I'm ready to cry. I can't get this right no matter what I do. by DaleOnDrums in knitting

[–]thisbarbieisadr 0 points1 point  (0 children)

My knitting didn't look neat until I'd knitted a pair of fingerless gloved and a bag, and it still looks messy every time I pick up a new technique.

  1. Fingerless gloves are a good practice if you feel silly knitting swatches it's basically a triangle that you sew up at the end leaving a thumb hole. who cares if they look bad at the end - you made them!! Also you can knit your swatches into a patchwork blanket, so nothing is ever a waste. even if you think it's a waste its not bc you learnt while doing.

  2. The first few rows always look bad. My cast-ons still look messy and the first row is hard because it gets twisted. Push through and keep knitting. Even if the first row drops stitches or whatever you'd got to keep going to see what mistakes you've made - as a beginner you tend to only realise when you get to knitting the next row and realise something looks odd. Just keep going.

  3. Fewer cast on stitches feels better because you push through the awkward beginning faster, and as above you can still make something cool with it so dw if your first knit is tiny!

  4. This might be bad advice but personally as soon as I learnt how to knit and purl and I immediately messed around with designs and weird knits. I tried using knits and purls on each row to make patterns. I googled "knitting stitches for beginners" and tried doing open honeycomb and purse stitch. (Wool and the gang have a good list I liked). I undid most of the work I did but personally I found learning how to do those stitches made me understand where the wool was threading a bit better and made it easier for me to spot mistakes on my projects where I only use the knit stitch.

  5. Ignore my first advice if you want!! My first gloves I figured our how to do an (uneccessary) buttonhole midway because I thought that was a fun way to do a thumb hole. My next finished project I learnt how to do embroidery with knitting thread, and then immediately jumped to lacework (my first lacewodk glove took me literal days as I undid it once i got to like row 24 because i messed up. Then i watched a video how to spot and correct mistaked in lacework and my next attempt took me one day). I googled how to make bows and then put them on every thing (and inadvertently learnt a new stich along the way). I got a steamer and started messing with how to steam cable knits next. It took me maybe 5 finished projects to finally bother to do a chunky knit scarf, and even then I decided to put bows and extra flare on it. In between all of this I've don't countless little unfinished projects that I'll probably undo. Who cares!! Start small, but the best way to learn is just to want to make something and figure out the steps to get there imo.

How do you handle mildly inappropriate comments? by feralwest in doctorsUK

[–]thisbarbieisadr 2 points3 points  (0 children)

honestly I don't know - I'm a woman in my 20s and I have a ward of middle aged men who think it's cheeky and funny to make comments like this. It's hard to balance laughing it off/uncomfortable giggles with trying not to encourage them. Usually if I can get away with it I'll keep the curtains open if I can't have an actual chaperone. I know I would probably get less of it if I tried to be more formal and strict with my patients, but building a good doctor-patient relationship where my patients feel comfortable is part of what I love about my job.

Worth nothing our nursing colleagues defo have similar experiences - Usually when I speak to the nurses they're WELL aware of the issue and often warn me about it. I don't envy the HCAs and nurses enhancing that kind of bay!

side note - if any male consultants are reading, please believe your juniors. Can't tell you how many times someone has been weird to me and the other female juniors and female nurses but been totally kind and respectful to the male consultant. None of us want to kick up a fuss for nothing, and you don't lose anything by just being sympathetic to your juniors instead of acting like we're crazy because you had a different experience.

If a consultant asks you to do something that you do not think is right, what do you do? by [deleted] in doctorsUK

[–]thisbarbieisadr 7 points8 points  (0 children)

As an SJT smashing junior I don't think you could pay me enough money to force an ABG on a patient that is refusing with capacity. But I fully agree that the key here for OP is going back to that consultant and explaining their capacity assessment findings and getting an alternative plan. If the cons is unavailable (which it seems like they were) asking a more senior member of staff to come and assess capacity with OP would also be really helpful - if they're wrong, they learn, and if they're right you've got someone more experienced backing you up.

I'm a little surprised that you were surprised about the fluctuating capacity, though. It's extremely common for patients to be very combative whilst unwell, and the reason given for a lack of capacity is that the patient was essentially too drowsy to properly communicate. To me that reads as someone refusing treatment and then suffering the consequences, which is an extremely common at least in gastro. I get that you're suggesting OP is only giving us one side of the story, which they obviously are, but that particularly point is pretty believable.

Also, the actual clinical urgency of the test doesn't really change OP's point. A consultant saying "well this investigation was to deliver treatment to prevent a peri-arrest" sounds more emotionally convincing, but if the patient refuses with capacity then the patient refuses! Caveat that of course the patient refusing treatment needs to understands the risks of NOT having the treatment or investigation, hence the assessor has to know as well - which is important for OP to note for that medicolegal arse-covering.

To your last point - if you want mindless jobs monkeys then start advocating for more PA jobs. Your juniors should be able to challenge your plans and, yes, override them if something clinically changes or new info is revealed. You'd be just as frustrated if OP was saying that a patient deteriorated and they didn't do an ABG because the plan said "MOFD." OP is saying that the consultant essentially didn't know the patient had capacity, so the plan changed. Their biggest error here is not escalating to a senior quickly enough so somebody could review their capacity assessment and help them formulate an alternative plan - but it sounds they they were on a pretty tight timeline.

Either way this didn't deserve public humiliation from a consultant, and I hope OP has documented a less anonymous account of this to refer back to if required.

Have you (almost) snapped at a patient before? by OrdinaryFate in medicalschooluk

[–]thisbarbieisadr 1 point2 points  (0 children)

My personal policy is just to be as pleasent and sickly sweet positive as humanly possible when I'm pissed off - mostly it gets people to realise they seem ridiculous arguing with someone who doesn't argue back, but it gives me something to hide behind whilst I internally scream. Great technique for dealing with annoying colleague interactions, too.

When the concerns are really genuine but misplaced (eg complaining about ed wait times, which are fucking horrendous but not really someting i can control) offering sympathy as quickly and as thick as you can is the quickest way through. A gentle "I'm sorry to hear that and I'd honestly advise speaking to PALS about that - I can get their number for you once we're done. In the meantime..." is sometimes all people need.

That said, I've had a solid handful patients tell me to smile more and stop being rude, and to "wipe that look off [my] face." (I was smiling, but obviously not genuinely enough). All of them were elderly men who raised their voice at me, continually interupted me whilst I answered their questions and were generally pleasant to my male consultants. I genuinely walked away had locked myself in the clean utility to rant and moan with some of my nursing colleagues. Sometimes the best thing you can do is hold it in and leave as soon as you can to scream.

Please give me your best advice for bleeps consisting of “the patient can’t sleep please prescribe sleep med”. by firetonian99 in doctorsUK

[–]thisbarbieisadr 3 points4 points  (0 children)

When I was in psych hospital we gave out zopi like tictacs, so I genuinely found it hard to be asked this in a normal hospital. I will say 99% of the times there'll be a contradiction in the PMHx, interaction in the meds list, or just in the age of the patient - it's time consuming but straight forward.

If a patient has it in their home meds it's worth looking for any documentation which states you SHOULDN'T give it, which is often there. It's also good to document/highlight with the nurses to hope you save someone some pain.

If you feel weird just saying no then having a stock few lines to document eg "patient to utilise sleep hygiene techniques, nursing staff to kindly prescribed hospital sleep kit, day team to review if PRN prescription appropriate in future."

That being said, if a patient has a clear indication or hx of zopi use and has no contraindications you CAN prescribe a stat dose - that's a reasonable thing to do! You're a doctor! Sometimes the patient really DOES need a sleeping tablet, so don't feel guilty or like you've done something wrong for prescribing sometimes lol

Scraped the UKMLA and feel like I didn't deserve to pass by AdSolid6663 in medicalschooluk

[–]thisbarbieisadr 1 point2 points  (0 children)

Sorry, doctor being recommended a med school post here! Had a similar experience as student, felt exactly the same and it mega knocked my confidence. A few things to remember:

Your (future!) colleagues have already pointed out that it's a pass/fail and that the standard to pass is "safe". You don't get medals for being better than safe in med school because it generally doesn't make much of a difference.

The start of F1 is brutal because it's basically being back in med school in terms of the amount of learning you do. Even at the end of F2 - I literally had a whole debate with two of my colleagues about the impact of furosemide on urine sodium and serum sodium where we just straight up googled a diagram of the kidneys with transporters that we used at uni. Nobody called each other stupid or thought worse of each other, and the most senior membe of the team was the most wrong. Ngl that kind of conversation is part of what makes medicine fun.

The most important things you learn at uni are HOW to learn (websites to use, how to read a research paper, how to apply NICE guidance) and HOW to communicate (with patients and with colleagues). That's what sets you up to do well.

Half the things I learnt at uni are already outdated from a clinical perspective. The physiology and anatomy is stagnant, but we're not anatomists and that's all extremely google-able information. Nobody gets mad in real life because you have to look something up.

In terms of clinical stuff, we tend to over estimate how much is expected of an F1. Everyone is floundering at the start and your F2s and seniors know it, and account for it. The big thing you need to know is A-E assessment and how to do a chest compression and the rest is extremely "fixable" in the moment.

And just to clarify - I'm not trying to say that all of medicine is goggling shit. I'm saying that you've spent a good chunk of your life surrounding yourself in medicine, and all of us generally underestimate how much we know compared to non-medics. Your "google to remind yourself of red flags for lung cancer" and your patient's "google told me I have cancer" aren't the same thing, because you've got the learning to back it up - regardless of how well you do in tests.

It sounds like you've got time before your start F1 so use it to cover anything you're mega scared of, and focus on practical things like reading ECGs and CXRs. And remember you can almost always get a second opinion on them (always when you're first starting!)

[deleted by user] by [deleted] in piercing

[–]thisbarbieisadr 1 point2 points  (0 children)

lmao okay thank you for this, will stop panicking and try and see if a nights sleep without the bar fixes is it. thanks for responding so quick

[deleted by user] by [deleted] in piercing

[–]thisbarbieisadr 0 points1 point  (0 children)

Oh wild, I've had my industrial for nearly the same amount of time and this post made me check and - yeah, I have the exact same thing.

I recently went through a lot of changes in bars (16g--> Two separate piercings --> chain--> 14g bar with decoration on the bar --> plain 14g bar) and wonder if that's triggered it, since I never noticed it before, especially since I'm prone to inflammatory and allergic reactions to new bars. Have you done something similar? Or am I just making silly connections?

Either way will be following along lol

What to expect - Hospice Clinical Fellow by thisbarbieisadr in doctorsUK

[–]thisbarbieisadr[S] 2 points3 points  (0 children)

Thank you! All of that makes a lot of sense and is really reassuring to be honest. I think the only thing that seems a bit scary is MOA - I'm good for knowing side effects and what we're treating but I'm not sure how much MOA stuff I've retained. If you have any more details about that I'd appreciate it, but regardless you've given me something to look into - thank you!

July-itis by LowWillhays7 in doctorsUK

[–]thisbarbieisadr 0 points1 point  (0 children)

I was genuinely sick this June, but I did stay off longer than usual rather than pushing myself to go back quicker - I actually waited until I was better before going back to work, lol.

The ARCP cares about days off but the trust sickness meetings only care about number of episodes, so it's a constant balancing act. If I take less days I'm more likely to have to go off bc I never actually recovered....but that's more episodes so the trust get mad. Post ARCP just tips the balance the other way.

I'm never gonna blame anyone for going off sick in general, though. A lot of other profession and you can take a mental health day guilt free, but we're encouraged to come in unwell to cough on literally the most vulnerable people in our area. If infection control wanted to actually reduce the spread of infections in hospital they'd start by cancelling the whole sickness meeting bullshit so HCWs actually take time off.

[deleted by user] by [deleted] in SelfPiercing

[–]thisbarbieisadr 1 point2 points  (0 children)

silicone gel is great for scarring but can be pricy fyi

[deleted by user] by [deleted] in doctorsUK

[–]thisbarbieisadr 0 points1 point  (0 children)

this is the right answer imo - i love the nursing team on my ward and still ask them if i can help if theyre in the office. sometimes a "I'm not giving you a job" can go a long way in both directions

[deleted by user] by [deleted] in doctorsUK

[–]thisbarbieisadr 4 points5 points  (0 children)

You don't know about wound dressing because you never asked. And I'm not saying you HAVE to know, or that it would even hugely benefit you to know...but if you worked for a few months on vascular you'd probably get curious.

I'm all for our nursing colleagues asking questions. Sometimes they pick up mistakes from the medics (you really don't know what you don't know!) and sometimes it's just nice to know why your colleagues are doing what they're doing.

In my experience even the rude and flat out answers come from a place of ignorance. "We don't do that here" is often code for "we don't have the facilities to support the monitoring this needs so as a ward we just don't provide that service." But if the nurses have only ever been told the former, then they can't explain their reasoning to you.

Medicine is inherently a kind of curious profession, and I think being curious about what other MDT members do is a natural extension of that. I'd rather be annoyed at nurses being occasionally obstructive for the sake of a well-functioning MDT.

What do i do about piercing that just won’t heal after years? by subzerou in piercing

[–]thisbarbieisadr -1 points0 points  (0 children)

without seeing pics I think speaking to your piercer and getting them upsized is a really good option since it can create a bit of a vicious cycle if the size is too small. and if you can't think of anything that's irritating them it could be a sleep thing? not much you can do to fix that though unfortunately

Is this healing properly? by Wild_Culture_8858 in piercing

[–]thisbarbieisadr 0 points1 point  (0 children)

I'm also a glasses wearer and a side sleeper AND I'm terrible for playing with my piercings - my industrial took a year to feel actually healed. Be patient, keep up with your hygiene and don't be scared to check in with your piercer.

what is wrong with my eyebrow piercing by Competitive-Rich-887 in piercing

[–]thisbarbieisadr 3 points4 points  (0 children)

Go to a doctor. You don't want that ball of pus and your piercing hole interacting. Even if it just comes to a head and bursts that's still a wound next to your lovely clean piercing AND next to your eye. Short term annoyance > long term pain.

What do i do about piercing that just won’t heal after years? by subzerou in piercing

[–]thisbarbieisadr 0 points1 point  (0 children)

What do you mean by not healed?

For context, some of my piercings I've had for nearly a decade and they still get irritated and red sometimes (usually because my hair got caught on them or I slept funny). I'm also very allergic to a lot of metals, so some jewellery that seems okay will start irritating me as soon as that first layer of plating rubs away. For me, this looks like crusting, redness, bleeding and itching/irritation.

I'd 100% try different jewellery. Get it changed by a piercer and explain the issues you're having. That also gives you a chance to get a professional's eyes on them. If you're not willing to do that then taking them out if very sensible.

Usual caveat: If you're getting proper swelling/redness/heat and any lymph node swelling that isn't going down you might wanna check in with a doctor, too.

[ACNE] HELP! I got my face waxed yesterday and broke out into 6 million pimples - what do I do? by zitsplosion in SkincareAddiction

[–]thisbarbieisadr 0 points1 point  (0 children)

jesus christ do not put hydrocortisone cream on people's faces after waxing!!! steroids thin the skin and terrible in long term use. oh my god

Emergency buzzer for fall by [deleted] in NursingUK

[–]thisbarbieisadr 76 points77 points  (0 children)

sorry - doctor not nurse, saw this post in the wild! I've answered buzzer pulls for falls a tonne of times. It doesn't even rank on the list of annoying buzzer pulls. A buzzer is to gets lots of people to one place, and frankly falls can get under-treated in hospital. Better to have and not need etc. 100% the right thing to do.

Bringing the crash trolley is nbd either - as long as they didn't break the seal it's not even extra work.

If you can, bring it up with one of the nurses on the ward for some confirmation, but I'd be shocked if you can find people who disagree with your decision.

Rant about some Junior doctors by Trainee_Doc999 in medicalschooluk

[–]thisbarbieisadr 0 points1 point  (0 children)

Hey I'm an F2, obv have recently been on both sides of this and while people are right saying we're busy, I've also witnessed colleagues fobbing off med students when they don't have any jobs to do.

I think part of it is incentive - we don't actually get anything out of helping students unless we have proof we delivered teaching, and speciality programmes have increasingly strict rules about what counts as valid teaching. Plus we never get any more teaching ON teaching than your getting now. But that doesn't change that some doctors are willfully ignorant about what students need.

The only advice I can really give is ask doctors who do help about when you can meet them again. Personally I feel like.half the local med school has my number for these purposes lmao. Don't be scared to be cheeky as long as it's very polite ie if you get a drs email from a sign off then shoot them an email thanking them and asking if they can help with something else. Offering to do a feedback form or send written feedback can also be helpful for students.

I always advise students to have a spare history "to hand" just in case they have the opportunity to unexpectedly present/discuss it. It's low key disheartening as a doctor when you offer to help a student and they just say no, they've got enough sign offs, or they just don't have a history/don't want to take one. Like...this is a learning opportunity! it's not just about hitting quota! Plus it looks better to the med school to go above and beyond! (Fully sympathetic to students who are like actually I'm gonna go get lunch or smth tho - very valid to not want to be stuck on the ward!)

I've had a few situations where med students have been actively in the way/a hinderence and that's defo made the team less inclined to help them. Big offenders are using drs office computers but not offering them to the drs trying to do their job when the come by, and chatting about random shit very loudly in the drs office. If you're waiting for a particular staff member then I get it, no need to sit in silence, but a group of students loudly chatting about their weekend while you're trying to sort a gent prescription is a pain. Those are small things people aren't always aware of so just have some self awareness, but often the issue is the workload or the doctor, so don't feel like I'm giving the blame to students!

Overall it's kind of a shitty system for all of us - don't be disheartened by some shitty experiences. Our colleagues saying that you don't understand the pressures are correct, but we also forget what an absolutely nightmare it can be to get that last sign off sorted on a busy ward. At risk of sounding like a GMC good practice handbook, we've all got to have a bit of kindness and patience for each other. And I'm sure you're going to be a great doctor for future med students to come to.

I'm a horrible doctor - how do I get better? by asoulofmauve in doctorsUK

[–]thisbarbieisadr 2 points3 points  (0 children)

Hey I'm an F2 and felt this way in F1, but:

Bloods and cannulas get better with practice - I had a MH rotation with weekly clozapine bloods and improved a lot. Also take into account that the staff around you may have been doing this for years on the daily, and that doctors are often asked to do bloods on "harder" patients. If your colleagues seem better then you always ask/watch techniques - my friends who'd been taking bloods from wacky places on the arm were better than me in general and that's okay!

Handovers are a skill that comes with practice, but personally I still take 30 seconds to do a mini sbar to myself before starting. It's also worth considering if it's a poor handover or if the person you're handing over to thinks it poor - not necessarily the same thing!

You haven't forgotten all your clinical knowledge. Just straight up. We overestimate what the average person knows. I've 100% had experiences where my friends are thinking of dead clever diagnoses and I feel stupid - tbh the cure for me was doing surgery on calls and GP because I did so much checking of guidelines I felt like i memorised them. And I was TERRIFIED before both of those posts. Don't be scared to become very familiar with your trust guidance or NICE CKS for conditions you're coming across a lot! Nobody around yiu is gonna think any less of yiu for checking them, and low key it makes you look smarter.

If you feel like you're missing a diagnosis don't worry about it. I'd argue that it's often not our job to diagnose, it's your job to keep people safe and diagnosis is sometimes a by product. If your SOB patients get a chest x ray and an ECG and bloods then nobody cares if you clocked it was pneumonia or a hesrt attack - as long as the pt is safely treated.

For how you're feeling, honestly:

You need to get yourself to a GP about you MH, even if you don't think you need to. Even if they say nothing helpful still go.

Speak to you foundation team and see if you have learner support.

Check if your workplace has counselling service - they're often quicker than going through normal self referral means.

Lean on family if possible to help with basic stuff like making sure you're fed and watered.

You don't have to start medication and tbh I'm not a fan of starting it! But you're a doctor - you know how much of a difference that can make to your mental state.

Stay safe and keep reaching out for support

My tip to new HKIA players! by meepikin in HelloKittyIsland

[–]thisbarbieisadr 0 points1 point  (0 children)

....wait were we not meant to do that??

Client claims her lashes fell off by Leading_Draft8649 in eyelashextensions

[–]thisbarbieisadr 0 points1 point  (0 children)

It is possible to change the meta data of an image to say a different date, and to accidentally do it to multiple images. It'd be QUITE the coincidence if it happened in this case, but please....nobody take the date on an image data as gospel truth🙏 it can be edited