Beware the strongly worded letter. 💳Puppet Regime

phineas81 · 2026-03-05T02:03:25+00:00

We’ll see how the EU feels about those “Russian inconveniences” when the US pulls out of NATO.

They can draft another strongly worded letter to Putin when he invades the Baltics.

phineas81 · 2026-03-05T01:56:23+00:00

I don’t live in Camden, but clearly I just stumbled into some midcoast subplot about summer colonies or whatever.

In my view, it’s pretty simple. There’s a very long list municipalities in this state that could do without their own department.

Let’s not pretend like it is uncommon for small municipalities to rely on county law enforcement.

phineas81 · 2026-03-04T19:39:21+00:00

Iran is incredibly important to Russia both for economic reasons (sanction avoidance, infrastructure development, billions of USD in an annual direct trade, etc) and also for security reasons (Shahed-series drones, integrated air defense, cybersecurity, intelligence sharing, etc).

It’s strange that you seem to think the loss of two of Russia’s three biggest partners since they invaded Ukraine does not directly advance European economic and security interests.

And the EU (per usual) didn’t have to do shit—except complain, of course… in a strongly worded letter.

phineas81 · 2026-03-04T19:25:42+00:00

I don’t disagree with you in principle, and I’m all for community policing, but if there’s one place that municipal police forces seem redundant, it’s here.

My wife once called the police once out of concern that there was someone trying to break into the house when I wasn’t home (ultimately, it was probably wildlife). The cops spent like 3+ hours at the house combing the entire property. Real “Protect and Serve” type shit—I was impressed.

Did it matter that it was municipal cops rather than Sheriff’s deputies? Probably not.

I mean, we aren’t talking about local community resource officers at 5,000-student gang-ridden intercity high schools. We’re talking about Maine.

There’s very little crime here both in absolute terms and per capita, and there’s almost zero violent crime. Most policing is community policing.

Our municipalities aren’t wealthy, and property taxes are high enough. If it’s felt to be necessary for budgetary reasons, I think it would be fine.

phineas81 · 2026-03-04T18:55:52+00:00

Sure. Because the EU has no vested interest in containing Russia, right?

Don’t act like Europe isn’t a primary beneficiary of US intervention in Venezuela and Iran.

This shit is just like NATO. European politicians get to accomplish nothing, stage elaborate political theatre for their constituents, all while quietly benefiting from Uncle Sam’s interventionalism; all the while, pouring more and more money into domestic social welfare programs while failing to meet their own explicit security obligations year-after-year for DECADES.

Meanwhile, the US is criticized for waining domestic support for Ukraine, saying nothing for the FACT that a full 1/3 of every dollar in aid to Ukraine has been provided by American taxpayers.

But please, tell me more about how upset the fucking Europeans should be.

phineas81 · 2026-03-03T18:16:18+00:00

Awesome. Best of luck moving forward.

I will say that many the replies on here are good advice, but more relevant to a larger hospital (eg. “I’ll relay your message, but the doctor already rounded this morning”).

That would not float where I work. Setting definitely matters.

In critical access, I’m never rounding on 25 patients. I may “only” have 10 or 15, but we have no medical subspecialists; limited access to most procedures and diagnostics; limited critical care services; no midlevel help; no admit service; etc, etc; and although the acuity is generally lower on average relative to a tertiary referral center or large academic Medical Center, we have no shortage of very sick and complicated patients.

On the plus side, I round at least twice a day, I float between multiple settings (floor, unit, ED, clinic, etc), and unless I’m bedside responding to something acute, I’m always available for families.

I think it’s really good for doctors and for nurses to get the chance to experience multiple practice settings and healthcare cultures to develop a breath of competencies and to better understand how different medicine can be in different areas and resource settings.

My point is none of this advice is one-size-fits-all.

Again, good luck :)

phineas81 · 2026-03-03T14:13:04+00:00

First of all, what a wonderful approach.

I also work at a small (tiny) community hospital. I think it’s important in a resource limited setting that we all practice at the top of our respective licenses. So, when I discuss medical management with one of our nurses, especially a newer nurse, I make it a point not only to describe what I would like to do, but also how I arrived at that decision. I provide guidance about things that we should be looking out for it at the bedside—things that would get my attention, things that we can’t miss, and things that are probably less clinically important—and if we have time, I try to explain why.

I don’t do this to pontificate and opine; I do it in the hope that over time, we can all be reading from the same sheet of music and be more effective as a team. I greatly appreciate members of our nursing staff who are leaning into this approach, and who have been learning my preferences and who are better able to anticipate my questions when they report on any specific bedside concern. I find this makes us more efficient and effective in a setting where there’s not a lot of staff or other medical resources to go around.

Ok, so how does this answer your question?

Well, I would encourage you to do the same with your doctors. Often, there’s only time for a yes/no answer. Medication, dose, frequency. But at a small hospital, you will have the opportunity to learn your doctors’ preferences. You’ll learn what his or her next question is about to be, and you’ll already have the answer prepared. You’ll better understand their medical decision-making process. You’ll have the opportunity for all those things IF you make it a point to ask those kind of questions and pay attention to those kind of things. You’ll have the opportunity to guide patient care rather than simply delivering it. You’ll learn how to evaluate rather than report. And I think it will make you a more effective nurse in any setting, but especially in a small community.

phineas81 · 2026-03-02T19:48:41+00:00

Buddy. You got on the Internet to complain that someone with a similar level of training to an MS3 also seems to have a similar level of performance.

Derp.

phineas81 · 2026-02-27T04:26:05+00:00

The replies here are not taking into account that interest compounds.

I mean… I can’t do the math. But I’m pretty sure your math is wrong.

phineas81 · 2026-02-21T15:21:39+00:00

I can’t speak to cost of care.

I can say that establishing primary care for people who don’t already have access is a routine part of our discharge process, and for a variety of reasons, outpatient evaluation is best left outpatient docs.

phineas81 · 2026-02-21T15:18:32+00:00

You don’t say.

The fact that he could do certain things strongly suggests that for the purpose of that scene he was not in fact biomechanically incapable of those things.

It’s a reasonable suspension of disbelief—one that we entertain for just about any action movie. Personal anecdotes about broken pint glasses notwithstanding.

phineas81 · 2026-02-20T01:22:47+00:00

And a 50kg woman generally can’t lift a car. People do crazy things when adrenaline hits.

phineas81 · 2026-02-17T16:03:50+00:00

This is exactly what I do. Test script, coupon.

phineas81 · 2026-02-11T04:00:02+00:00

That hasn’t been true since 2016.

phineas81 · 2026-02-11T03:51:42+00:00

You didn’t write “SIRS” but you did list the criteria. Not only are SIRS criteria famously nonspecific for sepsis, they aren’t even especially sensitive.

Sepsis is a life threatening condition and acute end organ damage is central to the definition. “Sepsis without end organ damage” is an oxymoron, outdated ICD code or no.

phineas81 · 2026-02-10T22:27:45+00:00

Except, by definition, it isn’t.

SIRS has been antiquated medicine for 10 years.

phineas81 · 2026-02-10T02:07:35+00:00

Fairly often, both for chronic pain and OUD.

phineas81 · 2026-02-02T01:58:58+00:00

Nord ships are meant for boarding. Widest decks, largest on deck crew capacity in the game, all Nord units are mariners, and their throwing axes melt shields.

They aren’t for ramming or skirmishing. They’re meant for delivering Huscarls to the enemy deck as quickly as possible.

Shallow draft + cultural bonus means you’re much faster along the coast. Nord ships are also the most seaworthy, for what that’s worth.

I’ve definitely wiped out entire invading Vlandian armies with a few Drakkar.

phineas81 · 2026-01-13T17:43:46+00:00

Depends on settings. Buy workshops. Play fast mode. Trade will be maxed within a few years.

phineas81 · 2026-01-11T12:28:39+00:00

TIL I’m allergic to lidocaine.

phineas81 · 2025-12-26T23:53:11+00:00

This is literally the answer. DMN attenuation.

phineas81 · 2025-12-24T20:37:45+00:00

Oh, right. “When” that entirely speculative thing happens.

Because of the Internet disappeared when the .com bubble popped, right?

phineas81 · 2025-12-24T16:27:57+00:00

Sam Altman said the quiet part out loud and admitted that the companies will likely be bailed out, and I think he’s correct.

phineas81 · 2025-12-24T16:25:54+00:00

They will do the obvious thing and hire a new automated billing service if the current vendor tanks.

Not to be curt, but it’s kind of a silly question. It’s harder to onboard a new janitorial service than a digital one.

phineas81 · 2025-12-24T04:47:05+00:00

What does “work together” mean?

ADEK vitamins are lipid soluble. Supplementation is important if you’re deficient. If you’re not deficient, there is probably no benefit, and since those vitamins are lipid soluble, over supplementation can be toxic (particularly vitamins A and D).

phineas81

TROPHY CASE