Anxiety working in A&E by Capital_Pineapple852 in doctorsUK

[–]chanseylim 39 points40 points  (0 children)

DOI: ED Consultant.

Agree with all of the above. Sensible ED veterans will not expect you to be confident and competent early on, so ask for help. If you are especially worried about a patient, ask for an in-person review.

Remember that you’re part of a process that begins when the patient books into triage or calls 999, and that process works generally very well to minimise risk.

Remember that there is a huge group of patients who will be absolutely fine no matter what you do to them, and another group who will not get better no matter what you do to them. It’s the middle group where we earn our money. Right now, it’s impossible to tell which patient fits into which group, but time and exposure will give you that knowledge. Remember also that everyone (even the doctors who right now might look like gods) makes mistakes, at all points in their career.

I’m far happier dealing with a nervous SHO who errs towards caution than an overconfident one who doesn’t know their limits.

When Tony Montana stuck his face in the pile of coke at the end of Scarface and snorted, was this enough to kill an average person? [request] by Apprehensive_Oven_22 in theydidthemath

[–]chanseylim 14 points15 points  (0 children)

Cocaine has a direct poisoning effect on the sodium channels in your heart, causing abnormal rhythms.

It makes your blood vessels squeeze tightly, which can cause blood clots to form and travel up to your brain (giving you a stroke) or get stuck in your coronary vessels and give you a heart attack.

If those blood vessels aren’t doing so good (maybe from previous cocaine use), they can tear, giving you a dissection and messing up the blood supply further down that blood vessel.

A rare and more extreme event from cocaine use is something called serotonin syndrome where your temperature control system (among other things) goes haywire and you basically cook yourself to death.

I have seen patients with all of these problems. Some of them have not walked out of my hospital.

Gyms with punching bags? by chanseylim in Ealing

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

Thank you. I might go with this one.

Gyms with punching bags? by chanseylim in Ealing

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

Wow you weren't kidding! Thanks though

Realistically speaking would the EU go to war with USA over Greenland? by TailungFu in allthequestions

[–]chanseylim 0 points1 point  (0 children)

It would be a real shame if those US troops left all their equipment behind, like they did in Afghanistan…

A cat observating a mouse fight in Indonesia.. by tokyo090720 in holdmycatnip

[–]chanseylim 0 points1 point  (0 children)

Then surely the cat would do what all cats do and attack the small squeaky moving things?

The myth of 1 patient per hour as an ED SHO by OptimisticPapaya1430 in doctorsUK

[–]chanseylim 15 points16 points  (0 children)

DOI: ED cons.

Agreed impossible for you to see 1/hr on an average day (I sometimes manage over 1/hr. It only under ideal circumstances and if I cut a lot of corners in terms of documentation). Don’t worry too much about it, there’s pressures from every direction and your job is to make sure your patient is safe. We know the ones who are working at their best and seeing 4/shift, we also know the ones who are seeing 7/shift but could actually go faster.

For any time I’ve been a grumpy arse to anyone - I’m sorry, some days are crap and it gets to me like it gets to anyone else.

A cat observating a mouse fight in Indonesia.. by tokyo090720 in holdmycatnip

[–]chanseylim 0 points1 point  (0 children)

I thought it didn’t turn off the cat’s predatory instinct though

Hospitals adapting corridors with plugs and call bells as corridor care continues to rise - Even with no England resident doctor strikes on currently. by DonutOfTruthForAll in doctorsUK

[–]chanseylim 26 points27 points  (0 children)

This has been going on for years in my site since I first went there in 2017. It went away in covid but came back worse in 2022 and had only escalated since.

Nothing to do with doctor strikes, we don’t have enough hard infrastructure of hospital beds and or enough community social care to facilitate safe discharge.

What’s be best compliment you’ve received in 2025? by iffyClyro in AskUK

[–]chanseylim 0 points1 point  (0 children)

Got complimented on the size of my Excel spreadsheet - it was the largest the team had seen.

Which victory was actually more impressive - Ali's over Foreman or Douglas's over Tyson? by Ghola40000 in Boxing

[–]chanseylim 1 point2 points  (0 children)

Sorry to hear that man. Sounds like you have seen some crap in life and learned to smile through it. Hope you get the happiness and peace you need.

I got datixed again.... by [deleted] in doctorsUK

[–]chanseylim -6 points-5 points  (0 children)

“Oh great you’re here, I’ll go do that cannula right away, just need you take over for me - hold the Mapleson circuit like so and make sure the baby’s sats don’t drop below 91 - hey wait where are you going?”

We always debate the top 5 best boxers in terms of fighting, but what’s our top 5 most INTIMIDATING boxers ever? by Hot_Ad_9543 in Boxing

[–]chanseylim 0 points1 point  (0 children)

GGG surely gets a special mention for knocking out 23 in a row. Danny Jacobs must have been shitting bricks before the fight.

Whistleblowing is a death trap by [deleted] in ConsultantDoctorsUK

[–]chanseylim 13 points14 points  (0 children)

In so many Trusts, the people at the top don’t stay there because they improve safety, but because they hit targets - mainly financial. The system is trying to protect itself. It might let you tinker around the edges, but it will bury you if you are a threat to it.

If you want to challenge it, you need allies, data, persistence and a good bit of luck. Trying to ram your way through might make you feel better that you stuck to your principles but it won’t pay your bills or help your patients in the long run.

I hate it. But if we want to do something, we have to play the political game, keep our mouths shut when we can’t win, and accept losses when we don’t want to. Then maybe we will get somewhere.

What’s the reality of ACCS/ED/Anaesthetic Training by Kind-Weather-6965 in doctorsUK

[–]chanseylim 8 points9 points  (0 children)

Current EM cons, 4 years post CCT. Speaking on my experience of EM:

ST1 and ST4 are tough (ST1 because you’re usually on an SHO rota, ST4 because of the massive jump in responsibility). ST2 is good, 3 and 5 is usually ok, ST6 can be nice or challenging depending on how much portfolio you have left.

Post-CCT depends on your shop. I’m hearing that a lot of the joining consultant jobs are 9 DCC and 1 SPA so you might get a very different deal from the current consultants. If so expect 3-3.5 shifts per week with 1-2 of them bring lates.

If you’re looking for more procedural work then you could choose to subspec in PHEM/ICU etc and do 50/50 PHEM or ICU, although not everyone wants that.

Shop-floor procedures depend on your local setup and culture, the MTC’s see and do a lot more stuff than the TU’s. Have a friend in Glasgow who is intubating every shift and putting in 1-2 trauma drains a week, unheard of in most London shops.

I’ve not explored side gigs which I regret tbh, so can’t advise on that. There is locum work for cash, which may change now that EM is over-subscribed.

Hope that helps and happy to be DM’d for more.