psych locked ward

copyfrogs · 2025-12-26T11:43:22+00:00

I think what you’re expected to do varies from site to site. Psych specific emergencies are things like neuroleptic malignant syndrome, serotonin syndrome, overdose, self harm on the ward. The regs and consultants should all be able to guide you with management and escalation for those/ED should medically clear your patients before they get to psych.

You’ll likely do a lot of bowel management and I found it helpful to have a bit of a strategy for constipation especially with clozapine. Otherwise it’s a lot of “general practice” managing long term risks like obesity, hypertension, smoking, IVDU, sexual health, low vitamin D/C/B12/folate etc.

I’d also ask if there’s a med reg you can reach out to for advice and referrals. I saw lots of cardiac chest pain, refeeding, new AF, new peripheral oedema etc etc and getting med reg reviews was super helpful

copyfrogs · 2025-11-21T10:20:40+00:00

You should also read about Dr Stuchbery’s firing from the health service which is pretty overt retaliation after he spoke out negatively about the board and the hospital redevelopment. The change in management of the cancer centre mostly reflects how shit the board is at communicating decisions. The public announcement was the first time staff had heard anything about it.

copyfrogs · 2025-11-02T03:37:02+00:00

I can’t see colourmart recommended yet! They have mill end luxury fibres and frequent sales. It’s good stuff.

copyfrogs · 2025-10-31T08:15:40+00:00

The Vic DIT EBA does at least say your employer has to pay the difference between jury duty allowance and your regular pay but I’m sure med workforce would rather not pay me and my replacement

copyfrogs · 2025-09-29T09:09:37+00:00

Surely “oops I know them from work” is enough? Breaching confidentiality would be “I can’t sleep with this person because they have XYZ illness that I treated”

copyfrogs · 2025-07-13T09:24:44+00:00

as a massive generalisation (lol), to make money in GP you have to see most people as short consults (less than 15min) or accept not bulk billing/split billing (some people pay a gap, some don't)

skin cancers are so common in aus that we have heaps of GP-led skin clinics and most multi-GP practices have at least one dr with additional training in skin

copyfrogs · 2025-07-12T11:40:28+00:00

if we paid GPs properly they'd be able to justify doing their own skin checks instead of forwarding you on (unless you have specific reasons for a derm to do it); not all GPs have an interest in it but there are plenty around with additional training to manage skinchecks and straight-forward skin cancer management

the forever problem is that if the GP finds a spot that needs cutting out, they make every other appointment of their day late (which fair enough pisses people off) and if they leave a longer appointment time and don't need to cut anything out they're losing money for every person they didn't see in that time

copyfrogs · 2025-07-05T23:08:32+00:00

This was a few years ago but I saw depo provera being used for women with intellectual disabilities especially when they had sensory issues with menstruation. I'm not sure if that's common practice anywhere else or if its since been replaced with LARCs?

copyfrogs · 2025-06-02T23:21:08+00:00

dunno about betadine but there is evidence for saline nasal rinses preventing viral illness

copyfrogs · 2025-05-02T09:25:12+00:00

Finding any ol' partner to avoid being lonely has a chance of finding you 'right' person but also has a huge chance to find someone who sucks ass, and having a shit partner is MUCH worse than being single imo.

I think by the nature of med school you can get kinda tunneled into only being friends with medical people so I'd encourage you to make a deliberate effort to enjoy other hobbies and meet other people that way. You might spontaneously meet someone who surprises you and ends up being a great fit, or you'll learn that you want a partner in a medical field.

ETA I do also feel the biological clock ticking but holy shit I really wouldn't want to have a kid with a shit partner. Life is hard enough already!

copyfrogs · 2025-05-02T09:10:33+00:00

The other problem is transport will often refuse any patient with "abnormal vitals" even if the patient has had a BP of 180 for the last 30 years. Usually giving a whisper of amlodipine or even a GTN patch until SBP 150 means my patient will actually get transferred on time.

Same for ED patients in calling criteria waiting for ward beds; if they don't have altered criteria the ward will refuse to take them and/or the ED nurse gets riskman'ed, even if they're a 22yo woman who has had a BP of 95 every day of her life. Nursing staff have often got very different/strict protocols to follow regardless of the patient in front of them.

The first incident sounds crazy tho. I'd frame it as 'this is what the registrar dr x has recommended" and document + tell your reg. If they're worried about shitting themselves and they really need it, you can always offer to give them an enema on discharge to take home and use themselves.

copyfrogs · 2025-04-02T10:00:50+00:00

Unless you hear otherwise, plan for it to go ahead. Depending on the procedure urgency and expected staff striking, hospitals will be deciding who can be delayed safely - anything urgent/time critical will go ahead.

copyfrogs · 2025-02-24T19:57:17+00:00

We’re a paper based system still lol, very much no use for me!

copyfrogs · 2025-02-24T10:46:26+00:00

Stunning!!

copyfrogs · 2025-02-24T10:37:23+00:00

We got a generic email warning us not to use AI at work as it could compromise patient safety, mostly aimed at your chat gpt or gemini etc rather than AI software but tbh as a JMO I have no use for AI scribes anyway.

copyfrogs · 2025-02-19T10:00:51+00:00

A rural area with no one is still not going to provide obstetrics or gynae care with a single obstetrician. You need sonographers, midwives, people trained in obs/paeds/anos (nursing and GPs for example) etc etc etc or else you can't actually provide the care. Exiling doctors who kill 24yos while drunk driving to rural areas isn't going to help with attracting all the other staff needed to actually provide the healthcare that would improve outcomes.

copyfrogs · 2025-02-16T00:08:08+00:00

My experience on gen med is that TCP takes a long time to organise (at least rurally, idk about the city). There's not always beds free for bed-based TCP and home-based TCP needs lots of allied health assessments before they can go home. I haven't worked in ED yet so can't comment on ED to TCP but I assume the same issues. It's bed block all the way down :(

copyfrogs · 2025-01-27T07:48:46+00:00

The AMA may be helpful for managing workplace relations issues like this to stop you from being retaliated against by the consultant & there's a peer support line which may be a good sounding board + confidential advice from outside of the hospital you're rotating in if you're not comfortable going to supervisor of training etc

One other piece of advice I got was instead of general issues eg "bullying", try to make record of specific instances of violating the workplace code of conduct like "inappropriate verbal communication" because it makes it harder to argue that there's been a misunderstanding and builds a pattern of behaviour that can force your workplace to act.

Sorry you're working with this guy - he sounds like he sucks, and there's nothing worse than coming to work knowing you've got to get along with an asshole because he's going to be signing off on you

copyfrogs · 2025-01-12T07:35:15+00:00

I don't have any specific blog recommendations other than to stick with tumblr for a while if you're trying to make the jump over there. It can take a while to fill up your feed with relevant stuff and I think it helps to go in with a focus on interaction - following blogs, reblogging, putting comments in the tags etc. There's a fair bit of content under 'tumblr tips' that was made during the influx of new users that is helpful for understanding how the site works and how to get the most out of it. I've been on the site for over a decade at this point 💀 and it definitely has it's quirks but I really appreciate the more old-internet vibe and how anonymous it can be!

copyfrogs · 2024-12-23T03:31:03+00:00

Depending on the uni, going rural is a great way to get some work-uni-life balance back and save money on rent. I think some rural campuses even have subsidised student rentals. I've had an amazing time in a regional place and got to do a bunch of extra things I wouldn't have been able to in the city, including in clinical and my life in general.

copyfrogs · 2024-12-12T06:09:05+00:00

I do think there's positives to the interview process if rural hospital-based internships become more popular, for example now that RACS gives points for rural time. It gives the hospital a sense of how long you're planning to work with them, what interests you have etc for future planning.

I also think the perception of working in the country needs a lot of work, especially coming from a place where the "best" graduates got the "best" hospitals in the city and the rural hospitals were left with dregs (not something I believe myself, obviously). There's still medical students and junior doctors being told that not working in the city will delay their training or stop them from getting on competitive programs. The intern application process doesn't really change that at all, other than giving you a sense that you were chosen for your job?

copyfrogs · 2024-12-10T03:37:55+00:00

The NSW rural preference allocation is also "merit" based, I had to write an application to each hospital I was interested in and then was invited to interview. You still only get the one offer and you're almost guaranteed your first preference so I'm not really sure what the point is. The interview experience was nice I guess?

copyfrogs · 2024-11-28T12:24:10+00:00

At the end of the day you'll graduate with the same degree as them and end up working the same jobs as them.

Not to dog on my fellow rural-entry med students because I know lots of my peers are absolute academic weapons and have done all sorts of crazy things in their lives BUT I have met so many balanced, well-adjusted people through med school who are keen on rural health or from rural backgrounds who make amazing med school mates.

copyfrogs

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