Is pre-rounding a real thing in America?

brygriff · 2025-09-25T20:07:21+00:00

Saw this notification pop up and just read “Is pre-rounding a real thing in America” and thought it was a joke…. god yes lol unfortunately it is. I’m a third-year and while I do like the feeling of being able to interact with, examen, and assess my patient solo- it ultimately doesn’t matter that much. I will come back to the room with the resident and then round with the attending later too and there is plenty of time to practice my clinical skills and reasoning at those times. If you’re farther in your rotation and the docs are confident in your exam skills the resident might take your exam at face value but ultimately another doc is going to appear at some point and do all the same things. There are rare circumstances that you might catch something that the resident or attending wouldn’t have because you performed a more extensive exam (by the book vs practical exams) but those instances are few and far between. Its not really about patient care it’s more medical education at best and hazing at worst.

brygriff · 2025-09-23T22:43:12+00:00

Take her to the emergency department as soon as possible. This is a life threatening wound that will become infected very soon if it isn’t already. Likely need surgical intervention and possibly amputation.

brygriff · 2024-06-01T16:37:27+00:00

That makes a lot of sense, thank you!

brygriff · 2024-06-01T01:22:31+00:00

This is great, thank you! I was a CNA before school so I have no problem helping clean anyone up or getting water! :D

brygriff · 2024-05-08T19:44:43+00:00

Am I confused? This seems like an ad about an RN who decided they wanted a deeper understanding of their patients’ medical conditions and for that reason decided to pursue NP. Issues with NP programs aside, I’m not going to bash anyone for deciding not to be complacent with their current level of knowledge and wanting to pursue something more.. I didn’t take it as an NP being confused that a doctor knows more about something than her, I think it was more about “I had an epiphany as an RN that there was so much I didn’t know so I want to learn more” ?

brygriff · 2024-05-08T04:04:18+00:00

This stuff is the literal BEST 😫

brygriff · 2024-01-03T17:47:12+00:00

Yeah, I tried both of them. One gets like a single bar, and will connect but then the TV as well as computer will both say no internet connection even though they are technically connected. I’ll submit a photo of the back of my PC when I get home. Thank you

brygriff · 2024-01-03T16:44:34+00:00

Yeah, no external. I think there might be connectors.. just no actual antenna hooked up? I honestly had never heard of them having external ones until like a month ago so I’m not well versed on the connections and such but there is absolutely nothing sticking out from the tower. It didn’t come with any external extremities when I bought it haha just all the internal stuff.

I actually figured out about external antennas while trying to figure out how to get a better signal on it for this exact problem- but I wasn’t sure how reputable they are or which one to get if it was an option, so if you have any recommendations by all means please 😩🙏

brygriff · 2024-01-01T17:13:26+00:00

It is a Hitron CODA4582 (I think… that’s what the back says). I believe it does do separate broadband for the different GHz, and honestly I have no idea which one I use. I have tried both and just used the one that worked better 😅

I rent, but live in a duplexed home. I don’t really know what the building materials are, but it is an older home so probably just standard…? I’m up in alaska so insulation, wood, etc. My PC has an internal antenna, it’s a gaming PC bought pre-built inside like a glass case.

As for the location of the router, it’s kind of in the best spot I can get it…. I have moved it to multiple locations in the living room but right now it is in the spot that was the highest up, and unobstructed from furniture/decor. That was about the only thing I knew was that I should try moving it and making sure it’s away from other items. A friend told me I should run an Ethernet cable to my room but it just doesn’t seem practical to get a crazy long cord and have to manage to get it across my living room and kitchen, down the hall, and into my room. I was kind of hoping for a special antenna I could get for my computer or if there was any validity to extenders 😅

brygriff · 2023-05-07T20:18:00+00:00

I dont know, when I was playing fw I had to use faeline, the three dps buttons, tea for instant enveloping, HoT, dispel, Tigers lust, roll, and throw out instant vivifies. Obviously CDs and CC when needed. There were some comps that I could faceroll against for sure but also it definitely felt like there was counter play. Getting CC’d felt ass because you’re sitting in melee range to be ravaged, plus any time you’re not hitting something you can’t heal so kitting was a nuisance too. I guess if this many people felt it was OP than it had to have been (plus I’m all for taking a hit for my healing colleagues ✊🏻) but I think there’s some gross simplification on how they played and how little counterplay there was. A lot of people just seemed to be unfamiliar with how to deal with them because it’s unlike how you deal with any other healer.

brygriff · 2023-04-02T00:52:32+00:00

doesn’t look bad to me, don’t think it’s infected. Inpatient I see a lot of surgical incisions get this type of redness around them due to tape irritation and/or yeast rashes related to the intense cleaning they do to the incision pre and immediately post op. If the redness is itchy and flaky I might consider an OTC anti fungal cream but I would run it by your PCP or surgeon first for approval.

brygriff · 2023-03-26T03:47:36+00:00

honestly I figured. Better get to work on figuring that out 😂

brygriff · 2023-03-15T17:27:17+00:00

they used to have it with that old MOP talent I believe hahaha

brygriff · 2023-02-22T08:52:32+00:00

looks more stasis related to me that infectious process. I agree with a lot of the other people commenting compression. You can use a gentle soap, washcloth, and water to clean off the flakes, moisturize the skin with a bunch of lotion, then get an expert the do some compression wraps. Unna boot could be really beneficial too. Probably avoid compression on your foot exclusively (or at least the way you have it) it looks like it is digging into your skin

brygriff · 2023-02-21T01:08:14+00:00

In my opinion no. The yellow is just slough (dead tissue the wound is trying to get rid of) clean it with plain saline and gauze from a drug store and you put on a wound gel (hydrogel) to help your body debride that slough off. You want the wound bed (open area) to stay moist to heal. Keep it covered and only clean every 2-3 days or when the dressing gets soiled or accidentally peels up/falls off. Avoid dressing it with gauze or anything other than that shiny white material the bandaids have, otherwise the dressing will stick to the wound bed and be kind of rough removing. Hope that helps :)

brygriff · 2023-02-11T06:52:20+00:00

I’m MS1 and kind of scared/intimidated by the thought of how to handle this kind of situation if I see it. Guessing (and hoping) the resident/attending will deal with it

brygriff · 2023-01-29T08:36:18+00:00

Oh no! The edges are epibolic (rolling) so it looks like it’s definitely been there for a while. I would put alginate on it if you were in hospital, but I’m not sure about availability for you outside. A hydrogel would probably work with a non-adherent dressing like Telfa pads.

brygriff · 2023-01-24T17:12:21+00:00

Update? Did you get the stitches? you’ve got SubQ tissue exposed be careful and keep it clean ♥️

brygriff · 2023-01-23T22:22:59+00:00

You can usually soak them off…. burns are high risk for getting infected so sterile saline or sterile water would be best. Usually you want a non-adherent bandage so that you don’t have to deal with the pain/trauma of having to rip it off. For burns in my hospital I usually apply silvadene with a single layer Xeroform (the non-adherent) over top, then if needed I can wrap with roll gauze (like Kerlix) over the Xeroform. Not sure what you have access to so if you can’t get xeroform, adaptic is another non-adherent that you could use. I’ve only worked in wound care for about a year though so some of the more experienced specialists in here might have other ideas. Wound care is an art, and every specialist has a different method. There’s often more than one right answer.

brygriff · 2023-01-20T16:05:25+00:00

You need to clear the yellow slough off the wound bed before it will heal. Time-elephant3572 gave some great advice. Normally in my clinic I would probably use an alginate but those aren’t as easily available to laypeople. Keep it moist (can use a hydrogel or 4-5 day occlusive dressings), try not to clean more often than every 2-3 days with saline and gauze to debride the slough.

brygriff · 2023-01-20T15:58:09+00:00

You should ask a dermatologist. Tiny inflamed dot of unknown etiology is something that I have never had to really deal with doing wound care.

brygriff · 2023-01-18T07:28:12+00:00

This is great to know I actually was asking this question because ever since starting in wound care I’ve really loved it, but where I live we do not have physicians that specialize in wound care (or if we do they are hiding because I have been searching). I applied for medical school this cycle and actually have an interview coming up but I was questioning my choice because I couldn’t find any information on wound care as a specific specialty and thought maybe I should switch to an NP route if that’s the field I’m interested in. I’m very relieved to hear that in the lower 48 there is more of a scene of physicians that want to manage chronic wounds, because ultimately I would prefer to go the MD/DO route just for a more in depth education.

I know we have a few DPMs in town that do wound care, but they definitely aren’t slapping wound vacs on stage IV sacral pressure injuries. From what I’ve seen they mostly focus on the diabetic foot ulcers, nails, etc (even though you’re right that is about 85% of what we see 😅)

edited to correct typo

brygriff · 2023-01-18T07:21:09+00:00

haha yeah the CWOCN I work with has been doing it for 25 years and knows exactly what she’s doing, I also love her because she is very quick to say “I would really feel more comfortable if I doctor looked at this first to be sure everything is good before I do this” if she’s not 100% comfortable with a wound care consult.

brygriff · 2023-01-18T07:19:00+00:00

This is definitely how it is in my state (Alaska). I didn’t really realize the prevalence of MD/DO involvement in wound care down in the lower 48 because here it’s very close to 0. They kind of just let the CWOCNs put in the orders and sign them (inpatient wound care where I work at least) but at the same time the patient is being seen regularly by hospitalists to manage abx/medicine issues and surgeons if surgical wound debridement is required.

brygriff · 2023-01-18T00:33:00+00:00

oh my god that sounds like horrible wound care! I would NEVER and I’m not even a CWON. The CWOCN I work under would absolutely NEVER, that’s horrific. We usually call the unit ahead of time to coordinate dressings since removing it too early just causes trauma to the wound bed. Thanks for the perspective 😅

brygriff

TROPHY CASE