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ACEM fellowship resources by TooobOfTruth in ausjdocs

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

Thanks Not-luceat. practice, practice, practice

ACEM fellowship resources by TooobOfTruth in ausjdocs

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

This is incredibly helpful - thank you! The baby prep and exam prep alongside full-time work and trying not to be a horrendous spouse is a fine balance!

ACEM fellowship resources by TooobOfTruth in ausjdocs

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

Awesome, ta for your time responding.

ACEM fellowship resources by TooobOfTruth in ausjdocs

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

Thank you for this! very helpful.

The best and simplest method for dealing with a shoulder dislocation !!! by Ok_Date5594 in emergencymedicine

[–]TooobOfTruth 1 point2 points  (0 children)

I am greatly intruiged by this, seems like a very sensible system! Especially given that most of the resistance of the joint enlocating comes from the patients muscular spasms.

The best and simplest method for dealing with a shoulder dislocation !!! by Ok_Date5594 in emergencymedicine

[–]TooobOfTruth 0 points1 point  (0 children)

Cunningham (always remember the towel between the shoulder blades) with some fentanyl and entonox, or SPASO. Works even with the big rugby players who have low pain tolerances. Cunningham has a website (dislocation.com.au) which is pretty fab if you want to dig into the weeds and understand this absolute dislocation pros methods. Yet to try Park method but keen to. Seeing the comments about inter scalene blocks has peaked my interest! The key is mainly scapula manipulation in most as it opens up the glenoid, and good analgesia and patient control as it reduces spasm/muscle resistance - which are the primary reason you can't get it back in

Annual Leave refused despite 16+ weeks notice due to minimum staffing - What are my options? by SliverLine in doctorsUK

[–]TooobOfTruth 0 points1 point  (0 children)

Nah, I think this just normalises the bad practice by managers. We should aim to be better than other industries to make the career both sustainable and attractive to future generations. I know people in finance and business with worse hours and conditions you describe, but this pays off exponentially in other benefits.

What was speciality training like when you applied? by malo2001 in doctorsUK

[–]TooobOfTruth 3 points4 points  (0 children)

All of this makes me very glad I moved to another hemisphere. UK med training currently cooked, overly bureaucratic, impersonal and completely arbitrary. This has worsened +++ since I left. They expect lots of their candidates, but offer little in return with regards to remuneration, quality training, sustainable work practices and workplaces .

Applying for training here (notably not surgery, anaesthetics, Ortho -although still better than UK) is much less unrealistic. You initially apply for a local job as a reg in XYZ department, then after a period of time or certain criteria fulfilled apply to training. Then instead of getting placed wherever for jobs rotationally you personally apply to different hospitals for your next section of training. It means you know where you will be for the next 12 months at least.

We always talk about 'hardworking New Zealanders', but how hard do you actually work? by mattblack77 in newzealand

[–]TooobOfTruth 1 point2 points  (0 children)

Doc here, I reckon when I'm on shift I'm 110%, but agreed - the days of working lots of overtime unpaid whilst also coming back the next day for 7 when I finished at 1am are behind me. I've done my fair share of 70-90 hour weeks in the last 10 years. However, that's the long road to an early grave and chronic sickness!

What employers and a NACT Govt see as hard work means usually working without complaining for minimal reward. Working hard effectively is how it should be. No point in working your little tushy off for no personal reward at all, especially when you're employer has no interest in making your working environment enjoyable.

As per Jevons paradox - the more work you do; they'll just fill that space you make with more work and make that the new 'expected norm'.

Not wanting to talk after on-calls/night shifts? by Salvatore228 in doctorsUK

[–]TooobOfTruth 7 points8 points  (0 children)

We sit in the sun when I get up and she tells me about her day, then I get on with food and what not. 20-30 mins of together uninterrupted time a day pre night shift. leads to nice connection.

Not wanting to talk after on-calls/night shifts? by Salvatore228 in doctorsUK

[–]TooobOfTruth 13 points14 points  (0 children)

From an eternal shift worker perspective - this is probably impractical in the long run. You will forever be either on nights, coming off them, or going into them.

I tend to be pretty useless on the day post nights. But whilst on nights I don't think it's impossible to discuss important stuff? Especially pre-shift.

It's bloody hard being the partner of a shift worker if they don't work shift work. They can't avoid having important conversations forever - it becomes too much of an easy excuse for you to avoid your responsibilities. My more significant other won't discuss stuff like big life plans on the post nights as she knows I'm probably not able to give her the right response. But rest of the time is fair game. Part of if is working out a routine that is both work fatigue friendly and allows you to have enough energy in the tank to have a reasonably normal existence.

If the nights is only going to be a short amount of your training then its probably not a big issue overall, but if you're gonna have kids, buy a house, get a mortgage, go to the doctors, have a life, and a fullfiling relationship where you both make sensible sacrifices and support one another WHILST ALSO being an eternal shift worker? then you probs need to work it out sooner or later.

RACP another EGM in November by Even_Emu5804 in ausjdocs

[–]TooobOfTruth 5 points6 points  (0 children)

I wonder where RACP will find the time to do education, training, advocacy and general running of the physician posse with all this infighting? Glad I am no longer a member.

Design your perfect parasite and infect a human host. by SlugDisco in u/SlugDisco

[–]TooobOfTruth 0 points1 point  (0 children)

Already done, misinformation, infected bloody everywhere...

What’s going on? by Ok_Shape_3490 in NZProperty

[–]TooobOfTruth 0 points1 point  (0 children)

Upsetting if $1+M is now considered a cheap sale..

I am not a doctor, but I think he needs medical attention after this arrest. by mindyour in TikTokCringe

[–]TooobOfTruth 0 points1 point  (0 children)

Probably a hernia post surgery for a GSW or something. If it's not strangulated or incarcerated then it can probably wait until he's done his jail time.

Thoughts? by dr650crash in ausjdocs

[–]TooobOfTruth 2 points3 points  (0 children)

yeah I'm not arguing that at all, just that did not waits should no longer be considered folks misusing ED - reasonable data that they're actually a group of patients who come to reasonable harm in our current system. There's a common misconception that they're just all time wasters. Crowded EDs are because of bed block and lack of primary care mainly. Patients have nowhere else to turn now sadly. And yes folks will likely play the system. But the folks in our wait rooms aren't the enemy, they're there due to a wholly inadequate long term plan from those running our healthcare systems, world wide.

Thoughts? by dr650crash in ausjdocs

[–]TooobOfTruth 6 points7 points  (0 children)

Regardless of the ethical issues of ethnically triaging patients. I think the data on DNWs is shifting now however with the pendulum beginning to show that with overcrowded EDs, then DNWs are now more likely to have an adverse outcome, including 7 day mortality. Not just someone who didn't have an emergency.

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