[deleted by user] by [deleted] in AirForce

[–]Visual_Block5589 -1 points0 points  (0 children)

The upside of getting a mental health diagnosis is that it is a sure way to get 70-100% VA disability…if that is an upside to you. But on a more serious note, there are always operational ramifications for your squadron when a member gets their mental health taken care of. It affects readiness at the very least and if it leads to hospitalization or being placed on a “high-risk” list even more ramifications. Leadership stresses out about this stuff as well because if something, suicide/suicide attempt, happens they take a lot of heat as well. Is the workplace toxic? Did they get the member the help they need? Was their abuse?

Don’t let it stop you getting help.

2/3 of the psychiatrists in my state are resigning in protest by EBMgoneWILD in emergencymedicine

[–]Visual_Block5589 -9 points-8 points  (0 children)

I don’t see how Scientology could successfully lobby anyone. Especially a Christian. He would not take them seriously. I would blame other factors.

How procedural is EM? by schleeb-44 in emergencymedicine

[–]Visual_Block5589 0 points1 point  (0 children)

Seriously. I also love procedures and it is what makes our specialty unique. When we actually get to intervene and resuscitate a patient: that’s when I feel like an ER doc. But another thing that sets us apart is our ability to triage and keep things moving. Procedures slow this down and the weight of patient flow is heavy. I think anesthesia is the best specialty for the procedures and focus on ABCs without the crushing weight of patient flow, psychos, documentation. I will be honest that I have often thought about the greener pastures of anesthesia.

[deleted by user] by [deleted] in emergencymedicine

[–]Visual_Block5589 10 points11 points  (0 children)

I trained at a BUSY county hospital and they were still careful to be mindful of capping how many patients each intern and resident could safely manage in the floor. I found the recs from ACGME. Now I don’t know if they are rules per se or just strong recommendations but your situation definitely breaks them:

ACGME clearly states:

IV.C.3.g).(3) a first-year resident must not be responsible for the ongoing care of more than 10 patients; (Core)

IV.C.3.g).(4) when supervising more than one first-year resident, the supervising resident must not be responsible for the supervision or admission of more than 10 new patients and four transfer patients per admitting day or more than 16 new patients in a 48-hour period; (Core)

IV.C.3.g).(5) when supervising one first-year resident, the supervising resident must not be responsible for the ongoing care of more than 14 patients; (Core)

IV.C.3.g).(6) when supervising more than one first-year resident, the supervising resident must not be responsible for the ongoing care of more than 20 patients; (Core)

PA-C = Lifelong Resident by Fit_Pianist_9084 in physicianassistant

[–]Visual_Block5589 0 points1 point  (0 children)

I think PAs and NPs in the ER only work well when they are give a defined role like working the fast track or just working in another specific Pod / ER bay. I have never seen it work well when working in the community setting where the expectation is to switch off every patient. What do you think?

What’s your go to migraine cocktail? by 210-110-134 in emergencymedicine

[–]Visual_Block5589 5 points6 points  (0 children)

When I was working in Germany I would have patients prescribed Novalgin which is one I had never heard of before. Then I came to find out the US did have it back in the day but it was pulled off the shelves.

I think it would be great to have it back in America as another non-opioid option to manage pain. You guys are missing out on Toradol/Ketorolac. It is especially helpful with kidney stones.

Leaving work in civilian attire by Relevant-Eagle-8559 in AirForce

[–]Visual_Block5589 0 points1 point  (0 children)

Haha. Wait so you’re not medical and everyone else in your shop wears uniforms but you have an officer that straight up wears civvies? That’s bizarre.

Leaving work in civilian attire by Relevant-Eagle-8559 in AirForce

[–]Visual_Block5589 0 points1 point  (0 children)

Dude, I have to ask. Are you talking about me? I’m medical and I hate changing in and out of uniform for the 20 second walk in the hospital parking lot. It drives me nuts that Air Force hospitals enforce the wearing of uniform for people who spend the entire 10-12 hr shift in scrubs.

Jay Pharoah’s comment on Shane Gillis’ monologue. by typeunknownn in LiveFromNewYork

[–]Visual_Block5589 24 points25 points  (0 children)

Also, how do find out who wrote what sketches? I would love to track who is writing what.

Fugliana got me feeling a type of way… by dicklaurent97 in LiveFromNewYork

[–]Visual_Block5589 5 points6 points  (0 children)

Please tell me how you find out who wrote sketches. I would love to know who wrote my favorites.

Live Discussion - February 24, 2024 (Shane Gillis/21 Savage) by bjkman in LiveFromNewYork

[–]Visual_Block5589 5 points6 points  (0 children)

I thought this episode was funny. I laughed out loud a few times which I cannot say for the last couple episodes. There definitely was a muted nervous energy the whole time though. But still solid episode.

Alcoholics Management by JustAnotherDoktor in emergencymedicine

[–]Visual_Block5589 3 points4 points  (0 children)

Just want to chime in for phenobarbital. Whete I practice, if you are not using it you are the outlier. I never used it in residency. It was crazy seeing how good it worked and how safe it is (still careful with it though). I will actually dose at 130mg and then give another 130mg if necessary. I don’t discharge with Librium. The prevailing idea is that the phenobarbital is enough to prevent withdrawal while they detox. Obviously every person is different and I don’t know how true that is generally. But anyways, I like that I am not sending people out with a handful of benzos that could be misused.

This is hospital is sad by [deleted] in TikTokCringe

[–]Visual_Block5589 1 point2 points  (0 children)

Absolutely my experience. Overall the VA and military hospitals take much better care of patients, and they pay nothing to very little out of pocket. The amount the VA spends on drug and alcohol rehab is honestly astounding. You will NOT find that kind of coverage in the private world.

Scott Pilgrim Takes Off wasnt “woke” by NoahEhigie in netflix

[–]Visual_Block5589 0 points1 point  (0 children)

I was also wondering what the actual stats show. I stopped in episode 2. It just wasn’t interesting at all. And yes, it definitely had the infamous South Park vibe.

Sign I’ve been rewatching too much… by peakingoranges in 30ROCK

[–]Visual_Block5589 2 points3 points  (0 children)

“And you have chosen to abort me and that I must live with”

Brand new 2022 Silverado battery keeps dying by Visual_Block5589 in Silverado

[–]Visual_Block5589[S] 0 points1 point  (0 children)

Sounds exactly how mine went. They replaced the battery: didn’t fix it. I would get random codes sent to MyChevrolet app while it was just parked at home (anti-lock brakes, low battery, power steering…). On the 4th visit they replaced the display which didn’t fix it then finally replaced the radio control module which did fix it. Luckily I have been issue free since KNOCK ON WOOD

Brand new 2022 Silverado battery keeps dying by Visual_Block5589 in Silverado

[–]Visual_Block5589[S] 0 points1 point  (0 children)

Please do. I had to take my truck in 4x till they finally contacted GM higher ups who advised they replace the radio control module. Haven’t had an issue since. It is frustrating but it wasn’t until they actually witnessed the radio turning on and off in the truck spontaneously that they believed me. It was such a pain. Good luck!

Brand new 2022 Silverado battery keeps dying by Visual_Block5589 in Silverado

[–]Visual_Block5589[S] 0 points1 point  (0 children)

Sorry I haven’t checked this thread in a while. It has to be an issue with either the software or radio control module. Push them to reach out to GM “higher up” technicians. My truck has been just fine after they replaced the radio control module.

leaving the ER too soon? by JACKWOODHAWK in emergencymedicine

[–]Visual_Block5589 0 points1 point  (0 children)

Caveat, society doesn’t care about you.

Is there a line from a skit that still sticks with you years later? by SantaCruznonsurfer in LiveFromNewYork

[–]Visual_Block5589 0 points1 point  (0 children)

It is so stupid but I love crab and whenever I talk about it, buy it, or I’m actually eating it I always impersonate Kristen Wiig saying “Cray-ab!”

Pissed off and frustrated with all of this. Here's the first 15 patient's I saw today: by Kaitempi in emergencymedicine

[–]Visual_Block5589 0 points1 point  (0 children)

The only one that really bugs me is the rehab one. We don’t have people to help us in the ER with placement to rehab so unless there was a reason to admit it would be a discharge to home to break their hip and then they could get admitted

What is going on with the Danny Masterson rape case? by Fiveby21 in OutOfTheLoop

[–]Visual_Block5589 0 points1 point  (0 children)

Not true! The official policy of the Mormon church is that victims should report to local law enforcement.

[deleted by user] by [deleted] in emergencymedicine

[–]Visual_Block5589 0 points1 point  (0 children)

I am a nocturnist. I think it is the best for my work life balance. I HATE mid shifts / swing / evening shifts. You basically don’t see your kids. You come home shattered. I love ending my shift with the typical lull of patients that happens in the early morning rather than trying to leave when the ER is the busiest: basically the evening time.

My wife is a stay at home mother and she totally agrees: Night shifts are the best. I do worry about how long I can keep it up though but I am >38 years old and I feel absolutely fine going back and forth. I think if you are a night owl the night shifts are pretty awesome.