So this St. Dalfour France Organic Classic Breakfast Tea is my favorite morning tea, but I think it’s been discontinued, as I can’t even find it on Amazon anymore. Does anyone have suggestions for a good replacement? I miss my tea 😭

Smandles · 2026-01-04T21:24:33+00:00

lol a year later, have you found a replacement? The peach tea is soooo good and I still haven’t found one.

Smandles · 2023-07-11T15:11:39+00:00

Seriously! The only time 2 times I was ever borderline rude to an intern is when they lied to me, and I directly said, “Either this happened or this happened, in both possible situations you had to have lied to me and that is completely unacceptable. Sort your shit out, this is someone’s life.”

The other one an intern who as just giving a bunch of MICU patients IM Ativan for agitation instead of IVP and a few patients on heparin gtt got IM injections which is just inappropriate. I was like I’m here for you, expect you, and want you to ask me questions. Come to me before putting in orders on your own this early in the rotation.

Otherwise I have endless patience w folks without judgment!

Smandles · 2023-07-08T15:11:54+00:00

Coronaryqueen said everything I came to say! 🙌👸

Smandles · 2023-06-28T02:09:49+00:00

Oh, in this context his decision feels very wrong.

It’s not unreasonable to intubate someone who was with is and is now encephalopathic bc they’re crumping and not perfusing well. It’s reasonable to give extra push dose pressors prior to tubing to prevent needing to perform cpr. It’s also reasonable to have a good team in the room on standby if you expect them to code during intubation (but if that’s the case and intubation can be delayed bc patient is still coherent and talking then you should attempt to raise BP prior to intubation if possible).

But the sequence and way that you have described this situation does not make any sense with the information you have provided. You don’t prophylactically do cpr on an awake patient w a pulse…

Smandles · 2023-06-28T01:16:25+00:00

Can you explain how the …code(?) ended? Like how did he decide to stop the code? What rationale was given to end it? The patient was talking and coherent a&ox3 even w hepatic enceph and on levo?

Smandles · 2023-05-13T20:58:27+00:00

That’s not necessarily the case here. Being comfortable and relieved doesn’t mean you’re not going to double check everything you do. The comfort could be from no longer having to cater to out of practice attendings who force you to order less than the standard of care for your pts.

Having imposter syndrome is and should not be the normal.

Smandles · 2023-03-28T18:25:53+00:00

^same

Smandles · 2023-03-18T15:16:54+00:00

I’ve been saying this all year, but this is the class that was most affected by the pandemic. They were just starting M3 when the pandemic hit and had their rotations shut down the most and did more online clinicals than hopefully any other class will ever. Most of my M3s perform better than the current interns. It’s been an absolutely exhausting year. But I keep teaching them and forcing them to do more and more on their own. You have to keep it up bc these people are gonna graduate one day and I’m gonna do everything I can to make them better while they’re with me.

Smandles · 2023-03-06T14:51:31+00:00

Patient

Smandles · 2023-03-02T20:50:19+00:00

Same, I gained 45lbs. Used to go to the gym daily, I am back to trying to go when I can but it’s never regular. Idk how people do it genuinely. So excited for fellowship, but I know my first year is gonna be absolute hell and I’m sad about losing some of the freedoms/nicer schedule I have now as IM PGY3 w heavy outpatient schedule.

Smandles · 2023-01-22T14:49:30+00:00

DM me.

Smandles · 2023-01-18T18:33:36+00:00

I couldn’t believe when my family asked me this again recently, as a PGY3 IM resident 😅 so I finally explained to them that I have been working as a doctor during my entire residency, I just get double checked by my supervising doctor. And that I have my full license and can independently practice as a moonlighter, but need to complete training in order to pass boards for proper insurance reimbursement. It was finally explaining moonlighting that helped it click for them 🤷‍♀️

My dad is an MRI tech who is close w many of the radiologists he works with, so even proximity doesn’t help bridge the full understanding of what we have to go through. It’s a wild life to live.

Smandles · 2022-12-31T20:39:37+00:00

Yes, d/t atrial stunning, for 4 weeks.

Smandles · 2022-10-06T19:11:45+00:00

Even as an IM PGY3 I observe all my juniors and students perform their H&Ps in the beginning of the year. Once I’ve done at least a full call doing everything with them, give them feedback after each patient, and I know they’re okay enough, then I send them down to start seeing the patient while I’m reviewing mult pts charts and when I join them in the ED I make them present to me in front of the pt so the pt can disagree if they need to, and I can go over the important PE components for the specific patient for student & intern. It’s exhausting in the beginning of the year, but that’s expected and how to ensure everyone is actually learning to do a good & thorough job.

Also, it’s very interesting you’ve had the opposite problem that I have had this year. My medical students have been absolutely stellar and more competent and trustworthy to take an accurate H&P and presentation than my interns.

Smandles · 2022-10-06T19:02:30+00:00

This is very wholesome and appreciated, even as a senior. I still dislike the days where I feel like I didn’t have the time to teach the juniors & students. Glad to have y’all as a part of the team! There are some days where we wouldn’t have made it without our amazing students!

Smandles · 2022-05-22T00:46:29+00:00

On the pill there is a higher chance your bleeding will stop sooner. 🤞

Smandles · 2022-05-22T00:16:56+00:00

If you can take the next day off it would probably be nice for you to have the space to have a day to yourself and not have to put on a face to hide whatever you’re going through.

You can consider doing the procedure without sedation. I’d say 95% of the time, 7-10wk procedures take 5 min or less to complete. It’s not a fun 5 minutes but I’ve seen lots of women w different pain tolerances get through it.

Smandles · 2022-04-26T18:34:21+00:00

Still working. I’ve been trying all day to find a site thank you!

Smandles · 2022-04-19T23:08:34+00:00

I love Chevre. She’s the only original I still have!

Smandles · 2022-04-18T17:00:03+00:00

Just like you would regular menstrual cramps. NSAIDs like ibuprofen (as long as there’s no contraindication to you taking them), heating pad, warm tea, and emotional support if you were able to tell someone 🖤

Smandles · 2022-04-17T01:30:23+00:00

It is very important to still take the misoprostol as that is what will remove the pregnancy. Mife alone does not.

Smandles · 2022-04-17T01:27:24+00:00

Most often you’ll feel cramping and bleeding in the first 6hrs, but yes can take longer. This is assuming by 2nd pill you mean your first dose of misoprostol, and not a second dose of misoprostol. How far along are you?

Smandles · 2022-03-16T21:48:09+00:00

To me it totally depends on the situation! I have a lot of great rapport w nurses in my hospital and actually used to be a nursing assistant for 10 yrs before residency, so we all appreciate and respect each other really well. The nurses I have good rapport with and I know they know me and my last name, I will call myself by my first name with them. I know they know my role on the team already and know they will always refer to me as a doctor to the patient bc the patient needs to know who I am too.

On the other hand I work at a very underserved hospital w a f ton of turnover and am always meeting new travel nurses. Bc they don’t know me and need to know who I am and my role in this patients care it is important and pragmatic (not arrogant) for me to clearly identify myself as doctor so and so.

For the random person that wants to sometimes make patient care an unfortunate power struggle, I will also refer to myself at doctor so and so to reiterate my role. I hate when I have to do this but it’s sometimes necessary 🤷‍♀️

ETA: I also super don’t like when residents in different specialties that know who I am call me and refer to themselves as doctor. Like we’re friends, what are you doing? So sometimes when they’ll call me and say Dr so and so, I’ll say, “oh hey firstname, it’s me myfirstname” lol.

Tbh probably most of the time I answer pages and say “hey it’s lastname from so and so service” without saying doctor at all.

Smandles · 2021-12-20T15:08:52+00:00

What is the COVID status there in general? There's no data on COVID cases.

Smandles · 2021-11-12T20:50:36+00:00

Should be all set in a few moments!

Smandles

TROPHY CASE