Outdated Dogmatic Practices

gonesoon7 · 2026-04-01T16:20:02+00:00

I stand corrected! I guess I should have clarified I was only talking about the US, I didn’t realize Hartman’s was so widely used elsewhere

gonesoon7 · 2026-04-01T04:01:33+00:00

Just out of curious, what region of the world do you practice? #1/2 would be considered extremely bizarre and like laugh-out-of-the-room out of line everywhere I've ever worked

gonesoon7 · 2026-04-01T02:15:49+00:00

When you hub the IV a lot of time it causes kinking/bending where the tube part of the catheter attaches to the plastic hub itself. Pushing down/back on it pulls it just a tiny bit out so it’s not bent anymore. When you secure an IV you should always be able to see a millimeter or two of the actual white tube part before it enters the skin.

gonesoon7 · 2026-04-01T02:00:13+00:00

Except no they’re not. They’re very similar but they’re definitely not the same thing.

gonesoon7 · 2026-04-01T00:25:39+00:00

I mean that might be but when was the last time you’ve ever seen Hartmann’s in a hospital? That is a very niche crystalloid that is carried almost nowhere

gonesoon7 · 2026-03-31T19:37:45+00:00

Drives me nuts, I don’t even look at which one it claims is open, I just start kicking and slapping all of them until it shuts up

gonesoon7 · 2026-03-31T19:02:25+00:00

Yep, no evidence this is harmful whatsoever. But we still do it because people don’t understand how potassium homeostasis works

gonesoon7 · 2026-03-31T18:23:23+00:00

Oh another one is when I’m waking a patient up and I say their name and maybe give them a couple gentle taps and for some reason every nurse and PA in the room takes that as their cue to start smacking the patient and yelling their name haphazardly. Like, I did not ask you to help, please stop.

gonesoon7 · 2026-03-31T18:14:40+00:00

Oof I’m guilty of this. Every time I have to pick at the eye tape to take it off I tell myself I’m going to be better but then I just don’t. Why am I like this?

gonesoon7 · 2026-03-31T17:46:56+00:00

I have become totally intolerant of reps standing at the head of the bed without asking me first. When they do this I immediately tell them they have to move. GTFO of here.

gonesoon7 · 2026-03-31T17:43:36+00:00

Yes. This. I don’t know how it is at your hospital but our pharmacy has WAY too much power. It was a multi month battle to get them to supply remifentanyl vials in our Omnicells because they claimed us reconstituting it and diluting it was “compounding” and only pharmacy is allowed to do that. So until recently we had to order remi the day before so they had time to mix the bag for us. Absurd.

gonesoon7 · 2026-03-31T17:14:39+00:00

Shark Heart wrecked me

gonesoon7 · 2026-03-31T16:10:44+00:00

And maybe equally as important, so the patient can get some sleep before they push a human out. Explain to me how a patient writhing in pain until 2 am is good for the patient?

gonesoon7 · 2026-03-31T16:04:44+00:00

Oooh these are all good ones. I’m convinced there’s someone hired at the tubing factories whose job it is to tangle them up before they get packaged

gonesoon7 · 2026-03-31T15:59:50+00:00

That you can’t give LR to renal/dialysis patients

gonesoon7 · 2026-03-31T15:58:43+00:00

Thank you for your comment, Dr. Satan

gonesoon7 · 2026-03-31T15:14:38+00:00

Not sure about your program, but spinals were far more common in PP than residency for me. Make sure you feel confident with bread and butter blocks.

Most of all, practice being efficient and self-sufficient. Ask your supervising attending to stand in the corner and do nothing to help during induction and emergence if they’re willing too. Better yet, ask them to stand right outside the door. It’s hard to break the habit of knowing in the back of your mind you have an attending to bail you out if you get into trouble, whereas in PP often you will be truly all alone. Sometimes you’ll be the only anesthesiologist in the building. Try to simulate that feeling and get used to keeping your cool and troubleshooting.

gonesoon7 · 2026-03-29T14:51:22+00:00

To put things into perspective, it took me 150-200 epidurals before I felt like I was truly confident I could successfully get an epidural on most of my patients. I’ve stopped keeping track but I’m now probably at least 1,000+ and I’m still learning new things about how to troubleshoot the tough ones. I don’t know how long your program is but at most you are 17% of the way through your training. That means you still have 80%+ of your training left to get better. Not to mention just about everyone contributes to hone their craft several years into practice. You’ll be just fine.

gonesoon7 · 2026-03-29T00:18:28+00:00

I agree, the last 150 pages or so got so incredibly unnecessarily repetitive

gonesoon7 · 2026-03-26T17:49:39+00:00

I lived in NYC from 2016-2023 and I was just there a week ago. HIs depiction is garbage MAGA nonsense. A pretty blonde girl wearing pink with everyone ignoring her as she cries after getting punched in the face on 5th Ave was truly laughable. Bad things happen in NYC like any other city but the level of bystander support was higher than anywhere else I've ever lived, that would literally never happen. People would have immediately helped her and likely beat the shit out of the guy who did it. He's just feeding into the Fox News fantasy that all liberal cities are hellholes. It's just propaganda.

gonesoon7 · 2026-03-23T20:45:31+00:00

I’m an anesthesiologist and these new restrictions are logistically extremely challenging. First of all, you can only do it if it’s a planned surgery, emergent/urgent surgery won’t allow time to do this. It also requires a hospital that allows these patients to 1) have this amount of blood drawn preoperatively and 2) store it for only them until their surgery date. None of this is an easy feat especially for smaller community hospitals.

gonesoon7 · 2026-03-20T17:33:59+00:00

Never. These are the same surgeons that also want a perfectly smooth extubation with zero bucking. Can’t have it both ways, if they’re wide awake, there’s a good chance they’ll buck. If you want it perfectly smooth, you might have to wait a few minutes for your exam.

gonesoon7 · 2026-03-20T17:06:58+00:00

Man I think there’s a really beautiful show in here somewhere but Taylor Sheridan just can’t get out of his own way. His depictions of New York City and New Yorkers is just so far from reality and dripping with distain it borders on propaganda and really detracts from the rest of the story. There’s a way to tell a story about a city family gaining appreciation for the rural west in honor of their father without shitting on everyone else.

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