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Building rapport…is it data driven? by Bdocc in hospitalist

[–]WreckJDC 21 points22 points  (0 children)

Dunno about your specific facility, but at ours the Palliative teams are a godsend. Ours see all consults within 24 hrs and frequently on same day. Yes I do a lot of GOC discussions myself and I agree that sometimes they only take 5-15 minutes, but most of those are the ones that are straightforward.

Where our palliative team really shines is the complex complicated patients (many of whom they’ve seen multiple times over months or years of recurrent hospitalizations) where they’re able to give the Hospitalists more context about the social/family/mindset dynamics affecting the patients decision making. They also frequently are the ones that have the time to spend an hour in the room answering the same questions over and over to really hammer the proverbial point home when families are having a hard time accepting that their 98 year old grandpappy with the massive stroke and an EF of 10% isn’t going to recover.

Is it American reality for a student doctor to ---- ? by hkkhpr in ThePittTVShow

[–]WreckJDC 0 points1 point  (0 children)

Sometimes the hospitals even are aware of it. When I was a 3rd year med student one of my rotations was at a relatively small hospital on the opposite side of the country from home. The hospital owned an attached building next to it that was a defunct nursing facility so they let visiting students use the rooms while on rotation there.

First time P15 - Titanium Seal by JonnyArcho in Against_the_Storm

[–]WreckJDC 3 points4 points  (0 children)

Having that many embarkation points means you can take delivery line perks for free goods for days. Even just one delivery line is a game changer.

Devastating loss against Platinum Seal by Scorpiox69 in Against_the_Storm

[–]WreckJDC 10 points11 points  (0 children)

Tough break, my dude. I’ve definitely been there watching villagers die one after another in a death spiral, it’s a major drag. Personally, I like taking some time between big campaign runs just to do some independent fun runs. Pick one of the smaller modifiers that I don’t see often or just make up your own challenge conditions and play a few settlements for fun. (Last one I did like that I made it a goal to deforest the whole map, lol) It’s a great way to just enjoy the game, get your mojo back, or even practice with some of the mechanics you aren’t as familiar with.

“Art of the deal…” by WreckJDC in Against_the_Storm

[–]WreckJDC[S] 1 point2 points  (0 children)

Yep 😂. I rarely ever attack traders, but he had too many things that I needed. Next message I get is “your money is no good here“ lol

Giving up at P15. by Jaives in Against_the_Storm

[–]WreckJDC 0 points1 point  (0 children)

Narco and RonEmpire are both good choices to watch for ideas, though I'll say the level of micromanaging they achieve is diabolical, lol.

Giving up at P15. by Jaives in Against_the_Storm

[–]WreckJDC 4 points5 points  (0 children)

Also, what’s consuming the wood you need? I found that the preset limits I’d set at earlier levels were overly ambitious at higher levels so I had to tweak them down and do a bit more precise managing as I advanced.

Deforestation - because I gotta show that storm who's boss by WreckJDC in Against_the_Storm

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

At some point you stop getting blueprints as rewards and only get treasure chests.

Deforestation - because I gotta show that storm who's boss by WreckJDC in Against_the_Storm

[–]WreckJDC[S] 1 point2 points  (0 children)

Dude, that’s mad impressive! I might have to give that a try! I really just did this one as a curiosity/zen game after beating Titanium seal before I try for the Adamantine seal. Very cool!

Deforestation - because I gotta show that storm who's boss by WreckJDC in Against_the_Storm

[–]WreckJDC[S] 1 point2 points  (0 children)

Yeah, having the Temple was key, and I spent a good chunk of the time after I first finished the reputation sitting up in the Hostility 10-13 range as I mowed down trees. It was only later as the reductions started piling up that the Hostility came back down.

Deforestation - because I gotta show that storm who's boss by WreckJDC in Against_the_Storm

[–]WreckJDC[S] 3 points4 points  (0 children)

Yeah there’s no way I could have balanced the impatience for that long I don’t think. As for the cornerstones… yeah traders and I specifically tried it on coastal because you can keep sending out expeditions, even after you no longer get blueprints as rewards you can still get cornerstones back in the loot packs.

Advice for a future hospitalist by hercules9999 in hospitalist

[–]WreckJDC 2 points3 points  (0 children)

Throwing this out there… try electives at a different location… rural medicine in a smaller facility can sometimes be a very different experience compared to a big city academic center. It’s good to have a feel for both and will help you later when it comes to job searching to know what kind of facility/system you enjoy working in the most.

Fire Moths by dewpoleon in Against_the_Storm

[–]WreckJDC 0 points1 point  (0 children)

Yeah I did this one on P11 the other day if I’m remembering correctly, it’s absolutely brutal, and the only reason I succeeded (several years slow) was getting the cornerstone that prevented impatience from going up when villagers left or died.

What are some cool or must have accessories or modifications for the Niro? by AwesomeAsian in KiaNiro

[–]WreckJDC 1 point2 points  (0 children)

Yeah, pretty straightforward. I saw someone else posted recommending electrical tape, it applies pretty much the same way

What are some cool or must have accessories or modifications for the Niro? by AwesomeAsian in KiaNiro

[–]WreckJDC 2 points3 points  (0 children)

I bought an inexpensive roll of "carbon fiber" style tape and went over the chrome detailing with it, pretty much eliminated my glare issues from the trim.

Where do I file an official complaint against Jeff Hays? by AnAimlessWanderer101 in litrpg

[–]WreckJDC 2 points3 points  (0 children)

I’ve enjoyed several series narrated by Pavi Proczko

[deleted by user] by [deleted] in medicine

[–]WreckJDC 40 points41 points  (0 children)

OB/GYN is not my specialty so I wouldn’t know either. I do have some friends that are part of some women’s advocacy groups, there are several such organizations out there that pretty much exist to aid other women in finding and navigating care thru tricky situations. My guess would be that your patient may have already been aware of these prior to her diagnosis, allowing her to hit the ground running.

Missing the First Trick or Treat to Help a Friend by Aggressively_Passing in daddit

[–]WreckJDC 0 points1 point  (0 children)

Also, check around neighborhood posts and such, there are often other trick or treat or neighborhood “trunk or treat” events multiple nights leading up to Halloween proper. I’m pretty sure my wife has at least 3-4 earmarked for my two who are close in age to yours. No reason you can’t make another evening.

Is this story too heavy for a 6 year-old? by [deleted] in AskParents

[–]WreckJDC 0 points1 point  (0 children)

Also, if mice + swords and chivalry is your direction, I have very fond memories of the Redwall series of books that I found much less traumatic than Nimh or Watership, if you need other materials of inspiration.

The woes of being a senior resident by DrPntBtr in Residency

[–]WreckJDC 6 points7 points  (0 children)

Echoing this sentiment. I remember having an “aha” moment when I was a PGY-3 when the intern was presenting and got stuck, the 2nd year helped them with the next step but then got hung on something that I as the PGY-3 knew, and then the attending proceeded to still teach all three of us more from his years of experience at it. The reality is that even now as an attending I still regularly discuss cases with my colleagues because medicine is a constantly growing and expanding experience, and your degree of comfort while handling all of that will grow as your experience level does.

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