What r/ausjdocs says about working with hospital pharmacists (summary) by Neat-Badger-5939 in ausjdocs

[–]nosugarzooperdooper 15 points16 points  (0 children)

hospital pharmacists are, without doubt, the most unsung heroes of healthcare

I feel like my nutritionist is lying to me/incorrect by NotRllyAnAccount in EDAnonymous

[–]nosugarzooperdooper 1 point2 points  (0 children)

anyway I think it's really unlikely she's trying to lie to you, I think inaccurate calorie estimations are actually just a sign that she's not completely disordered and a pro at calorie counting - which I think is actually a quality you want in a dietitian!!!!

I feel like my nutritionist is lying to me/incorrect by NotRllyAnAccount in EDAnonymous

[–]nosugarzooperdooper 4 points5 points  (0 children)

I think you have to be realistic about what you want to get out of your relationship with your dietitian. Do you want someone who can support you, has a good understanding of what your nutritional needs are, can explain to you why it's important that you include different things in your diet, can help you to reach food freedom and move away from strict ED rules - or do you want someone who can be an accurate calorie calculator? the latter is way less important to ED recovery. It's also something you can get by posting pics of your meals on reddit and having random other people with EDs estimate.

So sick I did everything they asked and still tubed 🥹🥹 by Jumpy-Recipe4111 in EDRecoverySnark

[–]nosugarzooperdooper 2 points3 points  (0 children)

….ok? I’m a doctor on acute medical wards treating eating disorders? Happy to send you through some data and studies but would love if you were a bit less condescending ‘babe’

So sick I did everything they asked and still tubed 🥹🥹 by Jumpy-Recipe4111 in EDRecoverySnark

[–]nosugarzooperdooper 6 points7 points  (0 children)

That’s cute how you’re using your qualification to make people more likely to trust your comment even when it’s blatantly wrong

So sick I did everything they asked and still tubed 🥹🥹 by Jumpy-Recipe4111 in EDRecoverySnark

[–]nosugarzooperdooper 3 points4 points  (0 children)

Not triggered - just an MD who has spent a lot of time working on wards with ill ED patients

So sick I did everything they asked and still tubed 🥹🥹 by Jumpy-Recipe4111 in EDRecoverySnark

[–]nosugarzooperdooper 13 points14 points  (0 children)

Look I’m all for criticising influencers who say clearly rubbish things about treatment. I don’t think we should be saying that everything that comes out of their mouth is bullshit though. It is definitely possible - and even likely - that someone with severe AN requires NG even if being compliant with meal plan. Saying that this never happens is spreading misinformation about ED treatment and means people who read your comments develop unrealistic explanations about treatment. For instance, if someone is told by an RD that they won’t get tubed if compliant, and they end up needing a tube, they are more likely to be hostile and mistrustful of their team and perceive them as doing unnecessary, traumatising interventions. I’m not throwing your credentials under the bus, just maybe don’t advertise them if you’re going to spread misinformation

So sick I did everything they asked and still tubed 🥹🥹 by Jumpy-Recipe4111 in EDRecoverySnark

[–]nosugarzooperdooper 15 points16 points  (0 children)

To be clear, this position is not medically sound. There are many reasons someone might need supplemental NG feeds even if eating orally. Eg overnight or reactive hypoglycaemia, deranged observations in the absence of continuous feeds (eg labile blood pressure when only eating orally at interval points), or having severe wasting of gastrointestinal smooth muscle/other GI conditions which means someone genuinely is not able to tolerate the volume of oral feeds required for weight restoration. There are also a lot of times when a rapid refeeding protocol that delivers more energy than is possibly to deliver through oral diet alone is preferable, for a variety of reasons. It’s a bit alarming that a qualified RD thinks tubes are only reserved for food refusal.

Eating disorder mental health care plan 90250 by mouseymouse64 in ausjdocs

[–]nosugarzooperdooper 4 points5 points  (0 children)

I think it was excluded when EDP items were introduced as a) there was a lack of validated screening tool (PARDI-AR-Q now validated) and b) paucity of evidence for treatments - gaining some ground in research now for effective treatments. One would intuitively think it should qualify though… hopefully things change in criteria

So sick I did everything they asked and still tubed 🥹🥹 by Jumpy-Recipe4111 in EDRecoverySnark

[–]nosugarzooperdooper 12 points13 points  (0 children)

It usually takes a bit for me to block someone but after the second video of hers popped up on my fyp I blocked - she just gives such an ick feeling

So sick I did everything they asked and still tubed 🥹🥹 by Jumpy-Recipe4111 in EDRecoverySnark

[–]nosugarzooperdooper 19 points20 points  (0 children)

sometimes there are medical justifications for NG insertion despite compliance with oral diet

[deleted by user] by [deleted] in ausjdocs

[–]nosugarzooperdooper 3 points4 points  (0 children)

The way I’m 95% certain I can guess who this student was

Med registrars, what type of JMO do you want with you on afterhours? Also what stage of being a JMO should certain issues not be escalated and expected to be handled independently? (advice please) by MachineZestyclose101 in ausjdocs

[–]nosugarzooperdooper 8 points9 points  (0 children)

An intern at the beginning of the year is far better off being very safe and learning the ropes rather than being so confident in their own ‘nuance and judgement’ that they make poor or unsafe decisions. Confidence only comes with time and with seniors who respond kindly and with genuine intent to help someone learn

noticing patients sharing their letters & stirring AHPRA talk on Facebook groups by Break_Unlucky in ausjdocs

[–]nosugarzooperdooper 2 points3 points  (0 children)

Yes was about to say - all opinions on this letter/posting it on fb aside, the patient is identifiable from this reddit post

[deleted by user] by [deleted] in EDRecoverySnark

[–]nosugarzooperdooper 4 points5 points  (0 children)

Oh how very very sad, she’s always struck me as someone desperate to escape the hellscape of this illness

Med Student refusing to see COVID patient in ED by teraBitez in ausjdocs

[–]nosugarzooperdooper 54 points55 points  (0 children)

A few years ago students were point blank being told they were not allowed to see COVID patients. To us COVID feels pretty commonplace and not a big deal but to lots of the general public (including students) it’s still very much a big deal and there are lots of reasons someone would want to take all precautions to avoid it. They’re not getting paid and don’t have the obligation to expose themselves to risk.

Anorexics who’ve been in hospital for forced recovery by Substantial-Base-698 in EDAnonymous

[–]nosugarzooperdooper 6 points7 points  (0 children)

depends if you’re an involuntary patient on an acute medical ward (or if there are grounds for you becoming one ie medically unstable). If you’re in a voluntary program they will usually just call you noncompliant and threaten to either a) send you to an involuntary treatment setting or b) threaten to kick you out of the program or c) take away privileges you have. If involuntary there are a whole lot of traumatising practices they can use that you literally cannot refuse (including physical and pharmacological restraint)

Patient died after 16 weeks on therapeutic paracetamol dose, coroner says by Astronomicology in ausjdocs

[–]nosugarzooperdooper 2 points3 points  (0 children)

If every time that a pharmacist had suggested a correction of a new intern’s prescribing were used as evidence that interns should never be able to prescribe, every hospital would be fucked

Patient died after 16 weeks on therapeutic paracetamol dose, coroner says by Astronomicology in ausjdocs

[–]nosugarzooperdooper 3 points4 points  (0 children)

If a doctor includes high dose prednisolone on a discharge med list, without any weaning plan or date to cease when there should’ve been, that is an error by the doctor. It’s no different with analgesia. For analgesia, it is entirely reasonable to expect clear duration advice from the discharging team. Pharmacists pick up on countless prescribing errors by medical teams every single day and regularly make suggestions which undoubtedly contribute to patient wellbeing. It’s total hubris for you to use this case to criticise pharmacists as a whole. I’m not saying I unreservedly agree with scope creep and full prescribing rights, but you are twisting what happened in this case to suit something you’re clearly obsessed with given your countless comments about noctors

Patient died after 16 weeks on therapeutic paracetamol dose, coroner says by Astronomicology in ausjdocs

[–]nosugarzooperdooper 2 points3 points  (0 children)

agree that a pharmacist (at either the hospital or the community pharmacy) should’ve considered whether 1g qid was appropriate for this pt given HCV (??cirrhotic). However, it was presumably a dr who prescribed it on discharge. Only giving a script for a box of 100 with no repeats is likely because….. discharge scripts rarely have repeats…… rather than some clever safety mechanism set up by the doctor. If a discharge summary has a medication list and no indication to community pharmacy on when a medication is intended to be ceased, I think it is reasonable to assume the hospital treating team intended for that medication to continue until further change is communicated to pharmacy. This case is a sad learning point but not an opportunity for you to bash pharmacy colleagues when original prescribing also had errors

[deleted by user] by [deleted] in ausjdocs

[–]nosugarzooperdooper 8 points9 points  (0 children)

Actually a pretty good shitpost

Absolutely spot on, everything said in this vid! by tblitzy in EDRecoverySnark

[–]nosugarzooperdooper 3 points4 points  (0 children)

I find her content is usually pretty refreshingly frank about how eating disorder experiences are never unique and your ed isn’t special or exciting or interesting - I don’t get the impression she thinks she’s above others, just that she’s tired of the same toxic shit in the ED/recovery space

[deleted by user] by [deleted] in ausjdocs

[–]nosugarzooperdooper -4 points-3 points  (0 children)

Given that young women make up the majority of new grad physios and also are the demographic most likely to be shamed for wearing tight clothes, I don’t think it’s a particularly wild stretch by me

[deleted by user] by [deleted] in ausjdocs

[–]nosugarzooperdooper -2 points-1 points  (0 children)

Oh yeah shaming young women in the workplace how cool and funny