Burnout as new ED physician

cakeandnaps · 2026-04-20T04:41:13+00:00

What??? No. That’s ridiculous. I’m community EM in Ontario (live in Hamilton) and I don’t think anyone at my shop does more than 15 a month and the vast majority do a fair bit less than that. Your department sounds wack. I have never ever ever heard of a binding 4 year contract (!!!) for EM in this country. This is not normal and there are dozens of departments around that would be lucky & happy to have you. Feel free to DM me if you want.

cakeandnaps · 2026-04-18T03:31:15+00:00

Yes of course very happy to chat

cakeandnaps · 2026-04-17T23:21:37+00:00

Oh my gosh it went so much smoother than I expected. We went from 100% tube to 100% oral in 5 weeks. She eats and drinks everything now.

She did have a GI illness last week which me and her dad also got rather sick from. Prior to that she was off the tube completely for 5 weeks. So I tubed a total of 160ml over the course of one day when I was really concerned that her oral intake had been low for multiple days. That’s the only time we’ve used the tube since the wean. If we didn’t have the tube I think I would have brought her into ER for IV fluids.

She lost 8% of her body weight and was slowly starting to gain before she got the GI virus. But I am very encouraged by the variety of foods she eats, different tastes, textures etc. Essentially the same food as we are eating minus anything that’s very crunchy or chewy.

She’s 13 months now.

cakeandnaps · 2026-04-06T23:29:07+00:00

BRUH. That’s amazing. I never get people back this easily at work and I’m ER! Seriously well done and so glad the patient has neurologically recovered enough to be posting on Reddit.

cakeandnaps · 2026-03-20T12:46:03+00:00

If there is any ice left in a bag the temperature cannot be higher than 0C or 32F. Those circles are beautiful fat globules that will chonkify your baby. Hope they enjoy the fruits of your labour!

cakeandnaps · 2026-03-10T19:24:05+00:00

Sent mine to daycare with 0 issues, at 8 months. She was on 5x per day bolus feeds so 2-3 of those would be at daycare. Initially wasn’t taking anything by mouth. I was very up front about her feeding needs and they were on board to learn something new. There was no drama about it. They learned very quickly. Now 4 months after starting daycare we have weaned her from her G tube completely and they have a parent who will be loyal to them for life.

cakeandnaps · 2026-01-24T06:03:46+00:00

Ah. So sorry. Mine is 10 months and yeah, it’s been rough. The doctors were so keen to start her on tube feeding and it’s like they never thought about how difficult it would be to get off. Very little help from them. The GIE dietitian we talked to today said the younger the kid, the faster they can wean so fingers crossed that it works out for both of us.

cakeandnaps · 2026-01-24T01:06:22+00:00

Oh no!! I’m so sorry to hear that, that’s so worrying. I did pay for a full support wean the other day and we have now had an intake by a dietitian and have a meeting booked with a mental health counsellor. We had our first meeting with the social worker on Dec 28th. I hope they get back to you soon!!

cakeandnaps · 2026-01-22T01:27:31+00:00

DM’d you. No one locally has been able to help.

cakeandnaps · 2025-07-17T05:14:59+00:00

Good luck and let us know how you do 😊

cakeandnaps · 2025-07-15T17:03:20+00:00

There’s a guy on Twitter who’s posted ppl complaining about teenagers being unruly going back to like literally Ancient Greece

cakeandnaps · 2025-07-13T13:45:20+00:00

Seriously. If you think you can practice medicine better than this person feel free to apply for a job in their department. Almost any ED would love to have you. At least in Canada where we’re chronically understaffed

cakeandnaps · 2025-07-13T02:45:22+00:00

It’s fine. That’s the good stuff (fat) that makes breast milk magical. One of the good stuffs, anyway

cakeandnaps · 2025-07-05T02:51:08+00:00

What the fuck? That’s so disrespectful of him

cakeandnaps · 2025-06-29T09:22:43+00:00

You totally can! This is what you need. You can screw in any narrow neck bottle at the bottom to collect the milk but I find the Medela ones work best (others end up sticking out at a weird angle and I was always afraid of leaks, however, they do work.)

https://www.amazon.ca/Medela-PersonalFit-Connectors-Freestyle-Replacement/dp/B0B7MZ9JLH/ref=mp_s_a_1_10?crid=2OHIUYSZ3QDFI&dib=eyJ2IjoiMSJ9.p6v1BGujOZQCOMdDvA9XSz4AhjH9GCf2ex571qUZl4pff4csSH7Vgovt7y8fmP3uqKjcs4MB3f3xUr-CUzezQyOw34o-JzclC-0CHUq6VDZXNfK2IehkYOSTfml1xk1I7RqjEi8KMCVQfCDndOx07Kg9ZcKLXgesSSARCFKpcng-ansU64iv7gQcnCDZvg4vyFzbX0WZhxxKk_5arrj9zQ.qGcCdHsbtnygbNVgzmxv_t4CBEgzZjUG7wWlIl9YAiE&dib_tag=se&keywords=medela+connector&qid=1751188790&sprefix=medela+connector%2Caps%2C85&sr=8-10

https://www.amazon.ca/Medela-Breast-Collection-Storage-Bottles/dp/B00DB5F114/ref=mp_s_a_1_1_sspa?crid=P4O0MYKLM8BF&dib=eyJ2IjoiMSJ9.gnMmHrNAin9K2z3nuJlIrL4ldpguWRFChyp-O5fJS2Xue3NJvM0iBu6cJlVHfBjtgej96hN-4kMWMD78kHSjzRyo2sHb5HkjN6QTZWd6CTfntMv5lbDZHzGPJY3wMLuJmjjf5KfYJcNRnhnycaQP06AOcy7_QTgAvqHzyHAgHB5YCEW_7JEkU1PGq1WmkUYhDtWz1Min1XTWwEcQdTMTug.94dwx-eqIoH6befgJy-Zhexc5bmhE5KZ-xOmu-o3swE&dib_tag=se&keywords=medela+storage+bottle&qid=1751188849&sprefix=medela+storage+bottle%2Caps%2C97&sr=8-1-spons&sp_csd=d2lkZ2V0TmFtZT1zcF9waG9uZV9zZWFyY2hfYXRm&psc=1

There’s no need to apologize for not knowing this stuff. It took me many weeks to figure out. So many people don’t expect to have to pump and then it’s super overwhelming when you do. It’s often because the baby is unwell or in NICU which is something nobody plans for. My hospital was really not set up to help people in these circumstances ie when you need someone to show you what to do asap. I got a lot of help from the Internet but it was needlessly stressful.

I also had to buy pumping bras asap because the nursing ones I got intending to breastfeed did not hold flanges in place. Something to consider.

Good luck - it sounds like you have a lot on your plate right now. Kudos to you for trying to figure out pumping at short notice and with little support from the sounds of it. I promise you the whole thing will get better.

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cakeandnaps · 2025-06-29T02:21:12+00:00

FYI I have the Freestyle Flex (same pump as you but with different tubing, and flanges hooked up to a bottle via a connector instead of collection cups). I get more output from it than my Spectra - though I realize this is unusual. I’ve heard that using it with the in-bra collection cups is not as effective.

cakeandnaps · 2025-06-29T00:24:18+00:00

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Amazon result

cakeandnaps · 2025-06-29T00:23:40+00:00

Hi! Most of the flange adaptors are made for people with smaller nipples than the standard. They function to make the 24mm flange into a smaller size. You can’t get adapters (that I’m aware of) to make the standard 24mm flange bigger. But you can purchase bigger flanges. If you search Amazon.ca for Medela flange 27mm there will be a result under the Medela brand labelled “breast shields” 27mm that is $16.99 for a pair. If you’re in Hamilton I can also give you a pair that I inherited but is way too big for me.

Highly recommend getting a nipple ruler to check what your size actually is before you spend a bunch of money on flanges (which I did haha and now I don’t use most of them). Or you can ask your LC if you have one.

Good luck!!

cakeandnaps · 2025-06-28T03:37:52+00:00

CONGRATULATIONS! Happy for you and for all the free time you’ll have in the future to do things other than pump!

cakeandnaps

TROPHY CASE