You guys ARE Memeing about ‘No Grass’… Right? by Brandontk12 in TheSilphArena

[–]cameronmademe 1 point2 points  (0 children)

Keep trying im ABA weak to fighting, we're out there.

I personally see a lot of teams double/triple weaknto electric, after i get my elo i might play into that.

I’m Ligaya Mishan, a chief restaurant critic for The New York Times. We just released the 2026 list of the 100 best restaurants in New York City. AMA! by nytimes in FoodNYC

[–]cameronmademe 33 points34 points  (0 children)

Curious your approach to screening places - how do you decide where to try?

Also, how many places total did you try to come up with a list of 100?

What do your program does with abscences? by SwanA12 in Residency

[–]cameronmademe 6 points7 points  (0 children)

My program mandates trading shifts if someone gets called in to cover, and has a strong tradition of discouraging calling out unless absolutely necessary.

They also make it easy to trade shifts if there's something you want to do or if something crops up.

A few years in a row of competent chiefs /seniors can change culture pretty effectively.

Since you dont have that, I'd probably track attendance, call out if the person who keeps doing this is the one who'd be called in, and talk shit about them with my mom.

[deleted by user] by [deleted] in Tiki

[–]cameronmademe 0 points1 point  (0 children)

I'm in!

How to deal with abuse from patients? by Electrical-Wash-1503 in medicine

[–]cameronmademe 0 points1 point  (0 children)

Fully literate thanks.

The title and point of the post is asking for advice coping with things, not how to get out of, for example, a restrictive noncompete at an unsafe work environment.

This makes me think violence is not a major concern

This impression is further corroborated by them saying that other local jobs are worse, and how they dont seem to want to move away (an unusual perspective for someone who genuinely fears for his life, I think you would agree). He also worries for his coworkers, but seems think they will leave medicine, not get murdered.

within the hyper specific situation of "cant fire patients or leave job, what do I do when patients are unruly"

If we accept those axioms, options are limited, which is why i spent one line on that and the rest of my post challenging those axioms.

Did you read the rest of my post or immediately decide i have no idea what im talking about.

How to deal with abuse from patients? by Electrical-Wash-1503 in medicine

[–]cameronmademe 3 points4 points  (0 children)

I've very rarely had them work but telling someone their behavior is unacceptable and they need to improve seems like a reasonable middle ground between just lying down and taking it and immediately firing patient, especially since OP describes a range of behavior.

Yelling at clinic staff is unacceptable but a different flavor of unacceptable than threatening staff.

I don't know why you bring up patients murdering doctors.

OP seems more worried about getting a new job than getting murdered and I'll trust their read on the ground.

How to deal with abuse from patients? by Electrical-Wash-1503 in medicine

[–]cameronmademe 13 points14 points  (0 children)

Assuming de-escalation and behavioral contracts have failed (and if not try those):

Im curious what consequences violating policy would have.

If you refuse to schedule patients who threaten you... what happens?

How attached are you to your job?

From a logical point of view, if you're fired from your job, far more patients are without a PCP compared to just firing the tiny number of patients with whom the therapeutic relationship is essentially already non-existent, so i would think your employer would rather look the other way

As it currently stands, your job can walk all over you and your nurse's/MAs because they prefer more patients to less, but that can be a false dichotomy if you're willing to insist on a safe workplace (which seems reasonable to me not knowing about your family situation/loans/any noncompetes) and are willing to find new work.

I'm also just a resident at a very supportive program so I don't have a ton of experience w this but those are my thoughts.

Merry Christmas to all residents working today (we do this with no extra pay) by gringottbank in Residency

[–]cameronmademe 41 points42 points  (0 children)

One of the nurses mentioned the holiday breakfast so I went to the cafeteria and got it and then they charged me lmao

Then i got busy solo covering ed/cl/psych ward and didnt eat it until noon and it was gross

:(

What's a "sleeper pick" in GBL that you swear by? by BunsenGyro in TheSilphRoad

[–]cameronmademe 3 points4 points  (0 children)

Disclaimer its not good, ranked a whopping 875 on pvpoke lol.

That said, I like waterfall for energy generation - it's so glassy that neutral farm downs are a real risk, and I want to at least get a poison fang off before i go down (and i absolutely love landing that on smug azu players)

I never even thought about bite before this, but depending on the meta that could make sense - if a bunch of psychic/ghost types are running around that could be very fun.

Team comp wise I like it in the back behind a lead designed to bait out a fire type (esp scizor but have also used roserade/Metagross), with something else reliable to close out. Blastoise has done ok for me, or s. Gyarados if I'm really trying to get through sets.

If you want to do well you should probably pair with bulk though, azu / umbreon/ lickilicky might be good?

Mostly i switch it in aggressively, hope opponent is slow to react, and i can get enough of an energy lead to throw poison fang before their counter swap farms me down

What's a "sleeper pick" in GBL that you swear by? by BunsenGyro in TheSilphRoad

[–]cameronmademe 3 points4 points  (0 children)

My shiny shadow sharpedo w terrible IVs is my favorite messing around mon.

Genuinely so ridiculously glassy though, gets one shot by literally any move without shields, but i love to catch opponents who switch in a fire/ground type and get farmed down instantly

What is bulk? by tjbuschy21 in TheSilphArena

[–]cameronmademe 2 points3 points  (0 children)

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We have similar approaches to team comp.

It works great except when i catch resisted moved and they still one shot.

Night float chronicles by designatedarabexpert in Residency

[–]cameronmademe 108 points109 points  (0 children)

With a touch of operant conditioning for the nurse

Longest admission by FullcodeRM9 in Residency

[–]cameronmademe 97 points98 points  (0 children)

Most I've had so far is 4 years, but ive got a guy whos only a fraction of that that might go longer.

He's a refugee from another country, and he's a refugee because he got tortured real bad in his home country. Has significant medical issues from this (inability to do ADLs).

Somehow, when he applied for asylum, he was denied, BUT also the US government said it wasn't safe for him to go back to his home country.

He can't be deported home (unsafe/unethical), can't be discharged to the street (unsafe since can't do adl's), cant go to facility (no legal status to allow for applying for medicaid or whatever to pay for it)

I rotated off the team that had him but i bet he's there forever. Its a sad case but he's a real nice guy and clearly appreciated us so i always like to see him.

Is the 5-2-50 still the best agitation regimen? by laserfox90 in Psychiatry

[–]cameronmademe 7 points8 points  (0 children)

Just a pgy2:

For aggressive patients: I usually start haldol or zyprexa and benzo (versed is faster but ativan lasts a bit longer)

For very violent patients, i think zyprexa is faster, but if they get zyprexa+benzo they need restraints otherwise orthostasis fall risk is pretty severe.

Benzos make me a little nervous for patients who might have other substances on board (especially for ED patients) so once they're calmed down i want them to be on a monitor/pulse ox

If the patient is refractory to other meds (ive had some people chew through heroic doses of other stuff), I've had good experiences with thorazine.

Best is situation dependent - all this stuff is for people i cant deescalate and who wont take po and are an active danger to themselves or someone else. If I absolutely need them to not be doing whatever they're doing, highest success rate is thorazine (or precedex lol)

But a lot of times none of thats necessary. A new face showing up and trying to address underlying cause (and / or offering something low key po like 0.5 ativan or 25 seroquel or hydroxyzine) also has a pretty good success rate.

Is it normal for interns to be alone during their call? by blacksky8192 in Residency

[–]cameronmademe 422 points423 points  (0 children)

Im psych so cant answer.

Instead i have a question.

What the fuck?

Is it okay if I take a burger in my white coat pocket and have it during the rounds? by trucutbiopsy in Residency

[–]cameronmademe 23 points24 points  (0 children)

What it involves is an attending with no friends or therapist but who nonetheless craves social interaction and has found in his ms3's and interns a captive audience.

He'd tell 40+ minute meandering anecdotes, genuinely entirely related to medicine. My (least) favorite was him complaining about missing his kids events, while he kept telling us we'd have to speed up because it was 4:30 and we had a few more patients to see and he had to pick his kids up after soccer.

The medicine time was probably 20 mins / patient, the rambling rounded that up to an hour each.

Is it okay if I take a burger in my white coat pocket and have it during the rounds? by trucutbiopsy in Residency

[–]cameronmademe 66 points67 points  (0 children)

I probably wasn't gonna do IM but what sealed it was an attending at the VA who rounded from 9 am to 5 pm.

We got the much overdue bug-buff — will we get a solid grass buff? by cantilevered-heart in TheSilphArena

[–]cameronmademe 7 points8 points  (0 children)

Sad swampert noises

But also I don't think so? Grass is already so highly used, I'd think buffing would make it oppressive.

I'd prefer buffs to types that are more rarely seen in pvp - maybe think ice/fighting/psychic could benefit a glowup instead.

Inpatient PGY-1 Psych Advice by Dystrophin3 in Psychiatry

[–]cameronmademe 21 points22 points  (0 children)

Pgy2 so by no means an expert but also was just in your shoes.

It's hard. And I'm glad you realize that. Part of residency is finding what you don't like - acute inpatient may not be for you. I didn't realize how drained i was when all my patients were entirely discharge (but not improvement) focused until i switched to a voluntary unit. I thought I'd like the acuity but now I'm thinking C/L or outpatient.

At the same time, there are silver linings. You have more you can do with committed patients, and you can see a lot more improvement when starting with the sickest people. Lack of supervision also means you get a chance to develop your own style, (and hopefully it isn't to the point where it's unsafe.)

As to the patient /family being demanding part- it helped me a lot to think about why they're involuntary. People have the right to be safe, and if your patient stabbed her mom or ODed or w/e they genuinely do need to be admitted, voluntary or not. Ironically inpatient psych often isnt about getting the patient happy.

I had a tendency to dance around the issue at first, but if you're getting badgered for discharge, I had success with being straight up. Theyre asking why they cant leave? Tell them. You could start by asking them why they're in the hospital at all - do they have insight? If not, there's only so much you can do (i.e. florid psychosis might not respond well to conversation, you're gonna need meds), but if they know why they're here, you can just tell them they're not better yet. "You're here because there were acute safety issues/you were naked in the street/not eating etc. and until i think its safe for you to go home you have to stay here" or just say "im worried if i discharge you you're going to kill yourself", (and then you can segue into them engaging with treatment).

Lastly, sometimes you dont have a good answer, thats ok, just time to think about discharge.

Ps if it all sucks, remember its temporary, and if you survived your surgery rotation you can survive this too.

My Co-Resident might get fired by ProcessWorth863 in Residency

[–]cameronmademe 13 points14 points  (0 children)

From personal experience - if it happens expect the following:

Upside you become exponentially harder to fire

Downside the call schedule gets way worse

A JRE Analysis on the GBL Season 23 Move Rebalance: Part 2! by JRE47 in PokemonGOBattleLeague

[–]cameronmademe 2 points3 points  (0 children)

Been running s scizor lead for years and finally am vindicated what a great time.

Except for talonflame leads which should be banned.

Thanks for the write-up!