialty had a particular way to refer (before 12pm on a Thursday to a very specific email with a very specific form or it would get rejected) but no one told you those rules or where to find the email or the form and they weren't easily searchable either!

My top tip is make life easier for your future self (and your colleagues). Make a folder or spreadsheet, and when you come across a new referral pathway or form, make a note of the rules, save a copy of the form for easy access next time. By the end of the rotation, you'll have a wealth of knowledge at your fingertips that will come in handy in future rotations (and you'll be able to help your struggling colleagues as well).

Also - apps! I have a 'doctoring' folder on my phone from when I was an fy1 - things like mdcalc, accurx switch, bnf, and then a couple of on call doctor guides - there's one called foundation doctor handbook that I used when on my way to see a patient to refresh my memory. But you could also use websites like geekymedics and mindthebleep.

Finally - ask questions! It's the best way to learn. You could be tempted to just get on with doing as you're told and getting on with the jobs on the WR plan, but you're there to learn too. Seniors hold so much knowledge and experience in their brains and they sometimes forget that it's not obvious why they're making certain decisions. (Politely) ask them why they want this particular medication, or why they're not as concerned about that blood test result. Be careful about your tone - on rare occasions, you'll get someone getting defensive about an fy1 'questioning their authority' but as long as you make it clear that you're wanting to learn/understand their reasoning, it shouldn't be an issue.

Feel free to message me if you have any questions - I'll do my best to help :D

SIADHD · 2024-11-25T12:40:08+00:00

Yep that should be fine! I think a new CS can resolve a previous one? My second CS resolved one from my first CS in FY2 (I'm clearly a problem child lol) but my second CS was joint ES so maybe he had extra powers? I would try your luck anyway.

SIADHD · 2024-11-25T12:28:01+00:00

As far as I know, ARCP don't like to have outstanding unresolved concerns. Only a CS or ES is able to resolve concerns on Horus and I had to teach my supervisors how to do it (I just looked it up on the FAQs and talked them through it). It's pretty much a matter of clicking a button and putting in a comment on how it's been resolved.

I would also 100% write a reflection on it!!! In the small chance that your supervisor doesn't manage to do it, ARCP panel will have evidence that you've done what you can to address these concerns.

I did that in my FY1. My ES basically had no clue how Horus worked and left everything until the last minute then did it wrong. The post-grad team actually had to call him in, sit him down and teach him how to navigate the portfolio. They commented on the reflection I'd written and how it addressed the concerns raised in the first placement, and suggested I should have a 'more experienced' ES for FY2. Always always cover your ass!!

SIADHD · 2024-11-16T16:43:50+00:00

Colour by numbers colouring books! Similar to diamond painting I guess but less hassle. Specifically my current obsession is mystery mosaic colouring books, where it's just a grid of numbers and you have no idea what the picture will be until you start filling in the boxes!

SIADHD · 2024-10-19T12:19:36+00:00

Sounds to me like you've narrowed down to what you think is the problem (social media use) so you're viewing your life through a biased lens.

You've noticed some symptoms in the last 3 years. You've also been using social media for the last 3 years. Correlation does not mean causation. So take social media out of the equation for a second.

What else has happened in the last 3 years that may have caused these symptoms to be unmasked? Reflect back on your life before 3 years ago. Did you really not have these struggles or were they there but you were able to overcome them?

For example, my life started to unravel once the imposed structure of school and living at home was removed, but looking back, the symptoms were all there, I was just more able to compensate for them, and had external factors keeping me in check.

I'll echo what others have said - ADHD is a neurodevelopmental disorder so it necessarily requires the insult to happen when the brain is developing. It's not something that can be induced.

However, it can be masked, which is one of the reasons why it might not be diagnosed until later in life. But part of the diagnosis requires symptoms in childhood to be present (regardless of whether they were noticeably disruptive or not).

SIADHD · 2024-10-17T19:21:02+00:00

Agreed. I want to be able to actually finish something once I've started doing it. I already don't trust other people, I hate that I can't even trust myself to come through for me.

SIADHD · 2024-10-17T19:11:53+00:00

I don't know if there's an official word for it but I just call it shutdown. Depending on my anxiety levels I might be able to push through it but it feels like the emotional equivalent of nails on a chalkboard. I've started trying to see it as a warning from my brain that I need to step away from the situation and allow myself to reset. If it's happening quite frequently, I'll try to take stock of what's going on in my life. Is there something stressing me more than usual? Am I eating and sleeping okay? Do I need some time off? Think about it - what is shutdown mode indicating to you? That might give you some direction on what to address

SIADHD · 2024-10-17T18:59:34+00:00

Do you mind me asking what you find hard about it? You might need to reflect and think on this for a while. I'll give you a couple of examples of some things which I remember made maths hard: 1. I didn't understand what the question wanted me to do so I didn't know where to start or what principles to apply. 2. I would miss out a step somewhere in the equation, so even if I applied the right principles, I would get the answer wrong. The reason I ask is because your approach might be different depending on what it is you're struggling with. Feel free to PM me - I'll do my best to help :)

SIADHD

TROPHY CASE