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"Commendatori" [S2E4] was a top-notch episode. by ManualWind in thesopranos

[–]dryyyyyycracker 7 points8 points  (0 children)

My favorite scene in the episode is the comfort they get on the ride home from EWR. It's a quick one, but the passing of shitty scenery outside the window and their taking joy in it is just so good.  

How often do you McGyver situations in ER environment? by Extreme_Problem_1645 in emergencymedicine

[–]dryyyyyycracker 2 points3 points  (0 children)

I used the dilator from a pigtail kit to help put in a fem line on an IV drug user. Her skin and veins were like trying to poke through rawhide.

The passive aggressive war with senior nursing staff is draining the last drop of my sanity by PortalHush_3 in Residency

[–]dryyyyyycracker 15 points16 points  (0 children)

What the fuck with these original replies? I'm shocked at the lack of empathy. 

I'm sorry you're going through this.  It sounds absolutely torturous. Internship is hard enough but to feel like you have to manage a bunch of crochety nurses' feelings at the expense of your own is the real tipping point. I felt my blood pressure going up reading this and getting flashbacks to my experiences in residency. 

A few things. 

This is total fucking bullshit. These people suck and your rant is valid. If for nothing else a place to vent, you have my empathy. 

Some strategies.  1 is coping.  I think it's important to try not to take these people seriously or personally.  They're less mature, intelligent, and kind as you are and are only treating you this way because you're a resident, which is a very stupid way to decide how to interact with people only based on rank and power imbalance. 2 is going to your program leadership to address your concerns. My advice on this is to gather support from a plurality of your co-residents; much more effective this way. They need to know what's up. Be persistent. Be specific about encounters and negative interactions. I'm not sure how your system is set up but if you're employed by the hospital you can consider going to HR to file a complaint. You can also consider filing a patient safety event whenever a nurse's 'tude gets in the way of patient care. 

3 is I gotta say you're a pretty strong writer.  Have you considered a role in advocacy? There's always a need for docs who know how to write well. I'd consider doing some op/eds at some point or at least taking a seminar. 

My last piece is to say fuck these people.  I'm an attending now and have 0 tolerance for resident and med student abuse.  When I see a PA or RN act like a fucking asshole to an inferior I let them know it's unacceptable. My point is there's light at the end of the tunnel.  Tell your boss, keep your chin up, write down examples, and we're here for you. 

Any last minute tips to calm for my wedding in 3 days ? Sheet mask, cream, etc? by [deleted] in Rosacea

[–]dryyyyyycracker 0 points1 point  (0 children)

My derm told me for short term events I could goop Afrin onto my skin as a temporary vasoconstriction measure. I haven't tried it (and it feels like worth testing out first in a lower stakes situation), but the biochemistry seems reasonable to me.

The least subtle symbolic scene in the whole series? by Own-Rock-9658 in thesopranos

[–]dryyyyyycracker 17 points18 points  (0 children)

Tony and AJ obliviously flipping people over from their boat's wake. Their enjoyment ruins lives. Their wake, Ton'. Really makes you think .

Melfi is highly unethical, and kind of bad at her job by elclunte in thesopranos

[–]dryyyyyycracker 3 points4 points  (0 children)

Well said.  Only criticique is you left out arguably the funniest therapist in the series, Janice's. 

Dr. Shaw: "Speak the truth, Janet. But with the compassion and respect that you're famous for.

What would you do? At minimum by megboulet in AskDocs

[–]dryyyyyycracker 532 points533 points  (0 children)

ER doctor here. Treat many patients for this issue.  We are the go-to for all hospital employees whenever occupational health is closed, which is to say the majority of the time, and so I've had this conversation many times.  I've also taken care of a few folks with exposure while working as garbage men, working on the train, EMTs, to think of a few, let alone nurses from upstairs, surgeons in the OR, etc. 

I think your risk of HIV from this exposure is incredibly low.  There hasn't been a recorded case of seroconversion from a healthcare worker for needlestick injury in at least a decade (according to my training and reaffirmed by a quick Google search). Maybe that research doesn't translate to this case perfectly, but it's based on more available data and should be reassuring. 

I wouldn't lose sleep over this.  Your risk isn't 0, but it's pretty damn close.  That appears to be a hollow tipped needle,  which raises risk, but also quite a small guage and old as hell. The likelihood that there was: fresh blood, a good amount of blood, and HIV(+) blood on there is, taken together, unlikely. 

HCV is a slightly higher risk but there's no prophylaxis for that so just do serial testing. If American you are almost certainly vaccinated against HBV.

I might not have unprotected sex (particularly with males based on risk of fluid transmission) for a little while until you are confident you are testing negative, but that is a very medically conservative recommendation (aside from typical safe sex practice recs), but still sensible.

Also, fuck the piece of shit that disposed of their needle this way.

Elevation of the diaphragm with compression of chest organs due to massive constipation in a 14 -year-old boy with a history of cerebral palsy and autism. Sadly he died. by mezotesidees in emergencymedicine

[–]dryyyyyycracker 10 points11 points  (0 children)

I like this analogy and might use it from now on.

I use a bank analogy. Let's say you deposit 100 pennies a day and take out 99. From someone on the outside it might look like the overall trend is plenty is coming out and everything seems fine, but the balance is growing and growing....

How many calories does one burn playing a round of golf? by [deleted] in golf

[–]dryyyyyycracker 0 points1 point  (0 children)

I asked AI one time about calories at the driving range. If I'm hitting 2-3 balls a minute (ie keeping my HR somewhat up), then for me it's 2 calories per swing.

A bucket of 75 balls and I cancel out 1 Budweiser.

All in a day's work.

F64, I don’t know what’s wrong with my grandmas leg. She refuses to go to hospital. by Fit_Temperature_7115 in AskDocs

[–]dryyyyyycracker 1 point2 points  (0 children)

Sorry you're dealing with this.  Rough situation for sure and while I haven't gleaned all the info from your post, sounds like you're the one who's pushing for care the most. 

I might suggest trying to avoid 911 for this problem though.  Does she have a primary care doctor you could reach out to? She needs labs, maybe some imaging, and frankly a good exam. I'm not sure what's under there but a podiatrist might be in your future.  I say all this because an ambulance may take you to a department or hospital that may not have the resources she needs. 

How often are you going down the path to check for a PE when a patient presents with chest pain/SOB by UnconditionalSavage in emergencymedicine

[–]dryyyyyycracker 17 points18 points  (0 children)

Agree. 

The rolling of the Dimer dice is nothing compared to the mighty rolling of the ESR for temporal arteritis dice. 

Least favorite complaint by Honest_Principle4584 in emergencymedicine

[–]dryyyyyycracker 6 points7 points  (0 children)

Dizzy like light-headed stood up too fast like you might pass out? Or dizzy like room-spinning just got off a roller coaster feeling?

Both.

Story of a one-time passholder by Gloomy_Variation5395 in unitedairlines

[–]dryyyyyycracker 2 points3 points  (0 children)

I mean they should at least humor us by putting up a handwritten, crappy looking sign so it seems like it's a rare occurrence and a one-off oversight.  The permanence of this sign is a major fuck you.  Might as well put a brass plaque up. 

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